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May TA, Koskey KLK, Provinzano K. Developing and Validating the Preschool Nutrition Education Practices Survey. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:545-555. [PMID: 38691080 DOI: 10.1016/j.jneb.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/10/2024] [Accepted: 03/12/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE Validate the Preschool Nutrition Education Practices Survey. DESIGN Iterative approach combining design-based research and Standards for Educational and Psychological Testing. SETTING Los Angeles, CA and Philadelphia, PA Early Care and Education (ECE) classrooms. PARTICIPANTS Expert panel members (n = 7); ECE teachers: interviews (n = 8), pilot survey (n = 31), and final survey (n = 136). VARIABLES MEASURED Early care and education nutrition education practices used in the classroom either during class time or mealtime. ANALYSIS Qualitative content analysis was implemented for content, response process, and consequences of testing validity evidence. Rasch rating scale analysis was conducted for the response process and internal structure validity and reliability evidence. RESULTS Qualitative field-testing produced strong content, response process, and consequences of testing validity evidence to inform survey modifications. Quantitative field-testing generated a psychometrically sound, well-targeted 12-item survey on a 4-point frequency scale with excellent item and person reliability (0.97 and 0.93 respectively) and separation (5.36 and 3.77 respectively); good Rasch Principal Components Analysis findings (60.3%); and productive item fit statistics (0.50-1.50 logits). CONCLUSIONS AND IMPLICATIONS Robust validity (content, response process, consequences of testing, internal structure) and reliability evidence were demonstrated for using the Preschool Nutrition Education Practices Survey to assess ECE teachers' use of nutrition education practices. Future research is needed to examine its relationship to other variables, such as nutrition teaching efficacy, and to determine its ability to detect change in ECE nutrition education practices over time and across groups.
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Affiliation(s)
- Toni A May
- School of Education, Drexel University, Philadelphia, PA.
| | | | - Kathleen Provinzano
- Departments of Teaching, Learning, and Educational Leadership and Social Work, College of Community and Public Affairs, The State University of New York - Binghamton University, Binghamton, NY
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Stage VC, Resor J, Dixon J, Hegde AV, Méndez LI, Lee T, Breinholt R, Goodell LS, McMillan VJ, Murphy Gilliam E. More PEAS Please! Teaching Teachers How to Integrate Food-based Learning Into Preschool Science. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:457-463. [PMID: 37019753 PMCID: PMC10257756 DOI: 10.1016/j.jneb.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 06/11/2023]
Affiliation(s)
- Virginia C Stage
- Department of Agricultural and Human Sciences, College of Agriculture and Life Sciences, North Carolina State University, NC State Extension, Raleigh, NC.
| | - Jessica Resor
- The Food-based Early Education (FEEd) Lab, Department of Human Development and Family Sciences, College of Health and Human Performance, Greenville, NC
| | - Jocelyn Dixon
- The Food-based Early Education (FEEd) Lab, Department of Human Development and Family Sciences, College of Health and Human Performance, Greenville, NC
| | - Archana V Hegde
- Department of Human Development and Family Science, College of Health and Human Performance, Greenville, NC
| | - Lucía I Méndez
- Department of Communication Sciences and Disorders, School of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, NC
| | - Tammy Lee
- Department of Science Education, College of Education, East Carolina University, Greenville, NC
| | - Raven Breinholt
- The Food-based Early Education (FEEd) Lab, Department of Human Development and Family Sciences, College of Health and Human Performance, Greenville, NC
| | - L Suzanne Goodell
- Department of Food, Bioprocessing, and Nutrition Sciences, College of Agriculture and Life Sciences, North Carolina State University, Raleigh, NC
| | - Valerie J McMillan
- Department of Family and Consumer Sciences, College of Agriculture and Environmental Sciences, North Carolina Agricultural and Technical State University, Greensboro, NC
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Dixon J, Hegde AV, Goodell LS, Arnold NL, Swindle T, Dev DA, Méndez LI, McMillan VJ, Lee TD, Stage VC. Integration of Food-based Learning With Science in the Preschool Classroom: Implementation Gaps and Opportunities. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:266-284. [PMID: 37028898 PMCID: PMC10083887 DOI: 10.1016/j.jneb.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/21/2022] [Accepted: 01/04/2023] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To explore Head Start teachers' use and integration of food-based learning (FBL) with science learning in the Head Start classroom. DESIGN Phenomenological approach using in-depth semistructured telephone interviews. SETTING North Carolina Head Start preschools. PARTICIPANTS Thirty-five Head Start lead and assistant teachers. PHENOMENON OF INTEREST All interviews were transcribed verbatim. Authors coded interview data for emergent themes. ANALYSIS Eleven primary themes were identified during analysis and inductively organized using the Systems Thinking Iceberg Model. RESULTS Teachers described most frequently using FBL during mealtimes. Teachers stated they felt successful when children were engaged and willing to try a new food. However, they struggled to connect food to science concepts. Teachers reported several motivators (eg, improving health) and barriers (eg, food waste) to integrating FBL. Teachers prioritized preparing children for kindergarten, but most teachers did not see how FBL could help them achieve this goal. CONCLUSIONS AND IMPLICATIONS Head Start teacher professional development programs could impact all 4 levels of the Systems Thinking Model to improve teachers' perceptions, underlying structures, and mental models regarding integrative FBL. Additional research is warranted to investigate the adoption, implementation, and potential impact of FBL on academic outcomes.
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Affiliation(s)
- Jocelyn Dixon
- The Food-based Early Education (FEEd) Lab, Project Coordinator, East Carolina University, Greenville, NC
| | - Archana V Hegde
- Department of Human Development and Family Science, College of Health and Human Performance, East Carolina University, Greenville, NC
| | - Lora Suzanne Goodell
- Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, Raleigh, NC
| | - Nicole L Arnold
- Ohio State University Extension, Family and Consumer Sciences, The Ohio State University, Columbus, OH
| | - Taren Swindle
- Department of Family and Preventative Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Dipti A Dev
- Childhood Health Behaviors Extension Specialist, University of Nebraska-Lincoln, Lincoln, NE
| | - Lucía I Méndez
- Department of Communication Sciences and Disorders, University of North Carolina Greensboro, Greensboro, NC
| | - Valerie J McMillan
- Department of Family and Consumer Sciences, North Carolina Agricultural and Technical State University, Greensboro, NC
| | - Tammy D Lee
- Department of Mathematics, Science, and Instructional Technology Education, College of Education, East Carolina University, Greenville, NC
| | - Virginia C Stage
- Department of Agricultural and Human Sciences, NC State Extension, North Carolina State University, Raleigh, NC.
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Swindle T, Bellows LL, Mitchell V, Johnson SL, Shakya S, Zhang D, Selig JP, Whiteside-Mansell L, Curran GM. Predictors of sustainment of two distinct nutrition and physical activity programs in early care and education. FRONTIERS IN HEALTH SERVICES 2022; 2:1010305. [PMID: 36925855 PMCID: PMC10012648 DOI: 10.3389/frhs.2022.1010305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022]
Abstract
Introduction The goal of the present study was to investigate factors associated with sustainment of two evidence-based programs for nutrition promotion in early care and education (ECE) settings - Food Friends (FF) and Together, We Inspire Smart Eating (WISE). Materials and methods In a cross-sectional study design, ECE directors (N = 55) from centers that had previously been trained in WISE or FF completed a survey. Program-specific measures included Steckler's Perception of Innovations, the Program Sustainability Assessment Tool (PSAT), and the Organizational Readiness for Change Assessment (ORCA). For our primary outcomes, two measures of sustainment were examined: Nutrition Continued Practice (i.e., the use of or general focus on nutrition programs) and Program Fidelity (i.e., how well centers used specific evidence-based practices of WISE or FF). Multiple regression was used to determine the association of these outcomes with program, years since last implementation, and overall scores on predictors. Follow-up correlation analyses were used to investigate outcome relationships with context submeasures due to high intercorrelations between predictor submeasures. Results Nutrition Continued Practice was significantly predicted by program and overall PSAT score. WISE programs had significantly higher Nutrition Continued Practice scores than FF program (p = 0.03). All subscales of the PSAT (e.g., environmental support, funding stability, organizational capacity, program adaptation, communications, and strategic planning) were significantly correlated with Nutrition Continued Practice (all rs > 0.30, all ps < 0.03). Program Fidelity was significantly predicted by PSAT and Steckler Perception of Innovation scores. All subscales of the PSAT were strongly positively correlated with Program Fidelity (all rs > 0.48, all ps < 0.001); relative advantage (r = 0.54, p < 0.001) and level of institutionalization (r = 0.61, p < 0.001) were positively correlated with Program Fidelity. Conclusion This study suggests that factors associated with the continued practice of program principles are partially distinct from those that are associated with the sustainment of specific practices driving program fidelity. Results suggest capacity building strategies may be important for both continued attention to nutrition and physical activity as well as sustaining fidelity to specific evidence-based practices.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Laura L. Bellows
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | | | - Susan L. Johnson
- Section of Nutrition, Department of Pediatrics, University of Colorado Anschutz, Aurora, CO, United States
| | - Samjhana Shakya
- Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Dong Zhang
- Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - James P. Selig
- Department of Biostatistics, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Leanne Whiteside-Mansell
- Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Geoffrey M. Curran
- Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Center for Mental Health and Outcomes Research, Central Arkansas Veterans Heathcare System, Little Rock, AR, United States
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Scrivano RM, Juris JJ, Jarrott SE, Lobb JM. Extending the Together, We Inspire Smart Eating Curriculum to Intergenerational Nutrition Education: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158935. [PMID: 35897305 PMCID: PMC9332355 DOI: 10.3390/ijerph19158935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic has made accessing nutritious foods difficult for older adults and children living in low-income households. The evidence-based preschool nutrition education curriculum Together, We Inspire Smart Eating (WISE) can be used to encourage children to try healthy foods. Written as a single generation curriculum, inviting older adult community members to WISE programming for an intergenerational experience may provide further supports and mutual benefits as participants cooperate towards a common goal. While creators have evaluated implementation of WISE, research has yet to explore factors that influence WISE adoption within an intergenerational setting. We conducted a pilot study using the implementation evaluation framework to explore WISE implementation within single generation and intergenerational settings by measuring five implementation outcomes (fidelity, acceptability, appropriateness, feasibility, and sustainability) through three methods: (1) direct assessment of program fidelity via video coding; (2) indirect assessment of stakeholders’ perceptions of WISE implementation, and (3) a directed qualitative content analysis on annual interview data. Fidelity scores were comparable between the two settings and stakeholder ratings of appropriateness, acceptability, and feasibility of WISE were high. Qualitative data revealed that aspects of WISE are less appropriate for older participants and reiterated known logistical barriers of intergenerational programming that may challenge program sustainability.
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Affiliation(s)
- Rachel M. Scrivano
- The College of Social Work, The Ohio State University, Columbus, OH 43210, USA;
- Correspondence:
| | - Jill J. Juris
- Beaver College of Health Sciences, Appalachian State University, Boone, NC 28608, USA;
| | - Shannon E. Jarrott
- The College of Social Work, The Ohio State University, Columbus, OH 43210, USA;
| | - Jennifer M. Lobb
- College of Food, Agricultural, and Environmental Sciences, The Ohio State University, Columbus, OH 43210, USA;
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Swindle T, Rutledge JM, Martin J, Curran GM. Implementation fidelity, attitudes, and influence: a novel approach to classifying implementer behavior. Implement Sci Commun 2022; 3:60. [PMID: 35668517 PMCID: PMC9171954 DOI: 10.1186/s43058-022-00307-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 05/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background The current study sought to (1) describe a new classification approach for types of implementer behavior and (2) explore the implementer behavior change in response to tailored implementation facilitation based on the classifications. Methods A small-scale, cluster-randomized hybrid type III implementation trial was conducted in 38 early care and education classrooms that were part of the Together, We Inspire Smart Eating (WISE) program. WISE focuses on 4 evidence-based practices (EBPs), which are implemented by teachers to promote nutrition. External facilitators (N = 3) used a modified Rapid Assessment Procedure Informed Clinical Ethnography (RAPICE) to complete immersion (i.e., observations) and thematic content analyses of interviews to identify the characteristics of teachers’ behavior at varying levels of implementation fidelity. Three key factors—attitudes toward the innovation, fidelity/adaptations, and influence—were identified that the research team used to classify teachers’ implementation behavior. This process resulted in a novel classification approach. To assess the reliability of applying the classification approach, we assessed the percent agreement between the facilitators. Based on the teachers’ classification, the research team developed a tailored facilitation response. To explore behavior change related to the tailored facilitation, change in fidelity and classification across the school year were evaluated. Results The classifications include (1) enthusiastic adopters (positive attitude, meeting fidelity targets, active influence), (2) over-adapting adopters (positive attitude, not meeting fidelity targets, active influence), (3) passive non-adopters (negative attitude, not meeting fidelity targets, passive influence), and (4) active non-adopters (negative attitudes, not meeting fidelity targets, active influence). The average percent agreement among the three facilitators for classification was 75%. Qualitative data support distinct patterns of perceptions across the classifications. A positive shift in classification was observed for 67% of cases between the mid-point and final classification. Finally, we generated an expanded classification approach to consider additional combinations of the three factors beyond those observed in this study. Conclusions Data from this study support the ability to apply the classification approach with moderate to high reliability and to use the approach to tailor facilitation toward improved implementation. Findings suggest the potential of our approach for wider application and potential to improve tailoring of implementation strategies such as facilitation.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., #530, Little Rock, AR, 72205-7199, USA.
| | - Julie M Rutledge
- Education and Research in Children's Health Center, College of Applied and Natural Sciences, Louisiana Tech University, Ruston, USA
| | - Janna Martin
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., #530, Little Rock, AR, 72205-7199, USA
| | - Geoffrey M Curran
- Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, #522-472205-7199, USA.,Central Arkansas Veterans Healthcare System, 4300 W 7th St, Little Rock, AR, 72205, USA
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Obesity prevention practices in early care and education settings: an adaptive implementation trial. Implement Sci 2022; 17:25. [PMID: 35303894 PMCID: PMC8932138 DOI: 10.1186/s13012-021-01185-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 12/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Despite the potential for Early Care and Education (ECE) settings to promote healthy habits, a gap exists between current practices and evidence-based practices (EBPs) for obesity prevention in childhood. Methods We will use an enhanced non-responder trial design to determine the effectiveness and incremental cost-effectiveness of an adaptive implementation strategy for Together, We Inspire Smart Eating (WISE), while examining moderators and mediators of the strategy effect. WISE is a curriculum that aims to increase children’s intake of carotenoid-rich fruits and vegetables through four evidence-based practices in the early care and education setting. In this trial, we will randomize sites that do not respond to low-intensity strategies to either (a) continue receiving low-intensity strategies or (b) receive high-intensity strategies. This design will determine the effect of an adaptive implementation strategy that adds high-intensity versus one that continues with low-intensity among non-responder sites. We will also apply explanatory, sequential mixed methods to provide a nuanced understanding of implementation mechanisms, contextual factors, and characteristics of sites that respond to differing intensities of implementation strategies. Finally, we will conduct a cost effectiveness analysis to estimate the incremental effect of augmenting implementation with high-intensity strategies compared to continuing low-intensity strategies on costs, fidelity, and child health outcomes. Discussion We expect our study to contribute to an evidence base for structuring implementation support in real-world ECE contexts, ultimately providing a guide for applying the adaptive implementation strategy in ECE for WISE scale-up. Our work will also provide data to guide implementation decisions of other interventions in ECE. Finally, we will provide the first estimate of relative value for different implementation strategies in this setting. Trial registration NCT05050539; 9/20/21.
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Yuan L, Muli S, Huybrechts I, Nöthlings U, Ahrens W, Scalbert A, Floegel A. Assessment of Fruit and Vegetables Intake with Biomarkers in Children and Adolescents and Their Level of Validation: A Systematic Review. Metabolites 2022; 12:126. [PMID: 35208201 PMCID: PMC8876138 DOI: 10.3390/metabo12020126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/23/2022] [Accepted: 01/23/2022] [Indexed: 12/10/2022] Open
Abstract
Fruit and vegetables (FV) are part of a healthy diet and should be frequently consumed already at a young age. However, intake of FV is difficult to assess in children and adolescents due to various misreporting aspects. Thus, measurement of dietary biomarkers may be a promising alternative to assess FV intake more objectively at young age. To date, dietary biomarkers have been primarily studied in adults, and research focused on their usefulness in children is scarce. However, clinical studies have revealed important differences between children and adults, most importantly in their gut microbiome composition, resulting in differences in postprandial metabolism, as well as in food choices and meal compositions that may influence individual biomarker levels. Therefore, the present review aimed to identify biomarkers of FV intake (BFVI) currently available in children and adolescents and to explore whether there are any differences in the BFVI profile above between children and adolescents and adults. In addition, the current level of validation of BFVI in children and adolescents was examined. In total, 28 studies were eligible for this review, and 18 compounds were identified as potential biomarkers for FV intake in children and adolescents. Carotenoid concentration in skin was a valuable biomarker for total FV intake for both children and adult populations. Common BFVI in blood in adults (e.g., carotenoids and vitamin C) showed inconsistent results in children and adolescents. Biomarkers particularly useful in children included urinary hippuric acid as a biomarker of polyphenolic compound intake originating from FV and the combination of N-methylnicotinic acid and acetylornithine as a biomarker of bean intake. Further studies are needed to assess their kinetics, dose-response, and other validation aspects. There is limited evidence so far regarding valid BFVI in children and adolescents. Thus, to put BFVI into practice in children and adolescents, further studies, particularly based on metabolomics, are needed to identify and validate BFVI that can be used in future epidemiological studies.
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Affiliation(s)
- Li Yuan
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Achterstraße 30, 28359 Bremen, Germany; (W.A.); (A.F.)
| | - Samuel Muli
- Unit of Nutritional Epidemiology, Department of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, 53115 Bonn, Germany; (S.M.); (U.N.)
| | - Inge Huybrechts
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (I.H.); (A.S.)
| | - Ute Nöthlings
- Unit of Nutritional Epidemiology, Department of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, 53115 Bonn, Germany; (S.M.); (U.N.)
| | - Wolfgang Ahrens
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Achterstraße 30, 28359 Bremen, Germany; (W.A.); (A.F.)
| | - Augustin Scalbert
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (I.H.); (A.S.)
| | - Anna Floegel
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Achterstraße 30, 28359 Bremen, Germany; (W.A.); (A.F.)
- Section of Dietetics, Faculty of Agriculture and Food Sciences, Hochschule Neubrandenburg—University of Applied Sciences, 17033 Neubrandenburg, Germany
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Bayles J, Peterson AD, Jilcott Pitts S, Bian H, Goodell LS, Burkholder S, Hegde AV, Stage VC. Food-Based Science, Technology, Engineering, Arts, and Mathematics (STEAM) Learning Activities May Reduce Decline in Preschoolers' Skin Carotenoid Status. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:343-351. [PMID: 33349594 PMCID: PMC8044028 DOI: 10.1016/j.jneb.2020.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/20/2020] [Accepted: 10/24/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To assess the effectiveness of food-based science, technology, engineering, arts, and mathematics (STEAM) learning activities on preschoolers' liking of 9 target vegetables and objectively-assessed fruit and vegetable (FV) intake. METHODS Seven hands-on, food-based STEAM learning activities were implemented to expose children to 9 target vegetables in 3 Head Start preschools (11 classrooms) across North Carolina. Child-reported vegetable liking scores and skin carotenoid status (SCS) were dependent variables collected at baseline, midpoint, and posttest. Adjusted repeated-measures ANOVA was used to examine intervention impact. RESULTS A total of 113 children (intervention = 49; comparison = 64) participated. Children were an average age of 3.7 ± 0.57 years at baseline. Mean target vegetable liking scores for the intervention and comparison groups, respectively, were 3.2 ± 0.19 and 3.2 ± 0.17 at baseline, 2.9 ± 0.17 and 3.1 ± 0.15 at midpoint, and 2.8 ± 0.15 and 3.1 ± 0.13 at posttest. A time × group interaction was not significant for target vegetable liking scores. Mean SCS were 268.6 ± 13.24 and 270.9 ± 12.13 at baseline, 271.3 ± 12.50 and 275.6 ± 11.46 at midpoint, and 267.8 ± 11.26 and 229.6 ± 10.32 at posttest for the intervention and comparison groups, respectively. A time × group interaction was significant for SCS (F1,77 = 3.98; P = 0.02; r = 0.10). Both groups declined from baseline to posttest (intervention = 0.06%; comparison = 15.09%), which occurred after winter break, with a smaller decline observed in the intervention group (P = 0.02). CONCLUSIONS AND IMPLICATIONS Food-based STEAM learning activities may present a unique opportunity to affect FV intake while meeting academic standards. More research is needed to understand how liking for familiar FV changes over time and its relationship with consumption. In addition, more implementation research featuring larger sample sizes, teachers as the interventionist, and a longer study duration is needed to confirm the outcomes of food-based STEAM learning observed in the current study and the long-term impact this approach may have on children's' dietary quality.
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Affiliation(s)
- Jocelyn Bayles
- Food-based Early Education (FEEd) Lab, Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Amanda D Peterson
- Food-based Early Education (FEEd) Lab, Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Stephanie Jilcott Pitts
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC
| | - Hui Bian
- Office for Faculty Excellence, East Carolina University, Greenville, NC
| | - L Suzanne Goodell
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, NC
| | - Sarah Burkholder
- Food-based Early Education (FEEd) Lab, Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Archana V Hegde
- Department of Human Development and Family Science, College of Health and Human Performance, East Carolina University, Greenville, NC
| | - Virginia C Stage
- Food-based Early Education (FEEd) Lab, Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC.
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Burkholder S, Jilcott Pitts S, Wu Q, Bayles J, Baybutt R, Stage VC. Skin Carotenoid Status Over Time and Differences by Age and Sex Among Head Start Children (3-5 Years). JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:103-109. [PMID: 33349596 PMCID: PMC8042778 DOI: 10.1016/j.jneb.2020.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/21/2020] [Accepted: 10/24/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Examine differences in skin carotenoid status (SCS) based on time, age, and sex of preschool-aged children enrolled in Head Start (HS) in North Carolina. DESIGN Data were collected using surveys from participating families. preschool-aged children's SCS were measured 3 times over a 6-month period. SETTING Three HS centers in North Carolina. PARTICIPANTS One hundred twelve children aged 3-5 years, enrolled in HS. MAIN OUTCOME MEASURE(S) Differences in SCS assessed using the Veggie Meter (Longevity Link, Salt Lake City, UT) based on time, sex, and age. ANALYSIS One-way ANOVA to assess SCS at time 1 between sex and age (n = 112). Repeated measures ANOVA with a Greenhouse-Geisser correction for assessment of SCS over time (n = 45) using Bonferroni correction. RESULTS On average, children were aged 4 years, African American (81.3%), male (57%), and had a mean SCS of 266 (SD = 82.9). Skin carotenoid status (Veggie Meter units) were significantly different over time (P < 0.001). Significant differences were observed between ages (P = 0.01) and sex (P < 0.01). CONCLUSIONS AND IMPLICATIONS The Veggie Meter is a promising tool to assess fruit and vegetable intake but needs to be validated in preschool-aged children as it has been in adults. Sex and age are potential confounders which should be assessed in future studies using the Veggie Meter.
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Affiliation(s)
- Sarah Burkholder
- Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Stephanie Jilcott Pitts
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC
| | - Qiang Wu
- Department of Biostatistics, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Jocelyn Bayles
- Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Richard Baybutt
- Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Virginia C Stage
- Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Greenville, NC.
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Swindle T, Zhang D, Johnson SL, Whiteside-Mansell L, Curran GM, Martin J, Selig JP, Bellows LL. A mixed-methods protocol for identifying successful sustainability strategies for nutrition and physical activity interventions in childcare. Implement Sci Commun 2021; 2:8. [PMID: 33446280 PMCID: PMC7807398 DOI: 10.1186/s43058-021-00108-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 01/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the importance of sustainability for nutrition and physical activity in public health interventions, limited studies have explored the factors that promote and inhibit evidence-based program sustainment in the childcare setting. This study protocol describes a mixed-methods approach to develop novel sustainability strategies based on real-world settings and stakeholder feedback, with the goal of providing support for future obesity prevention programs and related studies on intervention sustainability. Two interventions, Together, We Inspire Smart Eating (WISE) and The Food Friends' (FF) Fun with New Foods and Get Movin' with Might Moves, are studied to this end. METHODS The study will deploy an explanatory, sequential mixed-methods design. First, the research team will collect a quantitative survey to assess rates of sustainment among WISE and Food Friends sites. We expect to collect 150 surveys from WISE and FF sites combined. Data from these surveys will be used to purposively sample sites for 12 to 18 site visits. Specifically, we will purposively sample low, partial, and high sustaining sites where we will conduct key informant interviews and focus groups as well as validate self-reports on sustainability. Survey content, qualitative interviews, and coding will be based on the Dynamic Sustainability Framework. We will draw on findings from the quantitative survey on predictors of sustainment and the qualitative site visits to understand varying levels of program sustainment. Then, we will utilize evidence-based quality improvement sessions to engage stakeholders in developing a multi-component sustainability strategy. DISCUSSION This study will provide a stakeholder-informed sustainability strategy ready for testing in a full-scale trial examining effects on sustainment of evidence-based nutrition and physical activity practices in childcare. We expect this strategy to be relevant for educators and consistent with the views of administrators as a guide for future practice for the targeted nutrition and physical activity interventions and beyond.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Dong Zhang
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Susan L. Johnson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue Box C225, Aurora, CO 80045 USA
| | - Leanne Whiteside-Mansell
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Geoff M. Curran
- Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, 4301 W. Markham St, #522-4, Little Rock, AR 72205-7199 USA
| | - Janna Martin
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - James P. Selig
- Department of Biostatistics, University of Arkansas for Medical Sciences, 220 UAMS Campus Dr., #781, Little Rock, AR 72205-7199 USA
| | - Laura L. Bellows
- Division of Nutritional Sciences, Cornell University, Martha Van Rensselaer Hall, Ithaca, NY 14853 USA
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