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Warraitch A, Wacker C, Biju S, Lee M, Bruce D, Curran P, Khraisha Q, Hadfield K. Positive Impacts of Adolescent Involvement in Health Research: An Umbrella Review. J Adolesc Health 2024; 75:218-230. [PMID: 38597838 DOI: 10.1016/j.jadohealth.2024.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 04/11/2024]
Abstract
Despite an increased recognition of the right of adolescents to be involved in decisions that affect them, young people continue to be under-involved in health research. One of the reasons is a lack of awareness among researchers on the current evidence base around the benefits of involving adolescents. To address this, we conducted an umbrella review to synthesize the evidence on the positive impacts of adolescent involvement in health research. This umbrella review was preregistered with PROSPERO (CRD42021287467). We searched 11 databases, Google Scholar, PROSPERO, reference lists, 10 journals, websites of 472 organizations, and sought input from experts. Ultimately, we included 99 review articles. We found that adolescent involvement has many positive impacts on young people, including increased knowledge and skills; personal development; financial benefits; career and academic growth; enhanced relationships; and valuing their experience. The positive impacts of adolescent involvement on the research itself include increased relevance of the study to adolescents, improved recruitment, development of more adolescent-friendly materials, enhanced data collection and analysis, and more effective dissemination. Researchers also benefited from adolescents' involvement through increased knowledge, skills, and a shift in their attitudes. The evidence supporting the positive impacts of adolescent involvement in research is substantial but limited by a lack of rigorous evaluation, inconsistent reporting, and unclear evaluation methods.
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Affiliation(s)
- Azza Warraitch
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland; Department of Psychology, Trinity College Dublin, Dublin, Ireland.
| | - Ciara Wacker
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland; Department of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Sanjana Biju
- Department of Social Work and Social Policy, Trinity College Dublin, Dublin, Ireland
| | - Maria Lee
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland; Department of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Delali Bruce
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland; Department of Engineering, Stanford University, Stanford, California
| | - Paul Curran
- Department of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Qusai Khraisha
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland; Department of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Kristin Hadfield
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland; Department of Psychology, Trinity College Dublin, Dublin, Ireland
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Inácio MLC, Pereira FC, Fernandes LB, Oliveira IRCD, Pereira RC, de Angelis-Pereira MC. Food and Nutrition Education Using Intuitive Method and NOVA Food Classification: Implications for Food Practices of Children and Adolescents Intuitive Method in Food and Nutrition Education. Am J Health Promot 2022; 36:1170-1182. [PMID: 35420920 DOI: 10.1177/08901171221092394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the impact of food and nutrition education interventions based on the intuitive method (IM) proposed by Johaan Henrich Pestalozzi (1746-1827) at different time periods on the food practices of children and adolescents. DESIGN This was a prospective comparative intervention program assessed by a pre-post survey at shorter term (3 months) and longer term (6 months). SETTING Two institutions that provide extracurricular social support for children and adolescents with social and economic vulnerabilities in the city of Lavras, Minas Gerais, Brazil. The shorter-term intervention was conducted in Institution A and the longer term one conducted in Institution B. SUBJECTS The sample consisted of 245 students aged between 5 and 14 years who attended the institutions. For each institution, they were divided into two groups (control and IM). INTERVENTION We compared the effectiveness of the interventions performed by the IM or by expository actions (control) in both institutions. Interventions were focused on the guidelines of the Food Guide for the Brazilian Population and dealt with food choices, meal preparation, commensality, and obstacles to healthy eating. MEASURES The assessed outcomes were food consumption according to NOVA food classification, cooking self-efficacy, and knowledge about food and nutrition. ANALYSIS Paired t-tests were used to compare food consumption before and after interventions. Adjusted logistic regression models were used to analyze the outcomes on food and nutrition knowledge and cooking self-efficacy. RESULTS Subjects receiving IM interventions decreased mean intake of ultra-processed food (3.56 to 1.50 portions; P< .001) and had greater odds of increasing self-efficacy with cooking (OR = 2,33-4,17). Both methods were effective regarding teaching about food and nutrition. Intervention period did not homogeneously impact these outcomes. CONCLUSIONS The use of food and nutrition education interventions presented positive outcomes on the food practices of the participants. The IM is an alternative method to educate children and adolescents about healthy eating practices.
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Affiliation(s)
| | | | | | | | - Rafaela Corrêa Pereira
- Department of Nutrition, 67739Federal University of Lavras, Lavras, MG, Brazil.,Department of Agricultural Sciences, Federal Institute of Minas Gerais, Bambuí, MG, Brazil
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Llauradó E, Aceves-Martins M, Prades-Tena J, Besora-Moreno M, Papell-Garcia I, Giralt M, Davies A, Tarro L, Solà R. Adolescents encouraging healthy lifestyles through a peer-led social marketing intervention: Training and key competencies learned by peer leaders. Health Expect 2021; 25:455-465. [PMID: 34936175 PMCID: PMC8849247 DOI: 10.1111/hex.13406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/20/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background Adolescents who participate as peer leaders can benefit and acquire competencies from their peer leadership experience. Objectives To identify the competencies gained by adolescents who participated as peer leaders in a healthy lifestyle study and to determine whether the training characteristics were related to improvement in competencies. Design The present study was part of the European Youth Tackling Obesity (EYTO) project, a multicentre social marketing intervention involving four European countries. Setting and Participants Eighteen peer leaders (aged 13–15 years, three or five leaders per country) from disadvantaged neighbourhoods received training in designing and implementing activities for their peers. Measures The peer leaders' confidence, experience and interest in 11 tasks related to lifelong learning competencies were assessed with questions rated on a colour scale at baseline and at the end of the study. Results The peer leaders demonstrated improvements in experience, confidence and interest in different tasks, such as research, website or logo design, oral presentations, social media use and collaboration with people from other countries. They increased their confidence in management tasks (p = 0.03) and their confidence and experience in communication tasks (p = 0.01). The peer leaders from Spain and Portugal had greater improvements than those from the other countries. Conclusion The peer leaders improved their confidence in management tasks and their confidence and experience in communication tasks. Slight differences were detected in improvement in competencies by country, likely due to the differences in the peer training applied. Recommendations for peer leader training are proposed, although these results should be verified with larger sample size. Patient or Public Contribution The peer leaders contributed to the design and implementation of the training and intervention.
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Affiliation(s)
- Elisabet Llauradó
- Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
| | - Magaly Aceves-Martins
- Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Reus, Spain
| | - Jordi Prades-Tena
- Departament d'Estudis de Comunicació, Universitat Rovira i Virgili, Tarragona, Spain
| | - Maria Besora-Moreno
- Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Reus, Spain
| | - Ignasi Papell-Garcia
- Unitat de Nutrició i Salut, Eurecat, Centre Tecnològic de Catalunya, Reus, Spain
| | - Montse Giralt
- Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Reus, Spain
| | - Amy Davies
- Health & Social Care, National Children's Bureau, London, UK
| | - Lucia Tarro
- Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
| | - Rosa Solà
- Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili, Reus, Spain.,Hospital Universitari Sant Joan de Reus, Reus, Spain
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St. Pierre C, Guan W, Barry L, Dease G, Gottlieb S, Morris A, Merrill J, Sacheck JM. Themes in Train-the-Trainer Nutrition Education Interventions Targeting Middle School Students: A Systematic Review. Nutrients 2021; 13:2749. [PMID: 34444910 PMCID: PMC8398099 DOI: 10.3390/nu13082749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022] Open
Abstract
Context-appropriate nutrition education interventions targeting middle school students have the potential to promote healthy dietary patters that may help prevent unnecessary weight gain at a point in childhood development when youth experience increasing agency over their food choices. The aim of this review was to identify and synthesize themes in train-the-trainer approaches, intervention content and delivery, and youth receptivity across teacher, mentor, and peer-led nutrition education interventions that targeted middle school-age youth in urban, primarily low-income settings. A systematic, electronic literature search was conducted in seven electronic databases, PubMed/Medline, CINAHL, ERIC, PsycINFO, Scopus, SPORTDiscus, and Cochrane CENTRAL, using fixed inclusion and exclusion criteria. A total of 53 papers representing 39 unique interventions were selected for data extraction and quality assessment. A framework synthesis approach was used to organize the interventions into six categories and identify themes according to whether the intervention was classroom-based or out-of-school-based and whether adults, cross-age peers or same-age peers delivered the intervention. Ten of the interventions contained multiple components such that they were included in two of the categories. The review findings indicated that trainings should be interactive, include opportunities to role-play intervention scenarios and provide follow-up support throughout intervention delivery. Interventions targeting middle school youth should include positive messaging and empower youth to make healthy choices within their specific food environment context.
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Affiliation(s)
- Christine St. Pierre
- Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (G.D.); (J.M.S.)
| | - Win Guan
- Up2Us Sports, New York, NY 10018, USA; (W.G.); (J.M.)
| | - Leah Barry
- Department of Sociology, Tulane University, New Orleans, LA 70118, USA; (L.B.); (S.G.)
| | - Grace Dease
- Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (G.D.); (J.M.S.)
| | - Sydney Gottlieb
- Department of Sociology, Tulane University, New Orleans, LA 70118, USA; (L.B.); (S.G.)
| | - Arielle Morris
- School of Science & Engineering, Tulane University, New Orleans, LA 70118, USA;
| | | | - Jennifer M. Sacheck
- Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (G.D.); (J.M.S.)
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Firestone R, Matheson A, Firestone J, Schleser M, Yee E, Tuisano H, Kaholokula K, Ellison-Loschmann L. Developing principles of social change as a result of a Pasifika Youth Empowerment Program: A qualitative study. Health Promot J Austr 2020; 32 Suppl 2:197-205. [PMID: 32755045 PMCID: PMC8596690 DOI: 10.1002/hpja.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 06/07/2020] [Accepted: 07/29/2020] [Indexed: 11/11/2022] Open
Abstract
ISSUE Empowerment is a concept over-used in health promotion, yet it is an important process that can used in developing the capacity and capability of young people for creating social change to improve healthier lives. METHODS The Youth Empowerment Program (YEP), a pilot study aimed at empowering 15 youth (18-24 years) to lead healthier lives. We present secondary outcomes of the original YEP study, using focus groups and mobile-mentary approaches to capture the impact of the YEP through the youths' understanding of the program. Thematic analyses to examine the pragmatic usefulness of the empowerment program. RESULTS We identified three major themes: (aa) Knowledge: education and awareness of healthy living and understanding of the wider social health issues, compound the health complexities of obesity; (b) Youth as catalysts for change: the youth viewed themselves as agents of social change; and (c) Transformation: the youth recognised themselves as catalysts for change that can positively transform communities into action. CONCLUSION This study contributes new insights and depth of understanding about how the empowerment program can strengthen the process of individual capacity in an effort to mobilise social change for the betterment of the whole community, particularly among indigenous Pasifika population groups. SO WHAT?: Developing empowerment principles will enable others to consider "how apply" empowerment more practically when working with young people and not use it flippantly with no real action-oriented outcome.
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Affiliation(s)
- Ridvan Firestone
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Anna Matheson
- School of Health, Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Justice Firestone
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Max Schleser
- Department of Film and Animation, School of Arts, Social Sciences and Humanities, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Emily Yee
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Hana Tuisano
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Keawe'aimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
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Redmond LC, Jock B, Gadhoke P, Chiu DT, Christiansen K, Pardilla M, Swartz J, Platero H, Caulfield LE, Gittelsohn J. OPREVENT (Obesity Prevention and Evaluation of InterVention Effectiveness in NaTive North Americans): Design of a Multilevel, Multicomponent Obesity Intervention for Native American Adults and Households. Curr Dev Nutr 2019; 3:81-93. [PMID: 31453430 PMCID: PMC6700458 DOI: 10.1093/cdn/nzz009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 12/10/2018] [Accepted: 01/29/2019] [Indexed: 11/25/2022] Open
Abstract
Obesity prevalence is high in Native American (NA) adults, and there is a critical need to establish and implement evidence-based social, behavioral, and policy interventions that are theoretically informed. The use of multilevel, multicomponent (MLMC) interventions has been shown to be an effective strategy for comprehensive health behavior change; however, there is little guidance available in the literature to facilitate implementation in this underserved and understudied population. To decrease obesity and related comorbidities in NA adults, an MLMC intervention called OPREVENT (Obesity Prevention and Evaluation of InterVention Effectiveness in NaTive North Americans) was implemented in 5 rural NA communities to modify the food-purchasing environment, improve diet, and increase physical activity (PA). Five NA communities across the Upper Midwest and Southwest United States were randomly assigned to Immediate (n = 3) or Delayed (n = 2) Intervention. OPREVENT was implemented in Immediate Intervention community food stores, worksites, schools, and media over 1 y. A community-randomized controlled trial was used to evaluate intervention impact in adults at the individual and institutional levels, with individual-level data being collected on diet, PA, and psychosocial variables at baseline and follow-up; and institutional-level data being collected on food stores, worksites, and schools, media, and process measures. The OPREVENT intervention was one of the first MLMC obesity interventions in this population and provides evidence-based practices for future program development. The purpose of this article is to describe the design, implementation, and evaluation of OPREVENT. This trial was registered at isrctn.com as ISRCTN76144389.
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Affiliation(s)
- Leslie C Redmond
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
- University of Alaska Anchorage, School of Allied Health, Dietetics and Nutrition Department, Anchorage, AK
| | - Brittany Jock
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Preety Gadhoke
- St. John's University, Department of Pharmacy Administration & Public Health, Fresh Meadows, NY
| | - Dorothy T Chiu
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | | | - Marla Pardilla
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Jacqueline Swartz
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Harrison Platero
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Laura E Caulfield
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Joel Gittelsohn
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
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Oakley AR, Nelson SA, Nickols-Richardson SM. Peer-Led Culinary Skills Intervention for Adolescents: Pilot Study of the Impact on Knowledge, Attitude, and Self-efficacy. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:852-857.e1. [PMID: 28939370 DOI: 10.1016/j.jneb.2017.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 06/21/2017] [Accepted: 07/11/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To assess the impact and feasibility of a culinary skills intervention for adolescents led by peer educators compared with adult educators. METHODS Adolescents (aged 11-14 years) were randomized to peer educator (n = 22) or adult educator (n = 20) groups and attended 2 2.5-hour culinary skills lessons addressing knife skills, cooking methods, and recipes. Knowledge, attitude, and self-efficacy measurements were completed before and immediately after the intervention and at 3 and 6 months after the intervention. Fidelity checklists assessed the feasibility of program delivery. Differences within and between groups over time were assessed using ANOVA. RESULTS Adolescents (n = 42) increased knowledge (3.7 ± 2.6 points [mean ± SD]; P < .001), attitude (0.8 ± 4.5; P < .05), and self-efficacy of cooking (2.6 ± 5.3; P < .001) and cooking method (1.7 ± 4.6; P < .01) after intervention. Peer and adult educators were equally able to deliver the intervention. CONCLUSIONS AND IMPLICATIONS Peers and adults can feasibly lead a culinary skills program for adolescents that increases knowledge. To affect attitude and self-efficacy, additional training of peer educators may be needed.
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Affiliation(s)
- Amanda R Oakley
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL
| | - Sarah A Nelson
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL
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Bay JL, Morton SM, Vickers MH. Realizing the Potential of Adolescence to Prevent Transgenerational Conditioning of Noncommunicable Disease Risk: Multi-Sectoral Design Frameworks. Healthcare (Basel) 2016; 4:E39. [PMID: 27417627 PMCID: PMC5041040 DOI: 10.3390/healthcare4030039] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 06/21/2016] [Accepted: 06/27/2016] [Indexed: 12/27/2022] Open
Abstract
Evidence from the field of Developmental Origins of Health and Disease (DOHaD) demonstrates that early life environmental exposures impact later-life risk of non-communicable diseases (NCDs). This has revealed the transgenerational nature of NCD risk, thus demonstrating that interventions to improve environmental exposures during early life offer important potential for primary prevention of DOHaD-related NCDs. Based on this evidence, the prospect of multi-sectoral approaches to enable primary NCD risk reduction has been highlighted in major international reports. It is agreed that pregnancy, lactation and early childhood offer significant intervention opportunities. However, the importance of interventions that establish positive behaviors impacting nutritional and non-nutritional environmental exposures in the pre-conceptual period in both males and females, thus capturing the full potential of DOHaD, must not be overlooked. Adolescence, a period where life-long health-related behaviors are established, is therefore an important life-stage for DOHaD-informed intervention. DOHaD evidence underpinning this potential is well documented. However, there is a gap in the literature with respect to combined application of theoretical evidence from science, education and public health to inform intervention design. This paper addresses this gap, presenting a review of evidence informing theoretical frameworks for adolescent DOHaD interventions that is accessible collectively to all relevant sectors.
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Affiliation(s)
- Jacquie L Bay
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand.
| | - Susan M Morton
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand.
- Centre for Longitudinal Research-He Ara ki Mua, University of Auckland, Auckland 1743, New Zealand.
| | - Mark H Vickers
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand.
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Kohlstadt I, Gittelsohn J, Fang Y. NutriBee Intervention Improves Diet and Psychosocial Outcomes by Engaging Early Adolescents from Diverse and Disadvantaged Communities. J Am Coll Nutr 2016; 35:443-51. [PMID: 27315580 DOI: 10.1080/07315724.2015.1110507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE NutriBee was the first clinical nutrition intervention designed to bring the Institute of Medicine recommendations for 20 hours of experiential nutrition-themed learning to grades 4-7 into club and camp settings. We piloted NutriBee to assess acceptability and impact among early adolescents in diverse and disadvantaged communities in order to evaluate its future potential as a group medical nutrition intervention. METHODS Nine communities across Guam, Maryland, Michigan, and New Mexico representing South Pacific Island, American Indian, urban African American, recently immigrated Hispanic, and rural Caucasian ethnic groups piloted NutriBee in nonclinical settings (clubs, schools, camps). The 6 club and camp pilots administered consenting NutriBee participants a 41-question pre-post survey assessing impact on food selection and the psychosocial parameters of intentions, outcome expectations, self-efficacy, and knowledge. Process measures included dose, fidelity, and acceptability questions. RESULTS Pre- and postsurveys were completed by 170 of 179 (95%) consenting, eligible participants. Impact scores increased significantly (p < 0.001): Food selection behavior (+9.3%), intentions (+19.1%), outcome expectations (+15.1%), self-efficacy (+7.4%), and knowledge (+17.6%). Each pilot (n = 6) demonstrated significant (p < 0.001) impact, a mean dose delivered of 80% (16 hours) or higher, and an acceptability score of at least 74%. Girls participating in girl-only programs (n = 72) shared greater impact than girls in coed programs (n = 41; 13.6% vs. 10.4% mean score increase, p = 0.05). CONCLUSIONS NutriBee successfully extended the impact of an IOM-aligned intervention to club and camp settings to which clinicians can refer at-risk early adolescents.
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Affiliation(s)
- Ingrid Kohlstadt
- a Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland
| | - Joel Gittelsohn
- a Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland
| | - Yu Fang
- b Johns Hopkins University , Baltimore , Maryland
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