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Pierce TB, Aragón MC, Auld G, Barale KV, Hughes SO, Power TG, Lanigan JD, Parker L, Baker SS. Parents Report Positive Changes in Parental Feeding Practices 12 Months After Intervention. J Nutr Educ Behav 2024:S1499-4046(24)00057-5. [PMID: 38661626 DOI: 10.1016/j.jneb.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 03/08/2024] [Accepted: 03/13/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Determine self-reported parental feeding behavior changes and perspectives on parental feeding intervention at 12-month follow-up. METHODS Telephone focus groups using a 2 × 2 design (English/Spanish × in-class or online) with Expanded Food and Nutrition Education Program participants (n = 37) with children 2-8 years and high exposure to the Food, Feeding, and Your Family intervention (7 lessons). Researchers (n = 3) independently identified themes. RESULTS Parental behavior changes that (1) positively influenced children's diets, (2) involved children in food-related activities, (3) eased stressful situations around food, (4) led to healthier food choices, and (5) saved money when food shopping. Commonly implemented practices included establishing structured mealtime routines, introducing new foods multiple times, and encouraging children's eating competence. Online participants noted materials were easily accessible via text messages. CONCLUSIONS AND IMPLICATIONS Incorporating parental feeding content (in-class or online) into nutrition education interventions, such as the Expanded Food and Nutrition Education Program, supports developing positive parental feeding behaviors in families with low income.
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Affiliation(s)
- Theresa B Pierce
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | | | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Karen V Barale
- Washington State University Extension, Pierce County, Tacoma, WA
| | - Sheryl O Hughes
- US Department of Agriculture, Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA
| | - Jane D Lanigan
- Department of Human Development, Washington State University, Pullman, WA
| | | | - Susan S Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
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Power TG, Baker SS, Barale KV, Aragón MC, Lanigan JD, Parker L, Garcia KS, Auld G, Micheli N, Hughes SO. Using Mobile Technology for Family-Based Prevention in Families with Low Incomes: Lessons from a Randomized Controlled Trial of a Childhood Obesity Prevention Program. Prev Sci 2024; 25:369-379. [PMID: 38321316 PMCID: PMC10891227 DOI: 10.1007/s11121-023-01637-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 02/08/2024]
Abstract
Researchers are increasingly using web-based technologies to deliver family-based, prevention programming. Few studies have examined the success of such approaches for families with low incomes. The purpose of this study was to describe the level of in-class and online engagement in a childhood obesity prevention program for parents with low incomes, to examine the demographic correlates of parent engagement, and to examine dosage effects on parental feeding outcomes as a function of online exposure. All participants attended in-class nutrition education classes (Eating Smart · Being Active) as part of the Expanded Food and Nutrition Education Program (EFNEP) in Colorado and Washington State (classes were offered in English and Spanish). Participants in this analysis were 168 parents from a larger cluster randomized controlled trial who had been randomly assigned to also receive a newly developed, mobile-based version of an efficacious, feeding-focused, childhood obesity prevention program. Results showed that despite high levels of in-person attendance (70%), participants only accessed 47% of the videos (online content). Older parents and parents of girls showed higher levels of in-person attendance; currently employed parents showed lower levels. Online engagement varied as a function of ethnicity and acculturation: non-Hispanic parents accessed the most videos, low-acculturated Hispanic parents accessed the second most, and highly acculturated Hispanic parents accessed the least. In contrast, low-acculturated Hispanic parents showed the highest in-person attendance. For all but one outcome, significant online program effects were found only for parents who accessed at least half of the videos. Implications for mobile-based, family-based prevention programs for parents with low incomes are considered.ClinicalTrials.gov Identifier: NCT03170700; Registration Date: March 08, 2017.
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Affiliation(s)
| | | | | | - M Catalina Aragón
- Washington State University Extension, Tacoma, WA, USA
- Maternal and Child Health, Oregon Health Authority, Portland, OR, USA
| | | | - Louise Parker
- Washington State University Extension, Seattle, WA, USA
| | - Karina Silva Garcia
- Washington State University, Pullman, WA, USA
- Department of Public Health, County of San Luis Obispo, San Luis Obispo, CA, USA
| | - Garry Auld
- Colorado State University, Ft. Collins, CO, USA
| | - Nilda Micheli
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX, 77030, USA
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX, 77030, USA.
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Brooks A, Young G, Misyak S, Johnson ML, Serrano E. Contextual Factors Influencing the Adoption of Physical Activity Direct Education and Policy, Systems, and Environmental Change Initiatives by Virginia EFNEP and SNAP-Ed Staff. J Nutr Educ Behav 2024; 56:35-42. [PMID: 38032565 DOI: 10.1016/j.jneb.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To explore factors influencing the adoption of direct education programs and policy, systems, and environmental (PSE) change initiatives focused on physical activity for Supplemental Nutrition Assistance Program-eligible audiences by Virginia Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education (SNAP-Ed) staff. METHODS Online survey with Expanded Food and Nutrition Education Program and SNAP-Ed peer (paraprofessional) educators (n = 28) and SNAP-Ed agents (master of science level) (n = 9) in Virginia. Descriptive statistics were computed for sociodemographic characteristics and responses to questions on the basis of Likert-type scales. Exploratory factor analyses were run to identify the underlying structures of the different variables. RESULTS The main factors for peer educators were related to substituting nutrition programs or content for physical activity programs. Other factors included staff qualifications and expectations about leading vs teaching physical activities. For PSEs, the top factors were the capacity to reach many community members, attract new partners and stakeholders, and personal interest in the PSE. CONCLUSIONS AND IMPLICATIONS The results provide insight into potential barriers and motivators for adopting physical activity education and PSEs within community-based initiatives and can be used to inform program planning and staff training. Additional research is warranted to examine other factors influencing the adoption and implementation of physical activity programs and PSEs.
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Affiliation(s)
- Austin Brooks
- Virginia Family Nutrition Program, Virginia Cooperative Extension, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Gabrielle Young
- Virginia Family Nutrition Program, Virginia Cooperative Extension, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Sarah Misyak
- Virginia Family Nutrition Program, Virginia Cooperative Extension, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Meredith Ledlie Johnson
- Virginia Family Nutrition Program, Virginia Cooperative Extension, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Elena Serrano
- Virginia Family Nutrition Program, Virginia Cooperative Extension, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA.
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Baker SS, Cunningham-Sabo L, Franck KL, McGirr K, Mullins J. Development of EFNEP and SNAP-Ed Core Competencies in the Land-Grant University System. J Nutr Educ Behav 2023; 55:30-37. [PMID: 36435673 DOI: 10.1016/j.jneb.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
This report describes the development and revision of core competencies for the Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education program leaders, supervisors, and paraprofessional educators across the land-grant university system. The developing curriculum methodologies were used to engage panels of exemplary employees and an advisory panel of program leaders. A crosswalk examined key documents, and a gap analysis explored the competencies of similar professions. The resulting job duties and tasks reflect cultural, environmental, and educational trends. The core competencies are critical for writing job descriptions, guiding hiring, evaluating performance, and providing initial and ongoing training for the Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education.
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Affiliation(s)
- Susan S Baker
- Expanded Food and Nutrition Education Program, Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Leslie Cunningham-Sabo
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | | | - Kathryn McGirr
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Janet Mullins
- Department of Dietetics and Human Nutrition, College of Agriculture, Food & Environment, University of Kentucky, Lexington, KY
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Sankavaram K, Roe AJ, Whiteley J, Price WJ. Diet Quality and Nutrition Behavior of Federal Nutrition Education Program Participants before and during the COVID-19 Pandemic. Nutrients 2022; 15:nu15010141. [PMID: 36615798 PMCID: PMC9824662 DOI: 10.3390/nu15010141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022] Open
Abstract
Despite challenges due to the COVID-19 pandemic, reports from regional and national meetings of the Expanded Food and Nutrition Education program (EFNEP) have provided anecdotal evidence that the program has persevered, pivoted, and continued to positively impact the lives of some of the nation's most vulnerable populations. However, there have been necessary changes to program delivery, inevitable changes in the lives of participants, and changes in the food environment that may have impacted program outcomes. This study compares national EFNEP data (demographics, behavior change data, and 24 h dietary recall data) of participants from two federal fiscal years, before the COVID-19 pandemic and during the pandemic. Linear mixed model analysis of variance and covariance were used to assess the effects of year on program outcomes. Results of this study provide quantitative evidence of the resiliency of EFNEP to facilitate positive behavior changes related to diet quality, physical activity, food safety, food resource management, and food security. Amidst changes in the food environment during the COVID-19 pandemic, these results emphasize the importance and value of federal nutrition education programs in any food environment.
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Affiliation(s)
- Kavitha Sankavaram
- Department of Nutrition and Food Science, University of Maryland, College Park, MD 20742, USA
| | - Annie J. Roe
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844, USA
- Correspondence: ; Tel.: +208-885-1709
| | - Jolene Whiteley
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844, USA
| | - William J. Price
- Statistical Programs, College of Agricultural and Life Sciences, University of Idaho, Moscow, ID 83844, USA
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Neelon M, Price N, Srivastava D, Zheng L, Trzesniewski K. Association Between Educational Attainment and EFNEP Participants' Food Practice Outcomes. J Nutr Educ Behav 2022; 54:902-907. [PMID: 35970730 DOI: 10.1016/j.jneb.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Examine the association between educational attainment and improvement in food practice outcomes of the California Expanded Food and Nutrition Education Program (EFNEP) participants. DESIGN Secondary data analysis. PARTICIPANTS A total of 19,089 participants, 92.3% female, 77.2% Hispanic, 19.7% with ≤ sixth-grade education, and 68.9% with incomes ≤ 100% of the federal poverty level. MAIN OUTCOME MEASURES Improvement in food resource management practices (FRMP), nutrition practices, and food safety practices (FSP). ANALYSIS Wilcoxon signed rank tests examined pre-post outcomes. Mann-Whitney U tests compared whether participants in the lowest and highest educational attainment quartiles had similar levels of improvement. RESULTS California EFNEP is associated with improved FRMP (z = -95.33), nutrition practices (z = -94.91), and FSP (z = -92.37); (P < 0.001). Lowest educational quartile was associated with more improvement in FRMP and FSP (P < 0.001). CONCLUSIONS AND IMPLICATIONS California EFNEP contributed to improved food practice outcomes for low and high educational attainment participants. Program content and instruction are effective across the education continuum.
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Affiliation(s)
- Marisa Neelon
- Division of Agriculture and Natural Resources, University of California, Davis, CA.
| | - Natalie Price
- Division of Agriculture and Natural Resources, University of California, Davis, CA
| | - Deepa Srivastava
- Division of Agriculture and Natural Resources, University of California, Davis, CA
| | - Lucy Zheng
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Kali Trzesniewski
- Division of Agriculture and Natural Resources, University of California, Davis, CA; Department of Human Ecology, University of California Davis, Davis, CA
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Hughes SO, Power TG, Baker SS, Barale KV, Aragon MC, Lanigan JD, Parker L, Silva Garcia K, Auld G, Johnston CA, Micheli N. Short-Term Efficacy of a Childhood Obesity Prevention Program Designed to Pair Feeding Content with Nutrition Education. Child Obes 2022. [PMID: 35708621 DOI: 10.1089/chi.2022.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Family-based programs show considerable promise in preventing overweight and obesity in young children. However, dissemination is difficult because significant participant and staff involvement is required. This study examined the short-term efficacy of adding parental feeding content to a widely-used nutrition education curriculum for families in low-resourced communities comparing the influence of two delivery methods (in-class and online) on parents' feeding knowledge, practices, and styles. Methods: In this cluster randomized controlled trial, parents of 2- to 8-year-old children enrolled in the EFNEP (Expanded Food and Nutrition Education Program) in Colorado and Washington were randomly assigned to: in-class nutrition education only, in-class nutrition education with in-class feeding content, or in-class nutrition education with online feeding content. Data from the 382 participants who completed both pretest and posttest assessments are reported in this study. Results: Multilevel analyses showed empirical support for the influence of the program on parents' feeding knowledge, practices, and styles. Online and in-class methods were equally effective in delivering feeding content in low-resourced communities. Consistent effects were seen across the two delivery methods for encouraging children to try new foods (p < 0.05), use of child-centered feeding practices (i.e., greater responsiveness, p < 0.05), child involvement in food preparation (p < 0.05), and understanding the number of presentations often necessary for child acceptance of a new food (p < 0.001). Location and language differences were seen across some constructs. Conclusions: This study demonstrates the efficacy of in-class and online approaches to feeding highlighting the program's positive effects on promoting healthy feeding behaviors for parents of children in low-resourced families. ClinicalTrials.gov Identifier: NCT03170700.
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Affiliation(s)
- Sheryl O Hughes
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center at Baylor College of Medicine, Houston, TX, USA
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA, USA
| | - Susan S Baker
- Department of Food Science and Human Nutrition, Colorado State University, Ft. Collins, CO, USA
| | | | | | - Jane D Lanigan
- Department of Human Development, Washington State University, Vancouver, WA, USA
| | - Louise Parker
- Department of Human Development, Washington State University Extension, Seattle, WA, USA
| | - Karina Silva Garcia
- Department of Human Development, Washington State University, Pullman, WA, USA
| | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Ft. Collins, CO, USA
| | - Craig A Johnston
- Department of Health and Human Performance, University of Houston, Houston, TX, USA
| | - Nilda Micheli
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center at Baylor College of Medicine, Houston, TX, USA
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Barale K, Aragón MC, Yerxa K, Auld G, Hess A. Development of Reliable and Valid Questions to Assess Food Resource Management Behaviors in Adults With Limited Income. J Nutr Educ Behav 2022; 54:346-358. [PMID: 35131185 DOI: 10.1016/j.jneb.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 11/11/2021] [Accepted: 11/16/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Develop reliable, valid questions to assess changes in food resource management (FRM) behaviors in adults with limited incomes. DESIGN Questionnaire development using a mixed-methods approach: content validity (subject matter and curricula), face validity, temporal reliability (test-retest), sensitivity to change, and exploratory factor analysis (EFA). SETTING Community settings in 12 states. PARTICIPANTS Convenience samples of English-speaking Expanded Food and Nutrition Education Program (EFNEP) or EFNEP-eligible adults: 105 (cognitive interviews), 181 (test-retest), 185 (sensitivity), and 389 (EFA) adults. VARIABLES MEASURED Behaviors related to FRM skills: planning, shopping, and budgeting. ANALYSIS Consistency and agreement in cognitive interviews and temporal reliability; sensitivity at posttest (paired t tests, Wilcoxon signed-rank tests); internal consistency of scales identified in EFA (Cronbach α). P < 0.5. RESULTS All questions had acceptable temporal reliability ranges for the intraclass correlation coefficient (0.48-0.74) and Spearman rank-order correlation (0.48-0.73). All questions were sensitive to change at posttest (P < 0.001). Planning and saving scales, revealed by EFA, demonstrated internal consistency (> 0.80 Cronbach α). CONCLUSIONS AND IMPLICATIONS The 9 FRM behavior questions have acceptable temporal reliability and content and face validity and can be used nationally by EFNEP to assess participants' self-reported behavior changes. Other nutrition programs with similar audiences and content could use these questions to measure changes in FRM behaviors.
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Affiliation(s)
- Karen Barale
- Youth and Family Unit, Washington State University Extension, Tacoma, WA.
| | - M Catalina Aragón
- Youth and Family Unit, Washington State University Extension, Tacoma, WA
| | - Kate Yerxa
- University of Maine Cooperative Extension, Orono, ME
| | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Ann Hess
- Department of Statistics, Colorado State University, Fort Collins, CO
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Aragón MC, Auld G, Baker SS, Barale KV, Garcia KS, Micheli N, Parker L, Lanigan JD, Power TG, Hughes SO. Implementation Science Strategies Promote Fidelity in the Food, Feeding, and Your Family Study. J Nutr Educ Behav 2021; 53:1028-1037. [PMID: 34303602 DOI: 10.1016/j.jneb.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 05/19/2021] [Accepted: 06/01/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Use of implementation science strategies to promote fidelity in the Food, Feeding, and Your Family study. DESIGN Cluster randomized controlled trial with 3 conditions: control, in-class, or online, delivered in English or Spanish. Observations of 20% of classes. SETTING Expanded Food and Nutrition Education Program (EFNEP) in 2 states. PARTICIPANTS EFNEP peer educators (n = 11). INTERVENTION Parental feeding content incorporated into EFNEP lessons (in-class) or through text with links to videos/activities (online). Extensive educator training, scripted curriculum, frequent feedback. ANALYSIS Assessment of fidelity compliance. Qualitative analysis of verbatim educator interviews and classroom observer comments. RESULTS During 128 class observations (40-45 per condition), peer educators followed scripted lesson plan 78% to 89% of the time. There was no evidence of cross-contamination of parental feeding content in control and only minor sharing in online conditions. Variations with fidelity were primarily tied to the EFNEP curriculum, not the parent feeding content. Educators (n = 7) expressed favorable opinions about the Food, Feeding, and Your Family study, thought it provided valuable information, and appreciated support from EFNEP leadership. CONCLUSIONS AND IMPLICATIONS Incorporating implementation science strategies can help ensure successful adherence to research protocols. With proper training and support, EFNEP peer educators can deliver an evidence-based curriculum as part of a complex research study.
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Affiliation(s)
| | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Susan S Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Karen V Barale
- Washington State University Extension, Pierce County, Tacoma, WA
| | | | - Nilda Micheli
- US Department of Agriculture, Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | | | - Jane D Lanigan
- Department of Human Development, Washington State University, Vancouver, WA
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA
| | - Sheryl O Hughes
- US Department of Agriculture, Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
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Atoloye AT, Savoie-Roskos MR, Guenther PM, Durward CM. Effectiveness of Expanded Food and Nutrition Education Program in Changing Nutrition-Related Outcomes Among Adults With Low Income: A Systematic Review. J Nutr Educ Behav 2021; 53:691-705. [PMID: 33931296 DOI: 10.1016/j.jneb.2021.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/14/2021] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To review the effect of the Expanded Food and Nutrition Education Program (EFNEP) in changing nutrition-related outcomes. METHODS Relevant research conducted before December 2020 was identified using PubMed, Web of Science, Google Scholar, and the EFNEP Research Database. The methodological quality of each eligible study was assessed. RESULTS Of the 406 studies found, 30 were eligible; 26 studies were on EFNEP, and 4 included both EFNEP and Supplemental Nutrition Assistance Program Nutrition Education (SNAP-Ed). The sample sizes ranged from 35 to 122,961. Outcome measures included consumption of food groups, nutrients, other nutrition-related behaviors, and food security. At least 1 immediate behavior change (P < 0.05) was reported in each study, but long-term maintenance of behavior change was not evident. DISCUSSION This review found a consistent, immediate improvement in nutrition behaviors after program participation but poor retention over time. Overall, variation in programming and outcome measures, incomplete reporting, and generally low study quality by modern standards precluded strong conclusions. IMPLICATIONS FOR RESEARCH AND PRACTICE This review identified the need for control groups, improved reporting of program protocols, theory-based curriculum, and measurement of long-term outcomes.
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Affiliation(s)
- Abiodun T Atoloye
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT.
| | | | - Patricia M Guenther
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT
| | - Carrie M Durward
- Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan, UT
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Gills SMH, Auld G, Hess A, Guenther PM, Baker SS. Positive Change in Healthy Eating Scores Among Adults With Low Income After Expanded Food and Nutrition Education Program Participation. J Nutr Educ Behav 2021; 53:503-510. [PMID: 33541768 DOI: 10.1016/j.jneb.2020.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Using 24-hour dietary recalls, compare Healthy Eating Index (HEI)-2005 scores of Expanded Food and Nutrition Education Program participants before and after 8-12 weekly lessons. DESIGN Analysis of preexisting 24-hour dietary recalls information collected from October, 2012 through September, 2014. PARTICIPANTS Participants with complete pre-post dietary data (n = 122,961); subset of those with complete demographic data (n = 97,522). MAIN OUTCOME MEASURES Change in HEI-2005 scores (total and components). STATISTICAL ANALYSIS Linear regression model fit separately for total HEI and 12 components. The response variable was changed in the HEI-2005 score; predictor variables included age, education, sex, and race/ethnicity. RESULTS The mean total HEI scores were 51.1 (SD, 13.7) at entry and 56.5 (SD, 13.7) at exit, with a change of 5.4 (SD, 16.2). Nine of 12 component scores increased. Changes were greater as age increased, with increasing education, and in women. Hispanics had the greatest improvement (mean ± SE) in total HEI score (8.3 ± 0.1). CONCLUSIONS AND IMPLICATIONS Although diet quality remained poor, participation in the Expanded Food and Nutrition Education Program resulted in improvement in dietary quality. The degree of improvements varied among demographic groups, but all groups improved.
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Affiliation(s)
- Susan M H Gills
- Department of Clinical Nutrition, Children's Hospital Colorado, Aurora, CO
| | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Ann Hess
- Department of Statistics, Colorado State University, Fort Collins, CO
| | - Patricia M Guenther
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT
| | - Susan S Baker
- Expanded Food and Nutrition Education Program (EFNEP), Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
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12
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Hill TF, Stark CM, Sellers DE, Dollahite JS. Training Needs of Nutrition Educators Engaged in Policy, Systems, and Environmental Approaches. J Nutr Educ Behav 2020; 52:1131-1138. [PMID: 32896472 DOI: 10.1016/j.jneb.2020.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 07/09/2020] [Accepted: 07/19/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Assess training needs of nutrition educators incorporating policy, systems, and environmental (PSE) approaches into their obesity prevention efforts, to identify content for online training. METHODS Conducted a national, online survey of state and local Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program Education professionals engaged in PSE efforts. RESULTS Respondents (n = 601) rated the importance of 24 training topics related to planning, implementing, and evaluating PSE approaches. Most (21) topics were rated very important or essential, confirming the need for a comprehensive approach. Paired-sample t tests found significant differences (P <0.001) in some training needs between local and state staff (eg, training in evaluation rated higher for state staff). Training needs did not differ by program, region, or length of employment. The top 5 settings for PSE efforts were schools, farmers' markets, food banks/pantries, community gardens, and after-school programs. CONCLUSIONS AND IMPLICATIONS Results informed the development of an online training for program implementers. Future research will be needed to assess and refine training needs further, which will evolve as nutrition educators gain more experience in PSE approaches.
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Affiliation(s)
| | | | - Deborah E Sellers
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY
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Murray EK, Baker SS, Betts NM, Hess A, Auld G. Development of a National Dietary Behaviors Questionnaire for EFNEP Adult Participants. J Nutr Educ Behav 2020; 52:1088-1099. [PMID: 32763052 DOI: 10.1016/j.jneb.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Develop and establish the reliability and validity of dietary behavior evaluation questions for the Expanded Food and Nutrition Education Program (EFNEP). DESIGN A mixed-methods study using cognitive interviews, expert panels, test/retest reliability, and pretests/posttests. SETTING 14 states across the US. PARTICIPANTS A convenience sample of low-income EFNEP or EFNEP-eligible participants for cognitive interviews (n = 111), reliability testing (n = 181), and sensitivity to change testing (n = 382). MAIN OUTCOMES MEASURES Indicators of face and content validity, temporal reliability, and sensitivity to change. ANALYSIS Questions interpreted as intended in cognitive interviews, intraclass correlation coefficient and Spearman rank-order correlation for reliability testing; paired t tests or Wilcoxon signed-rank tests for sensitivity to change; and exploratory factor analyses to identify possible scales. RESULTS Cognitive interviews resulted in 3 rounds of question revisions; reliability value ranges were 0.48-0.77 for intraclass correlation coefficient and 0.43-0.77 for Spearman rank-order correlation. For sensitivity to change, 9 items had evidence of change (P < 0.05) between pretests and posttests, whereas 5 items had evidence for change after removing those with little room to change. Two scales were identified: diet quality and non-cheese dairy. CONCLUSIONS AND IMPLICATIONS The EFNEP's new dietary behavior evaluation questions demonstrated face and content validity, moderate to strong reliability, and sensitivity to detect self-reported behavior changes among low-income, diverse populations (culturally, racially/ethnically, and level of education) across 14 states. Nutrition education programs targeting similar behaviors with English speaking clients could consider this dietary behavior questionnaire.
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Affiliation(s)
- Erin K Murray
- Department of Nutrition, Metropolitan State University of Denver, Denver, CO
| | - Susan S Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Nancy M Betts
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK
| | - Ann Hess
- Department of Statistics, Colorado State University, Fort Collins, CO
| | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
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Baker SS, McGirr K, Auld G. Best Practices in Curricula Revisions: Using the Evidence-Based Eating Smart • Being Active as an Exemplar. J Nutr Educ Behav 2020; 52:652-657. [PMID: 32088121 DOI: 10.1016/j.jneb.2020.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/05/2020] [Accepted: 01/06/2020] [Indexed: 06/10/2023]
Abstract
This article describes the processes employed to revise the widely used curriculum, Eating Smart • Being Active. Because of its popularity among nutrition education programs serving the low-income population, the curriculum developers felt it was important to share the revision process after the release of the 2015-2020 Dietary Guidelines for Americans. Extensive feedback during formative evaluation, updated content from the Dietary Guidelines for Americans, and a modern look resulted in a fully revised curriculum released in 2017. Program leaders should have confidence that their educators will be able to implement this evidence-based curriculum with fidelity. An outcome evaluation of the revised Eating Smart • Being Active curriculum is recommended.
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Affiliation(s)
- Susan S Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Kathryn McGirr
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
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15
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Hughes SO, Power TG, Baker SS, Barale KV, Lanigan JD, Parker L, Silva Garcia K, Aragon MC, Johnston CA, Micheli N. Pairing Feeding Content With a Nutrition Education Curriculum: A Comparison of Online and In-Class Delivery. J Nutr Educ Behav 2020; 52:314-325. [PMID: 31866256 DOI: 10.1016/j.jneb.2019.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 10/22/2019] [Accepted: 11/07/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To develop a childhood obesity prevention program, Food, Feeding and Your Family (FFYF), which encourages eating self-regulation in young children. This article describes the research methods for FFYF. Activities that will be used to guide the development of the program are illustrated in a logic model. DESIGN A randomized control trial will be conducted with participant groups randomized into 1 of 3 conditions: (1) in-class delivery of feeding content and nutrition education, (2) online delivery of feeding content and in-class delivery of nutrition education, and (3) nutrition education only. Assessments will be collected at baseline, program completion, and 6 and 12 months after completion of the program. SETTING Study will be conducted through the Expanded Food and Nutrition Education Program in Colorado and Washington State. PARTICIPANTS Parents with 2- to 8-year-old children will be recruited from affiliated community agencies, 540 participants across both states. INTERVENTIONS FFYF derives content from an empirically validated parental feeding program, Strategies for Effective Eating Development, and will be administered with Eating Smart • Being Active, an evidence-based, nutrition education curriculum. MAIN OUTCOME MEASURES Parents will report on feeding practices, child eating behaviors, feeding styles, and acculturation. ANALYSIS Because of the nested nature of the data, multilevel analyses will be used: time points, within parents, and within groups.
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Affiliation(s)
- Sheryl O Hughes
- US Department of Agriculture, Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA
| | - Susan S Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Karen V Barale
- Washington State University Extension, Pierce County, Tacoma, WA
| | - Jane D Lanigan
- Department of Human Development, Washington State University, Vancouver, WA
| | | | | | | | - Craig A Johnston
- Department of Health and Human Performance, University of Houston, Houston, TX
| | - Nilda Micheli
- US Department of Agriculture, Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
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Moore CJ, Lindke A, Cox GO. Using Sensory Science to Evaluate Consumer Acceptance of Recipes in a Nutrition Education Intervention for Limited Resource Populations. J Nutr Educ Behav 2020; 52:134-144. [PMID: 31446110 DOI: 10.1016/j.jneb.2019.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/15/2019] [Accepted: 07/21/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This study evaluated consumer acceptance of recipes in a nutrition education intervention and assessed participants' intentions to change dietary behaviors. DESIGN Study participants tasted and evaluated 16 recipes in the University of Georgia Food Talk curriculum using the 9-point hedonic scale and indicated their likelihood of engaging in behaviors to improve diet quality on a similar, ordinal scale. SETTING AND PARTICIPANTS Convenience samples of 89 to 122 adult participants in the Expanded Food and Nutrition Education Program in Georgia evaluated each recipe. INTERVENTION Eight interactive nutrition education sessions in which study participants sampled and evaluated 2 recipes per session. MAIN OUTCOME MEASURES Mean scores for overall liking of each recipe and likelihood of engaging in promoted behaviors to improve diet quality were outcomes of interest. ANALYSIS Descriptive statistics were generated. Relationships between overall liking of recipes and intention to engage in promoted behaviors were assessed with Spearman correlation coefficients. RESULTS Results showed that 13 of the 16 recipes in the curriculum met criteria for acceptable sensory quality. Overall liking was significantly correlated with participants' intentions to engage in behaviors to improve diet quality. Notable age- and sex-related differences were identified. CONCLUSIONS AND IMPLICATIONS Evaluations of consumer acceptance may be useful in interventions designed to improve diet quality through the introduction of new recipes as improving consumer acceptance of recipes may improve program outcomes.
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Affiliation(s)
- Carla J Moore
- Department of Foods and Nutrition, University of Georgia, Athens, GA.
| | - Allie Lindke
- Department of Foods and Nutrition, University of Georgia, Athens, GA
| | - Ginnefer O Cox
- Department of Foods and Nutrition, University of Georgia, Athens, GA
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Nikolaus CJ, Loehmer E, Jones A, An R, Khan NA, McCaffrey J. Use of Survival Analysis to Predict Attrition Among Women Participating in Longitudinal Community-Based Nutrition Research. J Nutr Educ Behav 2019; 51:1080-1087. [PMID: 31402287 DOI: 10.1016/j.jneb.2019.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 07/16/2019] [Accepted: 07/21/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To identify participant characteristics and study methodology that influenced the completion of a 15-month community-based longitudinal study evaluating the impact of the Supplemental Nutrition Assistance Program Education and Expanded Food and Nutrition Education Program. DESIGN Observational longitudinal 15-month study across 12 data collection timepoints. Sociodemographic characteristics were collected with a paper-based survey at baseline. SETTING Five counties across central and southern Illinois. PARTICIPANTS Women, aged 18 to 65 years (n = 297), recruited at sites likely to serve families eligible for the Supplemental Nutrition Assistance Program Education and Expanded Food and Nutrition Education Program (housing departments, child care centers, etc). MAIN OUTCOME MEASURES Predictors of participant attrition during the study duration. ANALYSIS Cox proportional hazard models. RESULTS Ninety-seven participants were retained across the full study. In unadjusted models, greater income and education levels were significantly related to lower attrition; however, this relationship did not persist in a multivariate model. When adjusted for other characteristics, larger household size was the only measured variable significantly related to greater odds of attrition (odds ratio = 1.09; 95% confidence interval = 1.02, 1.17). CONCLUSIONS AND IMPLICATIONS Several characteristics predicting attrition in other settings were not significant in this study. Future attrition analyses that evaluate social support, transportation capacity, and type of phone in longitudinal nutrition education studies are warranted.
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Affiliation(s)
- Cassandra J Nikolaus
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL
| | - Emily Loehmer
- Office of Extension and Outreach, University of Illinois at Urbana-Champaign, Urbana, IL
| | - Alicia Jones
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL
| | - Ruopeng An
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL
| | - Naiman A Khan
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL
| | - Jennifer McCaffrey
- Office of Extension and Outreach, University of Illinois at Urbana-Champaign, Urbana, IL.
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Chlipalski M, Baker S, Olson B, Auld G. Evaluation and Lessons Learned From the Development and Implementation of an Online Prenatal Nutrition Training for EFNEP Paraprofessionals. J Nutr Educ Behav 2019; 51:749-757. [PMID: 30737094 DOI: 10.1016/j.jneb.2018.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/14/2018] [Accepted: 11/16/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Design, implement, and evaluate the effectiveness of a video-based online training addressing prenatal nutrition for paraprofessional peer educators. METHODS Quasi-experimental pre-posttest study with 2 groups of paraprofessionals working for the Expanded Food and Nutrition Education Program in 17 states and US territories: intervention (n = 67) and delayed intervention comparison group (n = 64). An online training was systematically developed using Smith and Ragan's instructional design model, the Cognitive Theory of Multimedia Learning, principles of adult learning, and selected constructs of the Social Cognitive Theory. Changes in knowledge, identification of inappropriate teaching practices, and self-efficacy, were assessed. Within- and between-group comparisons were done using ANCOVA. RESULTS The intervention group scored significantly higher (P < .05) in all evaluations compared with preassessments and the comparison group. After delayed intervention, the comparison group scored significantly higher (P < .05) than in preassessments. Paraprofessionals reacted positively to future online trainings and were interested in them. CONCLUSIONS AND IMPLICATIONS A video-based online training is an effective method to complement in-person trainings to prepare paraprofessionals to teach nutrition lessons.
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Affiliation(s)
- Micheline Chlipalski
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Susan Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Beth Olson
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
| | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
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Buscemi J, Odoms-Young A, Stolley MR, Schiffer L, Blumstein L, Clark MH, Berbaum ML, McCaffrey J, Braunschweig C, Fitzgibbon ML. Comparative Effectiveness Trial of an Obesity Prevention Intervention in EFNEP and SNAP-ED: Primary Outcomes. Nutrients 2019; 11:E1012. [PMID: 31060275 PMCID: PMC6566246 DOI: 10.3390/nu11051012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/19/2019] [Accepted: 04/30/2019] [Indexed: 11/17/2022] Open
Abstract
There is a need to disseminate evidence-based childhood obesity prevention interventions on a broader scale to reduce obesity-related disparities among underserved children. The purpose of this study was to test the comparative effectiveness of an evidence-based obesity prevention intervention, Hip-Hop to Health (HH), delivered through Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) versus the standard curriculum delivered by the programs (Standard Nutrition Education (NE)). A nonequivalent control group design was delivered to compare the effectiveness of HH to NE on weight gain prevention and health behavior outcomes at EFNEP and SNAP-Ed sites. One hundred and fifty-three caregiver-child dyads (n = 103 in the HH group; n = 50 in the NE group) participated in the study. HH is an evidence-based dietary and physical activity intervention for low-income preschool children. The NE curriculum provided lessons for children that are consistent with the Dietary Guidelines for Americans 2010. Data were collected on demographics, anthropometrics, and behavioral variables for parent-child dyads at baseline and postintervention. Mixed model methods with random effects for site and participant were utilized. No differences in child or caregiver diet, physical activity, or screen time by group were found. No between-group differences in child BMI z-score were found; however, caregivers in the HH group lost significantly more weight than those in the NE group. Results from this trial can inform future dissemination efforts of evidenced-based programs for underserved families.
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Affiliation(s)
- Joanna Buscemi
- DePaul University, Department of Psychology, 2219 N. Kenmore Ave, Chicago IL 60614, USA.
- University of Illinois at Chicago, Institute for Health Research and Policy, 1747 West Roosevelt Road, Chicago, IL 60608, USA.
| | - Angela Odoms-Young
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 1919 West Taylor Street, Chicago, IL 60612, USA.
| | - Melinda R Stolley
- Medical College of Wisconsin, General Internal Medicine, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
| | - Linda Schiffer
- Medical College of Wisconsin, General Internal Medicine, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
| | - Lara Blumstein
- University of Illinois at Chicago, Institute for Health Research and Policy, 1747 West Roosevelt Road, Chicago, IL 60608, USA.
| | - Margaret H Clark
- DePaul University, Department of Psychology, 2219 N. Kenmore Ave, Chicago IL 60614, USA.
| | - Michael L Berbaum
- University of Illinois at Chicago, Institute for Health Research and Policy, 1747 West Roosevelt Road, Chicago, IL 60608, USA.
| | - Jennifer McCaffrey
- Family and Consumer Sciences, University of Illinois Cooperative Extension Service, University of Illinois at Urbana-Champaign, 905 S. Goodwin Ave, Urbana, IL 61801, USA.
| | - Carol Braunschweig
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 1919 West Taylor Street, Chicago, IL 60612, USA.
| | - Marian L Fitzgibbon
- University of Illinois at Chicago, Institute for Health Research and Policy, 1747 West Roosevelt Road, Chicago, IL 60608, USA.
- Department of Pediatrics, University of Illinois at Chicago, 840 S. Wood Street, Chicago, IL 60612, USA.
- University of Illinois Cancer Center, University of Illinois at Chicago, 818 South Wolcott Avenue, Chicago, IL 60612, USA.
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20
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Moore CJ, Williams TN, Berg AC, Durward CM. An Evaluation of Inter-coder and Intra-coder Reliability for 24-Hour Dietary Recall Data Entered in WebNEERS. J Nutr Educ Behav 2019; 51:432-439. [PMID: 30737095 DOI: 10.1016/j.jneb.2019.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 12/31/2018] [Accepted: 01/14/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate inter-coder (between-coder) and intra-coder (within-coder) reliability among trained data coders who enter 24-hour dietary recall data collected through Expanded Food and Nutrition Education Program operations in the state of Georgia. DESIGN This study employed multiple cross-sectional evaluations of inter-coder reliability and a short-term longitudinal evaluation of intra-coder reliability. PARTICIPANTS/SETTING Study participants consisted of trained data coders (n = 9) who were employed during the 12-month period of evaluation. MAIN OUTCOME MEASURES Primary outcome measures were inter-coder and intra-coder reliability across data entered into the Web-based Nutrition Education Evaluation and Reporting System. Statistical analyses were conducted using IBM SPSS 24. Descriptive statistics were generated and inter-coder and intra-coder reliability were assessed using 2-way mixed intraclass correlation coefficients. RESULTS Results of this evaluation indicated good to excellent inter-coder reliability among all coders, and excellent intra-coder reliability among the majority of coders. However, some notable inconsistencies were identified within the intra-coder reliability analyses. CONCLUSIONS Future strategies to improve data quality within Expanded Food and Nutrition Education Program operations might include enhanced training for data coders, implementation of error detection protocols, expansion of the Web-based Nutrition Education Evaluation and Reporting System database, and exploration of automated, computer-assisted administration of 24-hour dietary recalls.
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Affiliation(s)
- Carla J Moore
- Department of Foods and Nutrition, University of Georgia, Athens, GA.
| | | | - Alison C Berg
- Department of Foods and Nutrition, University of Georgia, Athens, GA
| | - Carrie M Durward
- Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan, UT
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Auld G, Baker S, Hernandez-Garbanzo Y, Infante N, Inglis-Widrick R, Procter SB, Yerxa K. The Expanded Food and Nutrition Education Program's Impact on Graduates' Quality of Life. J Nutr Educ Behav 2019; 51:217-223. [PMID: 30268681 DOI: 10.1016/j.jneb.2018.07.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 07/26/2018] [Accepted: 07/31/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To determine how the Expanded Food and Nutrition Education Program (EFNEP) affects the quality of life (QoL) of its low-income adult participants. METHODS A cross-sectional exploratory study using focus groups (n = 15) in 8 states with EFNEP participants (n = 111) 2-4 months after graduation. Focus groups were conducted with non-Hispanic white (4 groups), black (4), English-speaking Hispanic (4), and Spanish-speaking Hispanic (3) respondents. A priori template analysis based on constructs from the University of Toronto's Quality of Life Profile for Adults and constant comparative procedures were used to generate results. RESULTS Participants reported following healthier dietary and physical activity behaviors and having increased motivation to improve themselves and greater satisfaction with life. All groups noted being a more positive influence on their families and a having willingness to learn and try new things. CONCLUSIONS AND IMPLICATIONS The EFNEP enhances the QoL of its participants, which suggests that the program's benefits go beyond participants' documented nutrition and health-related behavior changes. In the future, EFNEP might examine whether improved QoL is also a predictor of sustained behavior change and a means for differentiating program impacts owing to variations in dose (number of contacts) or delivery methods (face-to-face vs online).
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Affiliation(s)
- Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Susan Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Yenory Hernandez-Garbanzo
- Nutrition and Food Systems Division (ESN), Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
| | - Natalia Infante
- School of Teacher Education, University of Northern Colorado, Greeley, CO
| | - Ruth Inglis-Widrick
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Sandra B Procter
- Department of Food, Nutrition, Dietetics, and Health, Kansas State University, Manhattan, KS
| | - Kathryn Yerxa
- University of Maine Cooperative Extension, Orono, ME
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Murray EK, Auld G, Baker SS, Barale K, Franck K, Khan T, Palmer-Keenan D, Walsh J. Methodology for Developing a New EFNEP Food and Physical Activity Behaviors Questionnaire. J Nutr Educ Behav 2017; 49:777-783.e1. [PMID: 28697971 DOI: 10.1016/j.jneb.2017.05.341] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 04/26/2017] [Accepted: 05/03/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Research methods are described for developing a food and physical activity behaviors questionnaire for the Expanded Food and Nutrition Education Program (EFNEP), a US Department of Agriculture nutrition education program serving low-income families. DESIGN Mixed-methods observational study. The questionnaire will include 5 domains: (1) diet quality, (2) physical activity, (3) food safety, (4) food security, and (5) food resource management. A 5-stage process will be used to assess the questionnaire's test-retest reliability and content, face, and construct validity. SETTING Research teams across the US will coordinate questionnaire development and testing nationally. PARTICIPANTS Convenience samples of low-income EFNEP, or EFNEP-eligible, adult participants across the US. INTERVENTIONS A 5-stage process: (1) prioritize domain concepts to evaluate (2) question generation and content analysis panel, (3) question pretesting using cognitive interviews, (4) test-retest reliability assessment, and (5) construct validity testing. MAIN OUTCOME MEASURE A nationally tested valid and reliable food and physical activity behaviors questionnaire for low-income adults to evaluate EFNEP's effectiveness. ANALYSIS Cognitive interviews will be summarized to identify themes and dominant trends. Paired t tests (P ≤ .05) and Spearman and intra-class correlation coefficients (r > .5) will be conducted to assess reliability. Construct validity will be assessed using Wilcoxon t test (P ≤ .05), Spearman correlations, and Bland-Altman plots.
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Affiliation(s)
- Erin K Murray
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Susan S Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Karen Barale
- Extension Youth and Family Unit, Washington State University, Tacoma, WA
| | - Karen Franck
- Department of Family and Consumer Sciences, University of Tennessee, Knoxville, TN
| | - Tarana Khan
- State Program Coordinator, Expanded Food and Nutrition Education Program, Clemson University Cooperative Extension, Clemson, SC
| | | | - Jennifer Walsh
- Department of Health Sciences, James Madison University, Harrisonburg, VA
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Gills SMH, Baker SS, Auld G. Collection Methods for the 24-Hour Dietary Recall as Used in the Expanded Food and Nutrition Education Program. J Nutr Educ Behav 2017; 49:250-256.e1. [PMID: 27876323 DOI: 10.1016/j.jneb.2016.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 10/03/2016] [Accepted: 10/10/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Identify practices for the collection of the 24-hour dietary recall (24HR) as used by the Expanded Food and Nutrition Education Program (EFNEP) to assess the fidelity with which dietary data are collected. METHODS An electronic survey sent nationally to all 75 EFNEP coordinators to assess methodology for collection, staff training, and coding of 24HR. RESULTS A total of 67 surveys were returned, 53 of which were usable: 57% of programs used multiple collection periods (previous day vs previous 24 hours), 36% did not use a consistent number of passes in recall collection; only 17% exclusively used the validated 5-pass method; 88% trained paraprofessionals for ≤8 hours on recall collection and >6 different training programs were used; and 86% of programs used multiple coders. CONCLUSIONS AND IMPLICATIONS The wide variation in reported collection, training, and coding practices raises concerns about the validity of the recall data and the appropriateness of combining data from multiple programs. To improve consistency, EFNEP could establish standardized methods for training, data collection, and data entry for the 24HR. These results may encourage the national program office to establish programmatic change that will support the fidelity of collection methods across all programs.
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Affiliation(s)
- Susan M H Gills
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Susan S Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
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Auld G, Baker S, Infante N, Inglis-Widrick R, Procter SB, Steger MF, Yerxa K. EFNEP's Impact on Exemplary Educators' Quality of Life. J Nutr Educ Behav 2016; 48:647-654.e1. [PMID: 27527907 DOI: 10.1016/j.jneb.2016.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 07/01/2016] [Accepted: 07/10/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To determine how the Expanded Food and Nutrition Education Program (EFNEP) affects the quality of life (QoL) of its exemplary paraprofessional educators. METHODS Qualitative telephone interviews with EFNEP supervisors (15), educators (28), and agency partners (15). Template analysis based on the University of Toronto's QoL constructs. RESULTS The EFNEP had a positive impact on 6 of 9 a priori categories: physical being, psychological being, social belonging, community belonging, practical becoming, and growth becoming. CONCLUSIONS AND IMPLICATIONS The EFNEP enhances the QoL of its exemplary educators, which suggests that the program's benefits go beyond those documented in participants.
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Affiliation(s)
- Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Susan Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | | | - Ruth Inglis-Widrick
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Sandra B Procter
- Department of Human Nutrition, Kansas State University, Manhattan, KS
| | - Michael F Steger
- Department of Psychology, Colorado State University, Fort Collins, CO; Department of Psychology, North-West University, Vanderbijlpark, South Africa
| | - Kate Yerxa
- University of Maine Cooperative Extension, Orono, ME
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Murray EK, Auld G, Inglis-Widrick R, Baker S. Nutrition Content in a National Nutrition Education Program for Low-Income Adults: Content Analysis and Comparison With the 2010 Dietary Guidelines for Americans. J Nutr Educ Behav 2015; 47:566-573.e1. [PMID: 26566098 DOI: 10.1016/j.jneb.2015.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 08/28/2015] [Accepted: 09/02/2015] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to identify nutrition-related content employed nationally by the Expanded Food and Nutrition Education Program (EFNEP) with adult participants. A content analysis was used to assess the type, frequency, and depth of nutrition content in adult curricula most used by EFNEP nationally compared with the 2010 Dietary Guidelines for Americans (2010 DGA). All EFNEP curricula reviewed employed the vast majority of the 2010 DGA nutrition recommendations, with differences in the frequency and depth of nutrition content. Further research is needed to determine which 2010 DGA recommendations are most important to teach and evaluate within a low-income population.
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Affiliation(s)
- Erin K Murray
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Ruth Inglis-Widrick
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Susan Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
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Weatherspoon DD, Miller SR, Steele ME, Newkirk CJ, Santiago O, Dembele AS, Hoerr SL. What Social, Program, and Behavioral Factors Influence the Healthy Eating Index for EFNEP and SNAP-Ed Adult Participants? Am J Lifestyle Med 2015; 11:344-353. [PMID: 30202353 DOI: 10.1177/1559827615607194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 08/25/2015] [Accepted: 08/31/2015] [Indexed: 12/29/2022] Open
Abstract
The main objectives of this article were to determine the demographic factors, the program related factors and the behavioral factors that influence Michigan Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education outcomes. Secondarily, we sought to understand the trends and changes in Healthy Eating Index (HEI) scores across the differing baseline score groups. The data were collected by nutrition instructors in a pretest, posttest design to capture change in healthy eating habits through changes in HEI scores. The participants were all low-income program participants during the years of 2011 and 2012, living in Michigan. Findings show that eating habits improved most in households with weekly per-person income within $100 to $500, and with Caucasian females living in cities or suburbs. Improvements were also greater with those who took part in the Expanded Food and Nutrition Education Program, where the participants exhibited higher baseline frequency of planning meals before grocery shopping, comparing prices, and budgeting enough money for food and food related purchases. Overall, the average change in HEI scores increased by 2.3 points, however, the variability between the participants' changes was high, suggesting that more targeted program lessons might increase program efficacy, especially for those participants with high baseline HEI scores.
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Affiliation(s)
- Dave D Weatherspoon
- Agricultural, Food & Resource Economics (DDW, SRM, MES, ASD).,Extension Health & Nutrition (CJN, OS).,Food Science & Human Nutrition (SMH), Michigan State University, East Lansing, Michigan
| | - Steven R Miller
- Agricultural, Food & Resource Economics (DDW, SRM, MES, ASD).,Extension Health & Nutrition (CJN, OS).,Food Science & Human Nutrition (SMH), Michigan State University, East Lansing, Michigan
| | - Marie E Steele
- Agricultural, Food & Resource Economics (DDW, SRM, MES, ASD).,Extension Health & Nutrition (CJN, OS).,Food Science & Human Nutrition (SMH), Michigan State University, East Lansing, Michigan
| | - Cathy J Newkirk
- Agricultural, Food & Resource Economics (DDW, SRM, MES, ASD).,Extension Health & Nutrition (CJN, OS).,Food Science & Human Nutrition (SMH), Michigan State University, East Lansing, Michigan
| | - Olga Santiago
- Agricultural, Food & Resource Economics (DDW, SRM, MES, ASD).,Extension Health & Nutrition (CJN, OS).,Food Science & Human Nutrition (SMH), Michigan State University, East Lansing, Michigan
| | - Assa S Dembele
- Agricultural, Food & Resource Economics (DDW, SRM, MES, ASD).,Extension Health & Nutrition (CJN, OS).,Food Science & Human Nutrition (SMH), Michigan State University, East Lansing, Michigan
| | - Sharon L Hoerr
- Agricultural, Food & Resource Economics (DDW, SRM, MES, ASD).,Extension Health & Nutrition (CJN, OS).,Food Science & Human Nutrition (SMH), Michigan State University, East Lansing, Michigan
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Auld G, Baker S, Conway L, Dollahite J, Lambea MC, McGirr K. Outcome effectiveness of the widely adopted EFNEP curriculum Eating Smart-Being Active. J Nutr Educ Behav 2015; 47:19-27. [PMID: 25267324 DOI: 10.1016/j.jneb.2014.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 06/23/2014] [Accepted: 07/22/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To determine the effectiveness of the Expanded Food and Nutrition Education Program (EFNEP) curriculum Eating Smart-Being Active (ESBA). DESIGN AND SETTING A quantitative, multi-state, nonequivalent comparison group pretest-posttest design was used to compare nutrition-related behavior changes in participants. ESBA was compared to previously used curricula for 3 different time periods in 5 states using the EFNEP evaluation tool. PARTICIPANTS Adults enrolled in EFNEP who completed their entry and exit paperwork during any of the 3 time points. INTERVENTION An 8-lesson adult curriculum based on the Dietary Guidelines for Americans and MyPlate. ANALYSIS Analysis of variance and covariance (with pretests scores and demographic variables as covariates) were used to analyze data with significance at P ≤ .05. RESULTS ESBA elicited a mean positive behavior change for food resource management (P < .01), food safety (P ≤ .001), nutrition (P < .001), and physical activity level in participating states (P ≤ .01). Compared with previous curricula, ESBA produced better mean outcomes in food resource management, nutrition, physical activity, and intakes of fruit and vegetables. CONCLUSION AND IMPLICATIONS ESBA is effective at eliciting positive nutrition-related behavior change. The results of this multi-state, practice-based approach suggest that ESBA is effective in multiple settings and has external validity for use in EFNEP and other community nutrition programs.
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Affiliation(s)
- Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Susan Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Lisa Conway
- Lake Taylor Transitional Care Hospital, Norfolk, VA
| | - Jamie Dollahite
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Maria Carmen Lambea
- Department of Family and Consumer Sciences, The Ohio State University, Columbus, OH
| | - Kathryn McGirr
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
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Buscemi J, Odoms-Young A, Stolley ML, Blumstein L, Schiffer L, Berbaum ML, McCaffrey J, Montoya AM, Braunschweig C, Fitzgibbon ML. Adaptation and dissemination of an evidence-based obesity prevention intervention: design of a comparative effectiveness trial. Contemp Clin Trials 2014; 38:355-60. [PMID: 24952282 PMCID: PMC4115581 DOI: 10.1016/j.cct.2014.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 06/06/2014] [Accepted: 06/10/2014] [Indexed: 10/25/2022]
Abstract
Low-income youth are at increased risk for excess weight gain. Although evidence-based prevention programs exist, successful adaptation to provide wide dissemination presents a challenge. Hip-Hop to Health (HH) is a school-based obesity prevention intervention that targets primarily preschool children of low-income families. In a large randomized controlled trial, HH was found to be efficacious for prevention of excessive weight gain. The Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) are USDA-funded nutrition education programs offered to low-income families, and may provide an ideal platform for the wide dissemination of evidence-based obesity prevention programs. A research-practice partnership was established in order to conduct formative research to guide the adaptation and implementation of HH through EFNEP and SNAP-Ed. We present the design and method of a comparative effectiveness trial that will determine the efficacy of HH when delivered by peer educators through these programs compared to the standard EFNEP and SNAP-Ed nutrition education (NE) curriculum. Results from this trial will inform larger scale dissemination. The dissemination of HH through government programs has the potential to increase the reach of efficacious obesity prevention programs that target low-income children and families.
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Affiliation(s)
- Joanna Buscemi
- University of Illinois at Chicago, Institute for Health Research and Policy, 1747 West Roosevelt Road, Chicago, IL 60608, United States.
| | - Angela Odoms-Young
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 1919 West Taylor Street, Chicago, IL 60612, United States
| | - Melinda L Stolley
- University of Illinois at Chicago, Institute for Health Research and Policy, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Lara Blumstein
- University of Illinois at Chicago, Institute for Health Research and Policy, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Linda Schiffer
- University of Illinois at Chicago, Department of Medicine, Division of Health Promotion Research, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Michael L Berbaum
- University of Illinois at Chicago, Institute for Health Research and Policy, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Jennifer McCaffrey
- University of Illinois at Urbana-Champaign, Family and Consumer Sciences, University of Illinois Cooperative Extension Service, 905 S. Goodwin Avenue, Urbana, IL 61801, United States
| | - Anastasia McGee Montoya
- University of Illinois at Chicago, Chicago Partnership for Health Promotion, Office of Community Engagement and Neighborhood Health Partnerships, 828S. Wolcott, Suite B40, Chicago, IL 60612, United States
| | - Carol Braunschweig
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 1919 West Taylor Street, Chicago, IL 60612, United States
| | - Marian L Fitzgibbon
- University of Illinois at Chicago, Institute for Health Research and Policy, 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois at Chicago, Department of Medicine, Division of Health Promotion Research, 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois at Chicago, Institute for Health Research and Policy, Health Promotion Research Program, 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois Cancer Center, Population Health, Behavior and Outcomes Program, 1747 West Roosevelt Road, Chicago, IL 60608, United States
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Townsend MS, Ganthavorn C, Neelon M, Donohue S, Johns MC. Improving the quality of data from EFNEP participants with low literacy skills: a participant-driven model. J Nutr Educ Behav 2014; 46:309-314. [PMID: 24268971 DOI: 10.1016/j.jneb.2013.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 09/23/2013] [Accepted: 10/09/2013] [Indexed: 06/02/2023]
Abstract
Low literacy skills and poor evaluation tool readability combined with the stresses of the classroom environment create a high cognitive load for Expanded Food and Nutrition Education Program (EFNEP) participants, resulting in lower quality data. The authors advocate for 9 strategies for improving the participant cognitive load for the evaluation process using the EFNEP Family Record as an example.
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Affiliation(s)
| | | | - Marisa Neelon
- University of California Cooperative Extension, Pleasant Hill, CA
| | - Susan Donohue
- University of California Cooperative Extension, Oroville, CA
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Leak TM, Benavente L, Goodell LS, Lassiter A, Jones L, Bowen S. EFNEP graduates' perspectives on social media to supplement nutrition education: focus group findings from active users. J Nutr Educ Behav 2014; 46:203-208. [PMID: 24613446 DOI: 10.1016/j.jneb.2014.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Revised: 01/25/2014] [Accepted: 01/26/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To identify ways to effectively use social media to communicate nutrition-related information to low-income populations. METHODS The authors conducted 4 focus groups with female Expanded Food and Nutrition Education Program graduates who used social media at least twice a week (n = 26 total). Transcripts were analyzed using the constant comparative method to identify key themes. RESULTS For participants, page content, page maintenance, and networking opportunities with others were important aspects of a nutrition education social media page. Trust emerged as a central theme, because participants expressed a need for reliable information from known, credible sources and safe places to share ideas. CONCLUSIONS AND IMPLICATIONS Using social media to provide nutrition-related messages may be an effective way to encourage sustained positive behavior changes resulting from educational programming and to engage participants beyond class time. Establishing the trustworthiness of the social media site is essential to its use among low-income participants.
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Affiliation(s)
- Tashara M Leak
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Saint Paul, MN; Department of 4-H Youth Development and Family and Consumer Sciences, North Carolina State University, Raleigh, NC.
| | - Lisa Benavente
- Department of 4-H Youth Development and Family and Consumer Sciences, North Carolina State University, Raleigh, NC
| | - L Suzanne Goodell
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, NC
| | - Annie Lassiter
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, NC
| | - Lorelei Jones
- Department of 4-H Youth Development and Family and Consumer Sciences, North Carolina State University, Raleigh, NC
| | - Sarah Bowen
- Department of Sociology and Anthropology, North Carolina State University, Raleigh, NC
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Dollahite JS, Pijai EI, Scott-Pierce M, Parker C, Trochim W. A randomized controlled trial of a community-based nutrition education program for low-income parents. J Nutr Educ Behav 2014; 46:102-109. [PMID: 24268300 DOI: 10.1016/j.jneb.2013.09.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 09/11/2013] [Accepted: 09/18/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Assess effectiveness of the Expanded Food and Nutrition Education Program on nutrition behaviors post-education and longitudinally. DESIGN Switching replications randomized experimental design. Participants randomly assigned to immediate education (IE) or delayed education (DE). Participants in IE received intervention the first 8 weeks, and those in DE the second 8 weeks, with no intervention during alternate periods. Data were collected in 3 repeated measures. PARTICIPANTS Parents (n = 168 randomized; n = 134 completed) of children in 2 Head Start and 6 low-income schools. INTERVENTION Eight weekly workshops, based on Eating Right is Basic-Enhanced adapted to incorporate dialogue approach with experiential learning. MAIN OUTCOME MEASURES Ten-item self-reported behavior checklist on nutrition, food resource management, food safety, and food security; responses on a 5-point scale reporting frequency of behavior. ANALYSIS Chi-square, analysis of variance, and multiple regression. RESULTS Groups were demographically similar. Both groups reported improved behaviors pre- to post-education (P < .05). There was no significant difference between groups at Time 1 (T1) or DE control period (T1 vs T2). Changed IE behavior was retained T2 to T3. A multiple regression model of overall change, controlling for T1 score and educator, showed significant improvement (n = 134, β = 5.72, P < .001). CONCLUSIONS AND IMPLICATIONS Positive outcomes were supported by this experimental study in a usual program context, with reported behavior changes retained at least 2 months.
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Affiliation(s)
| | - Erika I Pijai
- Child Nutrition Division, USDA Food and Nutrition Service, Alexandria, VA
| | | | - Carol Parker
- Cornell Cooperative Extension, Cornell University, Ithaca, NY
| | - William Trochim
- Department of Policy, Analysis, and Management, Cornell University, Ithaca, NY
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