Journal of Nutrition Education and Behavior最新文献

Objective: Family Child Care homes (FCCH) are home-based child care settings that often care for children in their households, operating with limited resources, and are a common choice for children from low-income families. The purpose of this study was to examine changes in FCCH provider feeding practices after a virtual intervention.

Design: Randomized controlled clinical trial.

Setting: Rural Oklahoma FCCHs.

Participants: Thirty-six (intervention = 15; control = 21) FCCH providers participated at baseline.

Intervention: A virtual 20-minute module on implementing responsive feeding practices delivered by Extension educators.

Main outcome measures: Feeding practice scores at baseline, 3, and 12 months.

Analysis: The Kruskal-Wallis and paired t tests were used to detect between-group and within-group differences, respectively.

Results: Meal service style significantly improved over time (P = 0.05), intervention providers' meal service style (2.1 points; P = 0.05), role modeling (4.0 points; P = 0.007), and mealtime quality (11.3 points; P = 0.04) improved from baseline to 12 months. Intervention providers scored significantly lower than the control group for self-regulation at 12 months (9.6 ± 0.8 vs 8.5 ± 1.4; P = 0.02).

Conclusions and implications: Although the meal service style score improved over time, the scores remained low, indicating a need to improve implementation. Although self-regulation use decreased in the intervention group, it is an ambiguous and complex construct needing further exploration. Future studies must examine the implementation effectiveness of feeding practices and explore newer mealtime constructs such as sensory exploration of foods, peer modeling, and nonverbal cues to support rural FCCH providers' ability to implement optimal practices.

Objective: To assess associations between mothers' and fathers' food skills and children's diet quality.

Methods: Linear regression models using generalized estimating equations were used to assess the association between mothers' (n = 154) and fathers' (n = 100) self-reported conceptualizing and mechanical food skills with children's diet quality (n = 201) assessed using the Healthy Eating Index (HEI)-2015.

Results: Fathers' food skills were not associated with children's HEI-2015. Mothers' scores were significantly higher than fathers on conceptualizing (P < 0.001) but lower on mechanical food skills (P = 0.02). Mothers' conceptualizing food skills were associated with greater child HEI (B̂ = 1.04, 95% confidence interval = 0.016-1.93, P = 0.02).

Conclusions and implications: While results showed that mothers' food skills are a key determinant of children's diet quality, more studies are needed to explore how both parents' food skills as well as other factors interact to influence children's diets. Future family interventions targeting food skills may be more effective in emphasizing conceptualizing food skills.

Objective: This study sought to examine the efficacy of the Fresh Start Food is Medicine (FIM) + Food Literacy intervention on food literacy and racial/ethnic variances among rural, uninsured patients with type 2 diabetes (n = 150).

Methods: A single-group prepost intervention including 9 theory-grounded group classes focusing on food literacy. Prepost total and individual food literacy construct scores were examined using a validated tool. Descriptive statistics and repeated measures analysis of variance were conducted, with statistical significance set at P < 0.05.

Results: Total food literacy scores improved (P = 0.006). Hispanic patients had lower total food literacy (P < 0.001), meal planning/prepping (P = 0.005), shopping (P = 0.008), and budgeting (P = 0.003) scores compared with White patients.

Conclusions and implications: Findings suggest disparities in food literacy may persist among racial/ethnic minorities, even after participating in food literacy education. Developing and evaluating culturally tailored food literacy educational approaches for racial/ethnic minorities may be warranted.

Objective: This study examines the associations between family stress and sugar (total, free and added) intake among preschool-aged children.

Methods: Data were collected from 210 families, 267 children (138 girls, 129 boys); mean age of 3.6 ± 1.2 years enrolled in the Guelph Family Health Study. Family stress was assessed using measures of household chaos and family dysfunction. Sugar intake was measured using an Automated Self-Administered 24-hour Dietary Assessment Tool. Linear regression models with generalized estimating equations were used to estimate associations between family stress and energy-adjusted sugar intakes (g/1,000 kcal).

Results: There was an inverse association between family dysfunction and girls' intakes of total (β = -3.8, P = 0.03), free (β = -8.6, P = 0.005), and added (β = -7.6, P = 0.005) sugars, when controlling for age, ethnicity, and household income. No significant associations in boys were noted.

Conclusions and implications: Results suggest that the association between family stress and sugar intake may differ by child sex.

Objective: This cross-sectional study explored factors associated with school lunch participation with universal free meals.

Methods: Fifty-nine foodservice authorities representing 103 Minnesota secondary schools provided survey data assessing lunch participation and school factors, including location, school enrollment, school type, free/reduced eligibility, open campus policies, eating time, lunch start times, foodservice production type, and Smarter Lunchrooms techniques. Generalized estimating equation regression assessed the relation between these factors and lunch participation.

Results: Mean lunch participation rates were 53% for high schools, 63% for middle schools, and 65% for Jr/Sr high schools. Compared with conventional foodservice production systems, nonconventional systems were associated with a 16 percentage point lower participation (P < 0.01). No other factors were statistically associated with lunch participation.

Conclusions and implications: Foodservice production systems may be a key overlooked factor related to meal participation. Larger-scale research is needed to clarify the impact foodservice production systems have on meal participation.

Objective: To examine community food and nutrition assistance providers' perceptions of Latino adults with limited income and limited English proficiency (LEP), and the services provided to them.

Design: In-depth semistructured interviews.

Setting: US (2022).

Participants: Community food and nutrition assistance providers (n = 20) ANALYSIS: Verbatim transcripts were analyzed using thematic content analysis, fitted into a theory on language use, social positioning, and Latino adults' health. Member checking verified the findings.

Results: Subordinate social positions of Latino adults with LEP when procuring community food and nutrition assistance stemmed from perceived authority (community food and nutrition assistance providers' social power), loss of Latino participants' adequation (social isolation), and their diminished authentication (barriers to validate information).

Conclusions and implications: Subordinate social positioning in community food and nutrition assistance procurement among Latino adults with LEP may persist because of structures favoring those English proficient. Evaluating approaches that intentionally design community food and nutrition assistance for this population is needed to inform their influence on these structures.

Objective: To examine students' perceptions of school lunches, their association with self-reported participation, and variations based on free or reduced-price meal (FRPM) eligibility, race, and ethnicity.

Design: Cross-sectional study with data from an online survey administered in 2023.

Participants: A total of 1,230 middle and high school students from 8 US states.

Main outcome measures: Perceptions of school lunches and self-reported participation.

Analysis: Multilevel mixed-effects Poisson and logistic regression models.

Results: Around half of students liked school lunches (49%), and less than half had positive perceptions about their quantity (42%), variety (49%), healthfulness (41%), and familiarity (20%); however, positive perceptions were associated with higher self-reported participation. Black and White students reported higher participation and more favorable perceptions of school lunches than peers from other racial/ethnic backgrounds. Students eligible for FRPM and those near eligible had higher participation, but students eligible for FRPM had less favorable lunch perceptions compared with those not eligible for FRPM. Black students and those from lower-income households more often reported that school lunches are healthier than foods they bring from home, compared with students from other backgrounds and households with higher income.

Conclusions and implications: Enhancing the quality, variety, healthfulness, and familiarity of school meals may increase participation and, over time, promote students' health and development.

Objective: We developed a culturally-grounded intervention to promote healthy beverage consumption among Navajo children aged 2-5 years. This study, which took place from 2021-2023, evaluated prepost changes in beverage habits and caregiver knowledge and attitudes.

Methods: Prospective cohort study with prepost evaluation. Children attending participating early child education sites and their primary caregivers were enrolled. Survey data were collected at baseline, during the school year, and immediately after completion of the 4-month intervention.

Results: Average daily water intake increased significantly from 17.0 to 22.3 fl oz, P = 0.003. There was no significant change in consumption of other specific beverages, nor in the consumption of all sugar-sweetened beverages combined (P = 0.94). The proportion of caregivers who agreed or strongly agreed that they were knowledgeable about Diné traditions about water increased from 59.3% to 87.0% (P = 0.001). Similarly, those who agreed that Diné traditions about water influenced what drink they offered their children increased from 46.3% to 81.5% (P < 0.001).

Conclusions and implications: Our pilot study suggests that a culturally-grounded water promotion program for Navajo families may have a positive impact on strengthening cultural connections among caregivers and increasing water intake among children aged 2-5 years. Further research is needed to evaluate effectiveness.

Objective: To examine the relationship between meal plan subscription and fruit and vegetable (F&V) intake among first- and second-year college students.

Methods: A prospective cohort study (0-6 months) assessed F&V intake using a Veggie Meter and explored perceptions of F&V intake through focus group discussions (FGDs). Participants (n = 93, follow-up n = 58) were students at a public university. Paired Wilcoxon signed-rank tests and Mann-Whitney U tests were used for quantitative analysis and thematic analysis for FGD transcripts.

Results: Veggie Meter scores showed no significant changes within or between groups from baseline to 6 months. FGDs revealed similar influencing factors among students with and without meal plans, including sensory appeal, F&V knowledge, cost, and limited appealing F&V options.

Conclusions and implications: Meal plan subscription was not associated with higher Veggie Meter scores. Enhancing meal plan structures to improve the access, appeal, and affordability of F&V may support healthier dietary behaviors among college students.