Journal of Nutrition Education and Behavior最新文献

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.

Objective: To explore adolescents' perceptions of disordered eating behaviors, influencing factors, and perceived effects on health and well-being.

Design: Focus group discussions.

Setting: Porto, Portugal.

Participants: 80 adolescents aged 15-19 years.

Phenomenon of interest: Disordered eating behaviors.

Analysis: Thematic content analysis.

Results: Factors influencing disordered eating behaviors include individual (including response to emotional status, body image, and self-perception), interpersonal (encompassing interactions with school peers and family, and health professionals), and social factors (namely social norms regarding beauty and their influences, such as social media). In terms of the impact of disordered eating, health implications such as malnutrition, obesity, and some cardiometabolic disorders were mentioned. Disordered eating behaviors, according to the adolescents' perspective, can also lead to guilt and depression and serve as a pathway to eating disorders. In addition, concerns about weight and body image were identified as contributing to social isolation.

Conclusions and implications: Findings highlight the complex interplay of factors shaping disordered eating behaviors in adolescents. Comparison with others, body image concerns, beauty standards, and social media emerged as key influencing factors, along with appearance-related comments. Future research could assess longitudinal social media effects, media literacy interventions, and explore gender-specific experiences across clinical and nonclinical settings.

The digital transformation of the retail food environment is reshaping public health, producing both positive and negative impacts on how US consumers access food. This Research Report synthesizes these changes and explains why public health nutrition must modernize definitions and measures of food access, highlighting priority directions for new measurement approaches. Finally, we discuss future research and practice needs and directions, and describe how innovative nutrition education and behavior strategies, appropriate measurement, and policy, systems, and environmental (PSE) approaches can align public health and health equity efforts with the ongoing digital transformation of the food environment.

Objective: To evaluate the validity of 2 brief screeners designed to assess overall diet quality: the Med-South Dietary Risk Assessment for medium-contact dietary counseling and the Med-South Starting the Conversation tool for brief dietary counseling by primary care clinicians.

Design: Cross-sectional study comparing scores from brief dietary screeners to diet quality indexes derived from the Harvard Food Frequency Questionnaire.

Setting: Participants were enrolled from 7 practices located in North Carolina.

Participants: Patients (n = 346) referred to a weight loss study by primary care clinicians.

Main outcome measures: Correlations between screener scores and the Alternate Healthy Eating Index-2010, Dietary Approaches to Stop Hypertension, and alternate Mediterranean Diet scores.

Analysis: Pearson correlation coefficients for crude correlations and partial correlation coefficients for adjusted correlations.

Results: The mean ± SD age was 54.6 ± 12.1 years, and the median (interquartile range) body mass index was 35.1 (32.4-40.0) kg/m². Crude and adjusted correlations between the brief screeners and the diet quality indexes ranged from 0.53-0.61.

Conclusions and implications: Observed validation correlations were similar to those for other previously validated brief screeners. Because referent measures were diet quality scores associated with favorable health outcomes, these screeners are preferred over previously validated screeners, which focus on limited components (e.g,. fat intake) of dietary intake.

Objective: To explore attitudes and preferences related to remote nutrition education programming for Latino families in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and primary care.

Design: Community-engaged, qualitative, thematic analysis of interviews and focus groups.

Setting: Prenatal and pediatric primary care and WIC sites in Manhattan, Queens, and Nassau Counties, New York.

Participants: Four stakeholder groups: (1) past participants of a primary care-based obesity prevention program (Starting Early Program Prenatal) for Latino families that transitioned to remote delivery because of coronavirus disease 2019 (n = 40), (2) Latina WIC participants, including pregnant women and mothers of young children (n = 40), (3) Starting Early Program Prenatal staff (n = 6), and (4) WIC staff (n = 16).

Phenomenon of interest: Attitudes and preferences related to in-person vs remote nutrition education programming.

Analysis: Focus groups and interviews were audio-recorded, transcribed, and analyzed for emergent themes using reflexive thematic analysis.

Results: Four themes emerged: (1) valuing in-person social connection while recognizing barriers to in-person gathering, (2) navigating distraction-related barriers to remote engagement, (3) consistent content delivery but uncertain quality of remote programs, and (4) coronavirus disease 2019 pandemic-related contextual factors.

Conclusions and implications: Future remote programs in WIC may benefit from incorporating opportunities for social interaction, explicit discussion of anticipated barriers, and strategies to overcome them.

Objective: Assess exposure to advertising for food, beverages, and alcohol on Spanish-language television in the US.

Methods: Exposure was estimated using cross-sectional ratings data for 2022 from The Nielsen Company. Food and beverage products were coded for recommended nutrients to limit (saturated fat, trans fat, added sugars, and sodium) according to Interagency Working Group guidelines for advertising to children.

Results: Hispanic audiences aged 2-5, 6-11, 12-17, and ≥ 18 years saw 488, 334, 345, and 1,152 food-related advertisements per year, respectively, on Spanish-language television. Almost three-quarters (72%) of food and beverage advertisements seen by children aged 2-5 and 6-11 years were high in nutrients to limit. Hispanic audiences aged 2-17 years saw 62-83 alcohol advertisements per year, whereas those aged ≥ 18 years saw 194.

Conclusions and implications: This study finds substantial food-related and alcohol advertising exposure on Spanish-language television, including among children and adolescents, suggesting a potential role for government policies.

Objective: The objective of this study was to understand the drivers of food choice among adolescents, to examine their views related to sustainability, and to compare these across 3 school districts with different geographical and sociodemographic profiles in New Jersey.

Design: Semistructured interviews, including free-listing activities SETTING: Three different schools (an urban school serving students from households with middle income, an urban school serving students from households with low income, and a rural school serving students from households with middle income) in New Jersey.

Participants: A total of 41 fifth-grade students (aged 10-12 years) were recruited via classroom announcements (15 participants from an urban school serving students from households with middle income, 15 participants from an urban school serving students from households with low income, and 11 participants from a rural school serving students from households with middle income).

Phenomenon of interest: Key factors influencing adolescents' food choices relating to plant-based foods and knowledge and attitudes toward sustainability.

Analysis: Thematic analysis identified key themes related to drivers of food choice and perceptions of sustainability. Free-listing data were analyzed using Smith's Saliency Index to determine the most salient factors.

Results: Taste, texture, interpersonal relationships, and physical effects (e.g., digestion) were primary factors influencing adolescents' food choices. Participants generally lacked awareness of food-related environmental impacts but identified behaviors such as reducing littering as contributing to sustainability.

Conclusions and implications: Emphasizing taste, texture, and positive physical effects of plant-based foods could enhance adolescents' willingness to shift their food choices. Linking environmental impacts of food choices to behaviors may strengthen engagement with sustainability concepts and increase the likelihood of behavior change.

Objective: To identify Food Action Groups' activities that positively impact local food systems, and anticipated barriers to establishing Food Action Groups in rural, regional, and remote Western Australia.

Design: This qualitative study employed a phenomenological approach. Nineteen focus groups were conducted.

Setting: Rural, regional, and remote Western Australia locations, including 11 towns across 8 regions.

Participants: A total of 92 participants (61 interest holders and 31 community members).

Analysis: A thematic analysis was undertaken.

Results: Priority activities included government advocacy to support local commercial food production, processing, and sales; retain food within its region of origin; and home and community food growing. Another desirable activity was the delivery of nutrition education and cooking programs to enhance community food knowledge and skills. Participants perceived finding the right personnel to drive action would be the leading barrier to Food Action Group success.

Conclusions and implications: Our findings support prioritizing activities that align with locally identified needs, such as government advocacy and planning for barriers to maximize the impact of Food Action Groups. Future research could include comprehensive outcome/impact evaluation or implementation science approaches to determine effectiveness, critical success factors, and guide scale-up across rural, regional, and remote areas, followed by comparative studies of impact by location type.

As innovation in technology grows, systematic and innovative approaches to the development of digital health interventions are needed. This Perspective introduces the user-centered design for digital health interventions (u-CREATE) framework as a systematic approach for nutrition educators to apply user-centered design principles to digital health intervention development. In 4 development stages, the u-CREATE framework delegates "target actions," digital considerations, and how to iteratively apply the 4 user-centered design principles for both "end users"-the target audience and development team. Using u-CREATE to develop digital interventions across various settings, behaviors, and users holds promise for improving intervention implementation, engagement, and effectiveness.