Journal of Nutrition Education and Behavior最新文献

Objective: Identify themes essential to implementing policy, system, and environmental (PSE) interventions within kindergarten to 12th-grade (K-12) settings and provide associated indicators of readiness and capacity to support healthy eating PSE work among Supplemental Nutrition Assistance Program-Education (SNAP-Ed) practitioners in Ohio.

Design: Interview data were collected in Ohio from December, 2020 to May, 2021.

Participants: Ohio SNAP-Ed practitioners (n = 12), community residents with low income (n = 26), and K-12 experts statewide (n = 10) and nationally (n = 3).

Phenomenon of interest: Healthy eating PSE implementation.

Analysis: We conducted a qualitative analysis to identify themes and indicators related to implementing healthy eating PSEs in schools. During virtual consensus conferences (December, 2021-April, 2022), themes and indicators were sorted and ranked by perceived importance to PSE implementation.

Results: Four themes and 14 indicators were identified. Expert-derived weights quantified the themes' importance to PSE implementation efforts in K-12. Themes included: (1) school system support and capacity (weight 0.372), (2) school food environment (0.278), (3) SNAP-Ed practitioner capacity and resources (0.192), and (4) familial influence and awareness (0.158).

Conclusions and implications: Findings provide guidance for tailoring healthy eating PSEs in K-12 schools using local levels of readiness and capacity. Results highlight targeted areas of focus to support the implementation of healthy eating PSE interventions in K-12 schools through SNAP-Ed programming in diverse contexts. Future research is needed on the applicability of these findings based on feedback from school district staff and community members with children in different school settings.

Objective: To describe current food insecurity (FI)-related training among nutrition/dietetics, public health, and social work students.

Methods: A cross-sectional online survey was used among students (n = 306) enrolled in health-related programs at 12 US universities. Participants reported FI-related course-based and extracurricular experiences and rated confidence to address FI on a scale of 1-3. Open-ended questions investigated perceived definitions of FI and impactful course activities. Descriptive statistics and thematic analysis were used for data analysis.

Results: Participants' FI definitions were multifaceted. Most (80.6%) reported FI being covered in at least 1 course. The overall mean confidence to address FI was 2.2 ± 0.48. Participants suggested increasing application-based opportunities and skills training.

Conclusions and implications: Most students have a basic understanding of FI and report high confidence to address it in the future. Impactful FI-related experiences and participants' suggestions guide developing an FI training resource to enhance student FI competency and sensitivity.

Objective: To examine the factors that make such programs successful, this systematic review compared the outcomes of children's participation in cooking interventions based on intervention characteristics.

Design: Systematic review of randomized controlled trials of children's participation in cooking interventions published between 1998 and 2022 guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

Setting: All settings PARTICIPANTS: Children and parents.

Main outcome measures: Cooking skills, food acceptance and dietary behavior.

Analysis: Systematic search of 1,104 articles and review of 23 studies (42 articles) meeting inclusion criteria.

Results: Interventions varied in participant age, settings, cooking sessions, and program length. Knowledge of cooking skills, self-efficacy, and child cooking involvement were the most frequent positive outcomes; improvements in dietary intake were rarely achieved. Seven studies had a high rating for research quality.

Conclusion and implications for research and practice: Lack of standardized assessment, large variability in program characteristics, and insufficient intervention description made it difficult to discern best practices for children's cooking programs. Improvements in intervention development and measurement instruments are needed. Interventions that include hands-on cooking lessons seem promising in improving knowledge and self-efficacy; however, further exploration is required on the factors that make cooking programs successful in the long term.

Objective: To explore the feeding practices and feeding environment of Chinese families with 6-10-month-old infants.

Design: One day of caregiver-recorded feeding occasions.

Setting: Homes in Shaanxi, China.

Participants: Families recruited using convenience sampling.

Variables measured: Videos were coded for feeding practice frequency and acceptance rate, feeding environment, and responsiveness to infant fullness cues and eating pace.

Analysis: Wilcoxon rank sum tests examined the differences in feeding practice use based on caregiver type, infant sex, and infant weight status.

Results: Twenty-eight families provided videos for coding. The most commonly observed feeding practices were opening the mouth, giving instructions, and interfering with the child's actions. Prompts to eat were accepted 86.9% of the time. Overweight infants' caregivers used significantly more coercive prompts to eat than did caregivers of healthy-weight infants (P < 0.05). Mothers used more autonomy-supportive prompts to eat than did fathers (P < 0.05). Early, active, and late infant fullness cues were captured in 25.6%, 34.8%, and 8.5% of videos, respectively. 53.6% of caregivers fed at the right pace, whereas 14.5% and 31.9% fed too slow or too fast, respectively. Approximately 5.5% of videos had a screen on, and 33.5% of videos included at least 1 other distraction during the meal.

Conclusions and implications: Differences in feeding practices among caregivers suggest that targeted advice may further improve feeding practices. Improving the caregiver's ability to identify satiety cues and respond to infant eating speed may also reduce the risk of overfeeding.

Objective: To assess whether the adult Expanded Food and Nutrition Education Program (EFNEP) is a cost-effective intervention that generates sustained improvement in biomarkers of chronic disease risk.

Design: A longitudinal quasi-experimental design with 2 parallel arms (untreated comparison vs EFNEP) and 4 waves of data collection (pretest, posttest, 6 months, and 12 months after completion).

Setting: Eligible adult EFNEP community settings in Colorado, Florida, Maryland, and Washington.

Participants: Free-living adults (n = 500) aged 18-50 years, with income ≤ 185% of the Federal Poverty Line.

Intervention(s): Adult EFNEP delivered using an evidence-based curriculum, Eating Smart • Being Active.

Main outcome measure(s): Chronic disease biomarkers (body mass index, blood pressure, and HbA1c), food and physical activity behaviors, dietary intake, health status, and demographics will be measured using objective biometric indicators, the Adult EFNEP Questionnaire, a 24-hour dietary recall, a health questionnaire, and demographic forms.

Analysis: Linear mixed models will be used to assess whether adult EFNEP has a significant (P < 0.01) impact on 3 chronic disease biomarkers. The program's estimated impact on chronic disease biomarkers will be incorporated into a cost-benefit analysis framework to assess the economic value generated by adult EFNEP through chronic disease risk reduction.