Journal of Nutrition Education and Behavior最新文献

Background

The Comprehensive Feeding Practices Questionnaire (CFPQ) is a validated measure of 12 aspects of parent feeding that have been associated with child dietary intake and health outcomes.

Objective

To investigate latent profiles of CFPQ subscales (ie, patterns of individual responses) and test relationships with parental feeding styles (ie, authoritative, authoritarian, indulgent, uninvolved), child adherence to dietary guidelines, and the home food environment.

Study Design, Settings, Participants

Secondary analysis of data from 118 maternal-child dyads in North Carolina assessed at child ages 3 and 5 years.

Measurable Outcome/Analysis

Profiles of the 12 CFPQ subscales were examined using Latent Profile Analysis. Multinomial regression estimated associations of CFPQ latent profiles with feeding styles measured by the Caregiver Feeding Styles Questionnaire (CFSQ). Linear regression examined associations of profile membership with child Healthy Eating Index 2020 (HEI) overall and separately for adequacy (eg, fruit, vegetables, whole grains, HEI-adq) and moderation (eg, refined grains, sodium, HEI-mod) components. Associations of the Home Food Inventory obesogenic score (HFI-OB) and fruit/vegetable score (HFI-FV) with CFPQ latent profiles were estimated using ANOVA. Significance was set at p<0.05.

Results

Fit indices (BIC and ICL) supported a three-profile model: 1 high supportive and low controlling practices, 2 high controlling and high supportive practices, and 3 moderate controlling and low supportive practices. CFSQ feeding styles did not predict CFPQ latent profile membership. Total HEI, HEI-adq and HEI-mod were lower in profile 1 than profile 3 (Total HEI β=-5.85, p=0.05; HEI-adq β=-3.65, p=0.06; HEI-mod β=-2.19, p=0.11). HFI-OB was lower in profile 1 than profile 2 (mean difference= -4.85, 95%CI= -9.00 - 0.70) and profile 3 (mean difference= -4.68, 95%CI= -8.40 - -0.97). HFI-FV was higher for profile 1 than profile 3 (mean difference= 3.30, 95%CI= 0.10-6.49).

Conclusions

Profiles of parents who have high supportive and low controlling feeding practices were associated with improved diet quality and home food environment compared to parents who had high controlling and high supportive or moderate controlling and low supportive practices.

Funding

NIH

This paper describes the 30-year evolution of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) to provide evidence to support our perspective that SNAP-Ed has earned its position as a pillar of the public health infrastructure in the US. Legislatively designated as a nutrition education and obesity prevention program, its focus is the nearly 90 million Americans with limited income. This audience experiences ongoing health disparities and is disproportionately affected by public health crises. The SNAP-Ed program works to reduce nutrition-related health disparities at all levels of the Social-Ecological Model, follows a robust evaluation framework, and leverages strong partnerships between state-based practitioners, state agencies, and the US Department of Agriculture. The expansion of SNAP-Ed would enable the program to reach more Americans so that our nation can end hunger and reduce diet-related health disparities.

Background

The high prevalence of food insecurity in college students is a pressing issue. Increasing nutrition knowledge has potential to help improve factors related to food security. While a positive correlation between food literacy and food security status has been reported, little research has explored the impact of an existing college-level nutrition class.

Objective

To investigate how a college-level nutrition course impacts behaviors related to food-acquisition coping strategies.

Study Design, Settings, Participants

Students at the University of California, Davis were recruited from an introductory nutrition course taught both online and in-person (intervention) and other introductory courses (comparison). Students completed a pre-survey within the first two weeks of the quarter and a post-survey eight weeks later. Data were collected using a 65-item questionnaire that included several validated modules: the Money Expenditure Survey (MES), Coping Strategy Scale (CSS), Perceived Stress Scale, nutrition knowledge survey, and the USDA Adult Food Security Survey Module.

Measurable Outcome/Analysis

ANOVA with Tukey post-hoc corrections was used to assess differences across groups using STATA 13.0v. Significance was determined using p<0.05.

Results

Nutrition knowledge significantly increased within the in-person intervention group (n=282; 1.18 ± 5.24; p<0.01), and the online intervention group (n=373; 1.69 ± 5.12; p<0.01), while nutrition knowledge decreased in the comparison group (n=304; -1.41 ± 3.82 p<0.01). The CSS score significantly improved in the online intervention group (-2.62 ± 12.18; p<0.01), as compared to the other groups. In all groups, more students reported experiencing low or very low food security status from pre to post, with significant changes observed in the in-person intervention and comparison groups. Perceived stress also increased across all groups (p<0.05). There were no differences across groups in MES.

Conclusions

Although nutrition knowledge improved in the intervention groups and CSS improved in the online intervention group, food security status decreased and perceived stress increased. Further analyses will determine the importance of nutrition knowledge on MES and CSS and their relationship to temporal fluctuations in food security status.

Funding

None

Background

In recent years, there has been an increase in Produce Incentive Programs (PIPs) to motivate low-income families to purchase fresh produce. Research examining best practices for implementation of these program remains limited.

Objective

To examine barriers and motivators for implementing PIPs in grocery store settings.

Study Design, Settings, Participants

In depth, semi-structured interviews (via Zoom) were conducted with grocery store stakeholders involved in the Double Up Food Bucks New York (DUFBNY) PIP serving Supplemental Nutrition Assistance Program (SNAP) beneficiaries. Study participants included DUFBNY program staff who support DUFBNY grocery stores and their employees. Recruitment flyers were emailed to program staff and DUFBNY grocery stores. This study was conducted between February 2023 and September 2023.

Measurable Outcome/Analysis

Two research assistants independently coded interviews transcripts in Atlas.ti. using a mixed deductive (ie, interview questions guided some of the coding) and inductive (ie, open coding was used to allow codes to emerge from the data) approach. The outcomes assessed were program perceptions, barriers, and motivators.

Results

Participants (n=18, 5 program staff and 13 grocery store workers) underscored perceived barriers and motivators for implementation: 1) program differences (barrier), 2) staff burden (barrier), 3) community engagement (motivator) and 4) PIP recipients’ enthusiasm (motivator). In order for the program to run at different types of stores, there were several variations in the way the program was implemented. These differences often created confusion among stakeholders. The program created some burden for grocery store staff, as the transaction process was often cumbersome. Despite these challenges, both community engagement and participant enthusiasm were mentioned as a priority, and motivated interviewees’ continued support of the program.

Conclusions

Although grocery stores implementing PIPs can find these initiatives to be valuable, more research is needed into how PIPs can be implemented across multiple consumer food environments, and how to ease the burden off grocery store workers. Collaboration between different stakeholders is necessary for achieving program growth and sustainability.

Funding

USDA

Background

National health surveys in the US indicated a higher odds of chronic health conditions, through pathways of food insecurity, financial challenges, and poor disease management. Food assistance programs offer a unique opportunity to address the nutritional needs of participants in light of their health conditions. Characterizing the challenges and opportunities in USFB would be a first step to addressing the health needs of those food insecure.

Objective

The purpose of this systematic scoping review was to characterize the challenges in the USFB and to identify areas for further research and intervention.

Study Design, Settings, Participants

Systematic scoping review.

Measurable Outcome/Analysis

Adhering to the guidelines for systematic scoping review, the search results were reported per the PRISMA guidelines. Five electronic search engines, PubMed, ScienceDirect, Google Scholar, Embase, and Cochrane Library, were searched for articles on USFB or pantries, published between 2013-2023. Intervention studies were excluded.

Results

A total of 96 articles were selected. Themes under operational challenges encompassed supply-chain, partnerships, distribution, and adherence to equity principles. Resource accrual, allocation, and infrastructure that affect food safety and waste were other challenges. Beneficiaries particularly, the elderly, people with disabilities, and refugees, and their unmet needs were documented. During the pandemic the resilience of FBs was tested by lack of trained staff, increased exposure of staff to the virus, and disruptions in the supply-chain. Despite challenges, opportunities such as meeting the health needs of vulnerable demographics, increasing awareness through pantries, testing models for supply efficiency, and inviting donations were identified. Regardless of the opportunities to improve health through USFB, our synthesis revealed a higher representation of articles on operational challenges and limited literature (5 out of 96) on the nutritional needs to manage chronic conditions.

Conclusions

The scope of USFB has evolved, and so have the challenges. Given the established association between food insecurity and the surge of chronic diseases among the poor, our findings prioritize assessment of health needs and evidence-based interventions through the robust food security program.

Funding

Extension, Department of Nutrition and Experiment Station, University of Nevada, Reno

Background

Frozen foods can be inexpensive, easy-to-prepare options to help families meet nutritional recommendations. However, there is a dearth of data regarding the household sociodemographic variables associated with purchasing frozen foods.

Objective

Determine sociodemographic factors associated with buying frozen produce and meals using a nationally representative sample of U.S. households.

Study Design, Setting, Participants

Secondary analysis of the 2021 U.S. Bureau of Labor Statistics Consumer Expenditure Survey Public Use Microdata. This dataset includes detailed 2-week purchasing diaries from 6,028 randomly sampled American households.

Measurable Outcome/Analysis

Logistic regressions were performed on the compiled data using SAS 9.4 to determine relationships between select sociodemographic variables and frozen fruit, vegetable, and meal purchases.

Results

Compared to the highest income quintile, households in the lowest income quintile were about 60% less likely to purchase frozen fruits, vegetables, and meals. For each child in the household, the odds of purchasing frozen fruits and vegetables increased by 16 and 20%, respectively. Supplemental Nutrition Assistance Program participation was associated with a higher likelihood of purchasing frozen vegetables (OR 1.27; CI 1.00-1.61; p=0.05). Certain racial and ethnic groups were less likely, when compared to Non-Hispanic White households, to purchase frozen foods. Notably, Asian households were less likely to purchase frozen vegetables (OR 0.70; CI 0.53-0.93; p=0.01), and Hispanic households were less likely to purchase frozen vegetables (OR 0.78; CI 0.63-0.97; p=0.02) or meals (OR 0.69; CI 0.51-0.93; p=0.01).

Conclusions

Our findings suggest that educational programs that target low-income adults (eg, Supplemental Nutrition Assistance Program – Education and the Expanded Food and Nutrition Education Program) could be utilized to provide further education on including frozen produce and meals as nutritious, inexpensive, easy-to-prepare options. It may be warranted for these programs to provide culturally relevant education regarding frozen foods to certain ethnic audiences, particularly Asian and Hispanic populations. Further qualitative research could elicit cultural values and beliefs prohibiting Asian and Hispanic households from purchasing more frozen foods.

Funding

Frozen Food Foundation

Background

The school environment can enable and support healthy behaviours in children and the wider school community. To enhance this environment, it is important to understand what constitutes a school food environment, ie, how is it defined? and the characteristics of these. Currently there are varied approaches to defining school food environments in the literature.

Objective

To identify and summarise how school food environments are defined in the literature and the characteristics of these.

Study Design, Settings, Participants

A scoping review process, utilising a protocol developed a-priori and following the JBI methodology for scoping reviews, searched for all evidence that aims to define, describe, conceptualize and measure the school food environment in early childhood, primary and secondary school communities within a global context (quantitative, qualitative and mixed methods studies published in peer-review journals, and grey literature sources like government, organisation or research reports, theses and dissertations). A timeframe of 2001–2023 was used. Summary sheets, conference abstracts and opinion papers were excluded.

Measurable Outcome/Analysis

10,806 sources were initially identified. After checking for duplicates and undertaking title/abstract, and full text screening by at least two independent reviewers, 276 studies were included for data extraction using Covidence. Excel and NVivo were used for analysis. Data was categorised and presented by regional characteristics, with key themes summarised.

Results

Of 276 studies included, 76 defined the school food environment. The majority were from North America (n=27), while n=10 used a global focus. Sources included studies that focused on internal (within the defined school grounds/boundary), external (outside of the defined school grounds/boundary), or both spaces. Definitions varied with reference to policy, formal/informal food vendors/retail, food composition, labelling, education, marketing, and buildings/facilities included. Sociocultural, political, and economic surroundings were also identified.

Conclusions

Varied definitions of what constitutes a school food environment exist in the literature. These findings may assist researchers and professionals to consider a broad range of opportunities to further enhance supportive food and nutrition environments within schools.

Funding

None

Background

The Child and Adult Care Food Program (CACFP) provides tiered reimbursements (I/II) to family childcare homes (FCCH) to serve healthy foods to a large proportion of children from households with low-income. Due to COVID-19, federal waivers allowed all FCCH on CACFP to temporarily receive the higher Tier-I reimbursement rate from Jul. 1 2021-Jun. 30, 2023.

Objective

The study objective was to evaluate the impact of the increase in reimbursement on CACFP participation rates among FCCH in California.

Study Design, Settings, Participants

We conducted a secondary analysis of program data collected by the relevant state agency between Oct. 2018-Dec. 2023. The sample included all licensed FCCH in California (∼28,000).

Measurable Outcome/Analysis

We analyzed trends using Joinpoint regression (segmented regression) to detect monthly percent changes (MPC) and identify significant shifts in CACFP participation (p 90% of CACFP FCCH).

Results

Monthly percent changes (MPC) were detected and significant shifts in CACFP participation (p 90% of CACFP FCCH) identified. A different pattern was observed among Tier-II FCCH, which received a substantial increase in meal reimbursement during the waiver period. CACFP participation in this group increased from Oct. 2018-Sep. 2020 (MCP=0.12), followed by monthly decreases (MCP=-0.51), but only through May 2021, the month following the announcement of the waiver. No significant trend was detected from May 2021–Jun. 2022 (MCP=0.08). Newly analyzed results on trends from Jun. 2022-Dec. 2023 will also be presented.

Conclusions

Among Tier-II FCCH, the temporary increase in meal reimbursement appears to have stopped the decreasing CACFP participation rates that were likely due to the pandemic. This suggests that higher reimbursements could increase CACFP participation among this FCCH group, which currently serves more than 200,000 meals/month to young children in California.

Funding

Robert Wood Johnson Foundation UC San Francisco California Collaborative for Pandemic Recovery and Readiness Research (CPR³), funded by the California Department of Public Health (CDPH)

Background

Research suggests underestimation of body weight may be associated with beneficial psychological resilience against consequences of obesity, compared with accurate perception. Less is known about the comparison between those who underestimate versus those who overestimate their body weight.

Objective

To investigate differences in life satisfaction, social/emotional support, and weight change intentions between those who underestimate vs overestimate vs accurately perceive their body weight.

Study Design, Settings, Participants

Data were collected between 2008-2023 from the College Health and Nutrition Assessment Survey, a cross-sectional study of undergraduates, ages 18-24 years. After exclusions for missing data, the final sample (n=8203) was 93.9% white, 69.3% female, and had a mean age of 18.9±1.1.

Measurable Outcome/Analysis

Weight self-perception, weight change intent, life satisfaction, and social/emotional support, were measured via online survey. BMI (kg/m2) was calculated via height and weight measured by technicians, then compared with weight self-perception to determine self-perception accuracy. Chi-square analysis was used to evaluate differences between self-perception accuracy categories.

Results

About two-thirds (68.9%) perceived their weight category accurately, while one-third (31.1%) misperceived, with 19.5% underestimating and 11.6% overestimating. Women were more likely to overestimate (14.7% vs. 4.6%, p<.001), while men were more likely to underestimate their weight (37.5% vs. 11.6%, p<.001). Underestimaters were more likely to report weight maintenance intent or no weight change intent vs. overestimaters (33.2% vs. 14.2%, p<.001). Overestimaters were less likely to report high life satisfaction compared with underestimators and accurate perceivers (19.9% vs. 35.8% vs. 33.4%, p<.001). No differences in self-reported social support between groups were observed.

Conclusions

In young adults, data suggest underestimation of weight was associated with less intentional weight change behavior and higher life satisfaction. These results may help guide practitioners working with young adults by revealing differing patterns in weight misperception.

Funding

NIFA, New Hampshire Agriculture Experiment Station, USDA National Institute of Food and Agriculture Project 1010738, and the State of New Hampshire