Journal of Nutrition Education and Behavior最新文献

英文中文

Frequency of Attendance to a Behavioral Intervention on Health-related Outcomes in a Multicomponent Food as Medicine Intervention 多成分食物作为药物干预对健康相关结果的行为干预的出席频率

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Nutrition Education and Behavior

Pub Date : 2025-09-01 DOI: 10.1016/j.jneb.2025.05.197

Marcela D. Radtke PhD , Lan Xiao PhD , Wei-ting Chen PhD , Steven Chen MD , Ben Emmert-Aronson PhD , Ariana Thompson-Lastad PhD , Elizabeth Markle PhD , Lisa G. Rosas PhD, MPH , June Tester MD, MPH

Objective

Determine whether the frequency of attendance to Recipe4Health was associated with improvements in health-related outcomes.

Design

Secondary analysis of the Recipe4Health quasi-experimental study.

Setting

Federally Qualified Health Centers in Alameda County, California.

Participants

Patients with nutrition-related chronic conditions and/or food insecurity.

Intervention

Sixteen weekly produce deliveries and behavioral intervention sessions.

Main Outcome Measures

Attendance was categorized by percentage: low (< 50%), moderate (50% to < 75%), and high (≥ 75%), and outcomes included vegetable/fruit intake, physical activity (PA), mental health, and clinical biomarkers.

Analysis

Prepost changes were assessed using repeated measures linear mixed-effects models, adjusting for baseline values.

Results

Of the 199 patients, approximately one-third had low (36%), moderate (30%), and high (34%) attendance. Patients with high attendance had greater improvements in vegetable/fruit intake (0.3 cups/d; P = 0.03), PA (24.4 min/wk; P < 0.01), and depression symptoms (Patient Health Questionnaire score: −1.1; P < 0.01) compared with patients with low attendance. Patients with moderate attendance had greater improvements in PA compared with low attendance (15.1 min/wk; P = 0.03). Patients with high attendance had greater improvements in physically unhealthy days compared with moderate attendance (−2.4 d/mo; P < 0.01). Patients with high attendance had significant improvements in hemoglobin A1c from baseline (−0.7%; P = 0.02).

Conclusions

Strategies to improve attendance should be prioritized in food as medicine interventions.

目的：确定到Recipe4Health就诊的频率是否与健康相关结果的改善有关。设计：对Recipe4Health准实验研究进行二次分析。地点：加利福尼亚州阿拉米达县联邦合格医疗中心。参与者：患有营养相关慢性病和/或粮食不安全的患者。干预：每周16次生产和行为干预会议。主要结局指标：出勤率按百分比分类：低（< 50%）、中等（50%至< 75%）和高（≥75%），结局包括蔬菜/水果摄入量、身体活动（PA）、心理健康和临床生物标志物。分析：使用重复测量线性混合效应模型评估后置变化，调整基线值。结果：199例患者中，大约三分之一的患者出勤率低（36%）、中等（30%）和高（34%）。出勤率高的患者在蔬菜/水果摄入量方面有更大的改善(0.3杯/d；P = 0.03), PA (24.4 min/w；P < 0.01)，抑郁症状(患者健康问卷得分：-1.1；P < 0.01)。中等出勤的患者与低出勤的患者相比，PA的改善更大(15.1分钟/周；P = 0.03)。高出勤率的患者与中等出勤率的患者相比，在身体不健康的日子有更大的改善(-2.4 d/月；P < 0.01)。高出勤率患者的血红蛋白A1c较基线有显著改善(-0.7%；P = 0.02)。结论：提高出勤率的策略应优先考虑食品药物干预。

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引用次数: 0

Feasibility of a Fruit and Vegetable Home Food Environment Accessibility Intervention 果蔬家庭食品环境可及性干预的可行性研究。

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Nutrition Education and Behavior

Pub Date : 2025-09-01 DOI: 10.1016/j.jneb.2025.03.013

Adriana Verdezoto Alvarado PhD , Sonia Vega-López PhD , Laurie Ruggiero PhD , Carrie Earthman PhD, RDN , Shannon M. Robson PhD, MPH, RD

Objective

Examine the feasibility of an intervention to increase the accessibility of fruit and vegetables for children within the home food environment.

Methods

Thirty-two parents (aged 40.8 ± 4.9 years) and children (aged 9.5 ± 2.4 years) were enrolled in an 8-week pre-post intervention. Each week, parents attended virtual sessions and set goals to increase the accessibility (form, visibility, and reach) of 2 fruits and 3 vegetables. Feasibility indicators measured included retention rate, sessions attended, session length, adherence to goals, and parent satisfaction. Frequencies were used to analyze feasibility indicators, and open-ended questions related to satisfaction were analyzed using thematic analysis.

Results

Retention rate was 94%; average attendance was 7.4 of 8 sessions; session lengths ranged from 9.2 to 15.2 minutes; adherence to 3.6 of 5 goals/wk; and high parent satisfaction.

Conclusions and Implications

Goal setting to increase fruit and vegetable accessibility for children was feasible; however, examining efficacy will be an important next step.

目的：探讨在家庭食品环境中增加儿童水果和蔬菜可及性的干预措施的可行性。方法：对32名家长（年龄40.8±4.9岁）和儿童（年龄9.5±2.4岁）进行为期8周的干预。每周，家长参加虚拟会议，并设定目标，以增加两种水果和三种蔬菜的可访问性（形式，可见性和覆盖面）。测量的可行性指标包括保留率、参加的会议、会议长度、对目标的坚持以及家长满意度。使用频率分析可行性指标，使用专题分析分析与满意度相关的开放式问题。结果：留置率94%；8次会议的平均出勤率为7.4；会话时长从9.2到15.2分钟不等；每周完成5个目标中的3.6个；家长满意度高。结论和意义：设定目标增加儿童水果和蔬菜的可及性是可行的；然而，检查疗效将是重要的下一步。

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引用次数: 0

Meta-Analysis of the Effects of Cognitive Behavioral Therapy on Dietary Habits and Emotional Outcomes in Patients With Obesity Undergoing Metabolic and Bariatric Surgery 认知行为疗法对接受代谢和减肥手术的肥胖患者饮食习惯和情绪结局影响的meta分析。

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Nutrition Education and Behavior

Pub Date : 2025-09-01 DOI: 10.1016/j.jneb.2025.05.193

Haowen Gao MM, Guiqi Wang MM, Xinxin Zhang MM, Haobing Guo MM, Liyun Pang MM, Jingfeng Gu MM

Introduction

To evaluate the effects of cognitive behavioral therapy (CBT) on physical, behavioral, and psychosocial outcomes in patients with obesity undergoing metabolic and bariatric surgery (MBS) through a meta-analysis.

Method

Randomized controlled trials assessing the therapeutic effects of CBT in patients undergoing MBS were searched in databases including PubMed, Embase, Cochrane Library, and Web of Science. The search cutoff date was February 7, 2025. Data analysis was performed using Stata (version 16.0, StataCorp, 2019).

Results

A total of 7 randomized controlled trials were included in the final analysis. The meta-analysis indicated that CBT appeared to significantly decrease anxiety, depressive symptoms, uncontrolled eating, and emotional eating immediately after the intervention, but these effects seemed to disappear at the 1-year follow-up. In addition, CBT seemed not to affect weight, body mass index, physical quality of life, and mental quality of life at any time.

Discussion

CBT may alleviate anxiety, depressive symptoms, uncontrolled eating, and emotional eating in the short term.

Implications and Conclusions

Our findings suggest that CBT may enhance psychosocial and behavioral health among patients with obesity undergoing MBS. Future randomized controlled trials with larger sample sizes and longer follow-ups are needed to evaluate their long-term impacts.

前言：通过荟萃分析评估认知行为疗法（CBT）对接受代谢和减肥手术（MBS）的肥胖患者的身体、行为和社会心理结局的影响。方法：在PubMed、Embase、Cochrane Library和Web of Science等数据库中检索评估CBT对MBS患者治疗效果的随机对照试验。搜索截止日期是2025年2月7日。数据分析使用Stata（版本16.0,StataCorp, 2019）。结果：最终分析共纳入7项随机对照试验。荟萃分析表明，CBT似乎在干预后立即显著减少焦虑、抑郁症状、不受控制的饮食和情绪性饮食，但这些影响似乎在1年随访后消失。此外，CBT似乎在任何时候都不会影响体重、体重指数、身体生活质量和精神生活质量。讨论：CBT可以在短期内缓解焦虑、抑郁症状、不受控制的饮食和情绪性饮食。意义和结论：我们的研究结果表明，CBT可能会改善接受MBS的肥胖患者的社会心理和行为健康。未来需要更大样本量和更长随访时间的随机对照试验来评估其长期影响。

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引用次数: 0

Editorial Board/Board of Directors 编辑委员会/董事会

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Nutrition Education and Behavior

Pub Date : 2025-09-01 DOI: 10.1016/S1499-4046(25)00388-4

引用次数: 0

Comparison of US Army Soldiers’ Health-Related Behaviors Before and During the COVID-19 Pandemic Era 美国陆军士兵在COVID-19大流行之前和期间的健康相关行为比较

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Nutrition Education and Behavior

Pub Date : 2025-09-01 DOI: 10.1016/j.jneb.2025.05.001

Julianna M. Jayne PhD, RDN, CHES , Renee E. Cole PhD, RDN , Bradley M. Ritland PhD, DPT , Susan M. McGraw , J. Philip Karl PhD, RDN

Objective

To determine if the coronavirus disease 2019 (COVID-19) pandemic was associated with differences in eating behaviors, body mass index, physical activity, sleep, and perceived stress among US Army soldiers.

Methods

Retrospective cohort study using data from Army installations in 8 different states. Data were grouped by study year into a pre-COVID-19 era cohort (2017–2019; n = 1,591) or COVID-19 era cohort (2020–2022, n = 918) and analyzed using multivariate linear regression.

Results

The COVID-19 era cohort reported lower mean healthy eating scores, fewer meals but more snacks eaten per week, higher access to food, more emotional eating, higher perceived stress, higher body mass index, and less physical activity than the pre-COVID-19 era cohort (P ≤ 0.05).

Conclusions and Implications

Soldiers in the COVID-19 era cohort reported less healthy eating behaviors and health-related behaviors compared with the pre-COVID-19 era cohort. Further investigation is warranted on the potential cumulative effects and whether health-related behaviors improved after pandemic-related restrictions were lifted.

目的：确定2019年冠状病毒病（COVID-19）大流行是否与美国陆军士兵饮食行为、体重指数、身体活动、睡眠和感知压力的差异有关。方法：回顾性队列研究，使用来自8个不同州的陆军设施的数据。数据按研究年份分组为covid -19前时代队列(2017-2019；n = 1591)或COVID-19时代队列（2020-2022,n = 918），并使用多元线性回归进行分析。结果：与前COVID-19时代队列相比，新冠肺炎时代队列报告的平均健康饮食得分较低，每周膳食较少但零食较多，获得食物的机会较多，情绪性饮食较多，感知压力较高，体重指数较高，体力活动较少（P≤0.05）。结论和意义：与前COVID-19时代队列相比，新冠肺炎时代队列的士兵报告的健康饮食行为和健康相关行为较少。有必要进一步调查潜在的累积效应，以及在解除与大流行相关的限制后，与健康相关的行为是否得到改善。

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引用次数: 0

Food Access Matters: Quantifying the Price Differential Across Four Major Food Retailers and a Mobile Market Aiming to Improve Affordable Nutritious Food Access 食品获取问题：量化四大食品零售商之间的价格差异和旨在改善可负担的营养食品获取的移动市场。

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Nutrition Education and Behavior

Pub Date : 2025-09-01 DOI: 10.1016/j.jneb.2025.05.196

Shivani Muthya BSN , Melissa N. Laska PhD, RD , Jayne A. Fulkerson PhD , Stephanie Wagner BS , Kristen S. Gorman PhD , Lisa Harnack DrPH, RD, MPH , Melissa L. Horning PhD, RN, BSN, PHN

Objective

To understand how food prices differed between physical and online grocery stores and a well-established mobile market in a Midwest metropolitan area of the US.

Methods

Four major grocery retailers nearest to 8 subsidized apartments were identified. Two stores from each retailer were randomly selected (n = 8), and prices for 67 size-standardized foods were collected in person and online. An analysis of variance test assessed mean differences in cart prices across stores relative to the Twin Cities Mobile Market (TCMM).

Results

Relative to TCMM cart prices, cart prices were significantly higher at physical and online Walmart (21% to 22% higher, P < 0.001), Target (29% to 30%, P < 0.001), and Cub Foods (62% to 63%, P < 0.001) stores and online Aldi stores (14%, P = 0.02). Aldi physical store prices were not statistically significantly different (P = 0.72).

Conclusions and Implications

Results require cautious interpretation given the low number of observations per retailer; however, findings suggest TCMM provides foods at a lower cost than most nearby grocery stores, providing 1 example of full-service mobile market pricing. Future research is needed to assess mobile market pricing structures in other locations across the US.

目的：了解美国中西部大都市地区的实体和在线杂货店以及成熟的移动市场之间的食品价格差异。方法：选取距离8套补贴公寓最近的4家主要杂货零售商。每个零售商随机选择两家商店（n = 8），并亲自和在线收集67种尺寸标准化食品的价格。方差检验分析评估了相对于双城移动市场（TCMM）的商店手推车价格的平均差异。结果：相对于TCMM购物车价格，实体店和在线沃尔玛（21%至22%，P < 0.001）、塔吉特（29%至30%，P < 0.001）和Cub Foods（62%至63%，P < 0.001）商店和在线Aldi商店（14%,P = 0.02）的购物车价格明显更高。Aldi实体店价格差异无统计学意义（P = 0.72）。结论和含义：考虑到每个零售商的观察数量很少，结果需要谨慎解释；然而，调查结果表明，TCMM提供的食物比附近大多数杂货店的成本更低，这是全方位服务移动市场定价的一个例子。未来的研究需要评估美国其他地区的移动市场定价结构。

{"title":"Food Access Matters: Quantifying the Price Differential Across Four Major Food Retailers and a Mobile Market Aiming to Improve Affordable Nutritious Food Access","authors":"Shivani Muthya BSN , Melissa N. Laska PhD, RD , Jayne A. Fulkerson PhD , Stephanie Wagner BS , Kristen S. Gorman PhD , Lisa Harnack DrPH, RD, MPH , Melissa L. Horning PhD, RN, BSN, PHN","doi":"10.1016/j.jneb.2025.05.196","DOIUrl":"10.1016/j.jneb.2025.05.196","url":null,"abstract":"<div><h3>Objective</h3><div>To understand how food prices differed between physical and online grocery stores and a well-established mobile market in a Midwest metropolitan area of the US.</div></div><div><h3>Methods</h3><div>Four major grocery retailers nearest to 8 subsidized apartments were identified. Two stores from each retailer were randomly selected (n = 8), and prices for 67 size-standardized foods were collected in person and online. An analysis of variance test assessed mean differences in cart prices across stores relative to the Twin Cities Mobile Market (TCMM).</div></div><div><h3>Results</h3><div>Relative to TCMM cart prices, cart prices were significantly higher at physical and online Walmart (21% to 22% higher, <em>P</em> < 0.001), Target (29% to 30%, <em>P</em> < 0.001), and Cub Foods (62% to 63%, <em>P</em> < 0.001) stores and online Aldi stores (14%, <em>P</em> = 0.02). Aldi physical store prices were not statistically significantly different (<em>P</em> = 0.72).</div></div><div><h3>Conclusions and Implications</h3><div>Results require cautious interpretation given the low number of observations per retailer; however, findings suggest TCMM provides foods at a lower cost than most nearby grocery stores, providing 1 example of full-service mobile market pricing. Future research is needed to assess mobile market pricing structures in other locations across the US.</div></div>","PeriodicalId":50107,"journal":{"name":"Journal of Nutrition Education and Behavior","volume":"57 9","pages":"Pages 885-891"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Healthy Choices for Your Recovering Body: A Nutrition Education Curriculum for Adults With Limited Resources in Substance Use Recovery 健康的选择，为您的身体恢复：营养教育课程与有限的资源，在物质使用恢复成人。

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Nutrition Education and Behavior

Pub Date : 2025-09-01 DOI: 10.1016/j.jneb.2025.05.200

Omolola A. Adedokun PhD , Moses Desmennu PhD , Paula Plonski MA , Brooke Jenkins MS , Jean Noble MS, RD

引用次数: 0

Using Web Scraping as a Tool to Collect School Nutrition Data 使用网络抓取作为收集学校营养数据的工具。

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Nutrition Education and Behavior

Pub Date : 2025-09-01 DOI: 10.1016/j.jneb.2025.05.199

Aaron Brown BS , Joseph Price PhD , Joanne Guthrie PhD, MPH

Web scraping, a technique for collecting publicly available online data, may facilitate collecting school meal data from large, national samples of school districts in a timely, cost-effective manner. We explore its potential by examining the variation in sodium content of 2 popular entrees served through the US Department of Agriculture’s National School Lunch Program—pizza and chicken nuggets. Daily school menu data were obtained from a national sample of school districts via web scraping. Linking web scraped data to publicly available data on school districts permitted examination of entree sodium content variation across school district geographic and socioeconomic characteristics. Such information may assist nutrition professionals in targeting efforts to meet school nutrition menu objectives. Other potential applications are discussed.

网络抓取是一种收集公开可用的在线数据的技术，它可以方便地以一种及时、经济有效的方式从全国范围内的大型学区样本中收集学校膳食数据。我们通过研究美国农业部国家学校午餐计划提供的两种受欢迎的主菜——披萨和鸡块——钠含量的变化来探索它的潜力。每日学校菜单数据是通过网络抓取从全国学区样本中获得的。将网络抓取的数据与学区的公开数据联系起来，可以检查不同学区地理和社会经济特征的主菜钠含量变化。这些信息可以帮助营养专业人员有针对性地努力满足学校营养菜单的目标。讨论了其他潜在的应用。

引用次数: 0

Family Perspectives on Packing a Low-Waste and Nutritious School Lunchbox 从家庭角度包装低浪费和营养的学校午餐盒。

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Nutrition Education and Behavior

Pub Date : 2025-09-01 DOI: 10.1016/j.jneb.2025.04.007

Neha K. Lalchandani PhD , Caroline Miller PhD , Clare Hume PhD , Shona Crabb PhD

Objective

To explore family perspectives on food, packaging, and waste in lunchboxes, and the everyday practices of lunchbox packing and consumption.

Design

Exploratory qualitative study using semistructured interviews guided by a critical realist epistemology.

Setting

Online interviews with South Australian families.

Participants

Self-selected sample of 16 parents (94% mothers) and their children aged 8–12 years in primary school grades third through sixth (60% female) from public (75%) and private schools (25%) across medium (38%) and high (62%) socioeconomic backgrounds.

Phenomenon of Interest and Variables

Factors influencing preparation of a nutritious and low-waste school lunchbox.

Analysis

Data were analyzed inductively using a reflexive thematic approach to identify major themes.

Results

Three major themes were generated: (1) extrinsic factors and school environment structures, (2) intrinsic factors and a Hierarchy of Motivations, and (3) responsibility for change. External factors influenced familial lunchbox packing practices, whereas personal priorities shaped food and packaging choices. Families emphasized shared responsibility for improving nutrition and reducing packaging between parents, schools, and broader systems.

Conclusions and Implications

This study provides updated insights into family lunchbox practices. Preexisting challenges in lunchbox practices deter prioritization of environmental sustainability. School-level initiatives should address barriers and leverage enablers to support families. Further research is needed to integrate nutrition and sustainability agendas and clarify responsibility for driving change.

目的：探讨家庭对饭盒中食物、包装和浪费的看法，以及日常饭盒包装和消费的做法。设计：探索性质的研究，采用半结构化访谈，以批判现实主义认识论为指导。背景：与南澳大利亚家庭的在线访谈。参与者：自选的16名家长（94%为母亲）及其8-12岁的孩子（小学三年级至六年级，60%为女性），来自公立学校（75%）和私立学校（25%），中等（38%）和高（62%）社会经济背景。兴趣现象和变量：影响制作营养和低浪费的学校午餐盒的因素。分析：使用反身性主题方法归纳分析数据，以确定主要主题。结果：产生了三个主要主题：(1)外在因素和学校环境结构；(2)内在因素和动机层次；(3)变革的责任。外部因素影响了家庭午餐盒包装的做法，而个人优先事项则影响了食品和包装的选择。家庭强调家长、学校和更广泛的系统共同承担改善营养和减少包装的责任。结论和启示：本研究为家庭午餐盒实践提供了新的见解。午餐盒实践中先前存在的挑战阻碍了环境可持续性的优先考虑。学校层面的举措应解决障碍，并利用促进因素来支持家庭。需要进一步的研究来整合营养和可持续性议程，并明确推动变革的责任。

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引用次数: 0

Culturally-Informed Food Insecurity Screening: Evidence From Northern Navajo Medical Center 文化知情食品不安全筛查：来自北纳瓦霍医疗中心的证据。

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Nutrition Education and Behavior

Pub Date : 2025-09-01 DOI: 10.1016/j.jneb.2025.05.201

Tia R. Benally MPH , Kelli W. Begay MS, MBA, RDN , Lydia Kim MD, MPH , Preyanka Makadia DO , Amanda M. Fretts PhD , Cassandra J. Nguyen PhD

Objective

To develop and evaluate an alternative strengths-based and culturally-informed screener for food security among American Indian respondents.

Design

Two-phase mixed methods sequential exploratory study with a qualitative phase followed by a quantitative phase.

Setting

Northern Navajo Medical Center.

Participants

Twenty-five qualitative participants and 97 quantitative participants.

Phenomenon of Interest

Participants’ impressions of the existing food insecurity screener compared with an alternative set of questions focused on the type and amount of food consumed.

Analysis

Cognitive interviews were thematically analyzed and integrated with mixed methods in developing the quantitative survey, and survey responses on the 2 food insecurity screening questionnaires were analyzed for equivalent-form reliability with a Pearson correlation coefficient.

Results

The prevalence of food insecurity was high. Interviewees had concerns about the existing screener. Respondents provided suggestions for alternative food security questions. When feedback was integrated into the alternative screener for the quantitative phase, the correlation between screeners was weak to moderate (0.3).

Conclusions and Implications

Findings suggest the screeners may be collecting data related to unique concepts. Rampant food insecurity supports the need for future food access initiatives in the Navajo Nation to provide a foundation for a food-secure future.

目的：在美国印第安人受访者中开发和评估一种基于优势和文化信息的食品安全筛选方法。设计：两阶段混合方法序贯探索性研究，先定性后定量。环境：北纳瓦霍医疗中心。参与者：25名定性参与者和97名定量参与者。感兴趣的现象：参与者对现有食品不安全筛选者的印象，与另一组关注食品消费类型和数量的问题进行比较。分析：对认知访谈进行主题分析，并结合混合方法进行定量调查，对2份食品不安全筛查问卷的调查结果进行等效信度分析，采用Pearson相关系数。结果：粮食不安全发生率较高。受访者对现有的筛选程序表示担忧。答复者就其他粮食安全问题提供了建议。当反馈被整合到定量阶段的替代筛选器时，筛选器之间的相关性为弱至中等（0.3）。结论和启示：研究结果表明，筛选者可能正在收集与独特概念相关的数据。猖獗的粮食不安全支持了纳瓦霍族未来粮食获取倡议的必要性，为未来的粮食安全奠定基础。

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