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2.

Desafios da nutrição no Sistema Único de Saúde para construção da interface entre a saúde e a segurança alimentar e nutricional/ Nutritional challenges in the Brazilian Unified National Health System for building the interface between health and food and nutritional security/ Desafíos de la nutrición en el Sistema Único de Salud brasileño para la construcción de la interfaz entre la salud y seguridad alimentaria y nutricional

Rigon, Silvia do Amaral; Schmidt, Suely Teresinha; Bógus, Cláudia Maria
| Idioma(s): Portugués
Discute-se a construção da intersetorialidade entre o campo da saúde e da segurança alimentar e nutricional (SAN) no Brasil, entre 2003 e 2010, período que inaugura a priorização deste tema na agenda governamental. Para tanto, desenvolveu-se uma pesquisa qualitativa segundo a epistemologia construcionista, mediante entrevistas com informantes-chave do órgão de controle social do campo da SAN de abrangência nacional. Os avanços e desafios do processo são abordados enquanto categorias de análise. A Política Nacional de Alimentação e Nutrição (PNAN) foi mencionada como articuladora entre os dois campos, sendo descentralizada por uma rede com atuação nos estados e municípios. No entanto, registraram-se dificuldades políticas, institucionais e operacionais para que a PNAN possa ser efetiva no Sistema Único de Saúde e assim contribuir para o avanço da SAN no país. O predomínio do modelo biomédico, curativo e de alta complexidade foi referido como o principal impeditivo, conferindo ainda às políticas de promoção da saúde, como a PNAN, uma posição secundária em termos da sua priorização. This article discusses the establishment of inter-sector action between health and food and nutritional security in Brazil from 2003 to 2010, when this issue was launched as a priority on the government's agenda. A qualitative study was developed according to constructivist epistemology, using key-informant interviews in the field's nationwide social oversight body. Advances and challenges in this process are addressed as analytical categories. The National Food and Nutrition Policy (PNAN) was mentioned as the link between the two fields, decentralized through a network with activity in the states and municipalities. However, the study found political, institutional, and operational obstacles to the effective implementation of the PNAN in the Brazilian Unified National Health System and consequently to a contribution to the advancement of Health and Food and Nutritional Security in the country. The predominance of the biomedical, curative, and high-complexity model was cited as the principal impediment, while health promotion policies like the PNAN were assigned secondary priority. Se discute la construcción de la intersectorialidad entre el campo de la salud y el de la seguridad alimentaria y nutricional en Brasil, entre 2003 y 2010, período que inaugura la priorización de este tema en la agenda gubernamental. Para tal efecto, se desarrolló una investigación cualitativa, según la epistemología construccionista, mediante entrevistas con informantes-clave del órgano de control social en el campo de la seguridad alimentaria y nutricional dentro de una dimensión nacional. Los avances y desafíos del proceso se abordan por categorías de análisis. La Política Nacional de Alimentación y Nutrición (PNAN) se mencionó como articuladora entre los dos campos, siendo descentralizada por una red con actuación en los estados y municipios. Sin embargo, se registraron dificultades políticas, institucionales y operacionales para que la PNAN pudiera ser efectiva en el Sistema Único de Salud, y así contribuir al avance de la seguridad alimentaria y nutricional en el país. El predominio del modelo biomédico, curativo y de alta complejidad fue mencionado como el principal impeditivo, otorgando incluso a las políticas de promoción de la salud, como la PNAN, una posición secundaria en términos de su priorización.
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3.

A youth mentor-led nutritional intervention in urban recreation centers: a promising strategy for childhood obesity prevention in low-income neighborhoods.

Sato, Priscila M; Steeves, Elizabeth A; Carnell, Susan; Cheskin, Lawrence J; Trude, Angela C; Shipley, Cara; Mejía Ruiz, M J; Gittelsohn, Joel
| Idioma(s): Inglés
B'More Healthy Community for Kids (BHCK) is an ongoing multi-level intervention to prevent childhood obesity in African-American low-income neighborhoods in Baltimore city, MD. Although previous nutrition interventions involving peer mentoring of youth have been successful, there is a lack of studies evaluating the influence of cross-age peers within interventions targeting youth. This article evaluates the implementation of the BHCK intervention in recreation centers, and describes lessons learned. Sixteen youth leaders delivered bi-weekly, interactive sessions to 10- to 14-y olds. Dose, fidelity and reach are assessed, as is qualitative information regarding what worked well during sessions. Dose is operationalized as the number of interactive sessions, and taste tests, giveaways and handouts per session; fidelity as the number of youth leaders participating in the entire intervention and per session and reach as the number of interactions with the target population. Based on a priori set values, number of interactive sessions was high, and number of taste tests, giveaways and handouts was moderate to high (dose). The number of participating youth leaders was also high (fidelity). Of the 14 planned sessions, the intervention was implemented with high/moderate reach. Data suggest that working with cross-age peers is a promising nutritional intervention for recreation centers.
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4.

Increasing Community Access to Fresh Fruits and Vegetables: A Case Study of the Farm Fresh Market Pilot Program in Cobb County, Georgia, 2014.

Woodruff, Rebecca C; Coleman, Anne-Marie; Hermstad, April K; Honeycutt, Sally; Munoz, Jennifer; Loh, Lorna; Brown, Agnes F; Shipley, Rebecca; Kegler, Michelle C
| Idioma(s): Inglés
BACKGROUND: Ecological models of health suggest that to effectively prevent chronic disease, community food environments must support healthy eating behaviors. However, disparities in access to healthy foods persist in the United States. COMMUNITY CONTEXT: The Farm Fresh Market (FFM) was a fruit and vegetable market that sold low-cost fresh produce in Cobb County, Georgia in 2014. METHODS: This case study describes the development of the FFM through a community engagement process and presents evaluation results from the project's pilot implementation. Community engagement strategies included forming a community advisory board, conducting a needs assessment, and contracting with a community-based organization to implement the FFM. OUTCOME: In the pilot year, the FFM served an average of 28.7 customers and generated an average of $140.20 in produce sales per market day. Most returning customers lived in the local community and reported a range of socioeconomic backgrounds. Most returning customers strongly agreed that the FFM made it easier (69.0%) and less expensive (79.0%) for them to buy fresh fruits and vegetables, reported that they ate more vegetables (65.0%) and fruit (55.0%) as a result of the FFM, and reported that they were very satisfied with the FFM overall (92.0%). INTERPRETATION: Results from this community case study underscore the importance of engaging communities in the development of community food environment interventions. Results also suggest that the FFM initiative was a feasible and acceptable way to respond to the community-identified public health priority of increasing access to healthy foods.
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5.

Eat Right-Live Well! Supermarket Intervention Impact on Sales of Healthy Foods in a Low-Income Neighborhood.

Surkan, Pamela J; Tabrizi, Maryam J; Lee, Ryan M; Palmer, Anne M; Frick, Kevin D
| Idioma(s): Inglés
OBJECTIVE: To evaluate a multifaceted supermarket intervention promoting healthier alternatives to commonly purchased foods. DESIGN: Sales of 385 foods promoted between July and October, 2012 in the Eat Right-Live Well! intervention supermarket were compared with sales in a control supermarket. SETTING: Two supermarkets in geographically separate, low-income, urban neighborhoods. PARTICIPANTS: One control and 1 intervention supermarket. INTERVENTION: Product labeling, employee training, community outreach, and in-store promotions, including taste tests. MAIN OUTCOME MEASURES: Number of items sold; absolute and percent differences in sales. ANALYSIS: Difference-in-difference analyses compared absolute and percent changes between stores and over time within stores. Sub-analyses examined taste-tested items and specific food categories, and promoted items labeled with high fidelity. RESULTS: Comparing pre- and postintervention periods, within-store difference-in-differences for promoted products in the intervention store (25,776 items; 23.1%) was more favorable than the control (9,429 items; 6.6%). The decrease in taste-tested items' sales was smaller in the intervention store (946 items; 5.5%) than the control store (14,666 items; 26.6%). Increased sales of foods labeled with high fidelity were greater in the intervention store (25,414 items; 28.0%) than the control store (7,306 items; 6.3%). CONCLUSIONS AND IMPLICATIONS: Store-based interventions, particularly high-fidelity labeling, can increase promoted food sales.
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6.

Barriers to and Facilitators of Stocking Healthy Food Options: Viewpoints of Baltimore City Small Storeowners.

Kim, Mhinjine; Budd, Nadine; Batorsky, Benjamin; Krubiner, Carleigh; Manchikanti, Swathi; Waldrop, Greer; Trude, Angela; Gittelsohn, Joel
| Idioma(s): Inglés
Receptivity to strategies to improve the food environment by increasing access to healthier foods in small food stores is underexplored. We conducted 20 in-depth interviews with small storeowners of different ethnic backgrounds as part of a small-store intervention trial. Store owners perceived barriers and facilitators to purchase, stock, and promote healthy foods. Barriers mentioned included customer preferences for higher fat and sweeter taste and for lower prices; lower wholesaler availability of healthy food; and customers' lack of interest in health. Most store owners thought positively of taste tests, free samples, and communication interventions. However, they varied in terms of their expectations of the effect of these strategies on customers' healthy food purchases. The findings reported add to the limited data on motivating and working with small-store owners in low-income urban settings.
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7.

Intervención educativa para modificación de conocimientos, actitudes y prácticas sobre nutrición en Boyacá, Colombia/ Educational intervention for changing knowledge, attitudes and practices about nutrition in Boyacá, Colombia

Barrera Sánchez, Lina Fernanda; Herrera Amaya, Giomar Maritza; Ospina Díaz, Juan Manuel
| Idioma(s): Español
Introducción: La malnutrición, en las primeras etapas de la vida, es determinante de afectaciones en el crecimiento y desarrollo, la falta de conocimiento es su principal desencadenante. Objetivo: Evaluar el impacto de un programa educativo para modificar conocimientos, actitudes y prácticas sobre nutrición en madres de niños menores de 10 años. Materiales y Métodos: Estudio de evaluación, cuantitativo, de optimización de necesidades utilizando el modelo Preceder - proceder. Diseño cuasiexperimental, pretest - postest, sin grupo control; aplicado a 18 madres en Vereda La Colorada, (Tunja, Boyacá). Se planeó un programa con enfoque metodológico basado en aprender, haciendo uso de elementos de la comunicación social, a través de actividades teórico - prácticas de participación comunitaria. Resultados: Al inicio del proceso se encontró prevalencia para desnutrición crónica de 33.3%, desnutrición global 22.2%; como posibles factores asociados a la desnutrición se encuentra: edad de la madre de 21 a 25 años (p=.025); madre soltera (p=.02); bajo consumo de alimentos tipo verduras (p=.029), lácteos (p=.001), grasas (p=.006). El Programa favoreció de manera positiva y significativa cambios sobre conocimientos en nutrición (p< .01), actitudes (p=.001) y prácticas, con el aumento del consumo del grupo de proteínas (p=0.014). Discusión: Los resultados permiten inferir que se requiere de intervenciones prontas y productivas, basadas en asociaciones pedagógico-metodológicas para lograr la superación de las limitaciones actuales. Conclusiones: Impacto favorable expresado en modificaciones cuantitativas en los conocimientos, actitudes y prácticas que podría traducirse en algún grado de aceptación del programa por las madres participantes; la situación económica se apreció como un aspecto que influye negativamente en la implementación de nuevas y mejores prácticas alimentarias.(AU) Introduction: Malnutrition, in the early stages, is crucial to affectations on growth and development; it is considered, that lack of knowledge is the main trigger. Objective: To assess the impact of an educational intervention program toward changing knowledge, attitudes and practices about nutrition for children aged less than 10 years. Materials and Methods: Evaluation study, quantitative model, using the Precede-proceed metodology. The design was quasi-experimental, type pretest – posttest, without control group; it was developed with 18 mothers from La Colorada (Tunja, Boyacá); intervention used methodological approaches based on learning to doing, using elements of social communication, through theoretical and practical activities of community participation. Results: At the onset of the process, was found prevalence of chronic malnutrition was 33.3%, 22.2% had overall malnutrition; possible risk factors associated with malnutrition: mother's age since 21 to 25 years (p = .025); being single (p = .02); low intake of foods as vegetables (p = .029), milk or derivates (p = .001), fat (p = .006). The educational program favored positively and significant changes regarding nutrition knowledge (p <.01), attitudes (p = .001) and practices with increased consumption of protein (p = 0.014). Discussion: Current results allow us to infer that is required of prompt and productive interventions, based on pedagogical and methodological partnerships to overcoming seen limitations. Conclusions: Beneficial impact expressed in quantitative changes in knowledge, attitudes and practices that could result in some degree of acceptance of the program by participating mothers. Economic situation was seen as an issue that adversely affects the implementation of new and improved feeding practices.(AU)
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8.

Intervención educativa para modificación de conocimientos, actitudes y prácticas sobre nutrición en Boyacá, Colombia/ Educational intervention for changing knowledge, attitudes and practices about nutrition in Boyacá, Colombia

Barrera Sánchez, Lina Fernanda; Herrera Amaya, Giomar Maritza; Ospina Díaz, Juan Manuel
| Idioma(s): Español
Introducción: La malnutrición, en las primeras etapas de la vida, es determinante de afectaciones en el crecimiento y desarrollo, la falta de conocimiento es su principal desencadenante. Objetivo: Evaluar el impacto de un programa educativo para modificar conocimientos, actitudes y prácticas sobre nutrición en madres de niños menores de 10 años. Materiales y Métodos: Estudio de evaluación, cuantitativo, de optimización de necesidades utilizando el modelo Preceder - proceder. Diseño cuasiexperimental, pretest - postest, sin grupo control; aplicado a 18 madres en Vereda La Colorada, (Tunja, Boyacá). Se planeó un programa con enfoque metodológico basado en aprender, haciendo uso de elementos de la comunicación social, a través de actividades teórico - prácticas de participación comunitaria. Resultados: Al inicio del proceso se encontró prevalencia para desnutrición crónica de 33.3%, desnutrición global 22.2%; como posibles factores asociados a la desnutrición se encuentra: edad de la madre de 21 a 25 años (p=.025); madre soltera (p=.02); bajo consumo de alimentos tipo verduras (p=.029), lácteos (p=.001), grasas (p=.006). El Programa favoreció de manera positiva y significativa cambios sobre conocimientos en nutrición (p< .01), actitudes (p=.001) y prácticas, con el aumento del consumo del grupo de proteínas (p=0.014). Discusión: Los resultados permiten inferir que se requiere de intervenciones prontas y productivas, basadas en asociaciones pedagógico-metodológicas para lograr la superación de las limitaciones actuales. Conclusiones: Impacto favorable expresado en modificaciones cuantitativas en los conocimientos, actitudes y prácticas que podría traducirse en algún grado de aceptación del programa por las madres participantes; la situación económica se apreció como un aspecto que influye negativamente en la implementación de nuevas y mejores prácticas alimentarias. Introduction: Malnutrition, in the early stages, is crucial to affectations on growth and development; it is considered, that lack of knowledge is the main trigger. Objective: To assess the impact of an educational intervention program toward changing knowledge, attitudes and practices about nutrition for children aged less than 10 years. Materials and Methods: Evaluation study, quantitative model, using the Precede-proceed metodology. The design was quasi-experimental, type pretest – posttest, without control group; it was developed with 18 mothers from La Colorada (Tunja, Boyacá); intervention used methodological approaches based on learning to doing, using elements of social communication, through theoretical and practical activities of community participation. Results: At the onset of the process, was found prevalence of chronic malnutrition was 33.3%, 22.2% had overall malnutrition; possible risk factors associated with malnutrition: mother's age since 21 to 25 years (p = .025); being single (p = .02); low intake of foods as vegetables (p = .029), milk or derivates (p = .001), fat (p = .006). The educational program favored positively and significant changes regarding nutrition knowledge (p <.01), attitudes (p = .001) and practices with increased consumption of protein (p = 0.014). Discussion: Current results allow us to infer that is required of prompt and productive interventions, based on pedagogical and methodological partnerships to overcoming seen limitations. Conclusions: Beneficial impact expressed in quantitative changes in knowledge, attitudes and practices that could result in some degree of acceptance of the program by participating mothers. Economic situation was seen as an issue that adversely affects the implementation of new and improved feeding practices.
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9.

Hortas urbanas e a construção de ambientes promotores da alimentação adequada e saudável/ Urban gardens and build of environments promoters of healthy eating

Garcia, Mariana Tarricone
| Idioma(s): Portugués
Introdução: A alimentação é culturalmente e socialmente construída e é um direito humano básico, além de ser influenciada por determinantes sociais, do acesso, do ambiente e do sistema alimentar. Frequentemente, indivíduos que vivem em meios urbanos estão desconectados do ciclo de vida dos alimentos. As hortas urbanas promovem um aprendizado coletivo por meio da vivência e da experimentação e podem ser vistas como um espaço repleto de oportunidades para a prática da alimentação adequada e saudável. Objetivos: 1) Identificar e sintetizar os estudos publicados entre 2005 e 2015 que avaliaram a influência da participação em hortas urbanas em desfechos relacionados à alimentação e nutrição entre adultos e idosos; 2) Descrever as práticas de aquisição de frutas e hortaliças de moradores de áreas periféricas da região metropolitana de São Paulo e como eles percebem o acesso a estes alimentos naqueles ambientes; e 3) Descrever as influências na alimentação decorrentes da experiência de crianças com o cultivo de alimentos em hortas escolares. Métodos: Tese composta por três manuscritos. No primeiro foi realizada uma revisão sistemática dos estudos publicados entre 2005 e 2015, selecionados a partir da busca em cinco bases de dados, envolvendo adultos e/ou idosos não institucionalizados participantes de hortas urbanas que apresentassem resultados na alimentação. No segundo manuscrito foram realizadas entrevistas com indivíduos residentes em regiões adstritas a quatro Unidades Básicas de Saúde de um município da região metropolitana de São Paulo. No terceiro foram realizadas entrevistas com educadores e pais de educandos de três escolas do mesmo município que possuíam hortas escolares. Resultados: Os estudos incluídos na revisão sistemática apontaram que das experiências com hortas urbanas foram identificados eixos temáticos relacionados à alimentação adequada e saudável como: maior consumo de frutas e hortaliças, maior acesso a alimentos saudáveis, maior reconhecimento da culinária, o compartilhamento da colheita com familiares e amigos, valorização da produção orgânica e apropriação da importância da alimentação adequada e saudável. Em relação às entrevistas com os moradores, estes destacaram o abastecimento insuficiente de frutas e hortaliças, a demanda por mais variedade destes alimentos, a insuficiência de equipamentos que comercializem maior variedade de frutas e hortaliças, a associação da alimentação adequada e saudável a preços altos e a diminuição do número de feiras livres atribuída ao surgimento dos supermercados. Já as hortas escolares trouxeram elementos para reflexão sobre o ato de se alimentar e sobre os alimentos, pelo conhecimento que o contato direto com o cultivo produziu, e provocou mudanças não apenas nas crianças, mas também nas famílias envolvidas com as atividades. Isso se refletiu em mudanças concretas na alimentação, maior conhecimento sobre os alimentos e sobre o sistema alimentar, além de uma maior valorização dos alimentos produzidos e de um estímulo maior para experimentar novos alimentos. Conclusões: O ambiente alimentar pode constituir um fator restritivo à prática da alimentação adequada e saudável. Neste sentido, as hortas urbanas, por meio do contato com a natureza, sensibilização para o ato de se alimentar e maior acesso às frutas e hortaliças, contribuem para a promoção da alimentação adequada e saudável Introduction: Eating is culturally and socially constructed and a basic human right, besides being influenced by social determinants, access, environment and food system. Often, individuals living in urban areas are disconnected from the food life cycle. Urban gardens promote a collective learning through experience and experimentation and can be seen as a place full of opportunities for adequate and healthy food practice. Objectives: 1) To identify and to synthesise the studies published between 2005 and 2015 that evaluated the influence of participation in urban gardens on outcomes related to food and nutrition among adults and elderly people; 2) To describe the acquisition of fruits and vegetables practices by residents in socially disadvantaged areas of Sao Paulo Metropolitan Region - Brazil and how they perceive access to these foods in those environments; and 3) To describe the influences on eating resulting from children\'s experience with growing food in school gardens. Methods: The thesis comprises three manuscripts. In the first one we undertook a systematic review of studies published between 2005 and 2015, selected from searching in five databases, involving non-institutionalized adults and/or elderly participants of urban gardens reporting results on eating. In the second manuscript we conducted interviews with residents in four Basic Health Units\' areas in a city located in the Sao Paulo Metropolitan Region - Brazil. In the third one we conducted interviews with educators and students parents from three schools developing school gardens in the same city. Results: Studies included in the systematic review showed from the experiences with urban gardens we identified themes related to adequate and healthy eating: higher consumption of fruits and vegetables, increased access to healthy food, more recognition of the importance of cooking, sharing the harvest with family and friends, greater importance of organic production and greater importance of adequate and healthy eating. Regarding interviews with residents, they highlighted the insufficient supply of fruits and vegetables, demand for greater variety of these foods, lack of stores that sell greater variety of fruits and vegetables, association of adequate and healthy eating with high cost, and decrease in the number of street markets attributed to emergence of supermarkets. Concerning the school gardens, the activity brought elements to think about the act of eating and about food by itself through the knowledge created by direct contact with farming, and caused changes not only among children but also among families involved with the activities. This was reflected in concrete changes in diet, increased knowledge about food and food system, as well as greater appreciation of garden produce and a greater willingness to try new foods. Conclusions: Food environment can be a restrictive factor for adequate and healthy eating practice. Thus, urban gardens, through contact with nature, awareness of the the act of eating, and greater access to fruits and vegetables, contribute to adequate and healthy eating promotion
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10.

Educação alimentar e nutricional no contexto do desenvolvimento rural: estudo de caso do Rio Grande do Sul/ Food and nutrition education in the context of rural development a case study of Rio Grande do Sul

Oliveira, Nádia Rosana Fernandes de
| Idioma(s): Portugués
Introdução: A educação alimentar e nutricional (EAN) é campo de prática e reflexão de diversos atores sociais envolvidos na promoção da saúde, entre eles, os serviços de Assistência Técnica e Extensão Rural, que se relacionam com ações de desenvolvimento local e promoção da alimentação adequada e saudável e de segurança alimentar e nutricional das populações rurais. Objetivo: Analisar percepções e práticas sobre o processo de educação alimentar e nutricional no contexto do Desenvolvimento Rural no RS. Metodologia: Artigo 1: Realizou-se análise do texto do Guia Alimentar para a População Brasileira, discutindo-se os temas previstos e os temas emergentes a partir da intersecção dos conceitos de promoção da saúde e de desenvolvimento rural sustentável. Artigo 2: Investigaramse normas estabelecidas nos documentos de âmbito nacional e estadual e práticas executadas pelos extensionistas rurais a partir de busca em Sistema de Registros Administrativos que continham a descrição das atividades realizadas. Os dados foram tabulados e processados por meio da estatística descritiva, com o apoio do programa Microsoft Office Excel, versão 2007, em relação à produção e análise qualitativa dos dados; investigaram-se, na periodicidade histórica, rupturas e permanências contidas no material, com apoio do software NVivo 10 for Windows. Artigo 3: Realizaram-se 18 entrevistas individuais para produção de narrativas com os diferentes atores sociais envolvidos na Assistência Técnica e Extensão Rural no RS. Foi realizada a análise das narrativas a partir da perspectiva teórica e das categorias analíticas emergentes, sendo os dados interpretados, sistematizados e analisados em seu conjunto, com apoio do software NVivo 10 for Windows. Resultados: Artigo 1: Identificou 13 temas relacionados a quatro dimensões explicativas da interseção dos conceitos, os quais foram identificados a partir dos elementos constitutivos dos itens princípios e diretrizes do Guia Alimentar, dez passos para uma alimentação saudável; superação de obstáculos para realização dos dez passos. Artigo 2: Oito documentos e 212.502 atividades foram analisadas, sendo 11,13 por cento relacionadas à EAN. As normas determinaram número mínimo de atividades a serem realizadas por meio de metas estabelecidas nos contratos de serviços, em contrapartida, as práticas derivaram, majoritariamente, das demandas das famílias assessoradas ligados aos temas da Segurança Alimentar e Nutricional, Produção de Cuidados em Saúde, e Alimentação Adequada e Saudável. Artigo 3: A compreensão e a estrutura de significações da EAN foram visualizadas sob três eixos: reconhecimento e não reconhecimento da EAN na ATES; a EAN como um dos temas da dimensão social; a EAN como sinônimo de Segurança Alimentar e Nutricional. Conclusão: Existe uma polissemia de percepções sobre a educação alimentar e nutricional e um espaço permanente de tensões entre as normas e as práticas. Existe uma orientação normativa para a promoção da alimentação adequada e saudável, principalmente na perspectiva de relação com os sistemas alimentares locais. As práticas em educação alimentar e nutricional e as percepções sobre elas se estruturam em um conjunto de valores, signos e sentidos nos quais o alimento é visto como elemento aglutinador-compreensivo de um modelo de extensão rural que é reivindicado Introduction: Food and nutrition education (FNE) is a field of practice and reflection of various social actors involved in health promotion, including the Technical Assistance and Rural Extension Services, which relate to local development actions and to the promotion of adequate and healthy food, as well as to food and nutrition security of rural populations. Objective: To analyze perceptions and practices about the process of food and nutrition education in the context of Rural Development in RS. Methodology: Article 1: We analyzed the text of the Food Guide for the Brazilian population, discussing the intended and the emerging themes from the intersection of the concepts of health promotion and sustainable rural development. Article 2: We investigated the rules established in the national and state level documents and practices implemented by rural extension agents from a search in Administrative Records System containing the description of activities. The data were compiled and processed through descriptive statistics, with the support of Microsoft Office Excel 2007 concerning the production and qualitative analysis; we investigated, in the historical basis, ruptures and continuities contained in the material, with the support of the software NVivo 10 for Windows. Article 3: We conducted 18 individual interviews to produce narratives with the different social actors involved in the Technical Assistance and Rural Extension in RS. The analysis of the narratives was performed from the theoretical perspective and emerging analytical categories; the data were interpreted, systematized and analyzed as a whole with the support of NVivo 10 for Windows. Results: Article 1: We identified 13 themes related to four explanatory dimensions of the intersection of the concepts, which were identified from the constituent elements of the items principles and guidelines of the Food Guide, ten steps to a healthy diet; overcoming obstacles to achieving the ten steps. Article 2: Eight documents and 212,502 activities were analyzed, being 11.13 per cent related to FNE. The rules determined minimum number of activities to be performed by goals established in service contracts, in contrast, the practices mainly come from the demands of advised families linked to the themes of Food and Nutritional Security, Care Production in Health, and Adequate and Healthy Food. Article 3: The understanding and the structure of meanings of FNE were viewed under three axes: recognition and non-recognition of FNE in TSEA; EAN as one of the themes of the social dimension; FNE as a synonym for Food and Nutrition Security. Conclusion: There is a polysemic perception about food and nutrition education and a permanent space of tensions between rules and practices. There is a normative guidance to promote adequate and healthy food, especially from the perspective of relationship with local food systems. The practices in food and nutrition education and the perceptions about them are structured in a set of values, signs and meanings in which food is seen as a unifying-understanding element of a claimed rural extension model
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