Review of evaluation tools used to assess the impact of nutrition education on dietary intake and quality, weight management practices, and physical activity of low-income audiences.

Nutrition education programs and social marketing campaigns frequently focus on low-income audiences with the goal of improving dietary intake and quality, weight management practices, and physical activity. The impact of nutrition education can be assessed by measuring change in relation to any or all of these broad variables. Unfortunately, little information is available concerning the reliability, validity, and sensitivity to change of measures used to assess these constructs with low-income audiences of adults and adolescents. This article reviews the literature and discusses the types of available measures that have been used and evaluated for the above audiences. It describes specific measures used to assess total diet, consumption of food groups from the Food Guide Pyramid, and behaviors related to weight management and physical activity. Overall, this review suggests that there is a critical need for additional development and evaluation of dietary quality measurement tools for low-income and minority audiences.

Measures of food insecurity/security.

ABSTRACT Nutrition education has the potential to play an important role in ensuring food security and improving nutritional status. Therefore, food security is recommended for inclusion in nutrition education evaluation efforts. Considerable progress has been made in developing brief tools that can be used to measure food security at the household level. These tools are reliable in population-based surveys, and some studies have found that measures of food security are associated with nutrient intake. Hence, these tools can be valuable in monitoring, in community needs assessment, and in planning. These tools may also have the potential for use in evaluating nutrition education activities; this potential will be enhanced by research into the capacity of these tools to identify changes within households over time as a result of nutrition education and their sensitivity and reliability in doing so.

Use of qualitative and quantitative methods to define behavioral fat-reduction strategies and their relationship to dietary fat reduction in the Patterns of Dietary Change Study.

OBJECTIVE: The purposes of this study were to identify specific food choice behaviors used to decrease dietary fat intake in a community-dwelling population; assess how people categorize changes to diet; determine whether logical grouping of food intake changes revealed one or more common patterns or strategies used by these participants to decrease fat; and determine which strategies were responsible for the greatest decrease in dietary fat intake in the study population. DESIGN: Survey analysis and in-depth interviews were used to quantitatively and qualitatively define dietary change patterns retrospectively in a population who, according to self-report, had decreased their fat intake. Specific food changes made to decrease fat intake, interview statements, and participants' reduction of percentage energy from fat were examined. SETTING: Interviews were conducted from June 1993 through April 1994. SUBJECTS: Included in the study were 145 persons aged 30 to 55 years who reported that they had been decreasing their dietary fat intake for 5 years or more, maintained a healthful diet for at least 5 months, and resided in the United States while changing their diets. STATISTICAL ANALYSES PERFORMED: Confirmatory factor analysis, reliability analysis, and linear regression analysis were performed. RESULTS: Nine fat-reduction strategies were identified. Decrease fat flavorings, decrease "recreational foods," decrease cooking fat, replace meat, change breakfast, and use fat-modified foods accounted for significant reduction in fat intake. CONCLUSIONS: People use a variety of dietary changes to reduce their fat intake. These changes can be categorized into strategies according to the way people change their diets. Knowledge of these strategies and their importance in dietary fat reduction can improve and help nutritionists prioritize the messages they convey.