Field testing a questionnaire assessing parental psychosocial factors related to consumption of calcium-rich foods by Hispanic, Asian, and Non-Hispanic white young adolescent children.

Intervention strategies to increase calcium intake of parents and young adolescent children could be improved by identifying psychosocial factors influencing intake. The objective was to develop a tool to assess factors related to calcium intake among parents and Hispanic, Asian, and non-Hispanic white young adolescent children (10-13 years) meeting acceptable standards for psychometric properties. A parent questionnaire was constructed from interviews conducted to identify factors. Parents (n = 166) in the United States completed the questionnaire, with seventy-one completing it twice. Two constructs (Attitudes/Preferences and Social/Environmental) were identified and described by eighteen subscales with Cronbach's alpha levels from .50 to .79. Test-retest coefficients ranged from .68 to .85 (p < .001). Several subscales were statistically significantly associated with parent characteristics consistent with theory and published literature. This tool shows promise as a valid and reliable measure of factors associated with calcium-rich food intake among parents and young adolescent children.

Operation Frontline: assessment of longer-term curriculum effectiveness, evaluation strategies, and follow-up methods.

OBJECTIVES: To determine the effectiveness of a traditional pretest versus a retrospective pretest, the stability of self-reported behavior changes at 3 or 6 months post-class series, and the most effective method for longer-term follow-up assessment of Operation Frontline's Eating Right class series. DESIGN: Longitudinal study; subjects surveyed at some combination of traditional pretest, retrospective pretest/posttest after the last class, and at 3 or 6 months. SETTING: Communities in the metropolitan Denver area. PARTICIPANTS: Of the 53 participants, 90% were women, 70% were of Hispanic descent, 49% were between the ages of 20 and 29, and 64% had at least a twelfth-grade education or General Educational Development diploma. MAIN OUTCOME MEASURES: Contrast results from a traditional pretest with a retrospective pretest; assess temporal stability of self-reported behavior changes; and contrast response rates for multiple follow-up methods (mail, telephone, or reunion class). ANALYSIS: Item and scale scores were compared across various time points using repeated-measures analysis of variance. RESULTS: No significant differences were found for 6 of 7 variables between the traditional pretests and retrospective pretests. Most self-reported behavior changes were retained at 3 and 6 months post-class. Mail had the best response rate (62%) for this limited-resource population. CONCLUSIONS AND IMPLICATIONS: The maintenance of behavior changes at 3 or 6 months post-intervention supports the effectiveness of the Eating Right series. Mail follow-up achieved higher response rates than telephone. The lack of significant differences (except 1 variable) between the traditional pretest and the retrospective pretests does not support the retrospective pretest as being more accurate. However, the retrospective pretest may be more desirable for educators, as it eliminates the need to test participants twice.

Development of a decision tree to determine appropriateness of NVivo in analyzing qualitative data sets.

A decision tree was developed to determine when NVivo is an appropriate tool for qualitative analysis. NVivo, a qualitative analysis software package, was used to analyze interviews of 204 Asian, Hispanic, and white parents in 12 states. The experience provided insight into issues that should be considered when deciding to use the software. NVivo can enhance the qualitative research process, quickly process queries, and expand analytical avenues. Before using, however, the following must be considered: training time, establishing inter-coder reliability, number and length of documents, coding time, coding structure, use of automated coding, and possible need for separate databases or additional supporting software.

Adapting and implementing a long-term nutrition and physical activity curriculum to a rural, low-income, biethnic community.

This study adapted an urban-based school nutrition program for delivery in a rural community. Specific aims were to adapt the curriculum; expand it to include physical activity; determine effectiveness on students' attitudes, knowledge, and self-efficacy; and assess teachers' impressions. Three cohorts were established: 173 students taught by a resource teacher, 170 students taught by classroom teachers, and 187 students who did not receive the curriculum. Pre- and posttest surveys measured outcomes, and classroom teachers were observed and interviewed. The curriculum was shown to be effective in enhancing student outcomes for both the resource teacher and classroom teacher cohorts. Teachers reported that lessons needed to be simplified and that children enjoyed them. Findings support the transferability of an urban-based nutrition curriculum to a rural community and the need for students to receive health education annually.

Senior military officers' educational concerns, motivators and barriers for healthful eating and regular exercise.

The increasing trend of overweight in the military, the high cost of health care associated with overweight, and the failure to meet some Healthy People 2000 objectives related to diet identify the need for more appropriate nutrition and fitness education for military personnel. The purpose of this study was to assess senior military officers' concerns on various health topics, educational preferences for nutrition and health topics, eating habits, and barriers and motivators for eating healthfully and exercising regularly. The survey was completed by 52 resident students at the U.S. Army War College. Fitness, weight, and blood cholesterol were top health concerns, and respondents wanted to know more about eating healthfully on the run. The primary barrier to eating healthfully and exercising regularly was lack of time, whereas health and appearance were top motivators. Health interventions for this population should include their topics of concern and should address perceived barriers and motivators.

The Effect of Omega-3 Docosahexaenoic Acid Supplementation on Gestational Length: Randomized Trial of Supplementation Compared to Nutrition Education for Increasing n-3 Intake from Foods.

OBJECTIVE: DHA supplementation was compared to nutrition education to increase DHA consumption from fish and DHA fortified foods. DESIGN: This two-part intervention included a randomized double-blind placebo controlled DHA supplementation arm and a nutrition education arm designed to increase intake of DHA from dietary sources by 300 mg per day. SETTING: Denver Health Hospitals and Clinics, Denver, Colorado, USA. POPULATION: 871 pregnant women aged 18-40 were recruited between 16 and 20 weeks of gestation of whom 564 completed the study and complete delivery data was available in 505 women and infants. METHODS: Subjects received either 300 or 600 mg DHA or olive oil placebo or nutrition education. MAIN OUTCOME VARIABLE: Gestational length. RESULTS: Gestational length was significantly increased by 4.0-4.5 days in women supplemented with 600 mg DHA per day or provided with nutrition education. Each 1% increase in RBC DHA at delivery was associated with a 1.6-day increase in gestational length. No significant effects on birth weight, birth length, or head circumference were demonstrated. The rate of early preterm birth (1.7%) in those supplemented with DHA (combined 300 and 600 mg/day) was significantly lower than in controls. CONCLUSION: Nutrition education or supplementation with DHA can be effective in increasing gestational length.

Use of the stages of change model in improving nutrition and exercise habits in enlisted Air Force men.

Thirty-nine U.S. Air Force enlisted men participated in a randomized controlled study that evaluated an experimental program designed to enhance fitness. Subjects were assigned to either a treatment (access to the program) or control (no access to program) group for 6 months. To improve treatment group fitness (as measured by VO2, subjects received individually tailored information (based on a behavior change model) via the Internet to encourage adoption of positive diet and exercise behaviors. Results showed no significant effect in improving fitness in treatment. However, significant effects were observed for secondary outcomes such as weight (controls, +1.0 kg vs. treatment, -2.2 kg, p < 0.05), body mass index (+0.3 kg/m2 vs. -0.7 kg/m2, p < 0.05), and percent body fat (+0.6% vs. -1.5%, p < 0.001). The data suggest that the individually tailored exercise information was not effective in encouraging sufficient exercise intensity to impact fitness. However, the dietary tailored information appears to have encouraged the adoption of more positive nutritional practices as demonstrated by the beneficial effects reflected in secondary outcomes.

Osteoporosis knowledge, calcium intake, and weight-bearing physical activity in three age groups of women.

The purpose of this study was to determine the extent and integration of osteoporosis knowledge in three age groups of women and compare knowledge to calcium intake and weight-bearing physical activity (WBPA). In this cross-sectional study, knowledge, calcium intake and WBPA were assessed using probe interviews, a food frequency and an activity questionnaire, respectively. Seventy-five white women were separated into three groups: young (25-35 years), middle aged (36-46 years) and postmenopausal (50+ years). Concept maps were used to assess knowledge (concepts, integration and misconceptions). Calcium intakes from diet, supplements and fortified orange juice were estimated as were minutes of daily WBPA. Analysis of covariance was used to compare knowledge, calcium intake and WBPA by age group. Covariates included education, family history, physical problems making exercise difficult, and lactose intolerance. Chi square analysis was used to determine differences in these covariates across age groups. Correlations and regression analysis were used to determine relationships between knowledge and behaviors. Knowledge scores averaged 32-44 points (183 possible). Average calcium intake in all groups exceeded the Dietary Reference Intake's recommended Adequate Intake but 20-24% consumed less than 60% of the AI. Housework, walking at work, and standing at home and work accounted for 90% of WBPA. Knowledge about osteoporosis was limited and not associated with age, WBPA or calcium intake. Calcium intake and WBPA were not associated with age. Practitioners need to provide explicit information on osteoporosis and risk reducing behaviors to women of all ages.