Food supply adequacy in the Lower Mississippi Delta.

OBJECTIVE: To assess food supply adequacy within 3 food store types in the Lower Mississippi Delta. DESIGN: Regional food store survey to determine availability and quality of 102 food items in 62 supermarkets, 77 small/medium stores, and 86 convenience stores. SETTING: Lower Mississippi Delta region of the United States. PARTICIPANTS: 225 food stores in 18 counties. MAIN OUTCOME MEASURES: Percentage of Thrifty Food Plan (TFP) food items available and quality ratings of 6 food sections across store types. RESULTS: On average, supermarkets carried 96% of the items that compose the TFP. Mean percentage of TFP carried in small/medium stores was 50%. Convenience stores carried 28% of the TFP items. Supermarkets had higher overall quality ratings and quality ratings for fresh and frozen foods compared to small/medium and convenience stores (P<.01). IMPLICATIONS FOR RESEARCH AND PRACTICE: Although supermarkets carried a large percentage of items surveyed, the number of supermarkets in this region is limited. Community residents with limited transportation to reach supermarkets may experience limited food supply adequacy. Therefore, community-based nutrition interventions should include partnerships with small/medium food retailers while trying to impact residents' food choices within those stores.

Influences on fruit and vegetable consumption by low-income black American adolescents.

OBJECTIVE: The purpose of this study was to identify personal, behavioral, and environmental factors influencing fruit and vegetable consumption among 10- to 13-year-old low-income black American youth in the lower Mississippi Delta region. Social Cognitive Theory, along with other theoretical constructs, guided focus group questions and analysis. DESIGN: A qualitative study using focus group methodology. SETTING: Enrichment program of a sports summer camp for low-income youth. PARTICIPANTS: Forty-two adolescents (21 female, 21 male) participated in 6 focus groups. MAIN OUTCOME MEASURES: Personal, behavioral, and environmental influences on fruit and vegetable consumption. ANALYSIS: Content analysis methods were used by 3 independent reviewers to identify themes within the focus group transcripts. Themes were summarized and then categorized into the 3 domains of Social Cognitive Theory. RESULTS: The major themes were taste, availability, extended family influence, visual proof of the benefits of fruit and vegetable consumption, and the need for gender-specific behavioral skills. CONCLUSIONS AND IMPLICATIONS: This formative research will aid in the development of a culturally relevant nutrition intervention for low-income black American adolescents in the lower Mississippi Delta region. The results indicate that this group is more likely to respond to interventions that use role models who can provide proof that fruit and vegetable consumption is related to improved health.

Using self-efficacy to predict weight loss among young adults.

Many healthcare professionals support the idea that weight control and healthy eating should be emphasized early in a person's life to prevent obesity during middle and older adulthood. Unfortunately, although many weight loss programs are available to consumers, few are successful. Recently, constructs of behavioral theories have been integrated into weight loss programs and used to promote changes in health behaviors. In this study, methods used to increase self-efficacy for weight loss were incorporated into a 12-week program designed for weight loss promotion in young adults. Results found that as self-efficacy improved, eating habits improved and weight loss was greater. This study supports the hypothesis that using behavioral techniques to improve self-efficacy can be effective in weight loss promotion and can produce positive outcomes.

Stages of change and fluid intake in dialysis patients.

Nutrition professionals constantly strive to improve adherence to dietary recommendations in hemodialysis patients. The purpose of this study was to evaluate the effects of a 12-week intervention based on stages of change to decrease fluid gain in dialysis patients. Readiness to change, knowledge of appropriate weight gain, and mean weight gains were obtained from patients in five intervention (n=216) and five control (n=100) dialysis units. Intervention had more participants in the maintenance and precontemplation stages at the end of the intervention (P=0.001) compared to the control group. Knowledge scores significantly increased in the intervention group (P<0.001) during the course of the intervention. However, fluid gains did not decrease in either group. Although this intervention did not produce behavior change, the results can aid other educators in planning intervention programs for renal failure and other chronic diseases.

Energy density, nutrient adequacy, and cost per serving can provide insight into food choices in the lower Mississippi Delta.

OBJECTIVE: To compare differences across food groups for food cost, energy, and nutrient profiles of 100 items from a cross-sectional survey of 225 stores in 18 counties across the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi. METHODS: Energy, nutrient, and cost profiles for food items were calculated by using Naturally Nutrient Rich methodology and converting price per 100 g edible portion to price per serving. Foods were grouped into 6 food groups. Mean differences were compared with ANOVA. RESULTS: Significant differences existed by food group for each measure. Energy density was highest for fats/oils/sweets, whereas nutrient density was highest for vegetables. Price per serving was lowest for fats/oils/sweets and highest for meats. CONCLUSIONS AND IMPLICATIONS: Educational messages focusing on a complete diet should consider the role of food costs and provide specific recommendations for increasing nutrient-dense foods by replacing a portion of the meat serving at meals with culturally acceptable lower-cost nutrient-dense foods.

Food shopping perceptions, behaviors, and ability to purchase healthful food items in the lower Mississippi delta.

OBJECTIVE: To examine the agreement between perceptions, behaviors, and ability to purchase healthful food in the Lower Mississippi Delta (LMD). DESIGN: A regional food store survey of healthful food options in supermarkets, small/medium stores, and convenience stores. Focus group discussions were conducted on shopping perceptions and behaviors. SETTING: Counties in Arkansas, Louisiana, and Mississippi. PARTICIPANTS: Eighty-one LMD residents, 18-60+ years of age. MAIN OUTCOME MEASURE: Perceptions of healthful food and ability to acquire these food items across store types. ANALYSIS: Focus group data were analyzed using thematic coding. Summary food store statistics were weighted, and estimates were constructed using SUDAAN 9. Data triangulation was achieved by comparing focus group findings with food availability data. RESULTS: A majority (> 85%) of supermarkets had selected vegetables, breads, and cereals perceived as healthful, whereas availability was limited in small to medium grocery stores and convenience stores. Skim milk, perceived as healthful, was limited in all store types. CONCLUSIONS AND IMPLICATIONS: Limited availability and perceived costs of healthful food in the LMD influenced purchasing behaviors. Attitudes and perceptions should be incorporated into intervention development to improve food choices in conjunction with increasing the availability of healthful food in the LMD.