Measuring and Influencing Behavior Change in Dietary Intake: Integrated Photovoice Approach in Nutrition Interventions in Eastern Kenya.

A study conducted in two wards of Tharaka Nithi subcounty in Kenya documented the impact of using photovoice as a learning tool to build awareness about diets in order to influence behavior change, as well as a method to measure dietary intake. After a year's nutrition awareness drive using Smart Food branding, in the intervention area, a total of 60 participants from intervention and control areas were identified for the photovoice exercise. The analysis showed household and women's dietary diversity scores to be higher in the intervention group by 35% and 45%, respectively. An estimate of nutrient intake revealed a higher intake of calories, protein, calcium, iron and zinc ranging from 70% to 205% in the intervention group. Qualitative feedback on the photovoice approach reflected increased nutrition awareness and behavior change. Results showed the efficacy of the approach in evaluating diets while simultaneously improving participants' realization of what they were consuming using images captured and a one-on-one discussion with nutritionists. The improvement in dietary diversity scores reflected the effectiveness of this creative participatory and branded approach in imparting a strong message on and enthusiasm for learning about nutrition, resulting in behavior change.

Determinants of microbial contamination of cooked foods hawked in Tharaka Nithi County, Kenya: a cross-sectional study.

Introduction: hawking of cooked foods is an important socio-economic activity. However, hawked cooked foods are prone to contamination, especially by pathogenic microorganisms. Methods: this was a cross-sectional study of 151 cooked food hawkers and 151 cooked food samples, one sample each from every respondent. Data was collected through questionnaires, observation checklists, laboratory processes, and key informant interviews. Quantitative data were analyzed using SPSS, while qualitative data were analyzed using the thematic network analysis technique. Results: adjusted multinomial logistic regression revealed increased odds of microbial contamination in cooked foods hawked by persons with primary-level education (adjusted odds ratio) AOR = 9.278, 95% confidence interval (CI) 2.292, 37.548; p = 0.003), persons earning a profit of Ksh. ≤500.00 (AOR = 4.046, 95% CI 1.825, 8.969; p = 0.001), and in areas infested with rodents (AOR = 6.386, 95% CI 1.877, 21.724; p = 0.003). However, cooked foods hawked by males (AOR = 0.338, 95% CI 0.133, 0.856; p = 0.022), persons trained on food safety (AOR = 0.216, 95% CI 0.064, 0.733; p = 0.014), persons wearing outer garments (AOR = 0.399, 95% CI 0.196, 0.812; p = 0.011), and by persons who stored their garbage in a municipal receptacle or a standard dust bin (AOR = 0.13, 95% CI 0.041, 0.410; p = 0.000) recorded reduced risk of contamination. Conclusion: hawker´s characteristics, food handling practices, and the condition of the hawking station are important determinants of microbial contamination of cooked foods hawked in Tharaka Nithi County. Targeted interventions need to be developed and implemented to prevent related foodborne diseases.