Development of a Nutrition Education Intervention for Food Bank Clients.

The focus of this article is the development of a nutrition education intervention for food bank clients. Formative research using mixed-methods (qualitative and quantitative) and community-based participatory research principles was conducted to assess the nutrition education needs of clients obtaining service from the Houston Food Bank (HFB). Participants were HFB and pantry staff and clients. Interview data were coded and analyzed using grounded theory approach. Themes were then identified. Quantitative data were analyzed for frequencies and descriptives. Data were used to tailor the curriculum to the target population. Six HFB staff, 49 pantry staff from 17 pantries, and 54 clients from 10 pantries participated in interviews and focus groups and completed questionnaires. The participants provided opinion on the current nutrition education provided via the food bank and made suggestions on strategies for development of an intervention. Their feedback was used to develop the six-session intervention curriculum to be delivered over 6 months. This research provides evidence that it is critical for members of the target audience be included in formative research to develop behavior change programs that are relevant and appealing and target their needs and interests.

Multiple health behaviors among overweight, class I obese, and class II obese persons.

OBJECTIVES: Recent studies suggest an association between excess weightand increased risk of some cancers. Health disparities are evident for both obesity and cancer, each of which disproportionately affects African American adults. We examine the relationship between weight and selected health behaviors related to colorectal cancer (CRC) prevention (fruit and vegetable consumption, recreational physical activity, and CRC screening). We also examine behavioral psychosocial correlates including knowledge, perceived benefits and barriers, self-efficacy, and social support for these behaviors. METHODS: The WATCH (Wellness for African Americans through Churches) Project was a CRC prevention study implemented in African American churches in rural North Carolina. We analyzed the baseline data of 813 church members who provided information on their height and weight through a telephone-based survey. RESULTS: Most (78%) respondents were classified as overweight or obese. Self-rated health and level of physical activity were lower at higher weight levels, but little difference in fruit and vegetable consumption was observed among participants. Weight was negatively associated with past-year CRC testing among women but not among men. Levels of knowledge and self-efficacy were similar across weight groups, but some perceived barriers were significantly higher among obese participants. CONCLUSIONS: Obesity was associated with some health behaviors and psychosocial correlates associated with increased cancer risk. Cancer prevention programs in African American populations where overweight is prevalent may wish to specifically address these issues.

Social environment and physical activity: a review of concepts and evidence.

The rapidly growing and evolving literature on the social environment and its influence on health outcomes currently lacks a clear taxonomy of dimensions of the social environment and the differing mechanisms through which each influences health-related behavior. This paper identifies five dimensions of the social environment-social support and social networks, socioeconomic position and income inequality, racial discrimination, social cohesion and social capital, and neighborhood factors-and considers each in the context of physical activity to illustrate important differences between them. Increasing the specificity of terminology and methods in social environmental research on health will enable more systematic inquiry and accelerate the rate of scientific discovery in this important area.

Individual, social environmental, and physical environmental influences on physical activity among black and white adults: a structural equation analysis.

BACKGROUND: Social ecological models suggest that conditions in the social and physical environment, in addition to individual factors, play important roles in health behavior change. Using structural equation modeling, this study tested a theoretically and empirically based explanatory model of physical activity to examine theorized direct and indirect effects of individual (e.g., motivation and self-efficacy), social environmental (e.g., social support), and physical environmental factors (e.g., neighborhood quality and availability of facilities). METHOD: A community-based sample of adults (N = 910) was recruited from 2 public health centers (67% female, 43% African American, 43% < $20,000/year, M age = 33 years) and completed a self-administered survey assessing their current physical activity level, intrinsic and extrinsic motivation for physical activity, perceived social support, self-efficacy, and perceptions of the physical environment. RESULTS: Results indicated that (a) perceptions of the physical environment had direct effects on physical activity, (b) both the social and physical environments had indirect effects on physical activity through motivation and self-efficacy, and (c) social support influenced physical activity indirectly through intrinsic and extrinsic motivation. For all forms of activity, self-efficacy was the strongest direct correlate of physical activity, and evidence of a positive dose-response relation emerged between self-efficacy and intensity of physical activity. CONCLUSIONS: Findings from this research highlight the interactive role of individual and environmental influences on physical activity.