Development of the Food-Related Control Scale for Long-Term Care.

OBJECTIVE: Develop and test a Food-Related Control Scale (FRCS) measuring resident-perceived control in long-term care food service. DESIGN: A bank of 15 initial items based on a multidimensional locus of control construct was developed initially. Expert review, cognitive interviews, a pilot study, and factor analysis were used to validate the instrument and assess reliability. SETTING: Individual phone-based cognitive interviews and 16 skilled nursing facilities in the US. PARTICIPANTS: Cognitive interviews included a convenience sample of independently living adults aged ≥ 65 (n = 13), whereas the pilot study included skilled nursing facility-residing adults (n = 166). VARIABLES MEASURED: Perception of food-related control in a long-term care setting. ANALYSIS: Cognitive interviews were analyzed to develop items. Quantitative data from skilled nursing facility residents were analyzed using SAS software for structural equation modeling and factor analysis. RESULTS: A 2-dimensional construct (9 items) of the FRCS demonstrated reliability with factor analysis. Concurrent validity within the locus of control construct was demonstrated with the Multidimensional Health Locus of Control Scale (standardized estimate of 0.430; P < 0.1). CONCLUSIONS AND IMPLICATIONS: The FRCS may be used to determine how residents in long-term care perceive control over their food experiences. Further testing is necessary to determine the appropriateness of the FRCS for different population uses.

Menu labeling influence on purchase behaviors: Applying the theory of planned behavior and health consciousness.

Mixed findings have been reported in the literature on the effectiveness of menu labeling in assisting consumers to make informed purchase decisions when eating out. Therefore, this study examined factors that influenced consumers' intentions to use menu labeling and whether these intentions influenced caloric purchases relative to actual caloric needs. While other researchers have assessed impacts of menu labeling on total calories purchased, our study assessed the impact relative to caloric needs, therein recognizing that each consumer has different caloric needs. An extended theory of planned behavior (TPB) incorporating health consciousness served as the theoretical underpinning. The TPB addresses reasons why an individual takes action on a certain behavior; in the case of this research, that behavior was purchasing food. Food purchases were further operationalized using the calorie content of foods and comparing that number of calories to caloric needs. Two-step structural equation modeling was used to analyze 316 surveys from restaurant consumers. Results indicated that attitudes, subjective norms, and health consciousness positively influenced intentions to use menu labeling. Intentions to use menu labeling also significantly influenced actual purchase behaviors (measured as the difference between caloric purchases and caloric needs). Overall, the current research findings provide novel insights for researchers to further explore the role of menu labeling on purchase behavior by using the TPB model with integration of health consciousness.

Listeria monocytogenes Occurrence and Adherence to Recommendations: Small and Large Retail Delicatessens in Iowa.

The goal of this research was to determine the prevalence of Listeria monocytogenes in Iowa retail delicatessens and assess environmental aspects that mitigate L. monocytogenes. Fifty-seven small and large retail delicatessens in Iowa were selected randomly. More small operations (n = 43) were included as compared with larger stores, given the higher frequency of violations. An environmental assessment instrument was used to determine environmental factors and practices. At least five microbial samples were collected per site. We collected 286 (74.3%) of 385 microbial samples from small deli operations and 99 (25.7%) of 385 samples from large deli operations. Samples were taken from various zone 1 and 2 areas, such as the slicer, deli case, and meat scale; three (0.08%) samples were positive for L. monocytogenes. Regarding environmental aspects, not preparing, holding or storing ready-to-eat products near raw products (n = 30, 53%) was practiced by the fewest delis. The majority of establishments were observed covering, wrapping, or protecting ready-to-eat products when not in use to prevent contamination (n = 56, 98.2%). Comparisons were made to the U.S. Department of Agriculture Food Safety and Inspection Service Guidance on environmental practices, and 60% of the operations surveyed were in adherence with at least seven of the eight recommendations.

Leadership: reflections over the past 100 years.

Leadership, viewed by the American Dietetic Association as the ability to inspire and guide others toward building and achieving a shared vision, is a much written-about topic. Research on leadership has addressed the topic using many different approaches, from a very simplistic definition of traits to a more complex process involving interactions, emotions, and learning. Thousands of books and papers have been published on the topic of leadership. This review paper will provide examples of the varying foci of the writings on this topic and includes references for instruments used to measure leadership traits and behaviors. Research is needed to determine effective strategies for preparing dietitians to be effective leaders and assume leadership positions. Identifying ways to help dietitians better reflect on their leadership experiences to enhance their learning and leadership might be one strategy to explore.

Dietetics students perceive themselves as leaders and report they demonstrate leadership in a variety of contexts.

A leadership survey was designed and administered to undergraduate dietetics students (n=283) at eight universities to examine leadership actions reported most frequently, the context of these leadership actions, and students' reported perceptions of themselves as leaders. The majority of students perceive themselves as leaders in all context areas. The leadership practice, "Enabling Others to Act," was the most frequently reported. There were no significant differences in leadership behaviors based on college classification status and supervisory experience. Leadership behaviors were more prevalent in students who had previous leadership coursework, were older, or who had previous leadership experience. Dietetics students perceive they demonstrate leadership and do so in a variety of contexts, most frequently in class. Therefore, classroom activities may help strengthen leadership abilities of future dietetics professionals.

Reporting of foodborne illness by U.S. consumers and healthcare professionals.

During 2009-2010, a total of 1,527 foodborne disease outbreaks were reported by the Centers for Disease Control and Prevention (CDC) (2013). However, in a 2011 CDC report, Scallan et al. estimated about 48 million people contract a foodborne illness annually in the United States. Public health officials are concerned with this under-reporting; thus, the purpose of this study was to identify why consumers and healthcare professionals don't report foodborne illness. Focus groups were conducted with 35 consumers who reported a previous experience with foodborne illness and with 16 healthcare professionals. Also, interviews with other healthcare professionals with responsibility of diagnosing foodborne illness were conducted. Not knowing who to contact, being too ill, being unsure of the cause, and believing reporting would not be beneficial were all identified by consumers as reasons for not reporting foodborne illness. Healthcare professionals that participated in the focus groups indicated the amount of time between patients' consumption of food and seeking treatment and lack of knowledge were barriers to diagnosing foodborne illness. Issues related to stool samples such as knowledge, access and cost were noted by both groups. Results suggest that barriers identified could be overcome with targeted education and improved access and information about the reporting process.

Varying influences of motivation factors on employees' likelihood to perform safe food handling practices because of demographic differences.

Food safety training has been the primary avenue for ensuring food workers are performing proper food handling practices and thus, serving safe food. Yet, knowledge of safe food handling practices does not necessarily result in actual performance of these practices. This research identified participating food service employees' level of agreement with four factors of motivation (internal motivations, communication, reward-punishment, and resources) and determined if respondents with different demographic characteristics reported different motivating factors. Data were collected from 311 food service employees who did not have any supervisory responsibilities. Intrinsic motivation agreement scores were consistently the highest of all four motivational factors evaluated and did not differ across any of the demographic characteristics considered. In contrast, motivation agreement scores for communication, reward-punishment, and resources did differ based on respondents' gender, age, place of employment, job status, food service experience, completion of food handler course, or possession of a food safety certification. In general, respondents agreed that these motivation factors influenced their likelihood to perform various safe food handling procedures. This research begins to illustrate how employees' demographic characteristics influence their responses to various motivators, helping to clarify the complex situation of ensuring safe food in retail establishments. Future research into why employee willingness to perform varies more for extrinsic motivation than for intrinsic motivation could assist food service managers in structuring employee development programs and the work environment, in a manner that aids in improving external motivation (communication, reward-punishment, and resources) and capitalizing on internal motivation.

Dietetics students perceive themselves as leaders and report they demonstrate leadership in a variety of contexts.

A leadership survey was designed and administered to undergraduate dietetics students (n=283) at eight universities to examine leadership actions reported most frequently, the context of these leadership actions, and students' reported perceptions of themselves as leaders. The majority of students perceive themselves as leaders in all context areas. The leadership practice, "Enabling Others to Act," was the most frequently reported. There were no significant differences in leadership behaviors based on college classification status and supervisory experience. Leadership behaviors were more prevalent in students who had previous leadership course-work, were older, or who had previous leadership experience. Dietetics students perceive they demonstrate leadership and do so in a variety of contexts, most frequently in class. Therefore, classroom activities may help strengthen leadership abilities of future dietetics professionals.

Leadership: reflections over the past 100 years.

Leadership, viewed by the American Dietetic Association as the ability to inspire and guide others toward building and achieving a shared vision, is a much written-about topic. Research on leadership has addressed the topic using many different approaches, from a very simplistic definition of traits to a more complex process involving interactions, emotions, and learning. Thousands of books and papers have been published on the topic of leadership. This review paper will provide examples of the varying foci of the writings on this topic and includes references for instruments used to measure leadership traits and behaviors. Research is needed to determine effective strategies for preparing dietitians to be effective leaders and assume leadership positions. Identifying ways to help dietitians better reflect on their leadership experiences to enhance their learning and leadership might be one strategy to explore.

A preceptor focus group approach to evaluation of a dietetic internship.

Geographical dispersion of preceptors within dietetic internship programs creates educational challenges. Iowa State University's dietetic internship utilizes preceptors from more than 90 facilities statewide. Three preceptor focus groups were conducted to identify strengths and areas needing improvement in the internship, including preceptor and intern needs and expectations. Of the more than 90 preceptors representing medical nutrition therapy, foodservice management, and community nutrition, 36 were contacted and 18 preceptors participated, resulting in 5 to 7 participants per focus group. Emerging themes included effective feedback; preceptor networking; and communication between internship program/faculty, interns, and preceptors. Geographic isolation and minimal use of Internet-based resources may contribute to these themes. Whereas the majority of preceptors had access to the Internet, only 7 (38%) had accessed the Internet-based resources provided by the program. Preceptor suggestions can provide new perspectives for enhancing the learning environment. Regional workshops and e-mail list-serves can help facilitate communication and networking among preceptors.