Virtual Reality and Powerpoint Grocery Store Tours: Equally Effective in Improving Self-efficacy in Randomised Control Trial.

PURPOSE: Compare computer-based virtual reality (CBVR) and voice-over PowerPoint (PP) grocery store tours (GST) on adult nutrition literacy (NL) and healthful food purchasing self-efficacy (HFPSE). DESIGN: Participants (n = 68) recruited from University worksite wellness program and randomly assigned to CBVR or PP (CBVR = 35; PP = 33). INTERVENTION: Four-week culinary/nutrition education program. Initial three weeks provided identical education for both groups. Week four implemented GST intervention using CBVR or PP. MEASURES: NL and HFPSE surveys before, after, and three-months post from the start of program. ANALYSIS: Intent-to-treat (ITT) analysis with RMANOVA (95% confidence intervals [CI] and effect sizes) to examine change in NL and HFPSE between CBVR and PP groups over 4-week intervention and 3-month retention period. RESULTS: 43 of 68 participants [CBVR (n = 19) and PP (n = 24)] were included in analyses. Both groups significantly improved HFPSE over time (P<.001, CBVR = 46.23% PP = 33.34%), but there were no differences between groups (P = .21) or group by time interaction (P = .31). NL did not change for either group (P = .83, CBVR = 1.11%; PP = .12%) nor were there differences between groups (P = .07). CONCLUSIONS: CBVR and PP GST significantly improved and maintained higher HFPSE scores.

Effects of a Culinary Boot Camp intervention on food/nutrition aptitudes and dietary intake of college students.

OBJECTIVE: College is characterized by transition, students shifting from dependence to independence in numerous roles/responsibilities. Deficiencies in food/nutrition aptitudes and dietary intake exist, evidenced by declining physical well-being and poor eating patterns/practices within the population. Studies examining interventions to improve food/nutrition aptitudes and dietary intake among college students are limited. Participants/methods: A nutrition education program, Culinary Boot Camp (CBC), was developed and delivered to college students at a land-grant university. Online surveys assessed food/nutrition aptitudes and dietary intake pre-/post-/follow-up intervention. Results: Of 86 CBC participants, 71 pre-, 46 post-, and 20 follow-up surveys were completed. Several food/nutrition aptitudes improved (p ≤ 0.05), with greatest improvements in cooking skills/attitudes and healthy eating/grocery shopping self-efficacy (p < 0.01). Additionally, dietary intake of various micronutrients (vitamin C, magnesium, potassium) and fiber increased with statistical significance (p < 0.01). Conclusions: Results suggest CBC is an effective nutrition education program to improve food/nutrition aptitudes and dietary intake amomg college students.

Socio-Ecological Barriers to Dry Grain Pulse Consumption among Low-Income Women: A Mixed Methods Approach.

The purpose of this study was to determine the socio-ecological influences on dry grain pulse consumption (beans, peas, lentils, chickpeas) among low-socioeconomic women in Iowa. Seven focus groups were conducted, with 36 women who qualified for income-based federal assistance. Data were collected from October 2017 to January 2018. Participants completed a survey that gathered individual demographics, assessed perceptions of dry grain pulses, and level of food security. Fifty-eight percent of the women were non-Hispanic white, and 39% were African American, all with an average age of 34.7 years. Thirty-three percent of the women consumed pulses less than once per week. Over 80% agreed that beans were healthful and satiating. Some health benefits of beans were unknown by more than 33% of the population, e.g., lower cancer risk, lower LDL, maintain blood glucose. Only 30% of the women were food secure. Focus group audio recordings were transcribed and analyzed by two researchers, using the grounded theory approach. At the policy level, participants knew pulses were included in USA federal nutrition assistance programs like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Pulses were widely available in grocery stores in communities. Interpersonally, women felt that male partners preferred meats, and children needed animal-source proteins. Individually, women perceived uncooked dry pulses were challenging to prepare. Conclusively, more detailed instruction on pulse preparation, different pulse varieties, and offering canned pulses through WIC may increase consumption.

Food safety knowledge, practices and beliefs of primary food preparers in families with young children. A mixed methods study.

Food preparers in families with young children are responsible for safe food preparation and handling to prevent foodborne illness. To explore the food safety perceptions, beliefs, and practices of primary food preparers in families with children 10 years of age and younger, a mixed methods convergent parallel design and constructs of the Health Belief Model were used. A random sampling of 72 primary food handlers (36.2±8.6 years of age, 88% female) within young families in urban and rural areas of two Midwestern states completed a knowledge survey and participated in ten focus groups. Quantitative data were analyzed using SPSS. Transcribed interviews were analyzed for codes and common themes. Forty-four percent scored less than the average knowledge score of 73%. Participants believe children are susceptible to foodborne illness but perceive its severity to be low with gastrointestinal discomfort as the primary outcome. Using safe food handling practices and avoiding inconveniences were benefits of preventing foodborne illness. Childcare duties, time and knowledge were barriers to practicing food safety. Confidence in preventing foodborne illness was high, especially when personal control over food handling is present. The low knowledge scores and reported practices revealed a false sense of confidence despite parental concern to protect their child from harm. Food safety messages that emphasize the susceptibility and severity of foodborne illness in children are needed to reach this audience for adoption of safe food handling practices.

Local wellness policy strength and perceived implementation of school nutrition standards across three states.

BACKGROUND: Congress sought to address escalating rates of childhood obesity by mandating local wellness policies (LWP) (Child Nutrition and WIC Reauthorization Act of 2004). Previous research has examined LWP content and quality; however, data relative to LWP implementation is limited, and none has examined the relationship between LWP quality and implementation. The purpose of this study was to examine the influence of LWP strength on perceived implementation of LWP components. METHODS: Data collected from school districts in California, Iowa, and Pennsylvania included district LWPs and online surveys at the district (n = 23) and school levels (n = 76). LWPs were scored using a standardized coding tool. Binary and multinomial regression models were used to examine the predictive ability of covariates and independent factors on perceived implementation of reimbursable school meals and nutrition guidelines for competitive foods sold and offered. RESULTS: Overall LWP strength score did not predict perceived implementation of reimbursable school meals or nutrition guidelines for competitive foods. LWP component strength scores for reimbursable meals and nutrition guidelines did not consistently predict perceived implementation of those components. State and urban-centric locale did predict perceived implementation of some LWP components, particularly nutrition guidelines for competitive foods sold and offered. State was a particularly influential factor in the implementation of LWPs in this study, likely due to differences in state policies and laws. CONCLUSIONS: Overall LWP, reimbursable school meals, and nutrition guidelines for competitive foods strength scores do not predict perceived implementation of reimbursable school meals and nutrition guidelines for competitive foods.

Impact of travel distance on WISEWOMAN Intervention attendance for a rural population.

OBJECTIVE: The Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) is a program designed for financially disadvantaged women ages 40-64 and funded by the Centers for Disease Control and Prevention (CDC). This study investigates the role that travel distance plays in determining whether these women will attend an intervention program. METHOD: Women in the Iowa WISEWOMAN program were offered an optional health care education program. Distance from the woman's house to the intervention class site was calculated for participants from October 2002 through July 2005 resulting in 787 women. A generalized additive model is used in determining the combined effects of distance, demographic variables, and lifestyle variables on whether women in the study attend the intervention session or not. RESULTS: Distance plays an important role in attendance, although its impact depends on the age of the woman and the setting (urban or rural) of the intervention. In particular, older rural women were much more likely to attend if the intervention was close to home. CONCLUSION: The probability of attendance is affected by many factors, but travel distance appears to play an important role, particularly for older rural women.

Perceived barriers to community-based health promotion program participation.

OBJECTIVES: To examine barriers and self-efficacy relative to attendance at a cardiovascular risk reduction program. METHODS: Subjects (N=161) represented 3 levels of program participation: full, minimum, and none. Survey scales for barriers to attendance and health behavior change, food security, and self-efficacy for nutrition and physical activity were administered. RESULTS: Minimum and no-exposure participants perceived significantly more barriers to attendance than did the full-exposure participants (P<0.05); barriers to health behavior change were not significantly different. Self-efficacy for nutrition and physical activity were not significantly different among the groups. CONCLUSIONS: Health promotion programs need to consider anytime, any place modes of program delivery to address "program day and time" and "no time to attend" barriers perceived by target audiences.

The use of a handheld calorimetry unit to estimate energy expenditure during different physiological conditions.

BACKGROUND: Accurately determining rates of energy expenditure (EE) under free-living conditions is important in understanding the mechanisms involved in the development and prevention of obesity. Metabolic carts are not portable enough for most free-living situations. The purpose of this study was to compare a portable, handheld indirect calorimetry device (HealtheTech Incorporated, Golden, CO) to a metabolic cart (Physio-Dyne Instrument Corporation, Quogue, NY) during 3 different physiologic states. METHODS: EE was measured by both the handheld calorimeter (5-10 minutes) and the metabolic cart (15-20 minutes) in 20 healthy subjects (18-35 years of age). Measurements were made during 3 physiologic states: (1) postabsorptive rest (REE), (2) postprandial rest (fed energy expenditure, FEE), and (3) while walking in place (activity energy expenditure, AEE). RESULTS: There were no significant differences between the means of the cart vs the hand-held device for REE (mean +/- SE; kcal/d; 1552 +/- 64 vs 1551 +/- 63), FEE (1875 +/- 99 vs 1825 +/- 86), and AEE (3333 +/- 218 vs 3489 +/- 152). The range over which the techniques were tested was 1300-5000 kcal/d. The agreement between the 2 methods was excellent for REE (0.80, p < .0001), FEE (0.89, p < .0001), and AEE (0.75, p < .0002). CONCLUSIONS: Compared with the metabolic cart, the handheld device provided similar estimates of energy expenditure during resting, postprandial, and physically active states. This suggests that portable indirect calorimetry devices can provide reliable and valuable information in free-living research situations for which maximal energy expenditure is <5000 kcal/d.

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.

Promoting and evaluating competence in on-line dietetics education.

Professional organizations, such as the American Dietetic Association are challenged to assure competency of their practitioners. Competency includes higher-level skills such as critical-thinking, cooperative work, effective communication, and use of lifelong learning resources. Information literacy via computer technology is a key component of competency, which needs to be included in dietetic education and training. This dietetic internship examined use of online technology to develop competency using the key-feature exam. Seventy-five dietetic interns from three different programs were divided into those with (n = 44) and without (n = 31) online instruction, to which pre- and post- test key feature exams were administered. Those with online instruction had greater improvement (P < 0.05) on key-feature exams in nutrition support and pediatric nutrition. Competency is complex and difficult to assess, thus tools to better assess the comprehensive scope of practitioner competency are needed. The key-feature exam may be a tool to assess and verify practitioner competency in dietetics professionals.