Amy Block Joy

Selecting Items for a Food Behavior Checklist for a Limited-Resource Audience

OBJECTIVE To report 6 psychometric properties of food behavior checklist (FBC) items and then to use these properties to systematically reduce the number of items on this evaluation tool. DESIGN Random assignment to the intervention and control groups. SETTING Low-income communities. PARTICIPANTS Women (N = 132) from limited-resource families. MAIN OUTCOME MEASURES Reliability, internal consistency, baseline differences by ethnicity, sensitivity to change, and criterion and convergent validity of subscales. RESULTS The fruit and vegetable subscale showed a significant correlation with serum carotenoid values (r =.44, P <.001), indicating acceptable criterion validity. Milk, fat/cholesterol, diet quality, food security, and fruit/vegetable subscales showed significant correlations with dietary variables. Nineteen items have acceptable reliability. Twenty items showed no baseline differences by ethnic group. Eleven of the 15 items expected to show change following the intervention demonstrated sensitivity to change. CONCLUSIONS AND IMPLICATIONS This brief food behavior checklist (16 items) is easy to administer to a client group, has an elementary reading level (fourth grade), and has a low respondent burden in addition to meeting requirements for validity, reliability, and sensitivity to change. This study establishes a process that can be used by other researchers to develop and further refine instruments for use in community health promotion interventions.

The California Childrenʼs 5 a Day- Power Play! Campaign: Evaluation of a Large-Scale Social Marketing Initiative

Fruit and vegetable consumption among Californias fourth and fifth graders appears to be lower than in adults, and there is little literature reporting large-scale interventions that increase consumption. A oneyear evaluation funded by the National Cancer Institute (NCI) and the Centers for Disease Control and Prevention (CDC) was conducted with 3,966 students in 49 schools located in three geographically distant school communities. One community conducted intervention activities in the schools (T1), one conducted activities in school and community channels (T2), and the third served as a control. Behavioral and attitudinal changes were based on one-day food diaries administered preintervention and postintervention. Consumption rose in T1 and T2% and 14%, respectively, while dropping 12% in the control group (p<.05, control different from T1 and T2. While behavioral changes can occur in the school environment, even larger changes can be made when the school interventions are accompanied by community-wide involvement.

Learner-Centered Nutrition Education Improves Folate Intake and Food-Related Behaviors in Nonpregnant, Low-Income Women of Childbearing Age

BACKGROUND Recent studies suggest low-income women of childbearing age may be at risk of suboptimal folate intake. OBJECTIVE To evaluate the effect of learner-centered nutrition education on folate intake and food-related behaviors among nonpregnant, low-income women of childbearing age, compared to education unrelated to nutrition. DESIGN Participants were randomly assigned by recruitment site to receive either the nutrition lesson or a control lesson about resource management. PARTICIPANTS Nonpregnant, low-income (< or =185% federal poverty level) women of childbearing age (18 to 45 years, n=155) from five California counties. MAIN OUTCOME VARIABLES Changes in folate intake and other food-related behaviors. STATISTICAL ANALYSIS Analysis of covariance, adjusting for baseline responses and potential confounders. RESULTS Adjusting for baseline, participants who received the nutrition education had greater increases in folate intake and use of the Nutrition Facts label than the control group. Change in intake of specific folate-rich foods differed by ethnicity. Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children who received the nutrition education increased folate intake but had no significant changes in other food-related behaviors. Food stamp recipients who received the nutrition education had no significant changes in folate intake but did increase the frequency of eating more than one kind of vegetable each day, compared to controls. CONCLUSIONS This study supports the use of learner-centered approaches to nutrition education for low-income audiences, compared to education unrelated to nutrition. Future work is needed to compare learner-centered techniques to traditional pedagogical nutrition education, and to determine whether observed changes from this study persist over the long term.

Food Stamp Nutrition Education Program: Assisting Food Stamp Recipients to Become Self-sufficient

Abstract The Food Stamp Nutrition Education Program (FSNEP) has been assisting food stamp recipients since the first state program began in 1986. Funding, provided by the Food Stamp administrative budget, is available as an option to all states; for those states that participate, there is a 50% match requirement. USDAs Food and Consumer Service (FCS) is the federal agency that approves the Nutrition Education Plan (NEP). This paper will describe the FSNEP from the perspective of seven states: California, Georgia, Michigan, Missouri, New Hampshire, New Mexico, and Wisconsin. These states were chosen to represent various program administrative models used, as well as to describe the various forms of interagency collaboration.

Folate Intake and Food-Related Behaviors in Nonpregnant, Low-Income Women of Childbearing Age

Information about folate intake among low-income women of childbearing age remains limited. This report presents results from a cross-sectional study of folate intake and food-related behaviors in a sample of low-income, nonpregnant women of childbearing age in California. One hundred fifty-seven nonpregnant, low-income (<or=185% federal poverty level) women of childbearing age (18 to 45 years) were evaluated for usual intake of natural food folate and synthetic folic acid, as well as specific food-related behaviors. Eighty-five percent of participants met the Recommended Dietary Allowance for folate, but only 37% met the current synthetic folic acid recommendation for reducing the risk of neural tube defects. Intake of naturally occurring food folate and intake of synthetic folic acid from supplements were positively associated with overall healthful food-related behaviors. Nutrition education that includes information about folic acid may be one way to improve folate intake and other healthful food behaviors among low-income women of childbearing age.

Hunger in California : what interventions are needed ?

OBJECTIVE Although research exists on the nutritional status of individuals and families who seek emergency food, there is little guidance on what to do about it. Our purpose was to develop effective nutrition interventions to assist individuals and families seeking emergency food. DESIGN AND SUBJECTS Two survey instruments were used to collect data on 697 emergency food providers and 3,365 emergency food clients in 20 California counties between 1986 and 1990. STATISTICAL ANALYSES PERFORMED Data were analyzed using the Statistical Package for the Social Sciences. RESULTS Information from the food providers who staff the emergency food sites revealed insufficient food to meet the growing demand, client difficulties in using the donated food, and the need for information to improve the safety and nutritional quality of the donated food. Information from the emergency food clients documented that 70.4% of them were families with children, 84% had incomes below the poverty level, and 20% reported no income at all. In addition, most clients (70%) were not enrolled in the food stamp program. APPLICATIONS/CONCLUSIONS In response to the surveys, counties initiated a variety of interventions, including public awareness campaigns, community development activities, and nutrition education programs. Important strategies are to teach recipients ways to optimize food resources, encourage eligible individuals to enroll in federal nutrition programs, and link individuals with agencies that offer assistance.

Use of Home Study to Improve Nutrition Knowledge in Two Rural Counties of California

Abstract A home study approach to delivering nutrition education to rural low-income families was evaluated in two California counties. Low-income participants (N = 201), mostly Hispanic, were enrolled in a nutrition education program that covered basic nutrition in six mailed lessons. The study evaluated food-intake behavior changes using the 24-hour food recall. Significant improvements in nutrition-related knowledge and behavior were demonstrated by use of a Home Study Questionnaire (pre-/post-test). Other important results included reduced foods cost (from

Food behavior checklist effectively evaluates nutrition education

288 to

EFNEP: An investment in America's future

271) with no apparent reduction in nutritive intake; self-reported changes such as increased consumption of beans, fruits, and vegetables; and decreased consumption of high-fat foods. Estimates of the cost of delivering this type of nutrition education program were low (approximately

USDA program stimulates interest in farmers' markets among low-income women

64.00 per graduated or completed participant).