Barbara Lohse

Facebook is an effective strategy to recruit low-income women to online nutrition education.

OBJECTIVE Nutrition education research recruitment expense and effort are substantial; sample selection is crucial for intervention assessment. Effectiveness and cost of Facebook to recruit low-income women to an online nutrition program were examined, including biopsychosocial characteristics of Facebook responders. METHODS An ad appeared on the Facebook page of low-income women, 18-45 years old, living in Pennsylvania to invite access to an online nutrition program. Eligible persons completed surveys about food-related behaviors including eating competence, food security, and assistance program use. RESULTS Of 465 people who clicked on the ad, 81 completed the eligibility survey, and 62 were eligible; 52 completed a preprogram survey. Completers were mostly white (79%), overweight/obese (mean body mass index 36.2 ± 12.9), and not eating competent (75%). Low-income status was identified for 75% (n = 39) of completers. Total recruitment cost over 19 days was

Impact of an online healthful eating and physical activity program for college students.

596.71. CONCLUSIONS AND IMPLICATIONS Facebook appears to be an effective tool to recruit low-income women to nutrition education projects.

Internet-based Interventions Have Potential to Affect Short-term Mediators and Indicators of Dietary Behavior of Young Adults

Purpose. To identify impact of an online nutrition and physical activity program for college students. Design. Randomized, controlled trial using online questionnaires and on-site physical and fitness assessments with measurement intervals of 0 (baseline), 3 (postintervention), and 15 months (follow-up). Setting. Online intervention delivered to college students; a centralized Web site was used for recruitment, data collection, data management, and intervention delivery. Subjects. College students (18–24 years old, n = 1689), from eight universities (Michigan State University, South Dakota State University, Syracuse University, The Pennsylvania State University, Tuskegee University, University of Rhode Island, University of Maine, and University of Wisconsin). Intervention. A 10-lesson curriculum focusing on healthful eating and physical activity, stressing nondieting principles such as size acceptance and eating competence (software developer: Rainstorm, Inc, Orono, Maine). Measures. Measurements included anthropometrics, cardiorespiratory fitness, fruit/vegetable (FV) intake, eating competence, physical activity, and psychosocial stress. Analysis. Repeated measures analysis of variance for outcome variables. Results. Most subjects were white, undergraduate females (63%), with 25% either overweight or obese. Treatment group completion rate for the curriculum was 84%. Over 15 months, the treatment group had significantly higher FV intake (+.5 cups/d) and physical activity participation (+270 metabolic equivalent minutes per week) than controls. For both groups, anthropometric values and stress increased, and fitness levels decreased. Gender differences were present for most variables. First-year males and females gained more weight than participants in other school years. Conclusion. A 10-week online nutrition and physical activity intervention to encourage competence in making healthful food and eating decisions had a positive, lasting effect on FV intake and maintained baseline levels of physical activity in a population that otherwise experiences significant declines in these healthful behaviors.

Nutrition Education Intervention Improves Vegetable-Related Attitude, Self-Efficacy, Preference, and Knowledge of Fourth-Grade Students

OBJECTIVE Evaluate a theory-based, Internet-delivered nutrition education module. DESIGN Randomized, treatment-control design with pre-post intervention assessments. SETTING AND PARTICIPANTS Convenience sample of 160 young adults (aged 18-24) recruited by community educators in 4 states. Study completers (n = 96) included a mix of racial/ethnic groups and family demographics, but were predominately white females without children. INTERVENTION A Transtheoretical Model (TTM)-based, stage-tailored Internet program, F&V (Fruit & Vegetable) Express Bites, was delivered to treatment group participants; controls received nontailored messages in a comparable format. MAIN OUTCOME MEASURES AND ANALYSIS: TTM constructs at baseline, immediately postviewing, and at 30-day follow-up were compared via chi-square, McNemars test, and logistic regression. Qualitative use and acceptability indicators were collected postviewing (treatment only). RESULTS Of baseline respondents, 86.5% completed the study. At follow-up, self-efficacy, decisional balance, and selected processes improved for both groups, with only marginal advantages for the theory-based version. Fruit and vegetable consumption changes were similar for both groups. Qualitative measures of knowledge, confidence, and motivation improved (not measured for controls). Favorable ratings of treatment program acceptability and personal relevance were reported. CONCLUSIONS AND IMPLICATIONS The Internet is a favorable option for reaching young adults with nutrition messages. This study did not identify strong advantages of theory-based tailoring, especially for fruit consumption, which had weaker barriers than vegetable consumption among this target audience.

Feeding Practices and Styles Used by a Diverse Sample of Low-income Parents of Preschool-age Children

BACKGROUND Impact of a classroom-based, standardized intervention to address limited vegetable consumption of fourth graders was assessed. METHODS A 4-lesson, vegetable-focused intervention, revised from extant materials was repurposed for Pennsylvania fourth graders with lessons aligned with state academic standards. A reliability-tested survey was modified, then examined for face and content validity and test-retest reliability. Lessons and evaluation materials were modified through an iterative testing process with educator feedback. A nonequivalent control group design was stratified by local Supplemental Nutrition Assistance Program Education (SNAP-Ed) partnering organizations with random assignment of participating elementary schools as control (N = 68) or intervention (N = 72) treatments. Independent t-tests compared control and intervention group changes. A mixed effects model was created to account for classroom effects from the nested sampling method of selecting classrooms within SNAP-Ed partnering organizations. General linear model univariate analyses of variance were conducted to assess intervention effects considering gender, and food preparation/cooking experience. RESULTS During a 3- to 5-week time frame, 57 intervention classrooms (N = 1047 students) and 51 control classrooms (N = 890) completed pre- and post-testing. Intervention students improved in vegetable-related attitude, self-efficacy, preference, and knowledge scores (p < .001). For example, intervention vegetable preference increased 1.56 ± 5.80 points; control group mean increase was only 0.08 ± 4.82 points. Group differences in score changes were not affected by gender or interactions between gender and food preparation/cooking experience with family. CONCLUSIONS A defined intervention delivered in a SNAP-Ed setting can positively impact mediators associated with vegetable intake for fourth-grade students.

Diet quality is related to eating competence in cross-sectional sample of low-income females surveyed in Pennsylvania.

OBJECTIVE To describe the feeding practices and styles used by a diverse sample of low-income parents of preschool-age children. DESIGN Thirty- to 60-minute meetings involving a semistructured interview and 2 questionnaires administered by the interviewer. SETTING Low-income communities in Philadelphia, PA. PARTICIPANTS Thirty-two parents of 2- to 6-year-old children. PHENOMENA OF INTEREST The feeding practices and styles of low-income parents of preschoolers. ANALYSIS Qualitative interviews analyzed iteratively following a thematic approach; quantitative data analyzed using nonparametric and chi-square tests. RESULTS Qualitative analyses revealed parents used a myriad of feeding practices to accomplish child-feeding goals. Racial/ethnic differences were seen; East Asian parents used more child-focused decision-making processes, whereas black parents used more parent-focused decision-making processes. Quantitative analyses substantiated racial/ethnic differences; black parents placed significantly higher demands on children for the amounts (H = 5.89, 2 df, P = .05; Kruskal-Wallis) and types (H = 8.39, 2 df, P = .01; Kruskal-Wallis) of food eaten compared to parents of other races/ethnicities. In contrast, significantly higher proportions of East Asian parents were classified as having an indulgent feeding style compared to black parents and parents of other races/ethnicities (chi(2)[4, n = 32] = 9.29, P < .05). CONCLUSIONS AND IMPLICATIONS Findings provide support for tailoring nutrition education programs to meet the diverse needs of this target audience.

Purposive facebook recruitment endows cost-effective nutrition education program evaluation.

Women participants of two federally administered nutrition education programs (n=149, 56% white, 64% food secure, 86% 18-50 years of age,) completed telephone interviews that included three 24-hour dietary recalls and the Satter Eating Competence Inventory. Eating competence is delineated by an Inventory score≥32. Competent eaters had significantly greater intakes of fiber, vitamin A, vitamin E, vitamin C, most B-vitamins, magnesium, iron, zinc, potassium and a higher Healthy Eating Index. Two dietary patterns defined as Prudent and Western were observed. The Prudent pattern was correlated with eating competence and characterized by more healthful foods such as fruits, vegetables and low-fat dairy products. The Western pattern, characterized by foods higher in fat, salt, and sugar, was not related to eating competence. Findings suggest that dietary guidance using an eating competence approach for low-income women is compatible with goals to improve dietary quality and eating patterns.

Eat, Sleep, Work, Play: Associations of Weight Status and Health-Related Behaviors Among Young Adult College Students

Background Recent legislation established a requirement for nutrition education in federal assistance programs to be evidence-based. Recruitment of low-income persons to participate and evaluate nutrition education activities can be challenging and costly. Facebook has been shown to be a cost-effective strategy to recruit this target audience to a nutrition program. Objective The purpose of our study was to examine Facebook as a strategy to recruit participants, especially Supplemental Nutrition Assistance Program Education (SNAP-Ed) eligible persons, to view and evaluate an online nutrition education program intended to be offered as having some evidence base for SNAP-Ed programming. Methods English-speaking, low-income Pennsylvania residents, 18-55 years with key profile words (eg, Supplemental Nutrition Assistance Program, Food bank), responded to a Facebook ad inviting participation in either Eating Together as a Family is Worth It (WI) or Everyone Needs Folic Acid (FA). Participants completed an online survey on food-related behaviors, viewed a nutrition education program, and completed a program evaluation. Facebook set-up functions considered were costing action, daily spending cap, and population reach. Results Respondents for both WI and FA evaluations were similar; the majority were white, <40 years, overweight or obese body mass index, and not eating competent. A total of 807 Facebook users clicked on the WI ad with 73 unique site visitors and 47 of them completing the program evaluation (ie, 47/807, 5.8% of clickers and 47/73, 64% of site visitors completed the evaluation). Cost per completed evaluation was US

Validation of a measure of the Satter eating competence model with low-income females

25.48; cost per low-income completer was US

Eating Competence of Elderly Spanish Adults Is Associated with a Healthy Diet and a Favorable Cardiovascular Disease Risk Profile

39.92. Results were similar for the FA evaluation; 795 Facebook users clicked on the ad with 110 unique site visitors, and 73 completing the evaluation (ie, 73/795, 9.2% of ad clickers and 73/110, 66% of site visitors completed the evaluation). Cost per valid completed survey with program evaluation was US