Debra Palmer Keenan

Measures of Food Insecurity/Security

ABSTRACT Nutrition education has the potential to play an important role in ensuring food security and improving nutritional status. Therefore, food security is recommended for inclusion in nutrition education evaluation efforts. Considerable progress has been made in developing brief tools that can be used to measure food security at the household level. These tools are reliable in population-based surveys, and some studies have found that measures of food security are associated with nutrient intake. Hence, these tools can be valuable in monitoring, in community needs assessment, and in planning. These tools may also have the potential for use in evaluating nutrition education activities; this potential will be enhanced by research into the capacity of these tools to identify changes within households over time as a result of nutrition education and their sensitivity and reliability in doing so.

Maintaining Food Sufficiency: Coping Strategies Identified by Limited-Resource Individuals versus Nutrition Educators

OBJECTIVE This studys purposes were to identify food acquisition and management coping strategies used by limited-resource individuals to maintain food sufficiency, compare strategies named by the target audience to those previously identified by nutrition educators, and examine these strategies to advance grounded theory. DESIGN Eleven focus groups, conducted with 62 limited-resource individuals, elucidated coping strategies that they or others they knew used to acquire or manage food to maintain food sufficiency. The results were compared with practices as previously identified by nutrition educators who regularly worked with this audience. SUBJECTS/SETTINGS Subjects aged 19 to 67 from throughout New Jersey were recruited by Food Stamp agencies, low-income outreach programs, soup kitchens, welfare offices, Head Start centers, shelters, and food pantries. RESULTS Of the 95 coping strategies identified, 83% were known from nutrition educators previously. Ten new practices (eg, selling blood) had not previously been identified by educators. Four of 10 practices were not found in the literature (eg, repeated participation in research studies). Six practices previously reported by nutrition educators were not mentioned by the study population. IMPLICATIONS Educators who work with limited-resource individuals are a good resource for research with this audience. Study findings may be important considerations for nutrition program planning and policy making.

Food management practices used by people with limited resources to maintain food sufficiency as reported by nutrition educators.

The food management practices used by people with limited resources to ensure food sufficiency have not been fully characterized. Semistructured interviews were conducted with 51 nutrition educators from the New Jersey Expanded Food and Nutrition Education Program and Food Stamp Nutrition Education Program, regarding the food management practices of program participants. Practices were grouped into two categories using the constant comparative method: manage food supply (n = 14) and regulate eating patterns (n = 15). Well-documented stratagems, such as overeating when food is available and cycling monthly eating patterns, were confirmed. Novel practices were identified. Practices causing food safety or nutritional risks included removing spoiled sections, slime, mold, and insects from food; eating other peoples leftovers; and, eating meat found as road kill. A foundation was formed for a grounded theory concerning food management practices by people with limited resources. Verification of these results with audiences with limited resources and determination of prevalence and relative risk of these practices is necessary. This research is important for nutrition professionals who work with people with limited resources because it elucidated a spectrum of safe and risky food management practices, proposed methods to ameliorate monthly eating pattern cycles, and exposed the possibility of food insecurity in unsuspected cases.

Review of evaluation tools used to assess the impact of nutrition education on dietary intake and quality, weight management practices, and physical activity of low-income audiences:

Nutrition education programs and social marketing campaigns frequently focus on low-income audiences with the goal of improving dietary intake and quality, weight management practices, and physical activity. The impact of nutrition education can be assessed by measuring change in relation to any or all of these broad variables. Unfortunately, little information is available concerning the reliability, validity, and sensitivity to change of measures used to assess these constructs with low-income audiences of adults and adolescents. This article reviews the literature and discusses the types of available measures that have been used and evaluated for the above audiences. It describes specific measures used to assess total diet, consumption of food groups from the Food Guide Pyramid, and behaviors related to weight management and physical activity. Overall, this review suggests that there is a critical need for additional development and evaluation of dietary quality measurement tools for low-income and minority audiences.

Consumers’ Understanding of the Dietary Guidelines for Americans: Insights into the Future

The purpose of this study was to examine consumers’ knowledge and understanding of the 1995 Dietary Guidelines for Americans and the sources from where consumers obtain their health information. A telephone survey was administered to 400 adults in the Twin Cities area in Minnesota. The number of guideline recommendations recalled per person was, on average, less than 2.5 of a total of 13 recommendations. Participants had difficulties interpreting the guidelines. Knowledge of the dietary fat guideline was especially poor. Only 17% of survey participants correctly stated the amount of total fat they should have in their diet. The total number of media sources used to obtain health information was the variable that best explained the variance in knowledge of the Dietary Guidelines recommendations. To effectively change dietary behavior, health educators must work effectively with the media to develop behavior-focused nutrition messages that are meaningful and clear to consumers.

Factors Perceived to Influence Dietary Fat Reduction Behaviors

Abstract Dietary change is an inherently complex process. Although dietary fat reduction is an important issue in nutrition education, factors facilitating this type of change have not been fully examined. By accumulating information from individuals who have already been successful in initiating and maintaining dietary fat reduction, practical means of assisting others can be learned. This study collected information from 155 participants between the ages of 30 and 55. Participants were included if they reported the initiation of sustained dietary fat reduction strategies beginning at least 5 years prior to recruitment. Data used to examine individual patterns of dietary fat reduction were collected via in-depth, semistructured, retrospective interviews. Qualitative analyses identified 134 factors that played a role in facilitating the adoption of multiple fat reduction strategies. The factors identified were further classified into two categories: unplanned and planned. Unplanned factors were defined as life events or occurrences that are not nor should they be intentionally included in ones life as a means of dietary improvement (e.g., market influence, health issues, disease diagnosis). Planned factors were defined as occurrences often intentionally included in ones life to facilitate dietary change (e.g., going on a weight loss diet, acquiring an appliance, making a resolution).They frequently resulted from mediation by an unplanned factor.These factors can be used to help nutrition educators identify specific times conducive to initiating dietary change, as well as techniques for facilitating dietary fat reduction.

Focus on Fathers: A Qualitative Study of the Nutrition Education Needs and Preferences of Fathers

Abstract A two-phase series of guided, small-group discussions (GSGDs) was held to determine the food and nutrition-related educational needs of limited-income, urban fathers. The convenience sample of GSGDs was structured according to Krueger. Phase I consisted of two GSGDs attended by 14 urban agency staff involved with fathers’ programs. Phase II consisted of four GSGDs attended by 16 limited-income, urban fathers who had children between the ages of 4 and 11. Analysis involved extensive review of the videotaped and transcribed GSGDs, a pooling and coding of responses, and development of a written display and matrix. The topics of greatest interest reported by participants were cooking, inexpensive ways to eat healthily, meal planning, healthy eating for children, and the effect and importance of food on the body. Analysis suggested that important factors for effective nutrition education with this audience include focusing on food, focusing on the basics, providing a safe and supportive environment for learning, promoting a positive message delivered in a positive fashion, ensuring that attention is given to motivators, choosing an appropriate leader, and honoring the diversity of participants.

Identification of weight-control behaviors practiced by diverse groups of college students

This study investigated: 1) what weight-related behaviors college students practiced; 2) if the behaviors were performed for weight-related reasons; and 3) whether the behavioral practices differed by gender, race, and body weight status. This cross-sectional study used a questionnaire to collect information from a non-probability sample of undergraduate students (n=379; 48% men) recruited from large introductory psychology classes. Chi-square tests were conducted to examine simple comparisons, and multiple logistic regression analyses assessed differences. Male students reported adopting significantly fewer weight-related behaviors than females. Most frequently males increased exercise (69.2%), increased fruit and vegetable consumption (50%), skipped meals (46%), cut out sweets and junk foods (40%), and cut out between-meal snacks (35%). Female students most frequently increased exercise (67.4%), skipped meals (63%), increased fruit and vegetable consumption (62%), reduced the amount of food eaten (60%), and cut out between-meal snacks (51%). Negative behaviors were engaged in by only a few participants. Weight-related reasons were a significant factor for weight-related behavior adoption. Multiple logistic regression analyses showed that gender was consistently and significantly associated with the adoption of weight-related behaviors, while race and weight status were less consistently associated. Findings of this study will be helpful to dietitians who counsel college students. Results of this study may support efforts to bring more comprehensive behaviorally-focused health and nutrition interventions to college campuses.