Garry Auld

Sustaining local agriculture Barriers and opportunities to direct marketing between farms and restaurants in Colorado

Research explored methods for “shortening the food links” or developing the “local foodshed” by connecting farmers with food service buyers (for restaurants and institutions) in Colorado. Telephone interviews were used to investigate marketing and purchasing practices. Findings include that price is not a significant factor in purchasing decisions; that food buyers prioritize quality as their top purchasing criterion but are not aware that local farmers can provide higher quality, that institutions are interested in buying locally; that small farms can offer comparable or higher quality produce andservice; and that farmers need to show buyers what the quality of produce and service they can provide.

Osteoporosis Knowledge, Calcium Intake, and Weight-Bearing Physical Activity in Three Age Groups of Women.

The purpose of this study was to determine the extent and integration of osteoporosis knowledge in three age groups of women and compare knowledge to calcium intake and weight-bearing physical activity (WBPA). In this cross-sectional study, knowledge, calcium intake and WBPA were assessed using probe interviews, a food frequency and an activity questionnaire, respectively. Seventy-five white women were separated into three groups: young (25–35 years), middle aged (36–46 years) and postmenopausal (50+ years). Concept maps were used to assess knowledge (concepts, integration and misconceptions). Calcium intakes from diet, supplements and fortified orange juice were estimated as were minutes of daily WBPA. Analysis of covariance was used to compare knowledge, calcium intake and WBPA by age group. Covariates included education, family history, physical problems making exercise difficult, and lactose intolerance. Chi square analysis was used to determine differences in these covariates across age groups. Correlations and regression analysis were used to determine relationships between knowledge and behaviors. Knowledge scores averaged 32–44 points (183 possible). Average calcium intake in all groups exceeded the Dietary Reference Intakes recommended Adequate Intake but 20–24% consumed less than 60% of the AI. Housework, walking at work, and standing at home and work accounted for 90% of WBPA. Knowledge about osteoporosis was limited and not associated with age, WBPA or calcium intake. Calcium intake and WBPA were not associated with age. Practitioners need to provide explicit information on osteoporosis and risk reducing behaviors to women of all ages.

Outcomes from a School-based Nutrition Education Program Using Resource Teachers and Cross-disciplinary Models

Abstract The Integrated Nutrition Project is an ongoing comprehensive elementary school-based program focused on increasing consumption of whole grains, fruits, and vegetables in children and establishing nutrition education in the schools through local partnerships. This paper reports on years three and four outcomes. It was hypothesized that blending Social Cognitive Theory with the educational philosophies of Piaget and Dewey would enhance behavior change. The primary intervention consisted of (1) 24 weekly hands-on activities taught by a resource teacher and (2) six parent-taught lunchroom “mini-lessons.” Classroom activities were designed to reinforce concepts in math, science, literacy, and social studies. The quasi-experimental design used classrooms in matched schools; 20 and 17 classes were in treatment and comparison conditions, respectively, in year four. Surveys, interviews, and lunchroom plate waste were used to assess children; teachers were interviewed. Students in treatment classrooms achieved significantly greater gains in knowledge and self-efficacy regarding food preparation and fruit and vegetable consumption and consumed 0.4 more National Cancer Institute equivalent servings of fruits and vegetables in the lunchroom. Teachers responded favorably to the resource teacher model and the hands-on approach. The projects outcomes were attributed to the interventions theory-based behavior change focus and the use of a resource teacher who ensured consistent delivery of the intervention. Program implications include the need to explore variations of the resource teacher model and the potential for implementation on a larger scale.

Expanded Health Belief Model Predicts Diabetes Self-Management in College Students

An instrument was designed to determine relationships between constructs of the Expanded Health Belief Model and to identify characteristics of college students who successfully manage their diabetes. The Diabetes College Scale was developed to measure attitudes and behaviors pertinent to diabetes management and college life. It was tested for content validity, test-retest reliability, and internal consistency. Data were collected from college students using a cross-sectional design. Campus health care providers were invited via electronic mail to administer the survey to students with Type I diabetes. Ninety-eight questionnaires were mailed to interested providers, of which 86 (88%) were returned. Mean scores for attitude constructs, seven behaviors, and two outcomes were measured. Twenty-six experts established content validity. Instrument reliability was evaluated using paired t-tests, Cronbachs alpha, and correlation coefficients. Correlation coefficients and stepwise multiple regression analysis evaluated relationships among variables measured. Intention and emotional response were strong predictors of exercise, whereas health importance and intention were predictive of testing blood sugar. Situational factors and emotional response were substantial barriers to optimal diabetes self-care. College health care providers should address these areas in providing services to this population. Additional testing of the instrument is also recommended.

A Stage-of-Change Classification System Based on Actions and Beliefs Regarding Dietary Fat and Fiber

Purpose. The objectives of this study were to develop a stage-of-change classification system and to determine the degree to which various adult subgroups have adopted the behavioral changes necessary to achieve a low-fat and/or high-fiber diet as recommended by the Dietary Guidelines for Americans. Design. The study used a mail survey randomly sent to 7110 adults. Setting. The survey was conducted in 11 states and the District of Columbia. Subjects. The random sample included males and females over age 18. Of the eligible respondents, 3198 (51.5%) were included in this analysis, with 2004 and 2066 unambiguously classified into stages of change for fat and fiber, respectively. Measures. Stage of change was defined by an algorithm based on self-reported intent and behaviors to limit fat and/or increase fiber. Results. 45% of the respondents were classified as being in action/maintenance for fat and 38% for fiber. Women, older adults, individuals with advanced education, persons with diet-related chronic disease, people with higher levels of relevant nutrition knowledge and attitudes, and persons who indicated that health concerns were a primary influence on their diet were more likely to be in action/maintenance than other respondents. Conclusions. The algorithm in this study presents a model that more closely reflects the proportions of the adult population that have achieved low-fat diets and classifies a greater proportion in the preparation stage than classification systems in previous studies.

Formative Research and Strategic Development of a Physical Activity Component to a Social Marketing Campaign for Obesity Prevention in Preschoolers

The prevalence of overweight in childhood, including preschoolers, continues to rise. While efforts focusing on school-aged children are encouraging, obesity prevention programs to address nutrition and physical activity in the child care center are lacking. Food Friends® is a successfully evaluated nutrition program aimed at enhancing preschoolers’ food choices, the addition of a physical activity program would improve the programs overall efforts to establish healthful habits early in life. This study describes the formative research conducted with secondary influencers of preschoolers—teachers and parents—for the development of a physical activity program. Key informant interviews and focus group discussions were conducted with preschool teachers and parents, respectively, to examine current physical activity practices, as well as attitudes, opinions, and desired wants and needs for physical activity materials. Findings illustrate that teachers provided physical activity; however, most did not use a structured program. Teachers identified time, space and equipment as barriers to providing activity in their classroom. Focus group findings identified activities of preschoolers’, parents’ perceptions of the adequacy of activity levels, and items to help parents engage their children in more physical activity. Barriers were also identified by parents and included time, safety, inclement weather, and lack of knowledge and self-efficacy. Findings from this formative research were used to develop a marketing strategy to guide the development of a physical activity component, Food Friends Get Movin’ with Mighty MovesTM, as part of a larger social marketing campaign aimed to decrease the risk for obesity in low-income preschoolers.

Calcium intake of Asian, Hispanic and white youth.

Objective: To examine calcium intake and food sources among Asian, white and Hispanic youth, in order to develop and target interventions to improve calcium intake. Methods: Cross-sectional survey with two 24-hour dietary recalls one week apart. Calcium intake was evaluated in 167 male and female adolescents of Asian, Hispanic and white ethnicity, ages 10–18 years, from six states. Main outcome measures were mean daily calcium intake (mg/day). Statistical analyses performed: t tests, Chi-square and analysis of variance for differences by age, ethnicity and gender, multiple regression of factors influencing calcium intake. Results: Overall median calcium intake was 938 mg/day with 868 mg/day for Asians, 1180 mg/day for whites and 896 mg/day for Hispanics. Daily milk intake was the primary predictor of calcium intake with Asian ethnicity and female gender each showing a negative association to calcium intake in multiple regression models. Conclusions: Milk intake was the primary factor positively influencing calcium intake, while Asian ethnicity and female gender negatively influenced calcium intake. Thus, interventions to improve calcium intake should focus on improving milk intake of Asians and females.

Validation of a tool to measure processes of change for fruit and vegetable consumption among male college students.

OBJECTIVE To develop a valid tool to measure processes of change for fruit and vegetable consumption, and examine the relationship between stage and processes of change among several cultural groups. DESIGN Cross-sectional, using a self-report questionnaire. SETTING Convenience sample of male college students living in apartments. PARTICIPANTS 105 US white, 53 international Latino, and 92 international Asian males. MAIN OUTCOME MEASURES Fruit and vegetable intake, stage and processes of change characterizations. ANALYSIS Analysis of covariance, with age as a covariate, was used to determine differences in processes of change scores among 3 cultural groups and stages of change. Two-way analysis of variance investigated relationships between stage of change and fruit and vegetable consumption. The pattern of differences across cultural groups was examined using chi-squared analysis. RESULTS Self-reported fruit and vegetable intake was higher (P < .01) in action and maintenance than in other stages. Participants in precontemplation/contemplation used significantly less of any process of change than those in preparation or action/maintenance. There were no significant interactions between stage of change and culture for any of the processes of change, but international Asians used significantly more dramatic relief and environmental reevaluation than did US whites and more stimulus control processes than US whites or international Latinos. At all stages, students used significantly more cognitive/experiential processes than behavioral processes. CONCLUSIONS AND IMPLICATIONS The use of processes increased within action-oriented stages, consistent with previous studies using the Transtheoretical Model in the nutritional area. The greater use of cognitive/experiential than behavioral processes at all stages was not consistent with predictions. Evidence of cultural differences in the use of processes of change was found.

Medical Professionals' Attitudes Toward Breastfeeding:

This study examined the attitudes toward breastfeeding of medical professionals working with pregnant or new mothers. Most advocated breastfeeding to mothers who had not made an infant feeding decision; fewer talked about breastfeeding during the first trimester; and many recommended that mothers supplement a breastfed infant with prepared commercial baby milk. All agreed that a mothers return to work led to early discontinuance of breastfeeding and that the family is a major influence on a mothers decision to breastfeed. Tb increase the prevalence of breastfeeding, the study group recommended prenatal education, participation in support groups, and promotion of breastfeeding through the media.

The Healthy Toddlers Trial Protocol: An Intervention to Reduce Risk Factors for Childhood Obesity in Economically and Educationally Disadvantaged Populations

BackgroundThe number of overweight children in America has doubled to an estimated 10 million in the past 20 years. Establishing healthy dietary behaviors must begin early in childhood and include parents. The Healthy Toddlers intervention focuses on promoting healthy eating habits in 1- to 3-year-old children utilizing the Social Cognitive Theory and a learner-centered approach using Adult Learning principles. This Healthy Toddlers Trial aims to determine the efficacy of a community-based randomized controlled trial of an in-home intervention with economically and educationally disadvantaged mothers of toddlers. The intervention focuses on: (a) promoting healthy eating behaviors in toddlers while dietary habits are forming; and (b) providing initial evidence for the potential of Healthy Toddlers as a feasible intervention within existing community-based programs.Methods/DesignThis describes the study protocol for a randomized control trial, a multi-state project in Colorado, Michigan, and Wisconsin with economically and educationally disadvantaged mother-toddler dyads; toddlers are between 12 and 36 months. The Healthy Toddlers intervention consists of eight in-home lessons and four reinforcement telephone contacts, focusing on fruit, vegetable, and sweetened beverage consumption and parental behaviors, taught by paraprofessional instructors. Healthy Toddlers uses a randomized, experimental, short-term longitudinal design with intervention and control groups. In-home data collection (anthropometric measurements, feeding observations, questionnaires, 3-day dietary records) occurs at baseline, immediately following the intervention, and 6 months after the intervention. Main toddler outcomes include: a) increased fruit and vegetable consumption and decreased sweetened beverage consumption; and b) improved toddler-eating skills (self-feeding and self-serving). Main parent outcomes include: a) improved psychosocial attributes (knowledge, attitudes, self-efficacy, feeding style) related to child feeding; b) provision of a more positive mealtime physical environment (turning off the TV); and c) creation of a more positive mealtime social environment (sitting down together for meals).DiscussionIf this project is successful, the expected outcomes are that the intervention will be effective in helping toddlers develop healthy eating skills that contribute to improve overall health and development and to the prevention of obesity.Trial registrationCurrent Controlled Trials ACTRN12610000981022