Jamie Benedict

System, Environmental, and Policy Changes: Using the Social-Ecological Model as a Framework for Evaluating Nutrition Education and Social Marketing Programs with Low-Income Audiences

A variety of nutrition education interventions and social marketing initiatives are being used by the Food Stamp Program to improve food resource management, food safety, dietary quality, and food security for low-income households. The Social-Ecological Model is proposed as a theory-based framework to characterize the nature and results of interventions conducted through large public/private partnerships with the Food Stamp Program. In particular, this article suggests indicators and measures that lend themselves to the pooling of data across counties and states, with special emphasis on systems, environment, and public policy change within organizations at the community and state levels.

Care needs of home-based cancer patients and their caregivers. Quantitative findings.

The purpose of this study was to identify care needs of home-based patients receiving treatment for cancer and their caregivers. The sample consisted of 30 patients receiving radiation therapy and/or immunologically based treatments for a variety of cancers and 29 caregivers. Patient and caregiver needs scales were used to elicit the needs of patients and caregivers. Patients and caregivers were able to cite their unique needs. Patients had more needs for themselves in the areas of personal care, activity management, and interpersonal interaction than did the caregivers. The necessity for individualization of care was noted by both patients and caregivers, an area that nursing is in a unique position to address.

Use of the Health Belief Model to examine older adults' food-handling behaviors.

OBJECTIVE To measure the association among Health Belief Model (HBM) variables and safe food-handling behaviors among older adults. DESIGN A mail survey using Dillmans Total Design Method. SETTING In October 1999, a survey was sent to volunteers from a preexisting cohort of noninstitutionalized older adults living throughout Nevada. Data collection continued through January 2000. PARTICIPANTS With a 56% response rate, the sample (n = 266) was composed mainly of women (73%) and individuals from urban counties (74%). The mean age was 68.09 years (SD = 8.27). Except for gender, sample characteristics were similar to those of the preexisting cohort. VARIABLES MEASURED Perceived threat of foodborne illness (ie, perceived severity and perceived susceptibility), cues to action (ie, media cues and educational cues), and safe food-handling behaviors (ie, sanitation and cross-contamination). ANALYSIS Rank order correlation coefficients were computed to measure the association among variables. Significance was set at P <.05. RESULTS Cues to action were positively related to perceived threat of foodborne illness and safe food-handling behaviors. Perceived severity of foodborne illness was positively related to one dimension of safe food-handling behaviors (ie, sanitation). CONCLUSIONS AND IMPLICATIONS The HBM is a useful framework for examining food-handling behaviors among older adults.

Usefulness of the Food Habits Questionnaire in a Worksite Setting

OBJECTIVE To examine the validity and reliability of the 24-item Food Habits Questionnaire (FHQ) in a worksite setting. DESIGN In a longitudinal design, subjects in a 9-month worksite intervention program completed the FHQ pre- and postintervention. A randomly selected subsample also completed 2 sets of 4-day food records. SETTING Three locations within a multisite industrial equipment company. PARTICIPANTS Subjects (N = 178) self-selected to participate in the program and completed the FHQ. Mean age was 40.7+/-10.6, 60% were male, and 82% were white, and there were 15 occupational categories. Thirty-two subjects completed 2 sets of 4-day food records. MAIN OUTCOME MEASURES To examine the validity and reliability of the FHQ total scale and subscales in a worksite setting with both men and women from varying socioeconomic levels. ANALYSIS Cronbach a coefficient to estimate internal consistency for the total scale and the subscales, Pearson correlation coefficients to estimate test-retest reliabilities and criterion validity. RESULTS For the 5 subscales, findings showed generally low internal consistency, moderate test-retest reliability, and low to moderate correlations with food record results. Psychometric properties for the total score of the FHQ included satisfactory internal consistency, test-retest reliability, and criterion validity. CONCLUSIONS AND IMPLICATIONS The FHQ subscales did not perform well and need to be more fully developed. Therefore, the FHQ may best be used as a total scale score to indicate fat-related behaviors.

The Effectiveness of Adherence Intervention in a Colon Cancer Prevention Field Trial

BACKGROUND Adherence interventions were implemented in a 1-year community-based colon cancer prevention clinical trial (n = 110) using wheat bran fiber and calcium dietary supplements. The adherence promotion strategy was guided by a theoretical model. METHODS The adherence intervention contains both a generalized portion given to all participants and an individualized portion given to marginal (50-74% intake) and low (under 50% intake) adherers. A regression model was employed to assess the effectiveness of the interventions both at the first intervention and at subsequent times. RESULTS The Health Behavior in Cancer Prevention Model-based adherence promotion intervention was associated with retention of participants, both during the run-in period and after randomization (P = 0.05); and maximization of the percentage of the 13.5-g recommended fiber supplement consumed during the trial (92.5%). The positive effects of the adherence intervention were greater with first-time nonadherers and the control group than with the experimental group. The high-fiber group had notably more biological GI effects from the increased fiber intake, more preexisting comorbidities, and lower perceived cognitive and physical health status. CONCLUSIONS Randomized participants had excellent adherence overall. Retention rates in the trial were better than would be expected without the adherence intervention, especially among those participants who may have been at higher risk for dropping out of the study. This suggests that a systematic, theoretically based adherence strategy should be further tested in clinical trial settings in which lower adherence is a problem.

An exploratory study of recreational drug use and nutrition-related behaviors and attitudes among adolescents.

This study examined drug use and eating behaviors among adolescents. The data were collected by phone interviews from 401 northern Nevadan students in grades seven to twelve. Students were divided for comparison into three groups according to their involvement with drugs: Abstainers, conventional users, and high-risk users. Analyses indicated that high-risk users less frequently ate lunch, meals at home, and with their families, and ate more often at convenience stores, fast food restaurants, and with friends. In addition, female high-risk users had significantly more negative perceptions regarding their food choices than the other female groups, and were more concerned with dieting than their high-risk using male peers. Male and female high-risk users believed that their drug use affected their eating habits. Implications for prevention programming and future research are discussed.

Acceptability, Satisfaction and Cost of a Model-Based Newsletter for Elders in a Cancer Prevention Adherence Promotion Strategy

Though widely used by business, industry, academia, and social service agencies as a mass communication vehicle, the effectiveness of newsletters has received limited critical review. The sound research base needed to support the use of newsletters in cancer prevention interventions was not found in the literature. This article details the development, design, use and evaluation of a health behavior model-based monthly newsletter for participants in three community-oriented cancer prevention studies. Depending on the extent of behavior change asked of them, participants reported reading 60-100% of the content. Participants in the three different cancer prevention interventions perceived the newsletters to be informative, accurate, and interesting. Costing as little as

An Exploratory Study of Recreational Drug Use and Nutrition-Related Behaviors and Attitudes Among Adolescents

0.36 per participant per issue, this strategy has implications for other types offield studies with similarly educated participants. The adherencepromotion strategy, of which the newsletters were a part, kept the participants in field studies long enough to test the study hypotheses and potentially improve their health, and reduce morbidity and mortality.

Relationships Among Meal Patterns, Dietary Intake, and Work Schedule in Women.

This study examined drug use and eating behaviors among adolescents. The data were collected by phone interviews from 401 northern Nevadan students in grades seven to twelve. Students were divided for comparison into three groups according to their involvement with drugs: Abstainers, conventional users, and high-risk users. Analyses indicated that high-risk users less frequently ate lunch, meals at home, and with their families, and ate more often at convenience stores, fast food restaurants, and with friends. In addition, female high-risk users had significantly more negative perceptions regarding their food choices than the other female groups, and were more concerned with dieting than their high-risk using male peers. Male and female high-risk users believed that their drug use affected their eating habits. Implications for prevention programming and future research are discussed.

Evaluation of a Community-based Health Promotion Program for the Elderly: Lessons from Seniors CAN

Abstract LEARNING OUTCOME: To describe the relationships among dietary intake, meal patterns, and work schedule in women. Shiftwork has been associated with sleep disturbances, gastrointestinal disorders, psychological stress, substance use, and changes in eating behavior. This study was conducted to assess the effect of shiftwork on the nutritional status of women. This included an examination of the relationship between meal patterns and dietary intake. Study participants were women who worked five eight-hour shifts each week with consistent work schedules for the previous 30 days. Dietary intake was estimated using the Willett Food Frequency questionnaire and personal interviews were conducted to characterize meal patterns. Using the Bureau of Labor shift definitions, participants were assigned to one of three groups: day (n=49), evening (n=O3), or night (n=21). Results indicated that women working the evening or night shift ate lunch less frequently, compared to day workers (p