Jill Armstrong Shultz

Coping Strategies and Nutrition Education Needs Among Food Pantry Users

In response to unexpectedly high rates of household food insecurity in Washington State, focus groups were conducted with food pantry users in nine locations across the state to explore access and barriers to food, strategies for coping with food insecurity, and nutrition education needs. All respondents had children and spoke English. Participants reported household food insecurity and concerns about feeding children and getting through the month. Stretching food dollars was the most requested topic for nutrition education. Nutrition educators need to be responsive to peoples educational needs and the emotional demands associated with food insecurity at the program and community levels.

Understanding patient experiences with goal setting for diabetes self-management after diabetes education.

Diabetes educators need to understand self-care experiences of patients with diabetes in the early stage after diagnosis and education. A survey assessed patient-generated measures of experiences with goals (self-care behaviors) after diabetes education among patients with type 2 diabetes (N = 97) between 6 months and 1.5 years since diagnosis. Most patients set goals during diabetes education and thought that the goals were useful. There is evidence suggesting that patients experiencing difficulty with traditional self-care behaviors may use approaches to evaluate their diabetes control that are not encouraged in diabetes education, such as monitoring their physical and emotional feelings. Implications for diabetes education and counseling practices are suggested.

Nutrition knowledge of nurses in long-term care facilities.

BACKGROUND The purpose of this study was to determine knowledge-based nutrition competencies of nurses and describe needed nutrition education relative to reducing protein-calorie malnutrition (PCM) in nursing home residents. METHOD A sample of 44 nurses (35 RNs, 9 LPNs) from five eastern Washington nursing homes completed a 50-item questionnaire that measured nutrition knowledge based on Benners Novice to Expert Model. RESULTS Nurses scored an average 65% +/- 11% on the nutrition examination. CONCLUSION An educational program addressing the identified deficient areas could improve the ability of nursing staff to assess and monitor resident food intake, thereby reducing the prevalence of PCM of residents in nursing homes.

Creating Potential for Common Ground and Communication Between Early Childhood Program Staff and Parents About Young Children's Eating

OBJECTIVES To explore child care staff and parent perspectives and communications about childrens eating in child care. DESIGN Focus groups (FGs) conducted with child care staff and parents. SETTING Four Western states in the United States. PARTICIPANTS Thirty-nine child care staff in 7 FGs and 25 parents in 6 FGs. PHENOMENON OF INTEREST Thoughts and concerns about childrens eating and opportunities to improve communication between staff and parents. ANALYSIS Content analysis (FG coding inter-rater reliability: staff = 0.74; parents = 0.81) and identification of meta-themes. RESULTS Three meta-themes were identified: (1) recognition of positive influences of the child care setting in childrens development of healthy eating; (2) concerns about childrens eating in child care and at home; and (3) strategies to improve communications and transactions related to childrens eating. CONCLUSIONS AND IMPLICATIONS Staff reported that their roles included informing parents about food at mealtimes in child care (eg, menus, recipes) but also educating parents about child nutrition and feeding. Parents valued daily information about their childs eating to adjust home mealtimes and to feel connected to their child. Barriers to effective communication included limited time and concerns regarding parent reactions and defensiveness. Staff requested training about child nutrition and feeding and about sensitive communications with parents.

Organizational issues related to satisfaction with food and food service in the nursing home from the resident's perspective.

Abstract This paper reviews organizational factors that potentially affect food quality and food service in the nursing home. A model is proposed for assessing the influence of organizational technology on resident satisfaction with food and food service from the residents perspective. Findings from an exploratory phenomenological case study applying the model are presented. Staff knowledge of how to prepare and serve food properly, and staff availability to serve food on time, were key constructs. Resident-staff interactions appeared to moderate resident control over food and food service. Recommendations are suggested for improved communication between residents and staff to address certain limitations and enhance empowerment of residents.

Assessing Diabetes Dietary Goals and Self-Management Based on In-Depth Interviews With Latino and Caucasian Clients With Type 2 Diabetes

Latino (n = 10) and Caucasian (n = 8) clients with type 2 diabetes receiving care at a community health clinic participated in individual in-depth interviews assessing diabetes dietary self-management goal behaviors. Themes from interviews were identified using content analysis, which revealed current and future goals, influencing factors, and motivators and barriers to dietary modification for diabetes management. Implications for practice include simplifying goal setting to those goals with the greatest potential clinical impact or the greatest significance to the patient, in a socially supportive environment. Results contribute to future survey development and understanding how to optimize diabetes education for these populations.

Slavic Women’s Understanding of Diabetes Dietary Self-Management and Reported Dietary Behaviors

Background Slavic women with type 2 diabetes are an understudied group for issues related to dietary self-management for diabetes and heart health. Methods A single home or extension office visit was conducted with ten Slavic women for an individual in-depth interview, clinical and physical assessment, and a survey questionnaire. Results Participants were in poor diabetes control. They reported changes in traditional foods to better support diabetes control and heart health. Most appeared responsive to their health care provider’s recommendations and valued cooking classes from a Russian-speaking educator. Barriers included perceived expense of a healthy diet. Cultural bridges between patients and their caregivers were critical supports for self-management. Discussion and Conclusions Support of Slavic women with diabetes should include health care providers knowledgeable about Slavic dietary and health concepts, Russian-speaking educators who can bridge between traditional foodways and the U.S. food system, and appropriate involvement of the patient’s social support network.

Patterns of Food Coping Strategies Among Food Pantry Clients

Patterns of food coping strategies used by food pantry clients can reveal the complexity of the food insufficiency experience but are understudied. Clients (n = 103) with children were surveyed to identify coping strategy factor patterns and the relationship of factor scores to personal and household risk factors. Respondents who more frequently sold or pawned items for money tended to be younger and to report a disability. “Used cash assistance programs” was an independent factor pattern to get more money for food. Results provide important information for nutrition education and other services offered at food pantries.

Comparing nutrition knowledge exam scores with reported nutrition topics of interest among nursing home nurses.

Nursing home nurses (licensed practice nurses and registered nurses) were assessed to determine nutrition training issues that have a potential impact or influence on protein-calorie malnutrition of residents. The results of a 50-item nutrition knowledge exam are reported and compared with what nurses report they are interested in knowing about nutrition. Nurses in nursing homes were found to lack sufficient nutrition knowledge to meet dietary needs of elderly residents.

Nutrient Intake and Consumption of Fruit and Vegetables in Young Children

Children’s fruit and vegetable consumption (FVC) is below recommendations. Objectives of the study were to (a) describe the type and frequency of FVC, (b) analyze the average nutrient intake from young children’s fruit consumption and vegetable consumption separately, and (c) determine the contribution of demographic factors on FVC. Children aged 2 to 5 years (n = 821) were identified using the 2009-2010 National Health and Nutrition Examination Survey. Average servings and nutrient intake from FVC were estimated. Multiple comparisons among age, gender, body mass index (BMI), ethnicity, and poverty index ratio (PIR) were analyzed using an ANCOVA. Akaike’s information criterion determined relative contribution of each factor to FVC. Children consumed 3 times as many fruit servings as vegetable servings regardless of age, gender, BMI, ethnicity, and PIR. Potato products and fruit juice were consumed most frequently and in the greatest amounts. In general, children obtained more nutrients from fruits than ve...