M. Kathleen Yadrick

Using self-efficacy to predict weight loss among young adults

Many healthcare professionals support the idea that weight control and healthy eating should be emphasized early in a persons life to prevent obesity during middle and older adulthood. Unfortunately, although many weight loss programs are available to consumers, few are successful. Recently, constructs of behavioral theories have been integrated into weight loss programs and used to promote changes in health behaviors. In this study, methods used to increase self-efficacy for weight loss were incorporated into a 12-week program designed for weight loss promotion in young adults. Results found that as self-efficacy improved, eating habits improved and weight loss was greater. This study supports the hypothesis that using behavioral techniques to improve self-efficacy can be effective in weight loss promotion and can produce positive outcomes.

Influences On Fruit and Vegetable Consumption by Low-Income Black American Adolescents

OBJECTIVE The purpose of this study was to identify personal, behavioral, and environmental factors influencing fruit and vegetable consumption among 10- to 13-year-old low-income black American youth in the lower Mississippi Delta region. Social Cognitive Theory, along with other theoretical constructs, guided focus group questions and analysis. DESIGN A qualitative study using focus group methodology. SETTING Enrichment program of a sports summer camp for low-income youth. PARTICIPANTS Forty-two adolescents (21 female, 21 male) participated in 6 focus groups. MAIN OUTCOME MEASURES Personal, behavioral, and environmental influences on fruit and vegetable consumption. ANALYSIS Content analysis methods were used by 3 independent reviewers to identify themes within the focus group transcripts. Themes were summarized and then categorized into the 3 domains of Social Cognitive Theory. RESULTS The major themes were taste, availability, extended family influence, visual proof of the benefits of fruit and vegetable consumption, and the need for gender-specific behavioral skills. CONCLUSIONS AND IMPLICATIONS This formative research will aid in the development of a culturally relevant nutrition intervention for low-income black American adolescents in the lower Mississippi Delta region. The results indicate that this group is more likely to respond to interventions that use role models who can provide proof that fruit and vegetable consumption is related to improved health.

Validity of a Telephone-Administered 24-Hour Dietary Recall in Telephone and Non-Telephone Households in the Rural Lower Mississippi Delta Region

OBJECTIVE To determine if 24-hour dietary recall data are influenced by whether data are collected by telephone or face-to-face interviews in telephone and non-telephone households. DESIGN Dual sampling frame of telephone and non-telephone households. In telephone households, participants completed a 24-hour dietary recall either by face-to-face interview or telephone interview. In non-telephone households, participants completed a 24-hour dietary recall either by face-to-face interview or by using a cellular telephone provided by a field interviewer. SUBJECTS/SETTING Four hundred nine participants from the rural Delta region of Arkansas, Louisiana, and Mississippi. MAIN OUTCOME MEASURES Mean energy and protein intakes. STATISTICAL ANALYSES PERFORMED Comparison of telephone and non-telephone households, controlling for type of interview, and comparison of telephone and face-to-face interviews in each household type using unpaired t tests and linear regression, adjusting for gender, age, and body mass index. RESULTS Mean differences between telephone and face-to-face interviews for telephone households were -171 kcal (P = 0.1) and -6.9 g protein (P = 0.2), and for non-telephone households -143 kcal (P = 0.6) and 0.4 g protein (P = 1.0). Mean differences between telephone and non-telephone households for telephone interviews were 0 kcal (P = 1.0) and -0.9 g protein (P = 0.9), and for face-to-face interviews 28 kcal (P = 0.9) and 6.4 g protein (P = 0.5). Findings persisted when adjusted for gender, age, and body mass index. No statistically significant differences were detected for mean energy or protein intake between telephone and face-to-face interviews or between telephone and non-telephone households. APPLICATIONS/CONCLUSIONS These data provide support that telephone surveys adequately describe energy and protein intakes for a rural, low-income population.

Stages of change and fluid intake in dialysis patients

Nutrition professionals constantly strive to improve adherence to dietary recommendations in hemodialysis patients. The purpose of this study was to evaluate the effects of a 12-week intervention based on stages of change to decrease fluid gain in dialysis patients. Readiness to change, knowledge of appropriate weight gain, and mean weight gains were obtained from patients in five intervention (n=216) and five control (n=100) dialysis units. Intervention had more participants in the maintenance and precontemplation stages at the end of the intervention (P=0.001) compared to the control group. Knowledge scores significantly increased in the intervention group (P<0.001) during the course of the intervention. However, fluid gains did not decrease in either group. Although this intervention did not produce behavior change, the results can aid other educators in planning intervention programs for renal failure and other chronic diseases.

Theory of Planned Behavior and Multivitamin Supplement Use in Caucasian College Females

The objective of this study was to identify predictors of the use of multivitamin supplements (MVS) among Caucasian college females utilizing the Theory of Planned Behavior (TPB). Variables of the TPB and the self-reported use of multivitamin supplements were measured by two separate surveys within 1 week with a convenience sample of 96 Caucasian college student females. Two attitudinal beliefs and one control belief significantly predicted behavioral intention to use multivitamin. A belief that taking multivitamin supplements helps to feel and look good was the most important predictor of the use of multivitamin supplements. Editors’ Strategic Implications: Findings from this study, although in need of replication, suggest that prevention campaigns would be more successful if messages used to reach these females were consistent with perceived beliefs regarding benefits of using MVS. More broadly, TPB appears to offer a useful framework for understanding or predicting behavior based on psychological constructs theorized to influence behavior.

Energy Density, Nutrient Adequacy, and Cost per Serving Can Provide Insight into Food Choices in the Lower Mississippi Delta

OBJECTIVE To compare differences across food groups for food cost, energy, and nutrient profiles of 100 items from a cross-sectional survey of 225 stores in 18 counties across the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi. METHODS Energy, nutrient, and cost profiles for food items were calculated by using Naturally Nutrient Rich methodology and converting price per 100 g edible portion to price per serving. Foods were grouped into 6 food groups. Mean differences were compared with ANOVA. RESULTS Significant differences existed by food group for each measure. Energy density was highest for fats/oils/sweets, whereas nutrient density was highest for vegetables. Price per serving was lowest for fats/oils/sweets and highest for meats. CONCLUSIONS AND IMPLICATIONS Educational messages focusing on a complete diet should consider the role of food costs and provide specific recommendations for increasing nutrient-dense foods by replacing a portion of the meat serving at meals with culturally acceptable lower-cost nutrient-dense foods.

Food and Beverage Choices Contributing to Dietary Guidelines Adherence in the Lower Mississippi Delta

OBJECTIVES The objectives of the present study were to evaluate diet quality among Lower Mississippi Delta (LMD) residents using the Healthy Eating Index-2005 (HEI-2005) and to identify the top five dietary sources contributing to HEI-2005 components. Demographic differences in HEI-2005 scores were also explored. DESIGN Diet quality was evaluated using HEI-2005. Demographic differences in HEI-2005 scores were investigated using multivariable regression models adjusting for multiple comparisons. The top five dietary sources contributing to HEI-2005 components were identified by estimating and ranking mean MyPyramid equivalents overall and by demographic characteristics. SETTING Dietary data, based on a single 24 h recall, from the Foods of Our Delta Study 2000 (FOODS 2000) were used in the analyses. SUBJECTS FOODS 2000 adult participants 18 years of age or older. RESULTS Younger age was the largest determinant of low diet quality in the LMD with HEI-2005 total and seven component scores declining with decreasing age. Income was not a significant factor for HEI-2005 total or component scores. The top five dietary sources differed by all five of the demographic variables, particularly for total vegetables and energy from solid fats, alcoholic beverages and added sugars (SoFAAS). Soft drinks were the leading source of SoFAAS energy intake for all demographic groups. CONCLUSIONS The assessment of diet quality and identification of top dietary sources revealed the presence of demographic differences for selected HEI-2005 components. These findings allow identification of food patterns and culturally appropriate messaging and highlight the difficulties of treating this region as a homogeneous population.

Food Shopping Perceptions, Behaviors, and Ability to Purchase Healthful Food Items in the Lower Mississippi Delta

OBJECTIVE To examine the agreement between perceptions, behaviors, and ability to purchase healthful food in the Lower Mississippi Delta (LMD). DESIGN A regional food store survey of healthful food options in supermarkets, small/medium stores, and convenience stores. Focus group discussions were conducted on shopping perceptions and behaviors. SETTING Counties in Arkansas, Louisiana, and Mississippi. PARTICIPANTS Eighty-one LMD residents, 18-60+ years of age. MAIN OUTCOME MEASURE Perceptions of healthful food and ability to acquire these food items across store types. ANALYSIS Focus group data were analyzed using thematic coding. Summary food store statistics were weighted, and estimates were constructed using SUDAAN 9. Data triangulation was achieved by comparing focus group findings with food availability data. RESULTS A majority (> 85%) of supermarkets had selected vegetables, breads, and cereals perceived as healthful, whereas availability was limited in small to medium grocery stores and convenience stores. Skim milk, perceived as healthful, was limited in all store types. CONCLUSIONS AND IMPLICATIONS Limited availability and perceived costs of healthful food in the LMD influenced purchasing behaviors. Attitudes and perceptions should be incorporated into intervention development to improve food choices in conjunction with increasing the availability of healthful food in the LMD.

Development and evaluation of WillTry. An instrument for measuring children's willingness to try fruits and vegetables ☆

This paper describes the development and evaluation of the WillTry instrument, a psychometric tool designed to measure childrens willingness to try fruits and vegetables. WillTry surveys were interviewer-administered to 284 children in an elementary school and summer day camps located in rural Mississippi and Arkansas (United States) communities. Factor analysis was used to determine construct dimensionality. Additional evaluation included internal consistency, test-retest reliability, and predictive validity. Factor analysis suggested a single dimension for the food items. The WillTry food scale had substantial reliability (intraclass correlation coefficients between 0.61 and 0.80) and sufficient internal consistency (Cronbachs alpha > or = 0.70). Results of the regression analysis for percent consumption of foods offered on WillTry response confirmed the predictive validity of the instrument. The results of these analyses provide psychometric evidence for the use of the WillTry instrument as a measure of willingness to try fruits and vegetables in rural, southern US children 5-14 years of age.

Nutrition services for children with developmental disabilities and chronic illnesses in education programs

OBJECTIVE To determine the number of children attending school who require special nutrition services, types of nutrition services provided to children, involvement of registered dietitians in provision of nutrition services in the school setting, and continuing education needs of school nutrition personnel. DESIGN/SAMPLE Pretested questionnaires were mailed to a national, systematic random sample of 600 school nutrition managers, 600 district school nutrition directors/supervisors, and 600 district special education program directors. Response rates were 32.7%, 46.2%, and 32.8%, respectively. STATISTICAL ANALYSES PERFORMED Descriptive statistics were used to summarize data, including means, standard deviations, frequencies, and percentages. RESULTS A large percentage of school nutrition managers (46%) reported that they served no children with special food and nutrition needs. Special food and nutrition needs most frequently encountered by all groups included food allergy, food intolerance, diabetes, and conditions with which feeding problems are associated. The skills of dietitians were used by 23% of school nutrition managers, 21% of district school nutrition directors/supervisors, and 15% of special education program directors. Continuing education needs were greatest for the areas of assessing liability, calculating macronutrient content of menus, modifying menus, and understanding the physical and emotional needs of children with special needs. APPLICATIONS/CONCLUSIONS Communication between nutrition service providers and special education providers needs to be strengthened. A need exists to include nutrition in Individualized Education Programs for children in special education. Many opportunities are available for registered dietitians to provide consulting services for school nutrition programs related to special needs.