Marcel Horowitz

Goal Setting as a Strategy for Dietary and Physical Activity Behavior Change: A Review of the Literature

Objective. Estimate effectiveness of goal setting for nutrition and physical activity behavior change, review the effect of goal-setting characteristics on behavior change, and investigate effectiveness of interventions containing goal setting. Data source. For this review, a literature search was conducted for the period January 1977 through December 2003 that included a Current Contents, Biosis Previews, Medline, PubMed, PsycINFO, and ERIC search of databases and a reference list search. Key words were goal, goal setting, nutrition, diet, dietary, physical activity, exercise, behavior change, interventions, and fitness. Study inclusion and exclusion criteria. The search identified 144 studies, of which 28 met inclusion criteria for being published in a peer reviewed journal and using goal setting in an intervention to modify dietary or physical activity behaviors. Excluded from this review were those studies that (1) evaluated goal setting cross-sectionally without an intervention; (2) used goal setting for behavioral disorders, to improve academic achievement, or in sports performance; (3) were reviews. Data extraction and synthesis. The articles were categorized by target audience and secondarily by research focus. Data extracted included outcome measure, research rating, purpose, sample, sample description, assignment, findings, and goal-setting support. Results. Thirteen of the 23 adult studies used a goal-setting effectiveness study design and eight produced positive results supporting goal setting. No adolescent or child studies used this design. The results were inconclusive for the studies investigating goal-setting characteristics (n = 7). Four adult and four child intervention evaluation studies showed positive outcomes. No studies reported power calculations, and only 32% of the studies were rated as fully supporting goal setting. Conclusions. Goal setting has shown some promise in promoting dietary and physical activity behavior change among adults, but methodological issues still need to be resolved. The literature with adolescents and children is limited, and the authors are not aware of any published studies with this audience investigating the independent effect of goal setting on dietary or physical activity behavior. Although, goal setting is widely used with children and adolescents in nutrition interventions, its effectiveness has yet to be reported.

An Innovative Approach to Goal Setting for Adolescents: Guided Goal Setting

Goal setting has shown promise in promoting positive behavior change in the nutrition and physical activity fields.1-3 When designing the goal-setting strategy for an intervention, a decision about goal type (who develops and chooses the goal) has to be made. Several factors, such as participant’s age, intervention setting, and readiness to change, influence the type of goal to use: (1) self-set, (2) participatory, or (3) assigned.4 This GEM is about the development and use of a fourth type, guided goal setting.This GEM (1) describes the development of the guided goal-setting strategy, (2) shows how guided goal setting was implemented in the EatFit intervention, and (3) provides a step-by-step guide for the practitioner who wishes to duplicate the guided goal-setting strategy (Table).

Pilot Study: EatFit Impacts Sixth Graders' Academic Performance on Achievement of Mathematics and English Education Standards

OBJECTIVE Investigate the impact of a nutrition education program on student academic performance as measured by achievement of education standards. DESIGN Quasi-experimental crossover-controlled study. SETTING California Central Valley suburban elementary school (58% qualified for free or reduced-priced lunch). PARTICIPANTS All sixth-grade students (n = 84) in the elementary school clustered in 3 classrooms. INTERVENTION 9-lesson intervention with an emphasis on guided goal setting and driven by the Social Cognitive Theory. MAIN OUTCOME MEASURE Multiple-choice survey assessing 5 education standards for sixth-grade mathematics and English at 3 time points: baseline (T1), 5 weeks (T2), and 10 weeks (T3). ANALYSIS Repeated measures, paired t test, and analysis of covariance. RESULTS Changes in total scores were statistically different (P < .05), with treatment scores (T3 - T2) generating more gains. The change scores for 1 English (P < .01) and 2 mathematics standards (P < .05; P < .001) were statistically greater for the treatment period (T3 - T2) compared to the control period (T2 - T1). CONCLUSION AND IMPLICATIONS Using standardized tests, results of this pilot study suggest that EatFit can improve academic performance measured by achievement of specific mathematics and English education standards. Nutrition educators can show school administrators and wellness committee members that this program can positively impact academic performance, concomitant to its primary objective of promoting healthful eating and physical activity.

EatFit: A Goal-Oriented Intervention that Challenges Adolescents to Improve Their Eating and Fitness Choices

• Workbook. Each student receives his or her own copy of the full-color, 20-page, magazine-style EatFit workbook (Figure). It contains all worksheets, so no photocopying is necessary. • Web-based assessment (www. eatfit.net). Computer technology is used to assist adolescents in diet assessment. The personalized assessment program is an interactive application that begins with adolescents entering a 24-hour diet record and concludes with personalized dietary feedback, goal setting, and a contract. • Classroom curriculum for the teacher/leader. The curriculum includes 9 experiential lessons that teach skills, provide goal performance feedback, practice behaviors, and motivate. The topics include dietary and physical activity goal setting, reading food labels, eating at fast food outlets, learning the physical activities, and understanding media influence.

Correlates of food patterns in young Latino children at high risk of obesity

OBJECTIVE The present paper examines the influence of age and gender on food patterns of Latino children. DESIGN Data are from baseline of a 5-year, quasi-experimental obesity prevention study: Niños Sanos, Familia Sana (NSFS; Healthy Children, Healthy Families). In 2012, the researchers interviewed Latino parents, using a thirty-item questionnaire to ask about their childrens food consumption and feeding practices. Statistical tests included t tests and ANCOVA. SETTING Rural communities in Californias Central Valley, USA. SUBJECTS Two hundred and seventeen parents (87-89% born in Mexico) and their children (aged 2-8 years). RESULTS Fifty-one per cent of the children were overweight or obese (≥85th percentile of BMI for age and gender). Mean BMI Z-scores were not significantly different in boys (1·10 (SD 1·07)) and girls (0·92 (SD 1·04); P=0·12). In bivariate analysis, children aged 2-4 years consumed fast and convenience foods less often (P=0·04) and WIC (Supplemental Nutrition Program for Women, Infants, and Children)-allowable foods more often than children aged 5-8 years (P=0·01). In ANCOVA, neither age nor gender was significantly related to food patterns. Mothers acculturation level was positively related to childrens consumption of fast and convenience foods (P=0·0002) and negatively related to consumption of WIC foods (P=0·01). Providing role modelling and structure in scheduling meals and snacks had a positive effect on the vegetable pattern (P=0·0007), whereas meal skipping was associated with more frequent fast and convenience food consumption (P=0·04). CONCLUSIONS Acculturation and child feeding practices jointly influence food patterns in Latino immigrant children and indicate a need for interventions that maintain diet quality as children transition to school.

Adapting a Diet Analysis Program for an Adolescent Audience

Lytle and Achterberg identified key components to behavior change for youth interventions: (1) self-assessment of eating patterns for adolescents, (2) use of interactive computer technology, and (3) personalized and targeted messages.1 Building on this literature and our interviews with individual middle school students and teachers in California, we decided to include a focused computer component as an important strategy for a nutrition education intervention.The cost of developing a computerized diet analysis application was prohibitive (>

Adaptation of a Culturally Relevant Nutrition and Physical Activity Program for Low-Income, Mexican-Origin Parents With Young Children

100 000).As a viable alternative, saving time and money, we decided to adapt an existing computer application to meet the needs of our new audience. This adapted Webbased application (www.eatfit.net) starts with the entry of a 24-hour diet record by the adolescent and concludes with the output of a personalized and behaviorally focused goal. Although we believed that our plan was comprehensive, we learned otherwise.This GEM delineates the 6 steps we took to adapt this application. We offer supporting examples from our experiences. These steps might assist others who are considering the inclusion of a computerized diet analysis application into their nutrition education efforts.

Promoting Positive Youth Development Through Teenagers-as-Teachers Programs

Latino children experience higher rates of obesity than do non-Latino white children. Family-centered nutrition interventions can slow the rate of weight gain in this population. Niños Sanos, Familia Sana (Healthy Children, Healthy Family) is a 5-year, community-based, participatory research study that targets rural Mexican-origin farmworker families with children aged 2 to 8 years in California’s Central Valley. Adaptation of a culturally relevant obesity prevention program involved qualitative research to tailor key obesity prevention messages, pilot testing and implementation of key messages and activities at family nights, and continual modification to incorporate culturally innovative elements. Of the 238 families enrolled, 53% (125) attended the recommended minimum of 5 (of 10 possible) classes during the first year. A university and community partnership can guide development of a culturally tailored obesity prevention program that is suitable for reaching a high-risk Mexican-origin audience through cooperative extension and other public health programs.

Healthalicious Cooking: Learning about Food and Physical Activity: Lesson 6. Make It Fun: Eat and Share!

A promising approach to support positive youth development is having adolescents serve as teachers for younger children. Through a qualitative interview study, we explored adolescents’ development in their role serving as teachers for younger elementary-age children during out-of-school time; programs were managed by the University of California 4-H Youth Development Program. We interviewed 32 teenagers (median age 15; 27 female, 5 male) about their experiences, growth, and learning. Through consensus-based inductive thematic analysis, we identified 26 codes that we analytically sorted and found they aligned with the six indicators outlined by the Five Cs of the positive youth development model. Adolescents reported positive experiences and their own growth in competence, confidence, connection, caring, character, and contribution. Furthermore, data indicated that contributing in a meaningful way was developed in tandem with the other Cs.

Healthalicious Cooking: Learning about Food and Physical Activity: Lesson 4. Make It Colorful: Choose Fruits and Veggies by Color!

Author(s): Smith, Dorothy; Horowitz, Marcel; Neelon, Marisa; Spezzano, Theresa; Lippitt, Nancie; McMurdo, Tammy J.; Kaiser, Lucia | Abstract: Lesson 6. Make It Fun: Eat and Share! This after-school curriculum is a great setting to promote a healthy lifestyle with good foods and physical activity, helping kids build health skills that will last a lifetime.