Mary Jane Oakland

Solving the problems of iowa food deserts: Food insecurity and civic structure

Abstract  Rural regions include places where food sources are not evenly distributed, leading to areas of concentration and food deserts—places where few or no grocery stores exist. Individuals are hypothesized to depend on personal connections and the civic structure of where they live to help them solve the problem of food insecurity. We find that residents living in poor rural counties with few grocery stores and perceptions of high civic structure are significantly less likely to be food insecure. A great deal of food giving and receiving is reported, but these personal connections do not decrease the odds of being food insecure. Lower incomes and being younger increase the odds of food insecurity. Our findings suggest that investments in strengthening the social structure of rural communities along with strategies that increase incomes can help households solve the problem of food insecurity.

Quality of Life Issues for Families Who Make the Decision to Use a Feeding Tube for Their Child with Disabilities.

Qualitative research methods were used to study families who had made or were in the process of making the decision to use a feeding tube to meet the nutrition needs of their child with a disability. Data were gathered over a 2-year period through interviews with eight families. Family decision making in the context of quality of life was examined using a theoretical family systems model. Descriptive themes and issues emerged from the data that led to a greater understanding of what families face in making this decision for their child. The data can help families and professionals work in partnership before a child becomes severely malnourished or medically compromised as a result of inadequate nutrition. The themes and issues are discussed and implications for future interventions and research are presented.

Improving dietetics education with interactive communication technology.

Changes occurring in health care, education, and technology are altering dietetics education. A model of learnercentered, cooperative, distance education based on interactive online technology is described for use in a dietetic internship. Evaluation of this model includes review of key-feature exams, results of computer attitudes surveys, use of the technology by interns, exit interviews, and performance on the examination for registered dietitians. In a pilot study of the model with 8 subjects, comfort using the Internet improved significantly. Use of interactive communication technology in dietetics education has the potential to improve competency, technological aptitude, professional partnering skills, and lifelong learning skills.

Relationships between Intern Characteristics, Computer Attitudes, and Use of Online Instruction in a Dietetic Training Program.

Changes in health care and educational technology instigated the use of interactive online instruction in this preprofessional training program. Cooperative learning strategies, which require the interns to interact with each other, were incorporated into the online instruction to initiate learner/instructor and learner/learner interaction. Seventy-five dietetic interns from 3 universities were randomly assigned to groups with and without online instruction. Computer attitudes and use of the technology were examined. Demographic variables and previous computer experience did not influence the use of the online instruction. However, those who reported a preference of working with others used the online instruction more (p = .05). The amount of time reported using the online instruction had a positive effect on overall computer attitude and comfort using computers. Significant improvement in self-efficacy with the World Wide Web occurred irrespective of the treatment.

Promoting and Evaluating Competence in On-Line Dietetics Education

Professional organizations, such as the American Dietetic Association are challenged to assure competency of their practitioners. Competency includes higher-level skills such as critical-thinking, cooperative work, effective communication, and use of lifelong learning resources. Information literacy via computer technology is a key component of competency, which needs to be included in dietetic education and training. This dietetic internship examined use of online technology to develop competency using the key-feature exam. Seventy-five dietetic interns from three different programs were divided into those with (n = 44) and without (n = 31) online instruction, to which pre- and post- test key feature exams were administered. Those with online instruction had greater improvement (P < 0.05) on key-feature exams in nutrition support and pediatric nutrition. Competency is complex and difficult to assess, thus tools to better assess the comprehensive scope of practitioner competency are needed. The key-feature exam may be a tool to assess and verify practitioner competency in dietetics professionals.

Educator and Participant Perceptions and Cost Analysis of Stage-tailored Educational Telephone Calls

OBJECTIVE To identify strengths and weaknesses of nutrition education via telephone calls as part of a larger stage-of-change tailored intervention with mailed materials. DESIGN Evaluative feedback was elicited from educators who placed the calls and respondents who received the calls. SETTING An internet and telephone survey of 10 states in the midwestern United States. PARTICIPANTS 21 educators in 10 states reached via the internet and 50 young adults reached via telephone. VARIABLES MEASURED AND ANALYSIS: Rankings of intervention components, ratings of key aspects of educational calls, and cost data (as provided by a lead researcher in each state) were summarized via descriptive statistics. RESULTS, CONCLUSIONS, AND IMPLICATIONS: Educational calls used 6 to 17 minutes of preparation time, required 8 to 15 minutes of contact time, and had a mean estimated cost of

Dynamics of Catch-Up Growth in a Group of Premature Infants

5.82 per call. Low-income young adults favored print materials over educational calls. However, the calls were reported to have positive effects on motivating participants to set goals. Educators who use educational telephone calls to reach young adults, a highly mobile target audience, may require a robust and flexible contact plan.

Accessing food resources: Rural and urban patterns of giving and getting food

Abstract LEARNING OUTCOME: To identify a pattern of weight and height changes that produce catch-up growth and normal Denver Developmental Screening results in a group of 18 month old former premature infants. A retrospective chart review was done on a group of 28 (72% male) infants discharged from a level three NICU with outpatient follow up at the hospitals developmental screening clinic. Growth data was collected from hospital and developmental clinic charts at birth and discharge, as well as at 4, 9 and 18 month screenings. Dietary data was collected from hospital records and developmental screening visits. The mean birth weight was 1534 gm (+/− 372) and the mean gestational age was 31 weeks (+/− 2.6). Average weight at discharge was 2430 gm (+/− 354). The mean weight z-score at discharge was −2.96 (+/− .52) for actual age. 75% of the infants received breast milk in the hospital and 60% were discharged on breast milk. Analysis of variance of weight z-scores at 4, 9 and 18 month screenings showed significant decreases (p = .001) from a mean z-score of .64 at 4 months to .03 at 9 months and −.27 at 18 months adjusted age. Mean height z-scores moved from −.87 at 4 months to −.45 at 18 months adjusted age (p = .05). When weight for height was plotted on a NCHS growth chart, the average weight for height decreased from the 95%ile at the 4 month screening to the 50%ile at the 18 month screen. 116.8cal/kg was the average intake of the 23 formula fed infants at the 4 month screening . All the children had normal developmental screens at 18 months. In this group of low birth weight infants, catch-up growth occurred first as weight and than as height. To demonstrate catch-up growth by 18 months, the results suggests that weight for height should be at least the 95%ile at 4 months actual age. Infants at 4 months who are less than the 95%ile may need additional nutrition support to attain appropriate long term growth rates.