Sue Nicholson Butkus

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.

A Logic Model Framework for Community Nutrition Education

Logic models are a practical method for systematically collecting impact data for community nutrition efforts, such as the Food Stamp Nutrition Education program. This report describes the process used to develop and test the Community Nutrition Education Logic Model and the results of a pilot study to determine whether national evaluation data could be captured without losing flexibility of programming and evaluation at the state level. The objectives were to develop an evaluation framework based on the Logic Model to include dietary quality, food safety, food security, and shopping behavior/food resource management and to develop a training mechanism for use. The portability feature of the model should allow application to a variety of community education programs.

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.

Goal Setting Education and Counseling Practices of Diabetes Educators

Purpose The purpose of this study was to identify goal setting education practices used by diabetes educators working with type 2 diabetes patients. Methods Data were collected by a mail questionnaire with 179 diabetes educators purposively selected from the 2008 American Association of Diabetes Educators membership listing. Results Many diabetes educators (52%) reported that more than 75% of their patients set goals for diabetes control. Independent factor patterns for the frequency of information collected from the patient for the first diabetes education session showed that educators either focused on patients’ self-management practices (exercise and dietary practices, knowledge, and social impacts of diabetes) or issues with learning about self-management, such as understanding the patient’s learning style and motivation for managing diabetes. Factor patterns overall showed diverse approaches to working with patients, including strategies used with patients struggling with dietary goals and the importance of tasks to complete during the first patient session. Conclusion Although most educators reported practices that were largely patient centered as promoted by the American Diabetes Association (ADA) and models of chronic disease management, patterns of practice suggest that diabetes educators vary considerably in how they apply education practices, especially with dietary self-management education.

Evaluating EFNEP Audience Change through Attrition Patterns.

Data on attrition from the Expanded Food and Nutrition Education Program (EFNEP) were analyzed to determine whether there have been changes in the characteristics of the low-income audience served by the program. Data from the 1986, 1988, and 1989 programs in a Washington State county were used. Dropouts differed significantly in selected sociodemographic characteristics from year to year, but in ways that reflected year-to-year differences in enrollees. A pilot pro gram tested in 1989, which used new recruitment and instructional methods, led to enrollees and dropouts with higher levels of education, income, and dietary adequacy than had been seen in the previous years. There was also evidence that the program in all three years tended to lose clients in the lower income brackets and to retain clients who were less educated and of Asian-American ethnicity. Dropouts in each year had dietary inadequacies, although these inadequacies varied from year to year. Implications of the different patterns of attrition are discussed relative to program evaluation and future research.

Dietary goal attainment measures and psychosocial factors among Mexican Americans and non-Hispanic whites with type 2 diabetes.

Diabetes education programs need improved measures of goal setting for dietary control of diabetes. Additionally, measures of patient experiences with dietary goal setting are needed to better prepare patients for diabetes self-management. Measures of dietary goals and strategies were investigated via survey of 100 Mexican Americans and non-Hispanic whites with type 2 diabetes at a community clinic. Analyses tested novel goal measures as stages of change and goal attainment with a food plan compared to a traditional measure of food plan adherence. Ethnic groups varied in some reported experiences with goal setting education and goal attainment, but did not differ in most clinical characteristics of diabetes. Results indicated that different measures of goal setting vary in their psychosocial predictors, suggesting changes in how health care providers use and monitor goal setting for patients. At the time this research was conducted, Dr. Briggs Early was a doctoral candidate in the Department of Food Science and Human Nutrition at Washington State University. She is currently an Assistant Professor of Biochemistry and Nutrition at Pacific Northwest University of Health Sciences – College of Osteopathic Medicine, and a certified diabetes educator, and insulin pump trainer in Yakima, Washington.

Health Professionals’ Values Associated with Support for Food Assistance and Nutrition Education Programs

Abstract This study investigated the personal characteristics and values associated with support for food assistance and nutrition education programs in three groups of health professionals. Nearly 1500 dietitians and members of the public health and rural health associations responded to a mail survey. The membership lists were screened to eliminate duplicate mailings. Support for food assistance was positively associated with high values for food assistance, equity (support for opportunities for the poor, minorities, and women), and younger age respondents. Support for educational programs was most strongly associated with the values of equity, support for the environment and family, and being a nutritionist.