Virginia Carraway-Stage

Validation of a dietary intake tool for african-american dialysis patients with low literacy.

BACKGROUND This study analysed the validity and reliability of a food frequency questionnaire designed for African-American patients with low literacy. This instrument was designed specifically to meet the need for a tool that was short, easy to understand, and met clinical reliability and validity standards. OBJECTIVES Assessing patient nutritional status and dietary intake is crucial to the care of patients in end stage kidney disease. The development of a quick and reliable nutritional assessment tool for patients with low literacy could increase nutritional counselling effectiveness and improve patient outcomes. DESIGN The renal food frequency questionnaire (RFF) and a standard 24-hour recall were administered to a general population of African-American patients undergoing dialysis. Registered Dieticians and statistical analyses were used to validate the content and structural validity and reliability of the RFF to adequately measure dietary intake. PARTICIPANTS The study sample consisted of 30 African-American patients who received dialysis treatment at a regional teaching hospital facility. RESULTS The RFF was found to be a simple, easy to understand instrument with low reading complexity (grade level 4.4). Inter-rater reliability was found to be high (.81-1.00), and statistical analysis determined a high level of clinical validity. CONCLUSION The RFF was found to be a valid dietary recall tool that is appropriate for patients with limited literacy. It was found to have acceptable reliability and validity when compared with a standard 24-hour recall and has potential for use as a dietary intake and monitoring tool in patients undergoing dialysis.

Measuring me: using nutrition education curriculum activities to teach elementary mathematics.

Understanding basic functions of mathematics can greatly improve individuals’ future health risk.1 Numeracy skills help people understand medication prescriptions, nutrition plans, and which treatment option is best for them.2 However, one of the largest obstacles health professionals face is patient compliance to interventions; one reason being, lack of mathematical proficiency among the population.1,2,3, Teachers in K-12 learning environments have the greatest opportunity to lay core foundations in mathematics.5 A mastery of mathematics skills such as addition, subtraction, multiplication, division, proportions, and fractions is important for children to learn early to assist them in addressing health issues later in life.2, 6 School-based health promotion interventions focusing on nutrition and physical activity can also aid children in making connections between mathematics learned in the classroom and healthy living.7 Therefore, the authors developed an introductory activity called Measuring Me for the Food Math and Science Teacher Enhancement Resource (FoodMASTER) Initiative (Figure 1) to be used while collecting pre-study anthropometric data for the FoodMASTER study. The educational and developmentally appropriate interactive activity allows students to apply mathematics while becoming familiar with simple anthropometric measurements in the classroom. Figure 1 Measuring Me activity sheets. Program Description FoodMASTER Intermediate is a 3rd–5th grade curriculum that uses food as a tool to integrate nutrition concepts into the standard course of study for math and science.6 There are 10 units that make-up the FoodMASTER curriculum, each containing two or three activities (24 activities total). It meets national school standards for mathematics and science education and is also easily adaptable to each state’s standards. During the 2009–2010 school year, self-selected teachers in North Carolina (N=18) implemented the Measuring Me activity in their 4th grade classrooms as an introduction to FoodMASTER. Researchers from the program visited each classroom in the fall of 2009 to collect pretest data including students’ heights, weights, waist circumference, and food frequency. Other pretest data included nutrition, science, and mathematics knowledge, attitudes, and self-efficacy. Led by program researchers, Measuring Me was piloted in classrooms to allow children to become familiar with body measurements and connect abstract numbers to concrete applications such as health. Measurement plays an especially crucial role in helping children to identify relationships among objects.5 In using their own height measurement, students are able to identify items that are shorter, taller or the same height as them and make comparisons.5 Independent comparisons about other anthropometric measures, such as weight, can also be applied by students. Connecting comparisons students make about length and mass with nutrition and health concepts can be beneficial to improving students’ long term health literacy as adults.2 In intermediate grades, three core competencies children must learn are standard units of metric and customary measurement; collect, organize, analyze, and report data; and perform standard computations, all of which are included as components of Measuring Me.5 The Lesson Like other FoodMASTER activities, Measuring Me took one class period (30–45 minutes) to complete and is straightforward enough for teachers to pick-up quickly and implement in their classrooms. Eighteen classrooms and 298 students participated in the activity. Measuring Me followed a similar format as other FoodMASTER hands-on lessons. First, elementary student volunteers read a short passage about why health professionals measure height and weight. Next, each student completed the threereading comprehension questions independently and then answers were reviewed as a class. Subsequently, students participated in Height Math, the hands-on component of Measuring Me. A demonstration in how to measure height with yardsticks was shown to the class. The class was then divided into teams of 3–4 students to measure each others’ height using two yard sticks. The first student removed his/her shoes and stood straight. Limited wall space was available in most classrooms, so students estimated using free-standing heights. A second student held the yard sticks, one on top of the other, and the third student read the height in inches. Students switched roles until everyone in the group had been measured. Heights were recorded after each measurement. Students used individual results within teams to order heights from least to greatest; to calculate the sum, difference between the minimum and maximum height, mean, and median; and to perform several measurement conversions. Anonymous class results were used to make conclusions about students’ heights and to determine the class mode for height. The math concepts covered provided teachers with an opportunity to either review topics or introduce the topic for the first time depending on the teacher’s curriculum schedule. It also gives teachers an opportunity to discuss the nutrition concept of energy balance and how it relates to anthropometric measures.

College Students' Ability to Self-identify Healthiness of Diet and Dietary Components

although themothers taught their children nutrient values of foods, more mothers of breakfast eaters were concerned aboutmeals for family (eg, mothers provided children with a well-balanced diet, foods in season, local products, and food free from artificial additives). Conclusions and Implications: In addition to the pleasure of a meal, mothers’ dietary education for their children in childhood, especially by showing children that they care about a healthy diet, may prevent university students from skipping breakfast.