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Objective: To explore the barriers associated with the adoption of the Alberta Nutrition Guidelines for Children and Youth in schools according to characteristics of the innovation (guidelines) and the organization (schools). Design: Cross-sectional telephone survey. Setting and Participants: Schools in Alberta, Canada. Principals from 357 schools. Main Outcome Measure: Barriers to adopting the nutrition guidelines. Analysis: A 19-question telephone survey, including open- and closed-ended questions, was used to obtain information regarding schools' characteristics and barriers to adopting the guidelines. Qualitative data were coded according to common themes a priori, based on constructs from the Diffusion of Innovations framework. Results: Schools reported many barriers related to the relative advantage, compatibility, and complexity of adopting the guidelines. Parents' resistance to change and cost were the key reported barriers. Lack of knowledge, student preferences, the physical location of the school, and barriers related to the provision of healthful food were also reported. Conclusions and Implications: Disseminating guidelines without providing adequate support for their implementation may not promote change within the school setting. School nutrition initiatives need to involve the parents and have access to sufficient financial and human resource support. [ABSTRACT FROM AUTHOR]

Home visitation programs offer a unique opportunity to implement a novel digital early childhood obesity prevention program. Evaluate usability of a digital infant feeding nutrition education module with key stakeholders (N=21) of a home visiting program in Florida. Home visitors (n=11) and enrolled mothers (n=10) of a home visiting program in Florida participated in a one-time, 45-minute qualitative interview via Zoom with a trained researcher using a semi-structured script based on constructs from the Technology Acceptance Model (TAM) and Social Cognitive Theory (SCT). Participants also completed a modified version of the mHealth App Usability Questionnaire (MAUQ). Interviews were audio-recorded, deidentified, transcribed verbatim and coded by two trained researchers using an inductive thematic analysis approach based on TAM and SCT constructs to develop themes. MAUQ subscales were analyzed using descriptive statistics. Most participants noted that they liked the digital format, and specifically mentioned the visual or interactive components, convenience and accessibility of the information, and general preference for digital information over paper handouts. Home visitors were interested in content related to food allergies and readiness for solid foods, whereas mothers were interested in all of the infant feeding topics. Nonetheless, the majority (90%) reported that they would be very likely to use information in the learning modules as part of home visits. Usability of the module was high across all three MAUQ subscales (mean ratings out of 7±SD: ease of use = 6.88±0.2, interface and satisfaction = 6.90±0.4, usefulness = 6.78±0.1). Limited access to technology by parents, compatibility of the module with various phone types, and necessity of keeping information updated were mentioned by home visitors as limitations that may impact usability. The results revealed that a digital nutrition education module to prevent early childhood obesity was deemed usable by both staff and parents of a home visiting program. Future research is needed to determine impact on parental feeding behaviors and child health outcomes. University of Florida Mowery Innovative Research Fund [ABSTRACT FROM AUTHOR]

Objective: To identify how qualitative research has contributed to understanding the ways people in developed countries interpret healthy eating. Design: Bibliographic database searches identified reports of qualitative, empirical studies published in English, peer-reviewed journals since 1995. Data Analysis: Authors coded, discussed, recoded, and analyzed papers reporting qualitative research studies related to participants' interpretations of healthy eating. Results: Studies emphasized a social constructionist approach, and most used focus groups and/or individual, in-depth interviews to collect data. Study participants explained healthy eating in terms of food, food components, food production methods, physical outcomes, psychosocial outcomes, standards, personal goals, and as requiring restriction. Researchers described meanings as specific to life stages and different life experiences, such as parenting and disease onset. Identity (self-concept), social settings, resources, food availability, and conflicting considerations were themes in participants' explanations for not eating according to their ideals for healthy eating. Implications: People interpret healthy eating in complex and diverse ways that reflect their personal, social, and cultural experiences, as well as their environments. Their meanings include but are broader than the food composition and health outcomes considered by scientists. The rich descriptions and concepts generated by qualitative research can help practitioners and researchers think beyond their own experiences and be open to audience members' perspectives as they seek to promote healthy ways of eating. [ABSTRACT FROM AUTHOR]