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To explore the goals, barriers, and facilitators set by caregivers of preschool-aged children to improve food parenting practices and household food environments. Secondary qualitative analysis of collaborative goal sheets completed during in-home and telephone visits as part of a home-based pilot intervention. Thirty-three Hispanic/Latinx caregivers, predominantly of low income. Patterns in goal content and anticipated barriers and facilitators. Thematic analysis of goal sheets with a mixed inductive-deductive approach. Almost half of the goals were to support a healthy environment (40.7%) by increasing the availability of healthy foods through food shopping and meal planning. Other goals were to increase structure (33.7%) by establishing food-related routines and decreasing distractions. Goals related to autonomy support (25.4%) included involving their children (eg, cooking together). Caregivers' perceived barriers encompass individual (eg, stress, lack of time), interpersonal (eg, other family members' eating behaviors), and environmental-level (eg, food availability) factors. Caregivers only identified facilitators at the individual and interpersonal levels (eg, motivation). Understanding goals, barriers, and facilitators can be used to tailor key messages to improve food parenting practices and children's diets. Future interventions can target broader environmental barriers while increasing awareness of individual, interpersonal, and environmental-level facilitators. [ABSTRACT FROM AUTHOR]

Characterize experiences with cancer and perceptions of the preventable cancer burden attributable to diet among firefighters. A cross-sectional survey was distributed to assess cancer history and perceptions of cancer. US. US-based firefighters. History of cancer, perceptions of cancer, and perceptions of diet as a means to prevent cancer. Descriptive statistics and use of the Behaviour Change Technique Taxonomy v1 (BCTTv1) to evaluate qualitative responses. A total of 471 firefighters participated. Nearly half (48.4%) voiced they strongly agreed that they were at risk for cancer, whereas 44.6% agreed that changing diet could decrease cancer risk. The most common BCTTv1 codes focused on types of education, including "Instruction on how to perform the behavior" (45.1%, n = 189), followed by those centered on behavior execution (eg, "Action planning" [24.8%, n = 104]). Qualitatively, many were concerned about misinformation. Firefighters acknowledge the role of diet in cancer risk and have a desire for knowledge and behavioral support (eg, goal setting) that includes an emphasis on evidence and tackling misinformation. This information should serve as the basis of future interventions that target diet. [ABSTRACT FROM AUTHOR]

To explore how outpatient dietitians select and use applications (apps) to support nutrition education. Qualitative analysis of 20 dietitians who participated in semistructured interviews investigating their app use and recommendation processes. Transcripts were analyzed using thematic analysis. Four themes described how dietitians perceive apps for nutrition education: (1) nutrition education goals focus on long-term lifestyle behavior change while protecting patients' relationship with food, (2) attitudes toward tracking apps influence app selection, (3) dietitians differentiate among patients who will benefit from tracking vs information apps, and (4) barriers to optimal app use result in adaptations by dietitians. Barriers exist to optimal app use for nutrition education. However, accessible app design, app selection guides, and research expounding the effects of apps and their use by dietitians may improve how practitioners incorporate apps into nutrition education. [ABSTRACT FROM AUTHOR]

Evaluate the delivery of a "family night" event to demonstrate Accreditation Council for Education in Nutrition and Dietetics (ACEND) Didactic Program in Dietetics (DPD) curriculum standards. Experiences beyond the classroom can apply multiple aspects of nutrition education to enhance students' behavioral capability and self-efficacy for future practice. Undergraduate students in a junior-level Nutrition Education and Counseling course within an ACEND accredited DPD. Student delivered a family night event at a campus-based child development center. Through intentional design, event delivery encompassed audience assessment, goal setting, theory application, message identification, handout development, developmentally appropriate activities, food tasting, and interpersonal communication with diverse audiences. Outcome evaluation aligned select ACEND Knowledge Requirements for Dietitians and Nutritionists (KRDN) to these event components: apply assessment of target audience educational and resource needs to program materials (KRDN 1.3); develop a handout including instructor assigned components (KRDN 2.1); engage with parents and children during event (KRDN 2.1); develop a culturally appropriate handout and activity (KRDN 2.6); develop education strategies in the form of a handout, activity, and food tasting (KRDN 3.2); convey messages and developmentally appropriate feeding suggestions (KRDN 3.3). Primary themes within evaluation included: 1) student enthusiasm to deliver the event; 2) challenges conveying feeding information; 3) the need to foster students' cultural awareness prior to resource development; 4) the need for example handouts demonstrating appropriate and inappropriate formatting; and 5) identification of additional areas of student learning for similar assignments (ie communication "soft skills", advertising programs, negotiation). Delivering a "family night" event allows undergraduate students to develop behavioral capability and self-efficacy for nutrition education. Training students on "soft skills" for communication with facility staff and participants; intentional assessment to establish cultural awareness; and prior role play can help assure a successful event which promotes positive feeding practices among participants. None [ABSTRACT FROM AUTHOR]

To explore the feasibility of guided goal setting (GGS) delivered via a tele-nutrition intervention in a Rural Native American community. Based on the social cognitive and goal setting theories, GGS, was designed as an alternative to self-set and prescribed goals and gives choices from a collection of tailored goals suitable for group education. Native American caregivers of young children living in remote rural communities. The Healthy Kids tele-nutrition intervention consisted of 6-weekly sessions delivered remotely by an EFENP educator. Eating Smart Being Active curriculum was augmented with GGS, food-related parenting, storytelling, and My Healthy Plate to target child malnutrition prevention. Acceptability of the goal setting strategy and tele-nutrition delivery were explored via participant survey after each session. Process evaluation data was collected on participant shared goal content. Focus groups were conducted at the last session. Two intervention series were conducted. Thirty-three participants registered for the intervention with 23 attending 4 or more sessions. Participants actively engaged in the GGS procedure by choosing goals, tracking progress, and engaging in session activities. Parents shared weekly goals during class discussions which included those from the tailored list, intervention topics, or personally relevant (ie, turn off TV at dinner, add fruit to water, take nature hikes). Post-session surveys revealed that 95% reported GGS was useful. Additionally, during focus group interviews, participants described liking goal setting, particularly the goal options, weekly tracking, and that it was motivating. A majority of participants (93%) indicated that they agree that the tele-nutrition modality was effective. In the focus group interviews, it was shared that the virtual classes were a valued opportunity but prefer face-to-face. Participants in this study actively engaged in GGS delivered via tele-nutrition and routinely challenged themselves by selecting or creating new weekly goals. Further research should include exploration of optimizing the GGS strategy specifically for this community and modality. NIFA [ABSTRACT FROM AUTHOR]

To evaluate the feasibility of a Social Cognitive Theory-based intervention on cognitive, affective, and behavioral outcomes in a college nutrition course. A pre-post quasi-experimental design. Large metropolitan university. College students (n = 138) aged 18–40 years. Students participated in weekly food challenges during a 15-week nutrition course to apply nutrition knowledge, develop self-efficacy and promote positive behavior change. Food challenges were implemented by a guided goal-setting strategy. Cooking videos, which modeled important nutrition-related skills, accompanied each challenge. Students independently selected 2-goal options to implement weekly and wrote a reflection about their experiences. Cognitive outcomes (nutrition and cooking self-efficacy), affective outcome (cooking attitudes), and behavioral outcomes (fruit and vegetable consumption). Descriptive statistics and paired sample t tests. Analyses showed significant increases in cognitive outcomes (produce consumption self-efficacy [ P = 0.004], cooking self-efficacy [ P = 0.002], using fruit/vegetables and seasoning self-efficacy [ P = 0.001]) and behavioral outcomes (fruit consumption [ P < 0.001], and vegetable consumption [ P < 0.001]). This pilot study suggested a framework for behavioral change, grounded in constructs central to Social Cognitive Theory, that simplified the goal-setting process (by using guided goal setting) and used video technology to decrease the cost of implementation. [ABSTRACT FROM AUTHOR]

To explore parents' accounts of the goals they seek when choosing foods for their young children through the lens of goal-systems theory. In-depth interviews with parents of children aged from 6 months to 5 years. Montevideo, Uruguay. Forty-two parents (aged 19–44 years, 90% female). Parents' personal experiences, feelings, and opinions related to how they choose foods for their children. Content analysis based on deductive-inductive coding. Parents' accounts confirmed they intended to pursue different goals when choosing foods for their children. Health-related goals mainly motivated the selection of healthy foods, but they also drove the selection of some ultra-processed products because of misconceptions about their healthiness. Pleasure and enjoyment motivated the selection of ultra-processed products, whereas stress avoidance was associated with selecting convenient foods. The selection of unhealthy foods raised conflicts between goals, which were solved using goal shielding, changes in risk perception and/or compensatory health beliefs. Results point to the need for communication campaigns and community-based interventions to introduce changes in how ultra-processed products are conceptualized and increase the associations between healthy foods and children's pleasure and enjoyment to promote healthier eating patterns during infancy and early childhood. [ABSTRACT FROM AUTHOR]

To determine if counting and goal setting can increase red/orange vegetable intake. Pre-posttest experimental. Midwestern university. Undergraduate students (n = 165). Those in the intervention group (n = 85) were asked to count the number of times they ate red/orange vegetables and set a goal to eat 1 more time. An estimate (number of times/d) of vegetable intake based on an independent review of uploaded photographs and descriptions of meals from smartphones. Generalized estimating equations. For the intervention group, mean frequency intake increased from 0.9 times/d on Monday to 1.6 times/d on Tuesday and to 1.3 times/d on Wednesday, whereas mean intakes for the control group were 1.0, 0.8, and 0.8 times/d, respectively. There were significant group × time interactions for Tuesday (β = 0.8; P < 0.001) and Wednesday (β = 0.5; P = 0.006). A mobile method that helped people count their daily red/orange vegetable intake and set a goal appeared to increase consumption. This finding suggests that nutrition education programs that provide people with easy ways to track specific dietary behaviors might be effective at helping them attain goals. [ABSTRACT FROM AUTHOR]

To demonstrate how a shared measurement system can be utilized to track data and measure progress toward achieving mutual goals of a SNAC. U.S. federal nutrition programs are required to coordinate efforts across a variety of public health sectors by convening SNACs. Evaluation of state-level collaborations is encouraged; however, most SNACs do not have an established framework. To align efforts, track progress, and share successes, Maine SNAC developed a shared measurement system based on tenets of collective impact. Maine SNAC members and partners. Maine SNAC meets quarterly to support strategies on obesity prevention, nutrition, and food security. Two subcommittees collaborated on goals to promote participation in school meals and increase use of federal nutrition benefits among program recipients. Altarum, the external evaluator, worked with Maine SNAC leaders to develop logic models and an evaluation framework based on the mission and workplans of SNAC subcommittees. A shared measurement system was then developed to aggregate data from multiple sources using common process and outcome measures aligned with the framework. A template was distributed to SNAC members to compile data on these measures. Altarum reviewed and summarized collected data to prepare an infographic on the SNAC's success in reaching goals. In 2021-2022, the shared measurement system captured data from 14 Maine SNAC members representing 5 different sectors. Contributed data included surveys (3 sources), federal assistance program participation (3 sources), social marketing analytics (5 sources), and nutrition incentive program sales and redemption (2 sources). Two infographics were produced and distributed to more than 50 state and federal public health partners. Maintaining a shared measurement system allows the systematic compilation of data from multiple partners to demonstrate the progress of mutual goals. Presenting tabulated data in an infographic provides a compelling way to showcase collective impact. This process can be replicated in the future by other SNACs or coalitions. Supplemental Nutrition Assistance Program - Education [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the feasibility and implementation of goal setting activities added to the Teen Cuisine (TC) nutrition education curriculum with youth participating in the Expanded Food and Nutrition Education Program at the University of Georgia (UGA EFNEP). TC, developed by Virginia Cooperative Extension, utilizes a learner-centered approach and Experiential Learning Model. The Social Cognitive Theory, commonly used in adolescent nutrition education, identifies goal setting as a component of health behavior change. UGA EFNEP adapted the original curriculum to include SMART (Specific, Measurable, Achievable, Realistic, Timely) goal setting in each session. High school-aged youth participating in UGA EFNEP (9th-12th grade). TC is a six-session, evidence-based adolescent nutrition education curriculum. UGA EFNEP adapted TC to include goal setting activity sheets, including instructions and an example for creating a SMART goal. EFNEP nutrition peer educators presented these sheets to participants at the end of each session. Implementation of goal setting activities during TC programming was evaluated by EFNEP state staff observations and informal interviews with peer educators. A question to assess self-report goal setting was developed and included in post survey data collection. The use of goal setting was explored as a factor of diet quality improvements measured by the EFNEP Youth 9th-12th Nutrition Education Survey using independent t-tests. Preliminary analyses suggest that mean overall diet quality improvements did not significantly differ between classes using goal setting activities (n = 290, 0.24±0.54) vs. those that did not (n = 241, 0.28±0.57) (p = 0.478). Both the goal setting activities and non-goal setting activity groups demonstrated improvements in diet quality such as increased consumption of fruits and vegetables. Implementation and promotion of SMART goal setting activities with high school-aged youth is feasible and can be a part of UGA EFNEP youth programming. Further research is needed to assess if this population will self-report setting SMART nutrition/health goals. None [ABSTRACT FROM AUTHOR]

Polycystic Ovarian Syndrome (PCOS) is a prevalent condition manifesting in adolescence and is associated with obesity and type 2 diabetes. Given this lifelong burden, early dietary modifications are beneficial to mitigate PCOS severity. Registered Dietitians (RD) play an important role in guiding diet-related strategies following a PCOS diagnosis. While goal setting is a critical tool for promoting behavior change, standardized and effective approaches for dietary management of adolescents with PCOS are lacking. To characterize goal setting by RDs for adolescents newly diagnosed with PCOS at a multi-specialty PCOS clinic. Nutrition notes recorded by RDs of patients (n=118) seen for PCOS between 2015 and 2020 were extracted from medical records and de-identified. A collaboratively generated code book was used to code nutrition notes in Dedoose™ based on open coding and a priori objectives. One investigator (MG) coded all notes and exported excerpt subgroups stratified by number of nutrition goals set. Four investigators (MG, HV, EMG, AU) independently reviewed excerpts to identify emerging themes and then collaboratively discussed common themes to identify prevailing concepts. Goals were characterized for emerging themes using qualitative content analysis by four investigators. Adolescents were on average 16 years old (range, 11-21 years) and 70.3% had a BMI > 30kg/m2. Parent(s) attended 89% of visits. Of the 118 nutrition notes, 7 notes set 0 goals, 10 set 1 goal, 40 set 2 goals, and 61 set 3+ goals. The main themes identified were: 1) use of the MyPlate tool; 2) focus on modifying carbohydrate intake including restricting simple carbohydrates (eg, reduce sugar-sweetened beverages) or pairing carbohydrates with other macronutrients (eg, protein or fat); and 3) a lack of parental inclusion in the goals. MyPlate and carbohydrate intake are frequent goal setting starting points for RDs evaluating adolescents with PCOS at the multi-specialty clinic evaluated. Parental involvement in goal setting may be a missed opportunity to create feasible, effective nutrition goals. Canadian Institutes of Health Research Postdoctoral Fellowship (Dr. Vanden Brink) [ABSTRACT FROM AUTHOR]

Despite its importance in chronic disease management, primary care providers (PCPs; physicians, physician assistants, and nurse practitioners) receive limited training in obesity counseling. We developed a software application, Nutri, to improve brief dietary behavior change counseling by PCPs via "the 5 As" framework. Nutri 1) collects and synthesizes patient diet data (Assess), 2) provides goal recommendations prioritized by a patient's dietary risk (Advise), 3) guides PCPs to collaboratively select one diet goal with a patient (Agree), 4) tailors take-home materials support goal attainment (Assist), and 5) facilitates PCP follow-up (Arrange). To evaluate Nutri's effect on PCP obesity counseling competence. In a randomized controlled trial (RCT) of Nutri in a large primary care network, intervention group PCPs (n=8) received a 10-minute training video on theory-based nutrition education, a live Nutri demo, and Q&A. Control group PCPs (n=8) received training on a health record alerting tool. We assessed pre-post change in PCP's competence on the 5As of obesity counseling with a validated self-report measure. We compared intervention and control PCPs in an intent-to-treat analysis using multiple regression with Bonferroni correction. Intervention and control groups were demographically similar; however, we adjusted models for gender and years in practice to account for between-group differences. 100% of intervention PCPs received training. 75% used Nutri with one or more patients. Nutri PCPs improved in overall competence compared to control (b=0.8, p=0.001; model F=8.3, p=0.002, R=0.63). Nutri PCPs had significantly greater improvement on Assess and Agree subscales. Nutri improved PCP obesity counseling competence. This indicates that a technology used in clinic with real patients is a viable alternative to more didactic clinician training approaches. Nutri's effect on PCPs' perceived ability to Assess and Agree corresponds directly to Nutri's design, which emphasizes data collection/synthesis and collaborative goal setting between patient and provider. Future research will assess Nutri's effect on patient outcomes; however, current findings suggest that interactive, in-clinic technologies have potential to impact PCP counseling. Agency for Healthcare Research and Quality [ABSTRACT FROM AUTHOR]

Objective: To compare the effectiveness of online delivery of a weight management program using synchronous (real-time), distance-education technology to in-person delivery. Methods: Synchronous, distance-education technology was used to conduct weekly sessions for participants with a live instructor. Program effectiveness was indicated by changes in weight, body mass index (BMI), waist circumference, and confidence in ability to eat healthy and be physically active. Results: Online class participants (n = 398) had significantly greater reductions in BMI, weight, and waist circumference than in-person class participants (n = 1,313). Physical activity confidence increased more for in-person than online class participants. There was no difference for healthy eating confidence. Conclusions and Implications: This project demonstrates the feasibility of using synchronous distance-education technology to deliver a weight management program. Synchronous online delivery could be employed with no loss to improvements in BMI, weight, and waist circumference. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between goal setting and fruit and vegetable (FV) consumption and physical activity (PA) in an intervention for college students. Methods: Secondary data analysis of intervention group participants from a 10-week online intervention with complete weekly data (n = 724). Outcomes (cups of FV per day and minutes of PA per week) and goals for both behaviors were reported online each week. Weekly differences between goals and behaviors were calculated, as well as the proportion meeting individual goals and meeting recommendations for behaviors. Results: There were significant (P < .05) effects of goal setting on both behaviors and of goal group (tertile of meeting weekly goals) on behavior, as well as meeting recommendations for both behaviors. There was an increase in FV consumption (P < .001) but no change in PA over time. Conclusions and Implications: Goal setting as part of a Web-based intervention for college students was effective, but results differed for FV and PA. Goal setting for maintaining behavior may need to differ from goal setting for changing behavior. [ABSTRACT FROM AUTHOR]

Objective: Inadequate fruit and vegetable (FV) consumption signals a need for identifying predictors and correlates of intake, particularly in diverse adolescents. Design: Participants completed an on-line assessment in early 2010. Setting: Computer classrooms in 4 high schools. Participants: One hundred twenty-two Caucasian and 125 minority (African American and Hispanic) high school students (mean age = 15.3 years, SD - 1.0) with parental consent. Response rate was 89%. Variables Measured: Self-efficacy as measured by confidence in goal setting and decision making about healthful eating; perceived benefits and barriers to eating FVs; healthful eating-related social support; body esteem; and FV intake. Analysis: t tests were used to examine group differences, and binary logistic regression analyses were conducted to explore the predictors of 5-A-Day FV consumption. Results: Thirty-four percent of the non-minority group and 28% of the minority group reported eating 5 or more portions of FVs a day (P = .34). Self-efficacy and perceived benefits predicted consumption in minority participants, whereas barriers and social support were significant predictors in the non-minority group. Conclusions and Implications: These findings suggest different variables predict consumption for minority and non-minority groups and that self-efficacy is an important variable to consider in dietary change programs for minority adolescents. [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]

A protocol for a systematic onsite review of the Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education was developed to support quality programming and ensure compliance with state guidelines and federal regulations. Onsite review of local nutrition program operations is one strategy to meet this goal. Observation and interaction with staff allow a comprehensive understanding of strengths, weaknesses, and emerging issues. This information provides managers with timely feedback to strengthen and improve all aspects of nutrition programming. [ABSTRACT FROM AUTHOR]

The Youth Expanded Food and Nutrition Education Program (EFNEP) is one of the United States Department of Agriculture's hallmark nutrition education programs for limited-resource youth. The objective of this study was to gather opinions from experts in EFNEP and related content areas to identify costs, effects (impacts), and related instruments to develop a cost-effectiveness model (instrument) for youth EFNEP, which does not exist. A cost-effectiveness model determines the economic or financial cost of producing an impact. The findings highlight several challenges in identifying inputs through consensus and provide a roadmap for the creation of a model that can be adopted by state EFNEP coordinators. [ABSTRACT FROM AUTHOR]

Objective: Explore student-involvement goals in local weliness policies (LWPs) of local education agencies (LEAs) in Pennsylvania (PA) and investigate associations with LEA characteristics. Design: An observational study that helped examine student-involvement goals. Setting: Public PA LEAs. Participants: LWPs submitted by 539 PA public LEAs. Main Outcome Measures: Six student-involvement goals analyzed as dependent variables. Correlations between demographic and policy characteristics of LEAs and student-involvement goals were measured. Analysis: Policies developed by LEAs were abstracted and analyzed. Logistic regression models were developed to analyze relationships between student-involvement goals and the demographic and policy characteristics of LEAs. Results: Majority ofLEAs included policy goals that address student involvement in an array of activities related to weilness policy, food service, and role modeling. Regression models showed that LEAs with comprehensive and strong policies were most likely to include student-involvement goals regardless of LEA location, enrollment, or socioeconomic status of students. Conclusions and Implications: Student engagement in school nutrition policies has been shown to increase student acceptance in an array of health-related areas and is therefore promising in the area of obesity prevention. Comprehensiveness and rigor of LWPs were strongly correlated with the inclusion of student-involvement goals on LWPs. The upcoming reauthorization of the Child Nutrition programs in 2010 creates a good opportunity to address student involvement in LWPs. [ABSTRACT FROM AUTHOR]

Objective: The present study examined (1) whether respondents who were encouraged to make implementation intentions to eat more fruit increased their fruit intakes, as measured by three measures of fruit intake; (2) whether the effects of implementation intentions on fruit intake were dependent on positive goal intentions at baseline; and (3) the respondents' commitment to perform their implementation intentions. Design: Dutch adults (n = 535) were randomly assigned to either receive implementation intention instructions or not. Two questionnaires were completed with a 1.5-week time interval. Respondents in the implementation intention condition were asked to form implementation intentions to eat an extra serving of fruit per day during one week. Results: Respondents in the implementation intention group reported a high frequency of eating an extra serving of fruit per day. The implementation intention effect on frequency of extra fruit did not depend on goal intention at baseline. The more committed respondents were to carrying out their implementation intention, the more likely they were to increase their fruit intake. Conclusion: These results provide some indications that implementation intentions could be a useful strategy to induce a short-term increase in fruit intake. [ABSTRACT FROM AUTHOR]

To develop a computational system that uses dietary recall data to prioritize behavioral goals to facilitate efficient, personalized collaborative goal-setting in primary care. The Chronic Care Model posits that synergy between the healthcare system and patient self-management will improve chronic disease outcomes. Thus, improving how diet is addressed in primary care could augment the benefit of dietary self-management. Collaborative goal-setting with primary care providers (PCPs) can facilitate patient behavior change. However, PCPs lack time and training to set effective diet goals with patients. NutriPCP aims to address this gap by presenting PCPs with a set of evidence-based goals prioritized using patient data. PCPs NutriPCP uses ASA24 diet recall data to compute patient status for each of 9 previously developed, MyPlate-based goals (eg, "Make half my grains whole"). NutriPCP's inference engine consists of Python rule statements that synthesize a patient's data and compare it to evidence-based targets for nutrient consumption personalized for patient characteristics (eg, kcal intake/sex/age). PCPs are then presented with a list of the patient's status for each goal prioritized by degree of improvement needed. We tested our inference engine with test data (n = 12), and our team of nutrition, technology, and clinical experts validated the output. We used NHANES data to establish reasonable population-wide estimates. Testing revealed challenges for goal prioritization because datasets reflected consumption far from evidence-based targets. Therefore, we created standardized ranges to improve variability for relative ranking across goals. For goals with upper and lower limits (eg, "Reduce portion size") we added warnings for inadequate intake. We demonstrated that computational rules can automatically process recall data into prioritized behavioral goals. To our knowledge, this is the first system that personalizes MyPlate recommendations based on an individual's data. This has implications for nutrition education in primary care. Future research will examine implementation feasibility for PCPs and patients. Agency for Healthcare Research and Quality (AHRQ) R 2 1HS027660 Burgermaster, PI. [ABSTRACT FROM AUTHOR]

The article describes "Eat to Your Heart's Content" (EYHC), a cardiovascular disease (CVD)-nutrition education program in Wyoming aimed at increasing self-reported health-promoting behavior change for people with limited access to health care and/or no medical insurance coverage. The 4-week program consisted of a weekly class comprised of a cooking practicum and a discussion on issues such as CVD risk factors, heart-healthy diet and low-fat cooking. An evaluation of the program is included.

To address pediatric obesity risk reduction, EFNEP was embedded within medical clinics where pediatricians referred parents to the intervention. The traditional EFNEP intervention was augmented with guided goal setting (GGS), Healthy Kids (HK) obesity risk assessments, motivational modeling, and parenting topics. This investigation focused on assessing goal-setting behaviors of EFNEP participants attending the medical clinic intervention. Pediatricians referred 686 parents (30% Spanish speaking) to the EFNEP intervention. More than one-third (n = 264) of parents referred expressed interest in attending with 195 verbally agreeing to enroll in the intervention anchored with GGS. GGS gives goal choices from a collection of practitioner developed major and minor goals so parents can make their own goal decisions. Parents completed the HK assessment tools during session one, they were guided to select nutrition and parenting minor goals at session two, but at subsequent sessions, were given the options to continue with the same goal, select a new guided goal, modify the existing goal, or create a new goal. Goal selections, effort, and attainment were tracked weekly. Twenty intervention series with parents or caregivers (n = 105, 50% Spanish speaking) were conducted at five medical clinics with 78% of parents completing four or more sessions. All parents engaged in GGS with most making nutrition and parenting goal effort and achievement (Spanish 96%, 74%; English 92%, 69%, respectively). Parents selected fruit and vegetable goal topics frequently and rarely chose contingency management topics. Most parents selected a new goal each session with Spanish speaking parents more likely to select a guided option (72% vs 61%). Parents referred by their child's pediatrician attended the EFNEP intervention and engaged in the GGS activities. Parents reported a high level of goal commitment with Spanish speaking parents attending more classes and reporting higher levels of goal effort compared to English speaking parents. GGS was shown to be a suitable behavioral strategy for Spanish and English speaking parents attending EFNEP within a medical clinic setting. [ABSTRACT FROM AUTHOR]

The article focuses on the use of game and technology in assisting in improving health and preventing disease, the video game was assisting children in keeping up their plan in eating fruits and vegetables by setting goals for their intake of fruits and vegetables at specific meal and snack time. Parents food behaviors and eating preferences gave an opportunity to model and inculcate good eating habits in their children.

A review of the article "From Squires Quest! II: A Serious Video Game Intervention'': Methodological Issues" is presented.

Objective To describe families' selections of Conversation Cards (CCs), a priority-setting tool in pediatric weight management, and examine CC-related differences based on families’ anthropometric and sociodemographic characteristics. Methods A retrospective medical record review was conducted of 2- to 17-year-olds with obesity and their families who enrolled in a pediatric weight management clinic between January, 2012 and September, 2016. Results Medical records of 146 children were included. On average, families selected 10 ± 6 CCs (range, 3–32 CCs); only 50% of families (n = 73) indicated perceived readiness to make healthy changes. Adolescents (vs children) revealed less healthy eating behaviors ( P = .001) and physical activity habits ( P = .002). Goal setting was perceived to be a motivator across several sociodemographic characteristics (all P < .05). Conclusions and Implications The CCs were useful in describing families' priorities. The diversity of issues identified by families highlighted the importance of multidisciplinary expertise in pediatric weight management. [ABSTRACT FROM AUTHOR]

Objective Explore employees' perceptions of ability to follow the Mediterranean diet (MedDiet), preferences for setting goals if asked to follow the MedDiet, and expectations of an Internet-based, workplace MedDiet intervention. Design Seven focus groups to guide intervention development. Setting Four workplaces (business/professional services, government branches) in Southwest England. Participants Employees (n = 29, 51.7% women), ages 24–58 years. Phenomenon of Interest Ability to follow the MedDiet; preferences for goal-setting if asked to follow the MedDiet; intervention content. Analysis Data were analyzed with the use of thematic analysis. Results Participants perceived that adhering to some MedDiet recommendations would be challenging and highlighted cost, taste, and cooking skills as adherence barriers. Behavior change preferences included a tailored approach to goal-setting, reviewing goal progress via a website/smartphone app, and receiving expert feedback via an app/website/text/face-to-face session. Desirable features of an Internet-based MedDiet application included recipes, interactivity, nutritional information, shopping tips, cost-saving information, and a companion smartphone app. Engaging in social support was deemed important to facilitate adherence. Conclusions and Implications An Internet-based, workplace MedDiet intervention should address adherence barriers, utilize a tailored approach to setting and reviewing goals, and activate social support to facilitate adherence. These findings provide insights to planning to promote the MedDiet in non-Mediterranean regions. [ABSTRACT FROM AUTHOR]

An abstract of the article "Nutrition Lessons and Fast Food: Associations with Healthy People 2020 Dietary Goals among Low-income Children" by Angie Keihner and colleagues is presented.

The article highlights "Talk, Heart, Hands" and its components. The first session involves improved eating practices learned from family when child, the second session features reinforcement of goal-setting and action plan strategies and identification of main food groups such as grain, vegetables and fruit and the third session involves the creation of nutritious meal plates.

Objective Squire's Quest! II: Saving the Kingdom of Fivealot , an online video game, promotes fruit and vegetable (FV) consumption. An evaluation study varied the type of implementation intentions used during the goal-setting process (none, action, coping, or both action and coping plans). Participants who created action plans reported higher FV consumption 6 months after baseline. This study assessed changes by specific meal in that study. Methods A total of 400 fourth- and fifth-grade children completed 3 24-hour recalls at baseline and 6 months later. These were averaged to obtain FV intake. Analyses used repeated-measures ANCOVA. Results There was a significant group by time effect for vegetables at 6 months ( P = .01); Action ( P = .01) and coping ( P = .04) group participants reported higher vegetable intake at dinner. There were significant increases in fruit intake at breakfast ( P = .009), lunch ( P = .01), and snack ( P < .001). Conclusions and Implications Setting meal-specific goals and action or coping plans may enable children to overcome barriers and consume FV. [ABSTRACT FROM AUTHOR]

The article examines a nutrition education program for older adults known as the Chef Charles Club. The program was created as an extension of the "Pick a better snack" social marketing program in Iowa. Feedback for the program was obtained through focus groups. The Chef Charles Club included recommendations for daily exercise, information about the Food Guide Pyramid, food safety tips, crossword puzzles, recipes featuring fruits and vegetables, and a bingo card. The article discusses health behavior modification, fruit and vegetable consumption, and goal setting.

Objective To examine parents’ and children’s perceptions of and experiences related to a Parents as Agents of Change (PAC) intervention for managing pediatric obesity. Methods Ten families were recruited from a PAC intervention. Participants were interviewed before (10 adults and 9 children), during (9 adults and 8 children), and after (8 adults) the intervention. Results Before the intervention, families reported goals to increase physical activity, plan and eat healthier meals, reduce screen time, and lose weight. During the intervention, families described different approaches to making behavior changes depending on who assumed responsibility (parent, child, or shared responsibility). After the intervention, group setting, goal setting, and portion size activities were viewed positively. Suggestions for improvement included engaging children and reducing intervention length. Conclusions and Implications Practitioners delivering PAC interventions should discuss families’ goals and concerns, and who is responsible for making lifestyle changes. Practical activities are valuable. The length of interventions and engagement of children should be considered. [ABSTRACT FROM AUTHOR]

An abstract of the article "Efficacy of Obesity Risk Assessment Tools Integrated With Parental Guided Goal Setting to Maintain Healthy Weight Among Preschool Children: Year 5" by Marilyn Townsend et al. is presented.

An abstract of the presentation "Efficacy of Obesity Risk Assessment Tools Integrated with Parental Guided Goal Setting to Maintain Healthy Weight among Preschool Children," by Marilyn Townsend and colleagues is presented.