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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]

Intuitive eating interventions aim to improve individual health and promote sustainable changes to one's relationship with food. However, there is no evidence-based consensus on the impact of intuitive eating interventions on diet quality. This systematic review aimed to investigate intuitive eating interventions and their impact on diet quality. PubMed, Embase, CINAHL, PsycInfo, and Cochrane databases were systematically searched to October 2021 for studies reporting interventions that encompassed the principles of intuitive eating and measured diet quality. Other health outcomes were used for secondary analysis. Findings were synthesized narratively. Seventeen papers reporting 14 intervention studies (n = 3,960) were included in the review. All studies found a positive or neutral effect on diet quality following an intuitive eating intervention. A favorable change in eating behavior following these interventions was also observed. Intuitive eating promotes an attunement to the body, which aids in improving diet quality because of increased awareness of physiological cues. The reduction of emotional and binge eating may also increase diet quality. Findings from the current review suggest that intuitive eating interventions are most effective face-to-face, in a group setting, and sustained for at least 3 months. [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]

Objective: This paper presents the reliability and validity of a "competing food choice" construct designed to assess whether factors related to consumption of less-healthful food were perceived to be barriers to fruit and vegetable consumption in college freshmen. Design: Cross-sectional, self-administered survey. Setting: An urban public college with a large, diverse student population. Participants: A convenience sample of 408 college freshmen. Variables Measured: A "competing food choice" construct and fruit and vegetable intake. Analyses: Factor analysis, Cronbach α, and correlation coefficients were used to determine the reliability and validity of the construct. Results: Three factors were produced from the factor analysis of the 11-item competing food choice construct: "competitive food" barriers (Cronbach α = 0.73), fruit and vegetable-related "time" barriers (Cronbach α = 0.67), and "quality" barriers (Cronbach α = 0.64). Construct validity assessments revealed significant inverse correlations between fruit and vegetable consumption and competitive food barriers (r = -0.15, p < .01 current and r = -0.25, P < .01 prior) and time barriers (r = -0.12, P < .05 current and r -0.10, P < .05 prior). Conclusions and Implications: This "competing food choice" construct demonstrated satisfactory reliability and construct validity among college freshmen. [ABSTRACT FROM AUTHOR]

Objective: This paper describes the design and findings of a pilot Mothers In Motion (P-MIM) program. Design: A randomized controlled trial that collected data via telephone interviews and finger stick at 3 time points: baseline and 2 and 8 months post-intervention. Setting: Three Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) sites in southern Michigan. Participants: One hundred and twenty nine overweight and obese African-American and white mothers, 18-34 years old. Intervention: The 10-week, theory-based, culturally sensitive intervention messages were delivered via a series of 5 chapters on a DVD and complemented by 5 peer support group teleconferences. Main Outcome Measures: Dietary fat, fruit, and vegetable intake; physical activity; stress; feelings; body weight; and blood glucose. Analysis: General linear mixed model was applied to assess treatment effects across 2 and 8 months postintervention. Results: No significant effect sizes were found in primary and secondary outcome variables at 2 and 8 months post-intervention. However, changes in body weight and blood glucose showed apparent trends consistent with the study's hypotheses. Conclusions and Implications: The P-MIM showed promise for preventing weight gain in low-income overweight and obese women. However, a larger experimental trial is warranted to determine the effectiveness of this intervention. [ABSTRACT FROM AUTHOR]

Objective: To examine acceptability, attrition, adherence, and preliminary efficacy of mobile phone short message service (SMS; text messaging) for monitoring healthful behaviors in children. Design: All randomized children received a brief psychoeducational intervention. They then either monitored target behaviors via SMS with feedback or via paper diaries (PD) or participated in a no-monitoring control (C) for 8 weeks. Setting: University of North Carolina at Chapel Hill. Participants: Fifty-eight children (age 5-13) and parents participated; 31 completed (SMS: 13/18, PD: 7/18, C: 11/22). Intervention: Children and parents participated in a total of 3 group education sessions (1 session weekly for 3 weeks) to encourage increasing physical activity and decreasing screen time and sugar-sweetened beverage consumption. Main Outcome Measures: Treatment acceptability, attrition, and adherence to self-monitoring. Analysis: Descriptive statistics and nonparametric tests were used to analyze differences across time and group. Results: Children in SMS had somewhat lower attrition (28%) than both PD (61%) and C (50%), and significantly greater adherence to self-monitoring than PD (43% vs 19%, P < .02). Conclusions and Implications: Short message service may be a useful tool for self-monitoring healthful behaviors in children, although the efficacy of this approach needs further study. Implications suggest that novel technologies may play a role in improving health. [ABSTRACT FROM AUTHOR]

Objective: To design and pilot a questionnaire for assessing youth attitudes about the food system. Design: Nutrition educators provided important topics for food system education through a survey using the Delphi method. The resulting questionnaire of attitude scales was piloted with high school students. Setting: The Delphi survey of nutrition educators was conducted through the mail and electronically. A paper and pencil questionnaire was administered to high school students in Family and Consumer Science classes. Participants: Delphi participants were members of the Society for Nutrition Education's Division of Sustainable Food Systems. A convenience sample of high school students completed the pilot questionnaire. Variables Measured: Scales measured attitudes about farmland protection, participation in the local food system, hunger in the United States, organic agriculture, and environmental issues related to food. Analysis: Factor analysis was used to identify constructs. The internal consistency of each resulting scale was assessed using Cronbach's alpha. Results: Reliability of attitude scales ranged from .59 to .73. Conclusions and Implications: Attitude scales were created for the purpose of assessing youth thoughts and beliefs about the local or regional food system. Such assessments can serve as a starting point for food system educators interested in developing effective curricula on food system topics. [ABSTRACT FROM AUTHOR]

To determine the feasibility of using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24-2016) to assess children's diets as reported by parents enrolled in the Expanded Food and Nutrition Education Program (EFNEP). Washington EFNEP collects adult dietary data with a facilitated group 24-hour dietary recall (24HDR) using the form "Food Tracker: What I ate yesterday," supported by the facilitator and visual guides (Townsend et al 2013). The facilitation of ASA24 mirrored the facilitated process with guided instruction and visuals. A sample of English and Spanish speaking parents enrolled in WA EFNEP. As part of a larger study, parents were asked to complete a 24HDR via ASA24 for their youngest child between ages 2-8 at week two and nine of EFNEP classes. A facilitation kit was used to assist participants. All ASA24 data collections were conducted by trained professional staff. Raw data was exported from ASA24 to track the number of successful logins and attempts to enter recalls at each timepoint, total calories consumed, meal times, and food codes. Data collectors recorded errors frequently encountered, adjustments made to specific recalls, and user difficulties. Of the 88 enrolled participants, 62% completed ASA24 entry in Spanish and 38% in English. Fifty four percent (47) successfully completed ASA24, 27% (24) were unable to complete ASA24 and their child recalls were collected on paper, and 19% (17) did not attend the data collection. ASA24 can successfully be used to assess children's diets reported by parents enrolled in EFNEP. However, users may encounter challenges with connectivity, limited participant literacy levels, and technical difficulties within the ASA24 system. Identifying challenges and strategies to overcome them, is critical to inform the advancement and dissemination of this web-based tool. USDA. [ABSTRACT FROM AUTHOR]

Objective To examine the validity and reliability of a questionnaire administered with an audience response system (ARS). Design Cross-sectional study. Setting Two New York City public elementary schools. Participants Fourth- and fifth-grade students. Main Outcome Measures A Food, Health, and Choices questionnaire (FHC-Q) assessed energy balance-related behaviors (EBRBs) including intake of fruits and vegetables, sugar-sweetened beverages, processed packaged snacks, and fast food; physical activity; recreational screen time; and associated psychosocial determinants (≥ 3 questions/outcome scale). Previously validated reference instruments were used for relative validation. The ARS format was compared with a paper-and-pencil format. All measures were administered in a classroom setting. Analysis Pearson correlation coefficients between the reference instruments and the FHC-Q were calculated. Internal consistency reliabilities were evaluated with Cronbach α. Spearman rank correlation, intra-class correlation, and percent agreement were used for test-retest reliability between paper-and-pencil and ARS, and between 2 ARS FHC-Q administrations. Results Correlations for EBRBs with reference instruments ranged from 0.38 to 0.61 ( P < .01). Cronbach α ranged from .77 to .92 for EBRBs and .74 to .90 for psychosocial determinants. Test-retest reliability correlations ranged from 0.36 to 0.87 ( P < .001). Agreement for knowledge questions ranged from 69.8% to 84.8%. Conclusions and Implications The ARS FHC-Q has acceptable validity and reliability for collecting data on EBRBs and associated psychosocial determinants for upper-elementary students. [ABSTRACT FROM AUTHOR]

The article discusses the interactive nutrition evaluation program called the Once Upon a Time in America. Participants of nutrition education classes sponsored by the State Cooperative Extension System that are typically evaluated with a pencil-and-paper design. A research was created as an enjoyable first-time experience for individuals participating in Cooperative Extension education series programs. The environment helps foster a positive relationship between participants and the education. The initiative was developed to create an engaging, age-appropriate, easy-to-use evaluation tool for fourth and fifth grade students in a nutrition education program. The evaluation tool is composed of two components used simultaneously by students. The tool served as pre- and postassessments to determine changes in students' nutrition knowledge and behavior that resulted from participation in a six-week nutrition education program.

This paper presents an overview of the articles discussed in the issue of the journal. The goals for the 4 articles that are presented are to advance understanding of the life course perspective and its relevance to food choice and to foster new research in nutrition education at the intersection of life course and food choice. The first 2 articles orient the readers toward the concepts of the life course and their relevance to health, nutrition, and food choice. Meanwhile, the second 2 articles present empirical research that makes use of frameworks and concepts from the life course perspective.

This paper provides an overview of the articles published in the journal, which describe and illustrate how a life course perspective can provide an engaging, interdisciplinary means of understanding how food- and nutrition-related behaviors change across the life span of individuals. The life course perspective is common in sociology, but it is easy to see why data limitations make it challenging for nutrition researchers to appropriately develop and validate measures for 7 key life course constructs described as trajectories, transitions, turning points, culture and contextual influences, timing in lives, linked lives, and adaptive strategies.