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The purpose of this study was to understand recommendations of key stakeholders regarding cultural adaptation of an evidence-based nutrition and physical activity education curriculum for Spanish-speaking adults. Findings from focus groups with Spanish-speaking adults (n=43) and telephone interviews with experts in Spanish nutrition and health education (n=9) revealed: 1) emphasis of the heterogeneity of Spanish-speaking communities; 2) importance of including family in nutrition education; 3) importance of addressing cultural differences between Spanish-speaking and general United States culture; and 4) tips for engaging Spanish-speaking adults in health education. These findings were used to inform cultural adaptation of a nutrition education curriculum.

Given the economic burden and numerous morbidities associated with obesity and poor dietary choices, it is increasingly important for medical students to receive education on nutrition and preventive medicine so that they are equipped to advise patients about healthy lifestyle choices. Currently, 71% of US medical schools do not reach the minimum benchmark of 25 hours of nutrition education set by the National Academy of Sciences. In order to improve the quality and quantity of nutrition education at the Keck School of Medicine of USC (KSOM), medical students and faculty have partnered with LA Kitchen (LAK), a local teaching kitchen, and the Wellness Center at LA County Medical Center (LAC+USC). They developed a hands-on preclinical culinary and nutrition course that aims to teach students practical skills and knowledge that they will be able to apply to their own lives and pass onto patients. Following the completion of the first three years of the course (2016-2018), analysis suggests that the class was well-received and has improved students' nutrition knowledge, confidence in lifestyle counseling, and personal culinary skills. Given these highly encouraging observations, the project is currently aimed at incorporating nutrition education more broadly into the required preclinical curriculum at KSOM.

Interventions addressing links between media exposure and obesity risk for school-age youth have not explicitly addressed the role of family communication about media. Youths' influence attempts on parents to purchase advertised foods can create conflict and negatively affect parental food choices. This study tested whether a family-based media literacy curriculum improves parents' media management skills and decreases youths' susceptibility to appealing but unrealistic food marketing. A matched-group pretest/posttest field experiment of parent-youth dyads with control group (N = 100 dyads, youth M = 11 years of age) tested the six-session curriculum. Hypotheses were analyzed using a Bayesian structural equation model. The curriculum increased parents' active negative mediation to foster youths' critical thinking about food marketing, b* = 0.35, 95% CCI [0.17, 0.50], increased parent Efficacy for making healthy dietary changes for their families, b* = 0.59, 95% CCI [0.41, 0.75], and fostered family discussion about nutrition labels (total effect = 0.22). Additionally, cumulative influences of Perceived Desirability and Wishful Identification on youths' requests for marketed foods were reduced (total effect = 0.04). Media literacy education can empower parents and improve youths' critical thinking to reduce effects of food marketing on families and improve use of media to obtain nutrition information.

Receptivity to strategies to improve the food environment by increasing access to healthier foods in small food stores is underexplored. We conducted 20 in-depth interviews with small storeowners of different ethnic backgrounds as part of a small-store intervention trial. Store owners perceived barriers and facilitators to purchase, stock, and promote healthy foods. Barriers mentioned included customer preferences for higher fat and sweeter taste and for lower prices; lower wholesaler availability of healthy food; and customers' lack of interest in health. Most store owners thought positively of taste tests, free samples, and communication interventions. However, they varied in terms of their expectations of the effect of these strategies on customers' healthy food purchases. The findings reported add to the limited data on motivating and working with small-store owners in low-income urban settings.

Current trends in obesity and modifiable chronic disease are on the rise globally. Yet in primary care nutrition and lifestyle counseling, potentially the 'first line of defense' to address public health concerns, is limited. Unfortunately, nutrition and lifestyle education in the medical education curriculum is minimal and, in many countries, on the decline. Patients however expect their primary healthcare provider to assist them with diet and lifestyle modification to prevent and delay progression of chronic disease. This is indeed a paradox: the lack of nutrition focused education expertise in the face of the increased demand for nutrition counseling being placed on the physician. Across many countries, programmes of nutrition-centered continuing education, both online and face to face, are scarce. There is a pressing need for these educational opportunities to improve physician knowledge and self-efficacy in integrating nutrition counseling into routine practice, with the ultimate goal of improving overall patient health outcomes.

The purpose of the study was to determine the changes in knowledge of information technology (IT) professionals after receiving a nutrition education intervention for a month. The sample comprised of 40 IT professionals (29 males and 11 females). The sample was drawn from four IT companies of Hyderabad city using random sampling techniques. The data on the general information of the subjects was collected. The data regarding the commonly accessed sources of nutrition and health information by the subjects was also obtained from the study. The intervention study group received nutrition education by distribution of the developed CD-ROMs to them followed by interactive sessions. To assess the impact of nutrition education intervention, the knowledge assessment questionnaire (KAQ) was developed and administered before and after the education programme. A significant improvement in the mean nutritional knowledge scores was observed among the total study subjects from 22.30 to 40.55 after the intervention (p < 0.05). The findings support the importance of providing professionals with nutrition knowledge to promote healthy dietary behaviors.Thus, the method of e-learning and development of CD-Rom is essential for teaching the educated groups on nutrition, physical activity and overall health education to improve their health, lifestyle and eating habits.

Complementary foods (CFs) in Ethiopia are cereal based and adding locally grown pulses (legumes) to CF would provide needed nutrients. To assess the effects of nutrition education (NEd) using Health Belief Model (HBM) in promoting pulses for CF, a 6-month quasi-experimental study was conducted in 160 mother-child pairs. Knowledge, attitude, and practice (KAP) questions were given to mothers at baseline, midline, and endline, along with anthropometric measurements of children. NEd involving discussions and recipe demonstrations was given twice monthly for 6 months to the intervention group (n = 80) while control mothers received usual education. At baseline, mothers' KAP scores were low at both sites; at 3 and 6 months of NEd, mean KAP scores of mothers increased (p < 0.05) compared to the control site. Significant improvements in children's mean weight, weight for height, and weight for age occurred in the intervention site only. Nutritional status of children improved after providing mothers with pulse-based NEd.

We investigated the nutrition education (NE) practices of teachers of grade 4‒7 learners in 11 primary schools (85% of total number) of the Bronkhorstspruit district (Gauteng Province) to identify opportunities for improving NE in these schools. A descriptive cross-sectional survey was carried out among a convenient sample of the teachers (N = 73) using a structured nutrition education practice questionnaire. Descriptive data analysis was done. Results showed that the majority of the teachers taught nutrition in about 10% to 20% of their teaching time. Thirty percent had no training to teach nutrition, and most teachers (86%) would like to receive training in nutrition. Teachers mostly taught nutrition as part of the curriculum (67%) and very few (18%) integrated nutrition into other subjects. Needing improvement were adequate classroom time for nutrition education delivery, continuing training in nutrition for teachers, and provision of up-to-date instructional materials for teaching nutrition.

Background: There is consensus among stakeholders in Cameroon on the need to develop and strengthen human resource capacity for nutrition. This study was conducted to provide a comprehensive mapping of the current capacity for tertiary-level human nutrition training in Cameroon., Design: Participating institutions included university-level institutions offering dedicated nutrition degree programs or other programs in which nutrition courses were taught. A semi-structured questionnaire administered during in-person interviews was used to collect data on existing programs and content of training curricula. Nutrition curricula were reviewed against the following criteria: intended objectives, coverage of nutrition topics, and teaching methods., Results: In total, five nutrition degree programs (four undergraduate programs and one master's program) were identified. Three additional programs were about to be launched at the time of data collection. We did not find any doctorate degree programs in nutrition. All the undergraduate programs only had little focus on public health nutrition whereas the master's program in our sample offered a good coverage of all dimensions of human nutrition including basic and applied nutrition. The predominant teaching method was didactic lecture in all the programs. We did not find any formal documentation outlining the competencies that students were expected to gain upon completion of these programs. Nutrition courses in agricultural and health schools were limited in terms of contact hours and scope. Public health nutrition was not covered in any of the health professional schools surveyed. We found no institution offering in-service nutrition training at the time of the study., Conclusions: Based on our findings, we recommend that nutrition training programs in Cameroon be redesigned to make them more responsive to the public health needs of the country.

Background: There is a serious shortage of skilled nutrition professionals in West Africa. Investing in nutrition training is one of the strategies for strengthening the human resource base in nutrition. However, little is known about how nutrition training in the region is financed and the levels of tuition fees charged. The purpose of this study was to provide a comprehensive assessment about the levels of tuition fees charged for nutrition training in the West Africa region and to determine to what extent this is of reach to the average student., Methodology: The data for this study were obtained from 74 nutrition degree programs operating in nine West African countries in 2013 through semi-structured interviews during on-site visits or through self-administered questionnaires. They included the age of the programs, school ownership, tuition fees, financial assistance, and main sources of funding. Tuition fees (in 2013 US$) were expressed per program to enable uniformity and comparability. Simple descriptive and bivariate analyses were performed., Results: Results from 74 nutrition training programs in nine countries showed a wide variation in tuition fees within and between countries. The tuition fees for bachelor's, master's, and doctoral programs, respectively, ranged from 372 to 4,325 (mean: 2,353); 162 to 7,678 (mean: 2,232); and 369 to 5,600 (mean: 2,208). The tuition fees were significantly higher (p<0.05) in private institutions than in public institutions (mean: US$3,079 vs. US$2,029 for bachelor's programs; US$5,118 vs. US$1,820 for master's programs; and US$3,076 vs. US$1,815 for doctoral programs). The difference in the tuition fees between Francophone and Anglophone countries was not statistically significant (mean: US$2,570 vs. US$2,216 for bachelor's programs; US$2,417 vs. US$2,147 for master's programs; US$3,285 vs. US$2,055 for doctoral programs). In most countries, the tuition fees appeared to be out of reach of the average student. Recent master's programs appeared to charge higher fees than older ones. We found a significant negative correlation between tuition fees and the age of the program, after controlling for school ownership (r=-0.33, p<0.001)., Conclusions: Our findings underscore the urgent need for national governments in the region to establish benchmarks and regulate nutrition training costs. In a region where the average annual gross national income (GNI) per capita is barely 890$, the rising cost of tuition fees is likely to hinder access of students from poor background to nutrition training. Governments should institute financing mechanisms such as scholarships, public-private partnerships, credit facilities, and donor funding to facilitate access to tertiary-level nutrition training in the region.

Background: Health professionals play a key role in the delivery of nutrition interventions. Improving the quality of nutrition training in health professional schools is vital for building the necessary human resource capacity to implement effective interventions for reducing malnutrition in West Africa. This study was undertaken to assess the current status of nutrition training in medical, nursing and midwifery schools in West Africa., Design: Data were collected from 127 training programs organized by 52 medical, nursing, and midwifery schools. Using a semi-structured questionnaire, we collected information on the content and distribution of nutrition instruction throughout the curriculum, the number of hours devoted to nutrition, the years of the curriculum in which nutrition was taught, and the prevailing teaching methods. Simple descriptive and bivariate analyses were performed., Results: Nutrition instruction occurred mostly during the first 2 years for the nursing (84%), midwifery (87%), and nursing assistant (77%) programs and clinical years in medical schools (64%). The total amount of time devoted to nutrition was on average 57, 56, 48, and 28 hours in the medical, nursing, midwifery, and nursing assistant programs, respectively. Nutrition instruction was mostly provided within the framework of a dedicated nutrition course in nursing (78%), midwifery (87%), and nursing assistant programs (100%), whereas it was mainly embedded in other courses in medical schools (46%). Training content was heavily weighted to basic nutrition in the nursing (69%), midwifery (77%), and nursing assistant (100%) programs, while it was oriented toward clinical practice in the medical programs (64%). For all the programs, there was little focus (<6 hours contact time) on public health nutrition. The teaching methods on nutrition training were mostly didactic in all the surveyed schools; however, we found an integrated model in some medical schools (12%). None of the surveyed institutions had a dedicated nutrition faculty. The majority (55%) of the respondents rated nutrition instruction in their institutions as insufficient., Conclusions: The results of our study reveal important gaps in current approaches to nutrition training in health professional schools in West Africa. Addressing these gaps is critical for the development of a skilled nutrition workforce in the region. Nutrition curricula that provide opportunities to obtain more insights about the basic principles of human nutrition and their application to public health and clinical practice are recommended.

Background: There is a dearth of information on existing nutrition training programs in West Africa. A preliminary step in the process of developing a comprehensive framework to strengthen human capacity for nutrition is to conduct an inventory of existing training programs., Objective: This study was conducted to provide baseline data on university-level nutrition training programs that exist in the 16 countries in West Africa. It also aimed to identify existing gaps in nutrition training and propose solutions to address them., Design: Participating institutions were identified based on information provided by in-country key informants, UNICEF offices or through internet searches. Data were collected through semi-structured interviews during on-site visits or through self-administered questionnaires. Simple descriptive and bivariate analyses were performed., Results: In total, 83 nutrition degree programs comprising 32 B.Sc. programs, 34 M.Sc. programs, and 17 Ph.D. programs were identified in the region. More than half of these programs were in Nigeria. Six countries (Cape Verde, Guinea-Bissau, Liberia, Mali, The Gambia, and Togo) offered no nutrition degree program. The programs in francophone countries were generally established more recently than those in anglophone countries (age: 3.5 years vs. 21.4 years). Programs were predominantly (78%) run by government-supported institutions. They did not provide a comprehensive coverage of all essential aspects of human nutrition. They were heavily oriented to food science (46%), with little emphasis on public health nutrition (24%) or overnutrition (2%). Annual student intakes per program in 2013 ranged from 3 to 262; 7 to 40; and 3 to 10, respectively, for bachelor's, master's, and doctoral programs while the number of graduates produced annually per country ranged from 6 to 271; 3 to 64; and 1 to 18, respectively. External collaboration only existed in 15% of the programs. In-service training programs on nutrition existed in less than half of the countries. The most important needs for improving the quality of existing training programs reported were teaching materials, equipment and infrastructures, funding, libraries and access to advanced technology resources., Conclusions: There are critical gaps in nutrition training in the West Africa region. The results of the present study underscore the urgent need to invest in nutrition training in West Africa. An expanded set of knowledge, skills, and competencies must be integrated into existing nutrition training curricula. Our study provides a basis for the development of a regional strategy to strengthen human capacity for nutrition across the region.

It is generally acknowledged that pregnant women require healthy diets. However, the cultural idea of "eating for two" and what constitutes an "appropriate" diet during pregnancy have been contested grounds of research as guidelines have changed over the decades. Using a grounded theory approach, we examine how research on pregnancy nutrition is incorporated into practice and translated to patients by obstetricians and 2 categories of midwives--certified nurse midwives (CNMs) and direct-entry midwives (DEMs). Five themes emerged from interviews: (1) food and exercise as "two sides of the same coin"; (2) "good food" and "food that harms" dichotomies; (3) nutrition as holistic prevention; (4) institutionalized barriers to nutritional counseling; and (5) food and the obesity epidemic. An exploration of the conceptual connections between these themes by provider type suggests mechanisms that we argue may be functioning to produce, reproduce, and perpetuate midwifery and medical models of care and associated provider-effects on nutrition-related complications., (Copyright © Taylor & Francis Group, LLC)

This study aimed to improve dietary compliance, attitudes, morale, and self-efficacy for 58 community-residing women ages 54-83 years regarding heart healthy dietary practices using a randomized control group design in two North Carolina counties. Questionnaires administered prior to Visits 1 (Baseline) and 4 (Day 90) and three 3-day food records were completed within 1 week of Visit 1 and 28-30 days thereafter. Treatment included two individual counseling sessions using pre-tested materials: Controls received corresponding mailings. Data analyses included descriptive statistics, analysis of covariance, correlations, and paired sample t-tests. Collective (total group) and control morale improved (p ≤ 0.01). The efficacy construct "ability to choose healthy foods" improved collectively (p < 0.0001). Compliance correlated (p ≤ 0.05) with the ability to follow special dietary regimens collectively and by group. Treatment Compliance correlated (p ≤ 0.03) with the ability to choose healthy foods and morale. No significant between group differences were noted. Tailored nutrition programs empowered older women regarding their nutritional health improve morale and self-efficacy. In-home or mailed education materials with follow-up may be equally effective with similar older women in other locations.

A longitudinal, four-year study (2004-2007) with a cohort of 139 older adults (majority women;71%) was conducted to examine the impact of community-based nutrition and physical activity programs on health outcome measures. Demographic and anthropometric data were collected and nutrition screening was performed. Blood pressure, serum cholesterol and glucose levels, and pulse rate were also measured. The blood pressure, both mean systolic and diastolic, 141(± 19.0)/79.3 ± 9.7 (2004) vs. 127.8 ± 10.9/73.8 ± 10.2 mm Hg (2007), were improved (p < 0.05) in women. There were also improvements (p < 0.05 in both men and women) in pulse rate between 2004 and 2007. There is no doubt that nutrition education and exercise programs together enhanced the overall health and well being of these older adults. However, our findings emphasize the need for further systematic study and for appropriate biometric assessments to evaluate the full impact of nutrition education and physical activity interventions in older adults.

The objective of this project was to explore the effort necessary to transform the Older Americans Act Nutrition Program (OAANP) into core programs within an integrated health care delivery system that serves hospital-discharged older adults in order to assist them in reintegrating into the community. Six OAANPs in six states were funded and provided technical assistance to develop coalitions with hospitals and community organizations. Each demonstration site was unique and faced many challenges in reaching out to a hospitalized vulnerable population. This project also provided opportunities to try out new initiatives and examine their sustainability within the community.

Physicians' knowledge and attitudes can profoundly impact the quality of nutritional care provided to older patients. We assessed physicians' knowledge and attitudes concerning nutritional care for older adults and its correlates. Questionnaires were mailed to 898 physicians in the second largest HMO in Israel: the response rate was 26.5%. Questionnaires assessed aspects of geriatric nutrition, such as food choices, functioning, and medical conditions. Results indicated highest knowledge of nutritional issues for family physicians and for those who were younger (<50 age) and female. Although 68% believed it is important for physicians to explain nutritional issues to older patients, this role was also deemed important for dietitians (83%) and nurses (59%). A variety of factors influencing geriatric nutrition, especially functional and medical conditions, were identified; likewise, nutrition was perceived as influencing various health conditions. Although the low response rate limits generalizability, it appears that physicians in this survey recognized the impact of proper nutrition health and take responsibility for explaining nutrition to their older patients.

Practical nursing skills form the bedrock of nursing practice. In line with Government initiatives, practitioners also need to master skills in information technology. In an attempt to address these issues, funding has been awarded for a nursing led multi-professional development of a Clinical Skills Website at the Florence Nightingale School of Nursing and Midwifery at King's College London. The aim is to provide students with a high quality resource to promote mastery of clinical skills and information technology. It also provides practitioners with easily accessible teaching resources to use in their role as mentors. The following discussion explores the development of this innovative resource as well as the pedagogical underpinning, benefits, challenges and plans for future developments.

Many patients do not eat and drink sufficiently during hospitalization. Surveys have shown that 30-50% of the elderly patients are undernourished when hospitalized, and for the majority of these patients their protein and energy requirements are not met during hospitalization. Diseased people often experience reduced appetite, aversion against certain types of food or nausea, and these symptoms are part of the explanation for insufficient consumption of food and drinks. In order to locate other possible explanations, this study investigate medical inpatients' experiences and satisfaction with the nutritional care. The patients included a total of 91 medical inpatients at two internal medical wards, Aarhus University Hospital, Denmark. Their average age was 72 +/- 11 years. They were individually interviewed about the food service and the nutritional care upon discharge. Patient satisfaction with the meals was overall high (90%). About 80% found the meals to be very important, but they lacked information about the food service, and the patients-staff communication about the food service was poor. The results indicate that the nursing staff was exercising a 'knowledge monopoly' in relation to the food service. In conclusion, a majority of the patients did not perceive the nutritional care as part of the therapy and nursing care during their hospitalization.

This study aimed to understand how local Older American Acts Nutrition Program (OAANP) providers perceive and assess client need for the OAANP. Qualitative in-depth interviews were done with a sample of 36 local OAANP providers in upstate New York. Providers' perceptions of needs for the OAANP were determined by comprehensive understanding of the extent to which an elderly person has problems eating properly to maintain good nutritional and health status. Need was determined by various aging and environmental factors including food insecurity of the elderly, rather than by a single characteristic of problems of elders. Efforts to better understand and meet the needs of elders will enable nutrition programs to respond to heterogeneous needs in ever increasing older population.

This study examined the effects of a nutrition education intervention on improving the intake and behaviors related to whole grain foods in congregate meal recipients in senior centers in north Georgia. Participants were a convenience sample and completed a pretest, an educational intervention, and a post-test (N = 84, mean age = 77 years, 88% female, 76% Caucasian, and 24% African American). At the pre-test, most participants agreed that eating more whole grain foods would help reduce their risk of cancer (69%), heart disease (76%), type 2 diabetes (65%), and bowel disorders (82%), but consumption of 11 whole grain foods was low (10.5 times/week). Following the intervention, participants were more likely to suggest one or more correct ways to identify whole grain foods (45 vs. 62%, P< or = 0.05), and to report an increased intake of whole grain bread, cereal, and crackers (5.8 vs. 6.9 times/week, P < or = 0.05). While awareness of the health benefits of whole grain foods was high, the intakes were low. As a first step, this intervention improved several aspects of the consumption of whole grain foods; however, additional interventions that target the individual and the congregate meal program are needed to increase intakes to the recommended three servings daily.

Three years of process evaluation data are presented for Evergreen ActionNutrition food workshops conducted at an older adults' recreation center. Over a three-year period, 475 written evaluations of single and three-session series workshops were completed. Additionally, data were collected from four focus groups of older adult participants (n = 19). Older persons report intention to change behavior based on attendance at a single workshop. Series workshop participants report increased knowledge, confidence in cooking, and motivation to make changes. Focus group participants identified the following as key aspects to success and empowerment of behavior change: relevant information, specifically in the form of recipes; interactive format, including taste-testing; social experience; consistent, high-quality education; and small size of the group. Food workshops or demonstrations can be meaningful nutrition education activities for older adults.

Focus groups were conducted with 28 older, low-income women in order to identify factors that affected their fruit and vegetable (F&V) consumption. Themes emerging from data analysis include barriers to making dietary changes, specifically to increasing F&V consumption; beliefs about benefits of consuming F&V as compared with other dietary changes; and use of supplements as a substitution for eating F&V. A prominent subtheme concerned the conflict women felt between their desire to consume more F&V and their desire not to waste food. Focus group participants gave concrete suggestions on how to help older, low-income women increase F&V consumption, which included environmental supports.

Objectives: It is recognized that empowerment of Indigenous Peoples through training and education is a priority. The objective was to design a course that would provide an innovative training approach to targeted workers in remote communities and enhance learning related to the Nunavut Food Guide, traditional food and nutrition, and diabetes prevention., Study Design: A steering committee was established at the outset of the project with representation from McGill University and the Government of Nunavut (including nutritionists, community nurses and community health representatives (CHRs), as well as with members of the target audience. Course content and implementation, as well as recruitment of the target audience, were carried out with guidance from the steering committee., Methods: An 8-week long course was developed for delivery in January - March, 2004. Learning activities included presentation of the course content through stories, online self-assessment quizzes, time-independent online discussions and telephone-based discussions. Invitations were extended to all prenatal nutrition program workers, CHRs, CHR students, home-care workers, Aboriginal Diabetes Initiative workers and public health nurses in Nunavut., Results: Ninety-six health-care workers registered for Healthy Living in Nunavut, with 44 actively participating, 23 with less active participation and 29 who did not participate., Conclusions: Despite having to overcome numerous technological, linguistic and cultural barriers, approximately 40% of registrants actively participated in the online nutrition course. The internet may be a useful medium for delivery of information to target audiences in the North.

Literature citations of barriers to nutrition education found in those who teach and care for older adults, as well as within older adults themselves, are discussed. No attempt was made to compare educational barriers for learners of varying ages. These obstacles need to be addressed in order for nutrition to be taught or learned effectively so that nutrition practices and health improve. Barriers for healthcare professionals to providing nutrition education include misconceptions and stereotypes about older adults and about their nutritional concerns; lack of attention to and lack of funding for older adult educational programs; and difficulties recruiting older learners. Hindrances for older adults in responding to nutrition education can be categorized as attitudinal, motivational, environmental, and related to low literacy and poverty. Published examples of opportunities for education and training about nutrition and aging that are in place for health educators, healthcare providers, volunteers and caregivers regarding nutrition and aging are discussed. Suggestions are presented regarding future efforts to minimize educational barriers and to provide training for healthcare professionals, volunteers and caregivers. New research is needed in this field of study in order to realize the potential quality of life benefits and reduced healthcare costs associated with providing effective nutrition education to older adults. This is one of a series of reviews of recent literature on nutrition education for older adults.

Nutrition education programs for elder caregivers (CG) and their elder care recipients (CR) are important in preventing malnutrition. Using Social Marketing Theory, this study assessed the needs and preferences for nutrition education in elder CGs and their CRs in Guilford County, NC. Thirty-two pairs of community-residing elder CGs/CRs and three focus groups (FGs) participated. Health and diet questionnaires were administered to all CGs/CRs during in-home interviews. CGs/CRs and FGs evaluated nutrition education materials. Questionnaires were analyzed using SPSS v9. Ethnograph v5.0 was used to code the interviews regarding the education materials. The CGs were middle age (58.9 years), overweight (BMI = 28.8) Caucasian women. The CRs were old (79.4 years), overweight (BMI = 26.0) Caucasian women. Identified malnutrition risk factors of CGs and CRs included inadequate fluid and dietary intake, polypharmacy, and chronic disease. Identified nutrition needs and education preferences of CGs/CRs were similar. Perceived nutrition education preferences of the FGs did not reflect the interests of the CGs/CRs. This information is being used to revise the education materials and develop an in-home nutrition education program for CGs and CRs in Guilford County, NC.

This article discusses published reports and studies from the past decade that focused primarily on using written or other tangible nutrition educational resources with older adults, such as brief "handouts," newsletters, brochures, booklets, curricular lessons, board games, audiotapes and videotapes. Studies of health professionals' needs and desires for such materials are also reviewed. Thirteen articles, of which four were theory-based, were found. They are summarized in tables that include details regarding the educational resource(s) used; a description of the subjects and controls, if any; the evaluation methods used; and results obtained. Ten practical suggestions are offered to help educators select or develop more effective printed, audiotape, videotape and other tangible nutrition education resources appropriate for older adults. Much research remains to be done in this area. This article is one of a series of literature reviews of topics related to nutrition education for older adults.

This paper reports findings from a study that was conducted to identify perceived barriers to racial/ethnic minority elders' participation in an elderly nutrition program (ENP) in a large metropolitan area and effective strategies for reaching out to them. The data were collected from a survey with the ENP's staff and volunteers and three focus group discussions with professionals working with minority elders and minority community leaders. The study participants identified as their perceived barriers: the lack of information or misinformation; culturally driven reluctance to ask for outside help; fear and distrust of formal systems; lack of ethnic menus in the program; discomfort due to cultural differences; and inaccessibility and inadequacy of transportation. Recommended outreach strategies included: involvement of family members in the information dissemination process; establishment of good working relationships with community leaders and contact with key older persons; diversification of menus and increased use of food enhancements; increase in cultural activities/programs in congregate dining centers; solicitation of input from current participants; provision of intergenerational programs; recruitment of volunteer drivers from the minority community; location of the program in ethnic enclaves or places where minority elders can easily congregate; and improvement in transportation services.

This study reports on the process and outcome evaluation of a community-based nutrition and cooking education program for senior men. As part of Evergreen Action Nutrition, a community-organized, nutrition education program, a registered dietitian led a Men's Cooking Group in a seniors' recreation facility. Written questionnaires were completed by most of the men (n = 19) at the beginning and end of the evaluation year, and ten men participated in personal key informant interviews. The majority of participants gained cooking confidence, increased their cooking activities at home, developed healthy cooking skills, and improved cooking variety through the program. The men also identified social benefits to the program. Overall, this preliminary evaluation suggests that community-based nutrition and cooking education for older men is a beneficial nutrition education activity.

This study assessed gaps in nutrition education between what was offered by organizations and what was wanted by older adults. In Phase I, 258 gatekeepers were interviewed. In Phase II, 37 non-institutionalized older adults were assigned to five focus groups. Study results indicated a consistency between gatekeepers and participants for services, topics, methods/information sources, and communication routes. However, a gap was found because participants wanted education on more topics and were interested in more specific information, whereas gatekeepers provided more general information. This study concluded that gatekeepers need to provide more topics and in greater specificity when planning for nutrition education programs for older adults.

In order to determine older adults' (60+ years) attitudes and opinions toward a nutrition education program, six 45-minute focus groups were conducted. Twenty-eight congregate meal site participants in Atlanta, Georgia, participated in the focus group discussions. Questions addressed opinions toward nutrition education, reasons for participating, outcomes following the program, and suggestions for future programs. Participants generally responded positively toward nutrition education, but viewed foods as "good" or "bad," and nutrition guidelines as "rules" or "orders." A predominant theme to surface was that these older adults were interested in receiving disease specific nutrition information, including handouts and goal setting activities.

Providing relevant nutrition education at federally funded senior centers is one way of increasing nutrition knowledge of older adults. The purpose of this study was to present three nutrition education sessions on the revised Food Guide Pyramid, dietary protein, and dietary fiber to older adults at six senior centers in Atlanta, Georgia. Three 20-minute lesson plans were developed and delivered at six senior centers over the course of 3 weeks. Forty-eight matched pre- and post-nutrition knowledge tests were analyzed and a significant difference (p < .01) in nutrition knowledge was found for the total score and three subtest scores.

A thorough search of the literature revealed only nine articles published since 1993 that focused on nutrition education for older adults attending group classes and that measured outcomes. A table summarizes the reports, including the theoretical bases, descriptions of interventions, participants and comparison groups, program outcomes, methods of verification, and follow-up after interventions. Only three of the studies explicitly indicated that elements of a stated behavioral change theory had been incorporated. All of the educators employed a variety of older adult educational strategies to enhance learning. Six research teams reported on classes where nearly half or more of the participants represented minority groups. Six studies included comparison groups. Types of outcomes included measurements of change in knowledge, attitudes/ beliefs, behaviors, and/or physiological measures, but the actual variables examined differed among reports. No consistent patterns were detected among reported outcomes. The longest follow-up after interventions ceased was seven months. The review addresses issues raised from an analysis of the quantity, quality and findings of the articles and makes suggestions for future research and offers preliminary ideas for developing group nutrition education classes for older adults. This is one of a series of reviews of recent literature on nutrition education for older adults.

Fulfilling nutritional requirements in residents with eating problems can be a challenge for both the person in need of help and for the caregiver. In helping and supporting these residents, a positive attitude is assumed to be as important as practical skill. The aim of this study was to test the hypothesis that nutritional education and implementation of a nutritional programme would change the attitudes towards nutritional nursing care among nursing staff with daily experience of serving food and helping residents in municipal care. The study was carried out as a before and after experimental design. An attitude scale, staff attitudes to nutritional nursing care (SANN scale), was developed and used. The response on the scale gives a total SANN-score and scores in five underlying dimensions: self ability, individualization, importance of food, assessment and secured food intake. Nursing staff at eight different residential units (n = 176) responded to the attitude scale and, of these, staff at three of the units entered the study as the experimental group. After responding to the attitude scale, nutritional education was introduced and a nutritional programme was implemented in the experimental units. One year later, attitudes were measured a second time (n = 192). Of these, 151 had also responded on the first occasion. Education and implementation of a nutritional programme did not significantly change attitudes. Overall, nursing staff responded with positive attitudes towards nutritional nursing care. Most of the positive attitudes concerned items within the dimension importance of food. In contrast, items within self ability showed the lowest number of staff with positive attitudes.

Methods for determining appropriate content of older adult nutrition education intervention programs and strategies for effectively delivering nutrition messages to older learners are presented. Educators can determine the nutrition education needs and interests of their older learners by using results of food intake surveys and assessment screening tools, written surveys, interviews and group discussions. Findings of recent reports using these methods are summarized. Additionally, published experiences with and suggestions for tailoring education intervention programs for older adult audiences, including those of particular racial/ethnic groups, are reviewed. The need for research in this area is presented. This article is one of a series of literature reviews of topics related to nutrition education for older adults.

Older adults who participate in the Older Americans Act Title III-C Elderly Nutrition Program often are at moderate to high nutritional risk. Although nutrition education is a component of the Elderly Nutrition Program, there are numerous barriers to promoting behavior change in older adults. Nutrition education programs targeted to congregate nutrition site participants must address their unique nutritional needs, while engaging them in activities that promote learning and motivate them to make positive behavior changes. This paper describes a pilot study of a theory-driven, five-lesson educational module designed to promote healthful eating behaviors among congregate nutrition site participants through interactive learning.

Five focus groups assessed the nutrition education wants and needs of 37 non-institutionalized older adults ages 60 and older. Discussions were tape-recorded, transcribed and coded to facilitate data analysis. Findings cited most frequently included; doctors were influential, nutrition contributed to good health, basic nutrition topics were wanted/needed, written materials were used most often, demonstration and discussion methods were prevalently used/wanted, and service providers were primarily informed directly about wants/needs. Older adults wanted/needed nutrition education to improve their health and make informed decisions, and because the topic interested them. Information obtained could be used to develop more focused nutrition education programs for older adults.

This article examines characteristics of older adult learners and discusses adult education theory and empowerment concepts, along with nutrition education and behavioral change strategies for older adult nutrition education programs. Design components for older adult nutrition education programs are presented. Educational and behavioral change strategies should be selected based on characteristics of the intended audience, including their nutrition needs, wants and desires, and should be based on appropriate theory. Multi-disciplinary research is needed to develop behavioral and educational theoretical frameworks, as well as designs, intervention strategies, and evaluation methods for educational programs that lead to older adults adopting more healthful nutrition practices. This is one of a series of recent literature reviews on nutrition education for older adults.

Consumers make an estimated 70% of their food purchase decisions as they shop. Effective presentation of information about healthier food selections at the point-of-purchase should have an impact on their decisions. This study was designed to evaluate the effectiveness of two audio formats on knowledge, attitudes, and beliefs about fruits and vegetables and on intake of these foods. Participants identified as "regular shoppers" (n = 374) in three intervention stores were recruited as they entered. They provided baseline demographic data, answered questions about their knowledge and beliefs about fruits and vegetables, and completed a checklist to assess fruit and vegetable intake. They were given two one-hour audiotapes and asked to play them within the next four weeks. In-store public service announcements (PSAs) with information about fruits and vegetables were rotated every 30 minutes for four weeks. A control group (n = 378), recruited in three other stores matched by demographic characteristics, provided the same information. They received an audiotape with stress reduction information. At posttest, the original series of questionnaires were readministered in telephone interviews with 87.7% of the original intervention group and 93.7% of the original control group. Knowledge scores in the intervention group increased significantly over baseline and as compared with the control group. Self-reported fruit and vegetable intake increased significantly in both groups, perhaps in part because of a seasonal effect. The increase from baseline was significantly higher in the intervention group and compared with controls. These findings support the further exploration of the use of audiotapes in nutrition education interventions.

Nutrition is crucial to national development; an undernourished or a malnourished population is at risk for infectious diseases that may reduce its working and productive capacities. Sub-Saharan Africa leads the world in the proportion of its population that is chronically malnourished. This article presents a symmetrical and an integrated framework of norms for nutrition communication. It uses three nutrition communication projects in Africa to illustrate the application of those norms. Based on that review, it concludes that a community-based framework should emphasize at the outset--and throughout program implementation and evaluation--the importance of folk media (e.g., Africa's "oramedia") as both formative and summative norms for planning, implementing, and evaluating nutrition communication programs in Africa.

Nutritional information and support for the elderly are available from many sources. Yet many older adults still remain at risk for malnutrition. This study examined the nutritional status of homebound elderly in a physician-monitored population, with access to health and social services. Older adult patients from the Home Visit Program of the Department of Family Medicine were visited, and an assessment was administered. All patients had primary care physicians who visited patients in their homes, on average, every 3 months. For this survey, the Nutritional Risk Index, the Nutritional Screening Initiative Checklist, an ADL (Activities of Daily Living) assessment, and general history questions were asked. In order to evaluate content of diet, food frequency and a 24-hour diet history were used. Questions on basic nutritional knowledge were asked, and a kitchen survey was used to examine purchasing behavior. Most patients were found to be at high nutritional risk with an average Nutritional Screening Initiative Risk score of 7, but for reasons that varied among patients. Most patients claimed to have a good appetite and enough money for food. The 24-hour diet analysis showed that many individuals did not meet 70% of RDA for major energy sources and fiber. Patient knowledge of the four basic food groups was poor. Since none of the patients shopped for themselves and many did not cook, the nutritional knowledge and food preparation behaviors of caregivers may be important for the nutritional well-being of the patient. An educational program for this population should include the caregiver as well as the patient.

An instrument was developed to assess the relationship between knowledge of dairy products and milk consumption in participants of a community wellness program (age = 50 to 89; n = 103). Multiple regression analyses indicated that consumption of lower fat milk was predicted by nutrition knowledge and trying to reduce fat intake (R2 = .19, p < or = .0001), whereas, frequency of milk intake was predicted by milk consumption during youth, following a weight loss diet, and attitudes related to spoilage, packaging and expense (R2 = .24, p < or = .0001). Thus, nutrition knowledge about dairy products is a better predictor of the type of milk consumed rather than the frequency of milk consumption.

To define the effects of sociodemographic factors and life-styles on intakes and biochemical measures of iron, thiamine, riboflavin and ascorbic acid in healthy elderly Japanese, a survey was conducted on 190 subjects aged 65 to 80 years. Results of multivariate analyses of the data indicated that, independent of the other factors, smoking was significantly and negatively associated with ascorbic acid status and its intake (expressed as its concentration per unit of energy in diets). After controlling for the other factors, participation in a nutrition education program in the past was significantly and positively associated with intakes of thiamine, riboflavin and ascorbic acid. Biochemical measures of these three vitamins were also significantly better in the participants.

A multidisciplinary nutrition education and fitness training program was tested for its effectiveness in lowering lipid profiles of elderly clients through dietary modification and exercise. The program served 31 free-living, predominantly female, black elderly aged 56-88 years. Dietary, anthropometric, biochemical, and fitness assessments were performed before and after the 10-week, biweekly program. Significant decreases (p < 0.05) were seen in waist circumference, total cholesterol (TC), low-density lipoproteins (LDL-C), and TC/HDL-C ratio. These findings suggest a 10-week, biweekly program can be effective in producing both significant, as well as favorable changes, in atherogenic lipids in elderly black subjects.

This IQ test asks practitioners to designate true or false to a series of ten statements on nutrition education for older adults. The correct responses are given, along with detailed explanations for the responses. Topics which are explored include: how to offset hearing and visual defects among older adults, how to improve the relevance of nutrition education by touching their hot buttons, and how to provide a learning environment which improves retention. A summary of the seven principles for effective nutrition education for older adults is presented.

Menus provided by food service managers of boarding homes for the elderly in Washington State were analyzed for nutrient content and frequency with which disease preventive foods were offered. Nutrition knowledge and flexibility of attitudes were measured among the food service managers. Forty-three homes responded. More than half of menus provided by homes exceeded Recommended Dietary Goals for saturated fat, sodium and cholesterol by 33%. Over 60% of menus were deficient (less than 67%) compared to the RDA for zinc, copper and magnesium. Nutrition knowledge and attitude scores of food service managers were not significantly correlated to the frequency with which disease preventive foods were served. Future opportunities for nutrition education should aim at increasing the ability of food service managers to transfer nutrition knowledge into menu planning skills.