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Stakeholder involvement in research has been demonstrated to increase the effectiveness, validity, and quality of a study. This paper describes the engagement of a stakeholder panel in the development and implementation of an animal-assisted intervention (AAI) assessment and program for children diagnosed with Autism Spectrum Disorder (ASD). Canines for Autism Activity and Nutrition (CAAN) aims to promote physical activity and wellness among children diagnosed with ASD by integrating activities with their pet dog during the child's ongoing Applied Behavioral Analysis (ABA) in-home therapy sessions. Feedback from stakeholders guided program development at each stage of the research process, including this publication. Utilizing a stakeholder-informed approach was essential for the development of assessment tools, program materials, and program design. Methods that may assist others to effectively partner with stakeholders to implement an AAI among children diagnosed with ASD or related disorders are described.

Food is inextricably linked to human health and environmental sustainability, however, very little is known about children’s perceptions of the concept of sustainability in the context of food choices. We aimed to explore the perceptions of Chilean schoolchildren about environmental sustainability, food, and nutrition. Eight online focus groups were conducted with boys and girls aged 8–9 (n = 30). Questions related to environmental sustainability, pocket money, and food characteristics such as price, front-of-package (FOP) warning label, and eco-labels were included. Data analysis was conducted using ATLAS.ti through a hybrid content analysis approach. Five central themes were identified: (1) children’s favorite snacks, (2) knowledge of sustainability, (3) sustainability and eco-labels use, (4) healthfulness of food products, and (5) pocket money and food prices. Most children were not aware of the meaning of “environmental sustainability”, but the concept was understood when it was explained in plain language. Participants showed awareness about the environmental impact of their eating behavior, had a positive perception of eco-labels, and identified food with fewer warning labels as “better” options. Results indicate that children understand the concept of sustainability in food if it is communicated clearly, and that eco-labels may be an effective tool in that effort.

Snacks contribute nearly one-quarter of children's daily energy intake in the USA. Snack time therefore represents an opportunity for parents to provide foods with key nutrients. Instead, the most common snack foods are major contributors to children's consumption of added sugars and sodium. Parents face major barriers to providing healthier snacks, including perceptions of high cost and lack of child acceptance. We obtained both economic and qualitative data to inform and optimize interventions for parents to promote vegetable snacks for children. We conducted a survey with parents (n = 368) to estimate how much of a discount would influence vegetable snack purchases by estimating willingness-to-pay using the contingent valuation method, using baby-cut carrots as a sample product. We conducted three focus groups (n = 19) and 1 group interview (n = 2) with children to help understand how to increase the appeal of vegetable snacks. Most (70%) parents accepted the reference price for the vegetable snack. Among those who did not, contingent valuation analysis revealed that a mean discount of approximately 30% would shift consumers to purchasing the snack. Focus group results revealed that the appeal of vegetable snacks to children was influenced by how they were prepared and presented, and the child's familiarity with the vegetables and ability to choose among them. This study lays the groundwork for effective interventions to promote the provision of vegetable snacks by parents.

Children regularly consume foods from quick service restaurants (QSRs) in the United States, but little is known about how ordering decisions are made and the impact on selection and consumption. A total of n = 218 parents dining with a child (ages 4&ndash, 16 years) inside a participating QSR completed interviews and demographic surveys and provided their child&rsquo, s leftover foods at the end of the meal. Children&rsquo, s meal consumption was measured using plate-waste methodology. The majority of children selected their meal without parental involvement (80%) and decided what to order prior to entering the QSR (63%). Using mixed-model analysis of variance, children selected and consumed significantly fewer calories and less total fat and sodium when a parent ordered the meal compared with when the child ordered the meal alone. There were no significant differences in selection or consumption when a parent and child ordered the meal together. Approximately one-third of the children consumed foods that were shared. In conclusion, because children primarily select foods without parental involvement and prior to entering QSRs, innovative strategies are needed to influence ordering decisions inside QSRs toward healthier options. Additionally, because food is frequently shared, policies that only focus on children&rsquo, s menus may not be as effective in impacting children&rsquo, s dietary intake.

Background. Recent efforts supporting children’s dietary behaviors suggest the importance of food literacy (FL), which is a multidimensional concept that encompasses food-related knowledge, skills, and behaviors. To date, FL has been largely informed by adult and adolescent research. Aims. To assess the FL experiences, perceived skills, and knowledge of school-age children to inform FL educational opportunities. Method. Six focus groups were conducted with children (age 9-12 years) from three Massachusetts elementary schools. Two team members independently reviewed and coded a portion of the transcripts to assess interrater reliability. Predominant themes connected to children’s perceived FL skills and knowledge were identified using an inductive and deductive content analysis approach. Results. There were five central FL themes identified during the focus groups ( n = 31 children), including (1) food systems concepts; (2) food safety and food freshness; (3) gardening environment, perceived skills, and knowledge; (4) cooking environment, perceived skills, and safety; and (5) autonomy of meal preparation. Discussion. The themes that emerged in these focus groups with children provided new information surrounding children’s perceived FL skills and knowledge as well as important context regarding the food environment (school vs. home). These findings captured important concepts across the “farm to plate” spectrum and highlight potential school-based opportunities where FL topics could be expanded upon most successfully. Conclusion. This formative research informed educational opportunities for a FL curriculum, which holds promise for improving food-based education and programs, designing more effective interventions, and developing measurement tools.

Today's collaborations across fields of health and wellness are insufficient to meet societies' challenges in combating disease and maintaining the ecosystem and public health. In this article, we present a One Health curriculum model designed to encourage undergraduate students of varying disciplines to value the connectedness of animals, humans, and the environment and to think innovatively about solutions to priority global health issues.We present the design and implementation of a course that brought together multiple faculty from different fields of study, including the dental, medical, nutrition, and veterinary schools, in a curriculum designed for undergraduates primarily from Arts & Sciences fields. The curriculum was collaboratively designed around four key One Health categories: 1) Infectious zoonotic diseases and global health, 2) Naturally occurring shared disease in companion animals that can serve as models for human disease, 3) Human-animal interactions, and 4) Impact of environmental health on human and animal health.We show this course successfully deepened students' understandings of One Health, its role in addressing high priority health issues and the overall benefits of a One Health approach to tackling societal problems. We also report a positive experience by the faculty working in collaboration to implement the curriculum model and the overall enthusiasm of students for the course, all of whom would recommend it to their peers.We conclude by proposing the potential of the curriculum model underlying this course to fill the need for One Health Curricula in programs preparing future health professionals. Keywords: One health, Animal, Environmental, Human, Interprofessional education

Objective Food literacy provides a framework for food-related knowledge, skills, and behaviors. The aim of this study was to develop a Tool for Food Literacy Assessment in Children (TFLAC), grades 4–5. Methods Development of the TFLAC consisted of 3 phases: (1) content validity using a 2-round modified Delphi panel (n = 16) and content validity ratios (CVR); (2) pilot-testing (n = 38); and (3) assessment of internal consistency and test-retest reliability (n = 706) using Cronbach α and intraclass correlation coefficients, respectively. Statistical significance was set at P Results Round 1 (CVR = 0.40) and 2 (CVR = 0.70) Delphi panel feedback and the pilot test informed modifications to the TFLAC question format, wording, and difficulty. Food literacy domain-specific Cronbach α values were acceptable (range, .80–.98) except for cooking knowledge (.63), and intraclass correlation coefficients were 0.64–0.70 (P Conclusions and Implications The TFLAC meets basic psychometric standards and may serve as a foundation for nutrition education intervention design and evaluation. Further testing with a broader geographic audience may be warranted.

Objective To determine predictors of fluid milk waste in a Breakfast in the Classroom School Breakfast Program. Design Cross-sectional with 3 repeated measures/classroom. Setting Elementary schools in a medium-sized, low-income, urban school district. Participants Twenty third- through fourth-grade classrooms across 6 schools. Main Outcomes Dependent variables include percentage of total and served milk wasted. Independent variables included observed daily menu offerings, program factors, and teacher and student behavior. Analysis Descriptive statistics were used to characterize variables across classrooms and schools. Multilevel mixed-effects models were used to test associations between predictors and outcomes of interest. P ≤ .05 was considered statistically significant. Results Total milk waste increased 12% when juice was offered and 3% for each additional carton of unserved milk. Teacher encouragement to take and/or consume breakfast was associated with a 5% and 9% increase in total and served milk waste, respectively. When students were engaged in other activities in addition to eating breakfast, total milk waste decreased 10%. Conclusions and Implications Beverage offerings were predictive of greater total milk waste. Teacher and student behavior also appeared to influence milk consumption. Findings suggest that specific changes to School Breakfast Program implementation policies and practices could have an important role in waste mitigation.

s / Can J Diabetes 37 (2013) S217eS289 S273 databases were used. Results 17 534 articles were managed using EndNote (version 16). Results: Once duplications removed, we reviewed 12 837 abstracts. We kept 1 508 articles for further reading. These were mainly descriptive predictive, genetic or non-reproducible designs. We assessed in detail 70 articles focusing on interventions. Among them, the vast majority showed no success in inducing a weight reduction. Discussion: Based on our results, the amount of peer-reviewed publication dedicated to our topic of interest over the last twelve years appears to be scarce with regard to the important of resources’ invested. It seems worthwhile extending the review to the grey literature and use comprehensive approaches such as the 2012 Canadian Council Innovative Practices Evaluation Framework.

The allocation of resources with respect to food safety issues requires that decision makers prioritize these issues, which may conflict with the public's opinions on these matters. The purpose of this study was to compare how Canadian expert and lay respondents rank different food hazards, with a view to better understanding their underlying rationales for making decisions on food safety. A Carnegie Mellon risk ranking model was adapted for use by individuals with different backgrounds to rank six food safety issues: bovine spongiform encephalopathy (BSE), Escherichia coli O157:H7, Salmonella, botulism, paralytic shellfish poisoning (PSP), and acrylamide. Focus groups were conducted using public (n = 29) and expert (n = 21) participants. Key themes were identified from the focus groups as reasons why issues were rated high or low. The most common themes for high rankings were prevalence (of an agent) and/or severity (of a disease) and knowledge and control of a food safety issue. For the lowest rankings, common themes included low prevalence and severity and personal control over an issue. Explanations for why choices were made included availability, affect, numeracy, and optimistic bias. The majority of the rationales used by all participants were similar with the exception of the high ranking given to acrylamide by the public participants. The effect of attribute framing seemed to be the most influential in a participant's choices. Understanding that comparable reasoning is used in food safety decisions by both experts and the public has important implications for developing productive risk communication dialogues about issues and priorities.