Search

BACKGROUND Childhood is a critical period for developing food‐related skills and knowledge, known as food literacy (FL). Schools may be an important setting for interventions aiming to improve FL in children. This systematic scoping review aimed to characterize food literacy interventions in elementary schools. METHODS: Databases (PubMed, Web of Science, and EBSCO) were searched for FL interventions in elementary schools (students aged 4‐12 years). Studies were assessed according to design, duration, theoretical underpinning, and ascertainment of FL outcome(s). Interventions were assessed according to FL competencies (functional, interactive, and critical). RESULTS: After exclusions, 116 studies were eligible for review, including 105 original interventions. Interventions ranged from 45 minutes to 4 years. Social cognitive theory was the most referenced theory and common interventions included; classroom lessons, games, school gardens, food preparation, and cooking classes. Most studies measured FL outcomes quantitatively (96%, N = 111). All studies addressed functional FL (N = 116), while 77% (N = 89) addressed interactive FL and 28% (N = 32) addressed critical FL. CONCLUSIONS: This first international review of FL programs in elementary schools found great heterogeneity in school‐based FL intervention design and measurement of FL. Few interventions addressed critical FL, which should be a focus for future interventions. [ABSTRACT FROM AUTHOR]

Aim: Children's intake of discretionary choices is excessive. This study aimed to develop a questionnaire measuring parents’ attitudes and beliefs towards limiting provision of discretionary choices, using the Health Action Process Approach model. Methods: The questionnaire items were informed by the Health Action Process Approach model, which extends the Theory of Planned Behaviour to include both motivational (intention) and volitional (post‐intention) factors that influence behaviour change. The questionnaire was piloted for content and face validity (expert panel, n = 5; parents, n = 4). Construct and predictive validity were examined in a sample of 178 parents of 4–7‐year‐old children who completed the questionnaire online. Statistical analyses included exploratory factor analyses, Cronbach's alpha and multiple linear regression. Results: Pilot testing supported content and face validity. Principal component analyses identified constructs that aligned with the eight constructs of the Health Action Process Approach model. Internal consistencies were high for all subscales, in both the motivational (Cronbach's alpha 0.77–0.88) and volitional phase (Cronbach's alpha 0.85–0.92). Conclusions: Initial results from validation tests support the development of a new questionnaire for measuring parent attitudes and beliefs regarding provision of discretionary choices to their 4–7‐year‐old children within the home. This new questionnaire can be used to gain greater insight into parents’ attitudes and beliefs that influence ability to limit discretionary choices provision to children. Further research to expand understanding of the questionnaires’ psychometric properties would be valuable, including confirmatory factor analysis and reproducibility. [ABSTRACT FROM AUTHOR]

Background: Parental self-efficacy (PSE) refers to beliefs of parents to effectively engage in behaviors that result in desired outcomes for their children. There are several instruments of PSE for promoting healthy dietary or physical activity (PA) behaviors in children. These measures typically assess PSE in relation to some quantity or frequency of behavior, for example, number of servings or times per week. However, measuring PSE in relation to contextual circumstances, for example, psychological states and situational demands, may be a more informative approach. The purpose of the present study was to develop and psychometrically evaluate a context-based PSE instrument. Methods: Swedish mothers of five-year-old children (n = 698) responded to the Parental Self-Efficacy for Healthy Dietary and Physical Activity Behaviors in Preschoolers Scale (PDAP) and a questionnaire on dietary and PA behaviors in children. Interviews were conducted to explore participant perceptions of the quality of the PDAP items. Psychometric evaluation was conducted using exploratory and confirmatory factor analyses. Spearman correlations between PSE and child behaviors were examined. Results: Twenty-seven interviews were conducted with participants, who perceived the items as highly comprehensible, relevant and acceptable. A four-factor model of a revised 21-item version of the PDAP fitted the data, with different factors of PSE for promoting healthy dietary or PA behaviors in children depending on whether circumstances were facilitating or impeding successful performance. Internal consistency was excellent for total scale (Cronbach's a = .94), and good for factors (a =. 8 4-.88). Correlations were in the expected direction: positive correlations between PSE and healthy behaviors, and negative correlations between PSE and unhealthy behaviors (all rss ≤ .32). Conclusions: Psychometric evaluation of the PDAP provided preliminary support of construct validity and internal consistency. [ABSTRACT FROM AUTHOR]

Background: Assessing individual's readiness to change and targeting the intervention to the level of readiness may improve successful weight loss rates. This study aimed to assess readiness for weight loss in obese women using the trans theoretical model. Methods: A cross-sectional study was conducted on 90 volunteer apparently healthy obese women, in Ardabil, Iran. Participants completed the translated and validated University of Rhode Island Change Assessment questionnaire in their first visit. Subjects were categorized into one of the stages of change based on the highest of four z-transformed scale scores. The readiness to change score was calculated. Results: More than half of the participants were in early stages of weight loss and 24.5% were in the action stage. The readiness score in the precontemplation stage was significantly lower than the other stages, but no significant difference was observed among the contemplation, action and maintenance stages. The significant correlation was observed between the stages of change and waist-to-hip ratio (r=0.33, P<0.05). Conclusion: Obese women attending the nutrition clinic are in different stages to change for weight loss. Understanding person specific stages of change orientates the dietitian to use the most appropriate counseling strategies. Hence the stages and readiness to change should be considered before implementing any intervention in clinical settings for optimal outcomes. [ABSTRACT FROM AUTHOR]

The family and home environment are important in shaping the dietary patterns of children, yet research among low-income, minority groups is limited. We examined ethnic differences in the home food environment and parental practices among 706 low-income, African-American and Hispanic families of preschoolers. Questionnaires measured the access and availability of various foods in the home, parental practices, and meal consumption behaviors. Mixed model logistic regression and ANCOVA were used to assess ethnic differences. Unhealthy foods were available for both groups. Hispanic families were more likely to have fresh vegetables (AOR = 2.9, P ≤ 0.001), fruit (AOR = 2.0, P = 0.004), and soda available (AOR = 1.40, P = 0.001) compared to African-Americans. African-Americans families were more likely to restrict (AOR = 0.63, P ≤ 0.001) and reward with dessert (AOR = 0.69, P ≤ 0.001). Hispanic families consumed more family meals together ( P = 0.003) and less meals in front of the television ( P ≤ 0.006). Health promotion interventions should consider the behavioral differences between ethnicities. [ABSTRACT FROM AUTHOR]

Background: Until now, there is no clear overview of how fidelity is assessed in school-based obesity prevention programmes. In order to move the field of obesity prevention programmes forward, the current review aimed to 1) identify which fidelity components have been measured in school-based obesity prevention programmes; 2) identify how fidelity components have been measured; and 3) score the quality of these methods. Methods: Studies published between January 2001–October 2017 were selected from searches in PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library and ERIC. We included studies examining the fidelity of obesity prevention programmes (nutrition and/or physical activity and/or sitting) at school (children aged 4–18 year) measuring at least one component of implementation fidelity. A data extraction was performed to identify which and how fidelity components were measured. Thereafter, a quality assessment was performed to score the quality of these methods. We scored each fidelity component on 7 quality criteria. Each fidelity component was rated high (> 75% positive), moderate (50–75%) or low (< 50%). Results: Of the 26,294 retrieved articles, 73 articles reporting on 63 different studies were included in this review. In 17 studies a process evaluation was based on a theoretical framework. In total, 120 fidelity components were measured across studies: dose was measured most often (N = 50), followed by responsiveness (N = 36), adherence (N = 26) and quality of delivery (N = 8). There was substantial variability in how fidelity components were defined as well as how they were measured. Most common methods were observations, logbooks and questionnaires targeting teachers. The quality assessment scores ranged from 0 to 86%; most fidelity components scored low quality (n = 77). Conclusions: There is no consensus on the operationalisation of concepts and methods used for assessing fidelity in school-based obesity prevention programmes and the quality of methods used is weak. As a result, we call for more consensus on the concepts and clear reporting on the methods employed for measurements of fidelity to increase the quality of fidelity measurements. Moreover, researchers should focus on the relation between fidelity and programme outcomes and determine to what extent adaptations to programmes have been made, whilst still being effective. [ABSTRACT FROM AUTHOR]