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Objectives: This study explored the accuracy of self-reported heights and weights and factors associated with self-reported bias in a diverse American sample., Methods: Demographic, self-reported, and measured height and weight data from different studies with the same PI were compiled into one SPSS file and analyzed with paired t-tests to detect differences between self-reported and actual values. Kruskal-Wallis tests followed by pairwise t-tests detected differences among age, ethnicity, sex, income, and education. Stepwise regression analyses were done using anthropometric differences as the dependent variable and age category, sex, and ethnicity as independent variables to explore which variable was most predictive of anthropometric differences., Results: Individuals over-reported height and under-reported weight leading to an under-calculated BMI from self-reported height and weight by 0.6-1 kg/m 2 . These under-calculations of BMI led to misclassifications of obesity by 3, 6, 8, and 4% for African American, Euro-American, Native American women, and total women, and by 5, 6, 8, and 8% by African American, Euro-American, Native American men, and total men. Older individuals and males over-reported height more than younger individuals and females. African American females over-reported height to a lesser extent than other ethnicities. Asian males over-reported height to a lesser extent than other ethnicities., Conclusions: Self-reported heights and weights lead to invalid results. Most individuals over-report height and under-report weight, resulting in an inaccurate underweight and obesity prevalence. Being misclassified into the incorrect BMI category could result in inappropriate healthcare treatment. Age, ethnicity, and sex appear to influence the misreporting of height and weight., (© 2018 Wiley Periodicals, Inc.)

Focus groups (n = 7) were conducted with Chinese students (n = 43) studying in the USA to determine how acculturation and environmental factors influence dietary behavior and body mass index (BMI). This study used mixed methodology, collecting both qualitative (focus groups) and quantitative (24-h dietary recalls, food adoption scores, degree of acculturation, and height and weight measures) data. Themes emerging from focus group discussions were: a) dietary and social acculturation, b) factors influencing food intake, c) cultural importance of food, and d) changes in weight and BMI status. Environmental, behavioral, and cultural factors appear to have impacted the eating behaviors of the students. Because of the nature of the study, self-reported heights and weights were used to calculate BMI while living in China and actual heights and weights were taken for each student at the focus group to calculate current BMI after living in the USA. The majority of Chinese students (69% males; 85% females) experienced weight gain, resulting in an increased BMI based on weight/height data and as reported in focus group discussions. As a result, if students continue to gain weight, they may be at higher risk of developing chronic diseases in the future. Further, implemented dietary change may be transferred to other family members if students return to China. Results suggest that nutrition education should be provided to incoming foreign students during their orientation., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The objective of this study was to examine how language contraction, acculturation, and perception of modernity impact medicinal practices among younger and older generations of Hmong. Focus groups were conducted with newly immigrated and well established Hmong adults (n = 69) and children (n = 68) in St. Paul/Minneapolis, MN, USA. Dominant themes were language contraction and cultural loss, with subthemes on household dynamics, the educational system, and Western versus traditional Hmong medicinal practices. As younger generations acculturate to the United States (US) environment, there is potential for a restructuring of their medical culture resulting in a loss or silencing of pertinent cultural information regarding traditional medicine and therapies. The information from this study will be useful for educators, community leaders and health professionals to better understand changes occurring within the Hmong culture as traditions and cultural practices acculturate to the US environment.

After immigrating to the United States (US), obesity and diabetes have increased among the Hmong. Therefore, this study investigated how Hmong children perceive health and diabetes risk so that appropriate interventions may be planned. Hmong children (N = 335), ages 9-18 years participated in this study. A survey used Social Cognitive Theory (SCT) as the theoretical framework and silhouette drawing instrument. Heights and weights were measured and body mass indexes (BMIs) were calculated. About half of the children were either overweight (BMI ≥ 85th < 95th percentile) or obese (BMI ≥ 95th percentile). About 75% chose average sized silhouettes as healthiest and heaviest silhouettes as diabetic shape. Environmental influences including food availability, parents, and media influenced children's health perceptions. Results suggest a need for culturally appropriate interventions, aiming towards a child's environment and educating them about risks associated with obesity and diabetes.

Objective: To investigate factors affecting food choice and health beliefs among low-income women in the context of their weight and socioeconomic status., Design: Two researchers conducted 14 90-minute focus groups, which were audiotaped., Setting: Libraries, homeless shelters, and a community center., Participants: Ninety-two low-income women (18-65 years) with at least 1 child aged 9-13 years in the household., Main Outcome Measures: Food choice and health beliefs of low-income women., Analysis: Transcripts were coded and reconciled; common themes and subthemes were identified., Results: Over 75% of participants were overweight/obese (body mass index [BMI] > or = 25), and most were in charge of purchasing and preparing food for their families. Health concerns included diabetes, hypertension, and overweight/obesity, and most felt their health status had genetic or metabolic origins. Although many would like to regularly consume healthful food (eg, fresh fruits and vegetables), such food was perceived as unaffordable., Conclusions and Implications: A disconnect between diet and health among low-income women calls for nutrition interventions that educate low-income families on inexpensive, healthful eating in a structured environment, and diet-disease relationships. Changes at a policy level should be considered to increase affordability and accessibility of healthful food in low-income neighborhoods and through federal food assistance programs.

In-depth interviews were conducted with veterans (n=64) with an average age of 57 years to investigate eating behavior and food insecurity during military service and examine if it affects post-war eating behavior, and if this contributes to the high incidence of obesity found in veterans. About half of the subjects served during the Vietnam War, while smaller numbers served in WWII, the Korean War, Desert Storm, or other conflicts. The mean BMI was 30.5+/-6.7 kg/m(2). Only 12.5% of participants were classified as normal weight, while 37.5% were overweight, 46.9% were obese, and 3.1% were classified as excessively obese. Five major themes were identified including, (a) military service impacts soldier's food environment, (b) food insecurity influences eating behavior and food choices, (c) military impacts weight status during and post-service, (d) military service has health consequences, and (e) post-service re-adjustment solutions are needed to ease re-entry into civilian life.

Approximately 16.4 million people in the United States have been affected by homicide. Five million adults have experienced the murder of an immediate family member; 6.6 million people have experienced the murder of a relative other than a family member, and 4.8 million have experienced the murder of a close friend. These homicide survivors experience a variety of difficulties, some similar to post-traumatic stress disorder (PTSD). The large incidence of homicide in the U.S. warrants an examination of the research on the impact of a murder on a victim's friends and family and the implications for healthcare providers. Homicide survivors experience negative psychological and physical effects that often result in an increase in the usage of primary care services. Provider training should include protocols to screen for, discuss, and make referrals for the family and friends of homicide victims. This article recommends the development of a training program to equip providers with the tools to recognize and serve this growing population of patients.

The objective of this study was to identify factors affecting the purchase and preparation of fruits and vegetables according to stage of change for low-income African American women with young children. The think-aloud method was used to collect verbalization data in grocery stores as women shopped (N=70) and in their homes during meal preparation (N=68). Audiotaped verbalizations were transcribed verbatim before encoding. Content analysis procedures were used to identify common themes by stage of change. Factors affecting decision making that varied by stage of change were preferences and specific needs (eg, for meals, for family members). Preferences regarding variety, quantity, color, and liking were more often expressed by women in later stages. Women in the later stages also often used meal-planning skills to include fruits and vegetables in meals. Interventions could be tailored according to selected factors regarding purchase and preparation of fruits and vegetables by stage of change to contribute to greater changes in intake.

The purpose of this report is to describe the development and implementation of the think aloud method in relation to fruit and vegetable purchasing behaviors of low-income African American mothers. Women (n = 70) were audiotaped as they thought aloud while selecting fruits and vegetables during a routine shopping trip. Audiotapes were transcribed, text was coded, and coded text was sorted using a database software program. Data were analyzed using content analysis procedures. The method was found to be useful in its ability to provide verbalization data for the majority of the women in the sample that reflected a typical shopping experience, were not excessively affected by the presence of the investigator, and captured information processing in relation to salient factors that influenced food purchasing decisions. Because a few women indicated that the method itself may have influenced behavior, future research is needed to test the reactivity of the think aloud method and its relationship to final choice of products.

A survey was mailed to a representative, randomly selected sample of Minnesota Dietetic Association members (n=300) to evaluate attitudes and intentions regarding the integration of issues pertaining to sustainably produced foods into professional practice. The United States Department of Agriculture describes sustainable agriculture as including goals of farm profitability, environmental stewardship, and improved rural quality of life. Data analysis included descriptive statistics, independent t tests, one-way ANOVA, correlations, and multiple regression analyses (P< or =.05). Forty-three percent had heard of sustainable agriculture, 13% had integrated issues of sustainably produced foods into their practice, and 20% stated that it was likely that they would incorporate these issues within the next six months. Perceived behavioral control, subjective norm, and rated importance of knowing about agricultural practices independently predicted intention. Dietitians surveyed were interested in learning more, but most were not integrating these issues into practice because of perceived barriers, including a lack of knowledge about this topic.

The think-aloud method was used to determine factors influencing bread and cereal purchase by low-income African American women that have implications for whole-grain education. Women (N=70) were audiotaped as they thought aloud while purchasing groceries. Because bread and cereal account for the majority of whole-grain products consumed, transcribed verbalizations regarding purchase of bread and cereals were analyzed using content analysis procedures. Cost, preferences, eating and buying habits, and nutrition were the most important factors that influenced purchase. Nutrition issues included a general desire to eat healthy foods and specific concerns about fat, calcium, and calories, but no mention of wanting to purchase whole-grain products. Whole-grain education should focus on identification of whole-grain products, health benefits, and low-cost and tasty whole-grain options for mothers and children.