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Data from 1,548 Women, Infants, Children clients showed that 93% found nutrition education valuable. A process-oriented evaluation of 494 clients using a skills inventory, and 513 using self-efficacy measures, identified topics they knew most and least about. Clients in facilitated discussion groups scored highest in self-efficacy compared with those attending lectures or reading brochures. (SK)

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2005.09.052 Byline: Lynn S. Edmunds, Mary Lou Woelfel, Barbara A. Dennison, Howard Stratton, Robert M. Pruzek, Rayane Abusabha Abstract: The objective of this study is to describe overweight trends in a large, multiethnic, low-income population of preschool children by race/ethnicity and examine cohort changes in body mass index (BMI) distribution. Cross-sectional data were collected January 1 through March 31, every year, from 1989 to 2003. Subjects were children aged 2 to 4 years participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in New York State. The prevalence of overweight (BMI [greater than or equal to]95th age- and sex-specific percentile of the 2000 Centers for Disease Control and Prevention growth charts) was calculated for each year. Least squares regression compared trends in prevalence by race/ethnicity. Changes in BMI distribution were assessed graphically. Overweight prevalence increased 33% (12% to 16%). Prevalence was highest for Hispanics and lowest for non-Hispanic whites. Rates of increase (0.28 percentage points per year) were the same for Hispanic, non-Hispanic black, and non-Hispanic white children. The BMI distribution shifted toward higher values for all children studied; for 3- and 4-year-old children, the difference increased as BMI increased, indicating that, in 2003, the heaviest children were considerably heavier than the heaviest children were in 1989. Article Note: (footnote) Supported in part by a grant from the Economic Research Service, Food Assistance and Nutrition Research Program, US Department of Agriculture (grant No. 43-3AEM-1-80075).

Objectives To identify barriers that deter parents/caretakers of infants and children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) from taking full advantage of the services provided by the program. Subjects/Setting A total of 3,167 parents/caretakers at 51 New York State WIC local agency sites completed a barriers survey. Design Sixty-eight potential barriers to WIC were identified through a literature review, five focus groups with parents/caretakers of WIC participants, and an expert review panel. The barriers survey was administered person-to-person to parents/caretakers of infants and children on WIC. Statistical Analysis Classification tree analysis was used to identify characteristics that best predict WIC check usage behavior. Results A small set of barriers (n = 11) were identified by more than 20% of respondents. Waiting too long was the most frequently cited barrier (48%). Difficulties in bringing the infant/child to recertify and rescheduling appointments were key variables associated with failure to use (ie, pick up or cash) WIC checks. Further analyses indicated that (a) for each additional reported barrier, there was a 2% increase in failure to use WIC checks (P<.0001); (b) waiting for services was related to an increase in the number of people who failed to use checks; and (c) the longer the reported wait, the greater the number of reported barriers (P<.0001). Conclusions Conducting this barriers research enabled the New York State WIC to improve services provided to participants and their families. A decrease in waiting times should generally reduce exposure to noisy, crowded facilities and lead to fewer reports of nothing for kids to do. J Am Diet Assoc. 2004; 104:736-743.

Researchers in sociology, psychology, nutrition, public health, an d many other related fields have been engaged in along-standing debate about the use of qualitative vs quantitative approaches to research (1-4). [...]

A mixed-model approach has been used to help 1,805 nutrition practitioners to update their skills, and the project has been evaulated using a questionnaire. Participants were found to have benefited by increasing their knowledge, and they were positive about this method of learning, with 77% of the total keen to continue using the method. Professionals in this field seek continued training, and this is a practical way of allowing them to update their skills.

Facilitated group discussions provide an alternative method to lecture and one-on-one approaches for conducting educational interventions at clinic sites. They are an interactive form of education wherein learners generate the specific topics to be addressed and share their knowledge and experience with other group members through discussion. In brief, the educator becomes a facilitator who, rather than lecturing, encourages clients to discuss freely among themselves their own approach to the nutrition problems posed during the session. As a facilitator, the nutritionist strives to create a comfortable atmosphere for discussion, encourages participation, and interjects only to correct misinformation and manage group dynamics. Facilitated group discussions allow nutrition practitioners to deliver meaningful nutrition education in a manner that helps empower their clients to improve their dietary habits; at the same time such discussions meet the increased public administrative demands for efficiency. Possible benefits to clients include more confidence, better communication skills, improved thinking skills, and increased motivation and commitment to improving nutrition behavior. We recommend that nutrition educators try facilitated group discussions in their clinics., Facilitated group discussions are an innovative educational technique developed through grassroots input of personnel in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the State of [...]

This article reviews several cognitive predictors of health- and diet-related behaviors commonly used in theories and models of nutrition and health behavior change. Constructs such as self-efficacy, self-esteem, outcome expectancies, health value, and locus of control are examined. Self-efficacy has repeatedly been a good predictor of health behavior, sometimes explaining more than 50% of variability. Research on locus of control and other predictive factors has been less conclusive. The take-home message is threefold: (a) task specificity of self-efficacy and domain specificity of locus of control are crucial for unraveling their effects on behavior; (b) careful segmentation of different population groups under study may explain the inconsistencies in previous research; and (c) especially when studying dietary behavior, these predictors of behavior change should not be used alone or in place of one another but should be used simultaneously to explain complex food and diet-related behaviors. We recommend that nutritionists systematically integrate available theories and models and explore new areas for studying human behavior, such as sociology and anthropology, to form a more powerful, comprehensive model for behavior change., In the never-ending search for explanations of health-related behavior, many predictive factors have been identified. Three widespread models, or theories - Social Cognitive Theory, Theory of Reasoned Action, and the [...]

Objective The purposes of this study were to identify specific food choice behaviors used to decrease dietary fat intake in a community-dwelling population; assess how people categorize changes to diet; determine whether logical grouping of food intake changes revealed one or more common patterns or strategies used by these participants to decrease fat; and determine which strategies were responsible for the greatest decrease in dietary fat intake in the study population. Design Survey analysis and in-depth interviews were used to quantitatively and qualitatively define dietary change patterns retrospectively in a population who, according to self-report, had decreased their fat intake. Specific food changes made to decrease fat intake, interview statements, and participants' reduction of percentage energy from fat were examined. Setting Interviews were conducted from June 1993 through April 1994. Subjects Included in the study were 145 persons aged 30 to 55 years who reported that they had been decreasing their dietary fat intake for 5 years or more, maintained a healthful diet for at least 5 months, and resided in the United States while changing their diets. Statistical analyses performed Confirmatory factor analysis, reliability analysis, and linear regression analysis were performed. Results Nine fat-reduction strategies were identified. Decrease fat flavorings, decrease 'recreational foods,' decrease cooking fat, replace meat, change breakfast, and use fat-modified foods accounted for significant reduction in fat intake. Conclusions People use a variety of dietary changes to reduce their fat intake. These changes can be categorized into strategies according to the way people change their diets. Knowledge of these strategies and their importance in dietary fat reduction can improve and help nutritionists prioritize the messages they convey. JAm Diet Assoc. 1996; 96:1245-1250,1253., The adoption of a low-fat diet has been associated with decreased risk for chronic disease and excess body weight (especially for women) and associated physiological and psychological issues (1-3). As [...]

Field Goods® is a subscription-based, weekly delivery service of fresh produce that operates year-round. To determine the impact of program subscription on diet quality, new customers were asked to complete a survey that included a fruit and vegetable semi-quantitative food frequency questionnaire at baseline and again at 3–5 months after their first purchase. Grocery shopping habits, satisfaction with their own diet and their family's diet were also assessed. Findings revealed a significant increase in satisfaction with program subscribers' diet quality and their family's diet quality (P < 0.001) at follow-up. Subscribers who ordered bags weekly (n = 105) reported consuming five more servings of vegetables per week compared to baseline (P = 0.05) and saving approximately $20 per month. A weekly subscription to a fresh produce delivery program may be an effective intervention to improve vegetable intake and variety in adults without adding undue costs to participants. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective To investigate the fat-reduction strategies used by a group of older adults who successfully made and maintained positive dietary changes for 5 years or longer. Design Participants completed [...]

The Dietary Guidelines for Americans represent the cornerstone of the US federal nutrition policy and aim to provide sound, current advice to the public about food choices that promote optimal [...]

Assesses the effectiveness of a teleconference for teaching community nutritionists about facilitated group discussions (FGD). Implementation of the satellite teleconference; Conference materials; Pre-conference evaluation; Follow-up conference evaluation; Barriers to conducting FGD.