Search

Many quick-service restaurants (QSRs) instituted voluntary kids' meal default beverage standards (standards) between 2013 to 2017. Little is known about impacts of standards on QSR drive-through practices and on customer choices. This study assessed differences in restaurant practices including kids' meal beverages shown on menu boards, offered by cashiers, and selected by customers in QSRs with and without voluntary standards. Observations (n = 111) and customer surveys (n = 84) were conducted in 2018 at QSRs with standards (n = 70) and without (n = 41) in low-income California, U.S. neighborhoods. Kids' meal beverages on menu boards (n = 149) and offered by cashiers (n = 185) at QSRs with and without standards were analyzed using multilevel logistic regression. Significantly more menu boards at QSRs with standards (n = 103) vs. without (n = 46) featured only milk, water or unsweetened juice (65.1% vs. 4.4%; p < 0.001). Most cashiers at QSRs with standards and QSRs without (53.1%, 62.5%) asked what drink the data collector wanted rather than first offering default beverages. A small sample of customer interviews found that customers at QSRs with standards most commonly ordered juice (37.0%); at QSRs without standards, soda (45.5%). Although menu boards showed healthier kids' meal beverages at QSRs with standards than without, cashier behavior was inconsistent. Results suggest additional measures (legislation, implementation support, enforcement) may be needed to ensure optimal implementation.

UC ANR Cooperative Extension (UCCE) conducted six focus groups in 2013 with CalFresh-eligible adults to determine how to improve the existing evaluation method for the Plan, Shop, Save, Cook nutrition education classes. Focus group participants (n = 54) cited many behavior changes that are captured by the existing method. During the focus groups, changes in cooking practices and types of food purchased emerged as two domains that are not currently captured. A small pilot study conducted on 22 of the 54 focus group participants suggests that using a telephone interview to survey participants is a feasible and practical approach to collect follow-up data on long-term behavior changes. More rigorous follow-up studies may guide the development of policies aimed at increasing diet quality and food security of adult CalFresh participants.

Approximately 25 million children in the United States are obese or at risk of becoming obese, with anticipated negative consequences for individual health as well as the nation's future health-care costs. Effective interventions to prevent obesity require more than educating individuals. To bring about change, we must deploy tactics at multiple levels, from community facilities like parks and bike paths to foods offered in schools. The Spectrum of Prevention proposed in 1999 by L. Cohen and S. Smith first described this approach. UC Cooperative Extension (UCCE) has helped evaluate large-scale community-based obesity prevention programs and has experience aligning county nutrition programs with new dietary guidelines. This UCCE expertise enables UC to develop more effective obesity prevention strategies and to influence policy addressing childhood obesity. Notably, UCCE's expertise in nutrition and obesity prevention will be applied to implementing a new intervention program. The new program employs multiple components including UC Cooperative Extension materials and community networks and is designed to impact factors contributing to risk for childhood obesity.

Type 2 diabetes is increasing rapidly in the United States and Latin America and contributes significantly to the rise in health care spending. Diabetes increases the risk of cardiovascular disease, renal failure and blindness, and leads to other complications. Type 2 diabetes and its complications can be delayed in high-risk individuals through a healthy lifestyle and ongoing medical care. Some research suggests a relationship between diabetes and other underlying metabolic conditions, either as predisposing factors or as adverse outcomes of occupational exposures in farmworkers. UC Cooperative Extension can have a greater impact on the health and safety of California’s workforce by filling in research gaps and strengthening collaborations.

Determining optimal intervention dose to meet time constraints of the teacher while maximizing behavioral impact for students has proven challenging. This study investigated the influence of intervention dose on 7th & 8th grade participants’ dietary and physical activity (PA) behaviors. Participants were assigned randomly to a: 1) 6 week-12 session nutrition intervention [treatment#1], or 2) 3 week-6 session nutrition intervention [treatment#2] with data collected pre/post intervention. Using ANCOVA, measures assessed dietary and PA self-efficacy and behaviors. Ethnically diverse participants (n=107) were included in the analyses (46% male). All students set two goals: one dietary and one PA regardless of dose. Treatment#1 resulted in similar outcomes compared to treatment#2 with no significant differences between groups. As a result, we recommend that teachers using the 12 week intervention give students the option of setting new goals after the 6th lesson to maintain motivation.

We developed a short food behavior checklist (FBC) to evaluate the impact of nutrition education on fruit and vegetable intake among ethnically diverse women in the Food Stamp Nutrition Education Program (FSNEP) and the Expanded Food and Nutrition Education Program (EFNEP). To validate the FBC, interviewers collected three 24-hour dietary recalls as well as responses to 11 FBC behavioral questions about fruits and vegetables from 100 English-speaking, low-income women at baseline. A randomly selected subgroup (n = 59) provided a blood sample for analysis of total serum carotenoids at baseline and follow-up. After 6 hours of nutrition education, the treatment group reported significant improvements in three of the seven FBC questions related to fruit and vegetable intake, while no significant changes occurred in the control group. Furthermore, six of the seven FBC questions were significantly correlated with total serum carotenoids. This short, culturally neutral FBC is a valid and reliable indicator of fruit and vegetable consumption. Compared with the 24-hour dietary recall, it is also less time-consuming to administer, code and analyze, with a reduced respondent burden.

Food security is defined as access by all people at all times to enough food for an active, healthy life. In a study of 212 low-income Latino households in California, 45% were food insecure without hunger; 13% food insecure with moderate hunger; and 3% food insecure with severe hunger. Food insecurity was associated with a decline in household supplies of both nutritious and less nutritious foods. Among preschool children, the number of servings per day of all food groups was significantly correlated with household food supplies. A strong safety net to improve food security in low-income populations must include educational strategies and provision of nutritious foods to support a good diet at home and away from home.

We conducted focus group dis-cussions and a survey to explore diabetes-related health beliefs and to assess educational needs among low-income Latino adults, primarily of Mexican descent. We found that many low-income Latinos served through UC Cooperative Extension programs may be at high risk of developing diabetes. At the same time, many of those at risk lack awareness of risk factors for dia-betes, have never been screened and do not know where to go for advice. Although some were unsure of the true causal connection, 64% of the focus group participants had heard that susto (stress or strong emotion) might be related to onset of the illness. In addition to increas-ing awareness of the disease and reducing barriers to care, nutrition educators can help program partici-pants by identifying ways to alleviate the effects of stress and lower the risk of diabetes through a healthy lifestyle.

The Healthy Rewards study tested the effectiveness of goal setting to encourage behavior change in Latino and African American adults in three northern California counties. Four groups of adults were alternately assigned to receive either 1) basic health promotion and nutrition education without goal setting (control) or 2) the same education with personal goal setting. Participants (n = 31) attended four 2-hour weekly sessions over 1 month. While the community-based education was effective in promoting participant behavior change overall, the goal-setting groups reported even greater change than groups who did not engage in goal setting. (Contains 1 figure and 2 tables.)

Objective: To examine the effectiveness of learner-centered education in conveying the message to change participants' fruit and vegetable consumption. Design: Focus groups were conducted with sites participating in the Finding the Teacher Within (FTW) program and comparison sites 4-6 months after participants attended the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) fruit and vegetable class. Setting: Six California WIC agencies. Participants: Sixty predominantly Latina mothers with young children, 30 from 3 participating intervention agencies and 30 from 3 comparison agencies, participated in focus groups. Each agency independently recruited mothers for participation. Apart from selecting only mothers, no other exclusion criteria were applied. Intervention: An FTW learner-centered fruit and vegetable class. Analysis: An analytic team independently reviewed transcripts and coded themes. The long-table analytic approach was used to categorize results. Results from intervention and comparison groups were compared and ranked to create a textual summary. Results: The most significant difference between the intervention and comparison groups' reports was that intervention participants identified more value, importance, and relevance of the fruit and vegetable information and adopting new fruit and vegetable practices after attending the class. Conclusions and Implications: California WIC demonstrated that messages delivered through this process can be retained and integrated into family life practices.

The Youth Empowerment Strategies (YES!) project is an afterschool empowerment program and research project for underserved early adolescents. Central to YES! is an empowerment intervention that provides early adolescents with opportunities for civic engagement with other youth around issues of shared concern in their schools and neighborhoods. This article specifically focuses on the use of Photovoice as a promising way to engage youth in social change as they take photos capturing strengths and issues in their environment and use these as the basis of critical dialogue and collective action plans. Adding to a growing body of information on using Photovoice, this article reports how early adolescents in the YES! afterschool program experienced the Photovoice process, moving from photography and writing to initiate group-designed social action projects. Recommendations are offered for others engaged in empowerment work with early adolescents. (Contains 2 tables and 3 figures.)

A study examined low-income Latinos' attitudes concerning diabetes. Focus groups and surveys of 160 California Latinos, primarily of Mexican descent, found that many at risk of developing diabetes were unaware of risk factors, had never been screened, and did not know where to get advice. Most believed that stress or strong emotion caused the illness. Implications for nutrition education are discussed. (TD)

OBJETIVO: Estudiar la percepción y la experiencia sobre inseguridad alimentaria entre latinoamericanos de California, así como su interpretación de los insumos incluidos en la Escala de Seguridad Alimentaria. MATERIAL Y MÉTODOS: Entre noviembre y diciembre de 2000, en los condados californianos de Solano y San Joaquín, se efectuaron cuatro grupos focales, con 30 adultos de origen latinoamericano residentes allí. Los comentarios de los participantes fueron codificados por dos investigadores para determinar los temas principales, y fueron confrontados para verificar su convergencia. RESULTADOS: Las preguntas fueron bien comprendidas, no percibiéndose como ofensivas. El marco conceptual se confirmó como "proceso manejado" con diferentes niveles de severidad. Las causas de inseguridad alimentaria identificadas fueron: desempleo, alto costo de algunos alimentos y falta de información nutricional. La necesidad de educación nutricional fue una constante. CONCLUSIONES: Para interpretar datos nacionales de inseguridad alimentaria en latinoamericanos es esencial considerar su percepción particular de ese fenómeno.

Objective: The purpose is to describe the development and validation of a tool to measure the degree of past food insecurity in an immigrant US population. Design: Focus group discussions and a structured interview. As a first step, focus group discussions were conducted among immigrant Latino mothers. Based on these discussions, an 8-item tool was developed and pilot-tested in a convenience sample of mothers. Selling: California. Participants: Twenty-two low-income Latino mothers with children, ages 4 to 5 years, in the focus groups and 85 low-income Latino and white mothers of young children in the structured interviews. Analyses: Constant comparative analysis, Cronbach [alpha], Spearman correlations, Chi-square, and Kruskal-Wallis test. Results: Internal consistency of the remaining 7 items was good (Cronbach [alpha], = 0.84). Evidence of convergent validity included significant correlations between past food insecurity and maternal education (r = -0.45, p Conclusions and Implications: This tool may be useful to determine how past deprivation influences current food choices and other nutrition-related behaviors in low-income Latino immigrants. Key Words: Latino, food insecurity, life course perspective

Objective: To examine the relationship between food insecurity and food supplies in Latino households. Design: Cross-sectional survey, conducted February to May 2001. Setting: Six California counties. Participants: Convenience sampling was used to recruit 274 low-income Latino families with preschool children from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), Head Start, and other community-based organizations. Complete data were available for 256 families. Variables Measured: Food security, household food scores. Analysis: Pearson correlations, Kruskal-Wallis test, and logistics regression. Significance level at P < .05. Results: Controlling for maternal education, food insecurity over the past 3 months was associated with lower household food supplies: dairy, r = -.18, P < .01; fruit, r = -.36, P < .001; grains, r = -.27, P < .0001; meats, r = -.22, P < .001; snack foods, r = -.23, P < .001; and vegetables, r = -.29, P < .001. Conclusions and Implications: In Latino households, greater food insecurity is associated with a lower variety of most foods, particularly fruits and vegetables. Future research in Latino households should explore the effects of seasonal food insecurity and household food shortages on food intake of individual household members, especially young children. KEY WORDS: food insecurity, Latinos, household food supplies

Many clients in low-income community education programs have literacy problems, thereby making a text-only evaluation instrument difficult to use. There is a need for visually enhanced evaluation tools. Using a 16-item food behavior checklist (FBC) previously shown to be reliable, valid, and sensitive to change, we tested a series of formats and visuals (photographs and line drawings) to determine the best evaluation instrument for Food Stamp clients. A systematic process consisting of 3 levels of review was developed for the comparison of potential formats and visuals. Level I: research and academic program professionals. Level II: community-based paraprofessionals in the Food Stamp and the Expanded Food and Nutrition Education Programs. Level III: Food Stamp clients. Using cognitive interviewing procedures, Food Stamp clients described their preferences for the visuals. Clients were asked how the proposed visuals could be made to be more understandable to their peers. Generally, level I and II reviews resulted in more complex visuals for each of the 16 FBC items than the previous versions; however, the cognitive testing of Food Stamp clients revealed the need for less detail in the visuals. This systematic process produced an evaluation tool containing 16 visually enhanced items in a 4-page color booklet in which the items are easier to understand than the text-only version. Funding provided by the California Public Health Institute, the Expanded Food and Nutrition Education Program, and the University of California Cooperative Extension.

The Healthy Rewards study tested the effectiveness of goal setting to encourage behavior change in Latino and African American adults in three northern California counties. Four groups of adults were alternately assigned to receive either 1) basic health promotion and nutrition education without goal setting (control) or 2) the same education with personal goal setting. Participants (n=31) attended four 2-hour weekly sessions over 1 month. While the community-based education was effective in promoting participant behavior change overall, the goal-setting groups reported even greater change than groups who did not engage in goal setting. [ABSTRACT FROM AUTHOR]

School foodservice offers an ideal yet underutilized setting for experiential learning around food for children and for engaging parents in modeling healthy eating at home. The goal of the Nutrition Education in School Foodservice project was to take advantage of the potential of school foodservice settings to positively influence children's eating--both at school and at home. A toolkit was designed and pilot-tested for use in elementary schools, particularly those serving low-income populations. Providing foodservice staff with training and materials was instrumental in promoting the use of the foodservice setting for nutrition education. [ABSTRACT FROM AUTHOR]

Although the prevalence of diabetes has risen in the general population, ethnic disparities in health are also increasing. The University of California Cooperative Extension worked with Latino and African American adults to develop diabetes prevention programs that motivate people to be proactive about their health, improve cooking practices and eating patterns, and be more physically active. The program, team-taught by Extension and health care professionals, involved three, 2-hour sessions with hands-on cooking. Participants (n=60) reported significant changes in food-related barriers and behaviors. Extension and health entities can complement each other in diabetes prevention efforts that target high-risk communities. [ABSTRACT FROM AUTHOR]

Objective: To assess the perception and experience with food insecurity among Latinos living in California, as well as their interpretation of the items included in the Food Security Scale., Material and Methods: A series of four focus groups were carried out among 30 adults of Latin-American descent living in California. The participant's responses were coded by two researchers to identify the main issues, and to compare them for assessing their convergence., Results: The items were well understood and were not perceived as offensive. The conceptual framework was confirmed as a "managed process" with different severity levels. The causes of food insecurity were: unemployment, high cost of some food items, and lack of nutritional information. The demand for nutritional education was constant., Conclusion: Interpreting data on food insecurity in Latinos requires proper consideration of their particular perceptions.