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The purpose is to examine validity and reliability for an obesity risk assessment tool developed in Spanish for immigrant families with children, 3-5 years old using an 8-week cross-sectional design with data collected over 1 year at Head Start and Special Supplemental Nutrition Program for Women, Infants and Children [WIC]. Parent/child dyads (206) provided a child obesity risk assessment, three child modified 24 h dietary recalls, three child 36+ h activity logs and one parent food behavior checklist. Main outcome measures were convergent validity with nutrients, cup equivalents, and diet quality and three assessments of reliability that included item difficulty index, item discrimination index, and coefficient of variation. Validity was demonstrated for assessment tool, named Niños Sanos. Scales were significantly related to variables in direction hypothesized [p ≤ 0.05]: Healthy Eating Index, fruit/vegetable cup equivalents, folate, dairy cup equivalents, vitamins D, β-carotene, fiber, saturated fat, sugar, time at screen/ sleep/physical activity and parent behaviors. Three measures of reliability were acceptable. The addition of nutrient values as an analytical validation approach adds strength and consistency to previously reported Niños Sanos validation results using children's blood biomarkers and body mass index. This tool can be used by health professionals as an assessment of obesity risk in several capacities: (1) screener for counseling in a clinic, (2) large survey, (3) guide for participant goal setting and tailoring interventions, and (4) evaluation.

BackgroundAccurate measurement of food-related parenting practices is necessary to inform related interventions and program evaluation. Valid tools reflect cultural attributes that affect household food environments and feeding practices. Simple, unidirectional language adaptation approaches are insufficient to capture these attributes in assessment tools. My Child at Mealtime (MCMT) is a 27-item, validated, visually enhanced self-assessment tool to measure food-related parenting practices of low-income English-speaking parents of preschoolers.ObjectivesThe aim of this study was to describe the cross-cultural adaptation of MCMT into its Spanish version Mi Niño a la Hora the Comer (Mi Niño) and to establish its face validity, factor structure, and internal consistency.MethodsMCMT was adapted into its Spanish version after an iterative process that triangulated cognitive interviews with verification of conceptual equivalence by content experts to establish face validity and semantic equivalence. The resulting tool underwent confirmatory factor analysis to determine whether internal consistency was equivalent across the 2 versions.ResultsFour rounds of cognitive interviews (n = 5, n = 6, n = 2, and n = 4, respectively) with Spanish-speaking women caregivers of children aged 3-5 y recruited from Head Start were conducted. Ten items were modified throughout the adaptation process. Modifications included improved clarity (6 items), comprehension (7 items), appropriateness (4 items), suitability (4 items), and usefulness (2 items) of text and/or accompanying visuals. Confirmatory factor analysis with a sample of Spanish-speaking caregivers (n = 243) resulted in 2 reliable factors representing "child-centered" (α = 0.82) and "parent-centered" (α = 0.87) food-related parenting practices.ConclusionsFace validity, semantic equivalence, and internal consistency of Mi Niño were established. This tool can be used in community settings to inform program content and measure changes in food-related parenting practices of Spanish-speaking parents and assist in setting food-related parenting goals. The next steps include exploring the correspondence of Mi Nino with mealtime behaviors observed through video recording.

PurposeWithin a medical clinic environment, pediatric obesity prevention education for families faces challenges. Existing long-term government-funded nutrition education programs have the expertise and staff to deliver. The purpose is to determine feasibility of colocating the Expanded Food and Nutrition Education Program (EFNEP) into a medical clinic setting to support pediatric obesity prevention.MethodsPhysicians from a large university teaching and research hospital (n = 73) and 4 small Medicaid-serving community clinics (n = 18) in the same geographic area in northern California were recruited and trained in the patient-referral protocol for a primary prevention intervention provided by EFNEP. The 8-week intervention deployed in the medical clinics, included general nutrition, physical activity and parenting topics anchored with guided goal setting and motivational modeling. Referral, enrollment, and attendance data were collected for 2 years. Parent and physician feasibility surveys, parent interviews and parent risk assessment tools were administered. Paired-sample t-test analysis was conducted.ResultsTwenty intervention series with parents of patients (n = 106) were conducted at 5 clinics. Physicians (n = 92) generated 686 referrals. Every 6 referrals generated 1 enrolled parent. Physicians (91%, n = 34) reported the intervention as useful to families. Parents (n = 82) reported improved child behaviors for sleep, screen time, physical activity, and food and beverage offerings (P

Children of Hispanic origin bear a high risk of obesity. Child weight gain trajectories are influenced by the family environment, including parent feeding practices. Excessive body fat can result in unhealthful metabolic and lipid profiles and increased risk of metabolic diseases. The objective was to estimate criterion validity of an obesity risk assessment tool targeting Spanish-speaking families of Mexican origin using anthropometric measures and blood values of their young children. A cross-sectional study design with five data collection sessions was conducted over an eight-week period and involved 206 parent/child dyads recruited at Head Start and the Special Supplemental Nutrition Program for Women, Infants and Children in Northern California. Main outcome measures were criterion validity of Niños Sanos, a pediatric obesity risk assessment tool, using anthropometric measures and blood biomarkers. Niños Sanos scores were inversely related to child BMI-for-age percentiles (p = 0.02), waist-for-height ratios (p = 0.05) and inversely related to blood biomarkers for the metabolic index (p = 0.03) and lipid index (p = 0.05) and positively related to anti-inflammatory index (p = 0.047). Overall, children with higher Niños Sanos scores had more healthful lipid, metabolic and inflammatory profiles, as well as lower BMI-for-age percentiles and waist-to height ratios, providing evidence for the criterion validity of the tool. Niños Sanos can be used by child obesity researchers, by counselors and medical professionals during clinic visits as a screening tool and by educators as a tool to set goals for behavior change.

Misreporting of dietary intake affects the validity of data collected and conclusions drawn in studies exploring diet and health outcomes. One consequence of misreporting is biological implausibility. Little is known regarding how accounting for biological implausibility of reported intake affects nutrient intake estimates in Hispanics, a rapidly growing demographic in the United States. Our study explores the effect of accounting for plausibility on nutrient intake estimates in a sample of Mexican-American women in northern California in 2008. Nutrient intakes are compared with Dietary Reference Intake recommendations, and intakes of Mexican-American women in a national survey are presented as a reference. Eighty-two women provided three 24-hour recalls. Reported energy intakes were classified as biologically plausible or implausible using the reported energy intakes to total energy expenditure cutoff of 1.24, with low-active physical activity levels used to estimate total energy expenditure. Differences in the means of nutrient intakes between implausible (n=36) and plausible (n=46) reporters of energy intake were examined by bivariate linear regression. Estimated energy, protein, cholesterol, dietary fiber, and vitamin E intakes were significantly higher in plausible reporters than implausible. There was a significant difference between the proportions of plausible vs implausible reporters meeting recommendations for several nutrients, with a larger proportion of plausible reporters meeting recommendations. Further research related to misreporting in Hispanic populations is warranted to explore the causes and effects of misreporting in studies measuring dietary intake, as well as actions to be taken to prevent or account for this issue.

Previous research suggests obesity is negatively related to cognitive functioning and academic outcomes in addition to physical health. However, not much is known about this association in early childhood or potential physiological underpinnings. Biomarkers related to obesity have been associated with cognition, in particular the adipokine leptin, and pro-inflammatory cytokines including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and C-reactive protein (CRP). These associations may be further exacerbated for children who experience early life stress. With a sample of low-income preschoolers, the current study examined associations between obesity-related biomarkers and aspects of behavioral and cognitive school readiness. Partial correlations controlling for child age show hypothesized negative associations between pro-inflammatory cytokines and school readiness, while leptin was positively associated with cognitive school readiness and body mass index (BMI) z-score. Findings suggest connections between obesity, physiology, and school readiness need further examination, but may have implications for early childhood education and health interventions.

A disconnect exists between definitions of school readiness used in research and early childhood education (ECE). While researchers often discuss school readiness as a single, multidimensional construct, the majority of studies operationalize it using multiple measures rather than as one outcome. In comparison, in ECE settings a single measurement tool including multiple dimensions is used. The current study attempted to bridge this gap by examining the factor structure of the Desired Results Developmental Profile (DRDP), a measure of school readiness used in Head Start. We considered often-cited predictors of school readiness (parenting, effortful control) to replicate previous research findings. Analyses indicated a single factor was most appropriate for the DRDP. Measures of parenting and children's effortful control were significant predictors of DRDP scores. Findings from the current study suggest an existing single factor, ECE-based measure of school readiness, such as the DRDP, can also be used as a research tool.

BackgroundCurrently, no simplified approach to estimating food costs exists for a large, nationally representative sample.ObjectiveThe objective was to compare 2 approaches for estimating individual daily diet costs in a population of low-income women in California.DesignCost estimates based on time-intensive method 1 (three 24-h recalls and associated food prices on receipts) were compared with estimates made by using less intensive method 2 [a food-frequency questionnaire (FFQ) and store prices]. Low-income participants (n = 121) of USDA nutrition programs were recruited. Mean daily diet costs, both unadjusted and adjusted for energy, were compared by using Pearson correlation coefficients and the Bland-Altman 95% limits of agreement between methods.ResultsEnergy and nutrient intakes derived by the 2 methods were comparable; where differences occurred, the FFQ (method 2) provided higher nutrient values than did the 24-h recall (method 1). The crude daily diet cost was $6.32 by the 24-h recall method and $5.93 by the FFQ method (P = 0.221). The energy-adjusted diet cost was $6.65 by the 24-h recall method and $5.98 by the FFQ method (P < 0.001).ConclusionsAlthough the agreement between methods was weaker than expected, both approaches may be useful. Additional research is needed to further refine a large national survey approach (method 2) to estimate daily dietary costs with the use of this minimal time-intensive method for the participant and moderate time-intensive method for the researcher.

ObjectiveTo assess convergent validity, factorial validity, test-retest reliability and internal consistency of a diet quality food behaviour checklist (FBC) for low-literate, low-income Spanish speakers.DesignParticipants (n 90) completed three dietary recalls, the Spanish-language version of the US Department of Agriculture (USDA) Household Food Security Survey Module (HFSSM) and the Spanish-language FBC. Factor structure was examined using principal component analysis. Spearman correlation coefficients between FBC item responses and nutrient intakes from 24 h recalls were used to estimate convergent validity. Correlation coefficients were also calculated between FBC item responses at two time points in another group of participants (n 71) to examine test-retest reliability. Cronbach's α coefficient was determined for items within each sub-scale.SettingNon-profit community agencies serving low-income clients, migrant farm worker camps and low-income housing sites in four California counties.SubjectsSpanish-speaking women (n 161) who met income eligibility for the SNAP-Ed (Supplemental Nutrition Assistance Program-Education).ResultsFactor analysis resulted in six sub-scales. Responses to nineteen food behaviour items were significantly correlated with hypothesized 24 h recall data (with a maximum correlation of 0·44 for drinking milk and calcium) or the USDA HFSSM (0·42 with the food security item). Coefficients for test-retest reliability ranged from 0·35 to 0·79. Cronbach's α ranged from 0·49 for the diet quality sub-scale to 0·80 for the fruit and vegetable sub-scale.ConclusionsThe twenty-two-item FBC and instruction guide will be used to evaluate USDA community nutrition education interventions with low-literate Spanish speakers. This research contributes to the body of knowledge about this at-risk population in California.

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.

The purpose of this paper is to describe a process for developing and validating outcome measures relevant to dietary quality behaviors targeted by Food Stamp Nutrition Education (FSNE). The ultimate goal is a measure that is valid, reliable, sensitive to change, and practical for use for a wide variety of FSNE evaluation purposes. The development process has incorporated input from FSNE stakeholders at the federal and state level and follows a systematic, research-driven approach that incorporates both qualitative and quantitative research and includes methods for identification of subject domains, selection of evaluation items, initial pretesting, and reduction of items. This type of research establishes the trustworthiness of new evaluation measures.

The United States is experiencing an epidemic of obesity in both adult and children, particularly among low-income populations. In fact, overweight has replaced malnutrition as the most prevalent nutritional problem among the poor. We examine this seemingly paradoxical relationship and explore the causes and consequences of overweight, obesity and food insecurity. In a UC Cooperative Extension Body Weight and Health Workgroup study of 561 low income Latino mothers and their young children, we found important differences in the association between family food insecurity and overweight status for mothers and their children. Forty percent of the women were overweight and 37% obese, and 22% of their children were overweight. Furthermore, U.S.-born mothers who were food insecure as children were more likely to be obese adults. Awareness and understanding of the link between food insecurity and weight gain will facilitate the efforts of schools, food assistance programs, the food industry and others in the community to provide effective nutritional programs.

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.

Objective: Investigate the impact of a nutrition education program on student academic performance as measured by achievement of education standards. Design: Quasi-experimental crossover-controlled study. Setting: California Central Valley suburban elementary school (58% qualified for free or reduced-priced lunch). Participants: All sixth-grade students (n = 84) in the elementary school clustered in 3 classrooms. Intervention: 9-lesson intervention with an emphasis on guided goal setting and driven by the Social Cognitive Theory. Main Outcome Measure: Multiple-choice survey assessing 5 education standards for sixth-grade mathematics and English at 3 time points: baseline (T1), 5 weeks (T2), and 10 weeks (T3). Analysis: Repeated measures, paired t test, and analysis of covariance. Results: Changes in total scores were statistically different (P less than 0.05), with treatment scores (T3 - T2) generating more gains. The change scores for 1 English (P less than 0.01) and 2 mathematics standards (P less than 0.05; P less than 0.001) were statistically greater for the treatment period (T3 - T2) compared to the control period (T2 - T1). Conclusion and Implications: Using standardized tests, results of this pilot study suggest that "EatFit" can improve academic performance measured by achievement of specific mathematics and English education standards. Nutrition educators can show school administrators and wellness committee members that this program can positively impact academic performance, concomitant to its primary objective of promoting healthful eating and physical activity. (Contains 2 tables.)

Literacy is an issue for many low-income audiences. Using visual information processing theories, the goal was improving readability of a food behavior checklist and ultimately improving its ability to accurately capture existing changes in dietary behaviors. Using group interviews, low-income clients (n = 18) evaluated 4 visual styles. The text plus color photographs style was preferred over the other 3 visual styles: text only, text plus black and white line drawings, and text plus gray-scale photographs. Employing cognitive interviewing in an iterative process, clients (n = 25) recommended simplifying text for 10 items, modifying content for 15 of 16 visuals, and replacing text with visual content for 7 of 16 items. Professional staff (n = 7) and educators (n = 10) verified that visuals and revised text accurately reflected the content of each item. Clients reported that the revised checklist captured their attention, added pleasure to the evaluation process, improved their understanding of the behaviors in question, and facilitated comprehension of text. Readability scores improved by more than 2 grades. This process can be duplicated by others interested in enhancing the quality of existing evaluation tools.

Background: Accurate measurement of food-related parenting practices is necessary to inform related interventions and program evaluation. Valid tools reflect cultural attributes that affect household food environments and feeding practices. Simple, unidirectional language adaptation approaches are insufficient to capture these attributes in assessment tools. My Child at Mealtime (MCMT) is a 27-item, validated, visually enhanced self-assessment tool to measure food-related parenting practices of low-income English-speaking parents of preschoolers. Objectives: The aim of this study was to describe the cross-cultural adaptation of MCMT into its Spanish version Mi Niño a la Hora the Comer (Mi Niño) and to establish its face validity, factor structure, and internal consistency. Methods: MCMT was adapted into its Spanish version after an iterative process that triangulated cognitive interviews with verification of conceptual equivalence by content experts to establish face validity and semantic equivalence. The resulting tool underwent confirmatory factor analysis to determine whether internal consistency was equivalent across the 2 versions. Results: Four rounds of cognitive interviews (n = 5, n = 6, n = 2, and n = 4, respectively) with Spanish-speaking women caregivers of children aged 3-5 y recruited from Head Start were conducted. Ten items were modified throughout the adaptation process. Modifications included improved clarity (6 items), comprehension (7 items), appropriateness (4 items), suitability (4 items), and usefulness (2 items) of text and/or accompanying visuals. Confirmatory factor analysis with a sample of Spanish-speaking caregivers (n = 243) resulted in 2 reliable factors representing "child-centered" (α = 0.82) and "parent-centered" (α = 0.87) food-related parenting practices. Conclusions: Face validity, semantic equivalence, and internal consistency of Mi Niño were established. This tool can be used in community settings to inform program content and measure changes in food-related parenting practices of Spanish-speaking parents and assist in setting food-related parenting goals. The next steps include exploring the correspondence of Mi Nino with mealtime behaviors observed through video recording. [ABSTRACT FROM AUTHOR]

The usefulness of an evaluation instrument is dependent on its reliability, validity, and ability to capture change. The latter psychometric characteristic is particularly important, yet is often neglected. The purpose of this study was to assess the sensitivity of a psychosocial fruit and vegetable evaluation tool for use by two US Department of Agriculture community-based programs. As part of a prospective randomized controlled trial, a sample of limited-resource women (n=93), recruited from eight counties, provided dietary recalls, behavioral assessments, and psychosocial assessments. A randomly selected sub-sample was used for venipuncture (n=55). Sensitivity of the tool was estimated using serum carotenoids, selected micronutrients, fruit/vegetable servings, and fruit/vegetable behaviors. Controlling for energy intake at baseline and change in energy intake, the change scores for the tool were correlated with reported changes in fruit and vegetable behaviors (r=0.28, P=0.01), vitamin C (r=0.25, P=0.02), and the biomarker serum carotenoids (r=0.31, P=0.02). This systematic process yielded a moderately sensitive evaluation tool useful with a limited-resource audience participating in two US Department of Agriculture programs. This is the first study to estimate sensitivity of a psychosocial tool for a fruit and vegetable intervention.

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: Examine effectiveness of a state's Youth Expanded Food and Nutrition Education Program (EFNEP) and assess the validity of the federal impact indicator method for reporting program outcomes. Design: A randomized, controlled field trial of 229 groups with 5,111 youth, 9-12 years old, in community settings. Intervention: 6- to 8- hour, 7-lesson education experience with food preparation and tasting, an education experience typical of EFNEP in California. Outcome Measures: US Department of Agriculture (USDA) impact indicators: nutrition knowledge, eating a variety of foods, food selection, and food preparation and safety practices. Analysis: Analysis of covariance model controlling for pretest, gender, age, and ethnicity, with group nested in condition. Results: Organizing responses by impact indicators, treatment participants made significant gains on the posttest compared to controls for 3 of 4 indicators (P < .008 to P < .0001). Gains were made by 34 to 68% of youth participants for 4 indicators. The impact indicator method for federal reporting compared favorably with results from a randomized controlled trial with groups nested in conditions. Conclusion and Implications: This is the first report in the literature of (1) a large evaluation study of Youth EFNEP and (2) an estimate of the validity of the USDA impact indicator method for reporting program outcomes. Key Words: EFNEP, evaluation, youth, children, impact indicator, USDA

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2005.11.008 Byline: Marilyn S. Townsend

Objective: Development of an evaluation tool of psychosocial constructs for use by participants in 2 federal programs, Food Stamp Nutrition Education and the Expanded Food and Nutrition Education Program. Design: Cross-sectional data from a longitudinal study. Participants: Limited-resource women (n = 111) living in low-income communities. Measures: Test-retest reliability, internal consistency, ethnic differences, convergent validity. Analysis: Spearman rank order correlation, analysis of variance, principal components analysis. Results: Reliability coefficients ranged from a low of r = .18 (not significant) to r = .74 (P < .0001). Two items were deleted for not meeting criteria for reliability and 2 for redundancy. Ethnic differences at baseline were significant for 1 item. Domain constructs loaded on 4 to 5 factors for the biopsychosocial framework. Estimates of convergent validity of 9 constructs led to the deletion of 3 (ie, perceived barriers, social support, and perceived norms), with retention of perceived benefits, perceived control, self-efficacy, readiness to eat more fruit, readiness to eat more vegetables, and perceived diet quality. As an estimate of convergent validity, the final version of the tool with 6 constructs remaining showed significant correlations with indicators of diet quality: serum carotenoid values (r = .38, P < .001); hypothesized nutrients calculated from the mean of 3 24-hour dietary recalls (vitamin C, r = .47, P < .0001; vitamin A, r = .39, P < .0001; folate, r = .37, P < .0001; betacarotene, r =.31, P < .001; and fiber, r = .46, P < .0001); fruit and vegetable servings (r = 0.55, P < .0001); Healthy Eating Index (r = .27, P < .05); and a fruit and vegetable behavioral scale (r = .60, P < .0001). Conclusion and Implications: This systematic process yielded a fruit and vegetable evaluation tool useful for practitioners and researchers. This is the first validation study of this type to estimate convergent validity with 5 indicators of diet quality, including a biomarker. KEY WORDS: evaluation, health beliefs, Expanded Food and Nutrition Education Program (EFNEP), Food Stamp Nutrition Education (FSNE), low income, fruits, vegetables, Healthy Eating Index

Objective: To describe depictions of food, alcohol, and exercise and sport in popular films. Design: Content analysis of the 10 top-grossing films each year from 1991 to 2000 (N = 100 films). Analysis: Coding reliabilities were assessed with Cohen's [kappa]. Research questions were addressed with basic descriptive statistics. Associations among variables were examined through a cross-tabulation procedure that corrects for the clustering of exercise and food depictions within movies. Results: Food and drink appeared regularly in the films analyzed, typically as a background element or prop. On average, food appeared on the screen once every 4.2 minutes. The foods shown were most likely to be fats, oils, and sweets; fruits, vegetables, and dairy products were rarely seen. More than 20% of the food items shown were alcoholic beverages, which were nearly 2 times more likely to be ingested as nonalcohol food items. Planned exercise and sports appeared at a rate of about 2 incidents per hour. These activities rarely received explicit evaluation by characters. Conclusions and Implication: Films frequently portray foods and exercise. These depictions have the potential to cultivate beliefs about normative eating and exercise behavior, suggesting a need for public health professionals to encourage the media to offer healthier images. KEY WORDS: movies, film, food, exercise

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

Objective: To report 6 psychometric properties of food behavior checklist (FBC) items and then to use these properties to systematically reduce the number of items on this evaluation tool. Design: Random assignment to the intervention and control groups. Setting: Low-income communities. Participants: Women (N = 132) from limited-resource families. Main Outcome Measures: Reliability, internal consistency, baseline differences by ethnicity, sensitivity to change, and criterion and convergent validity of subscales. Results: The fruit and vegetable subscale showed a significant correlation with serum carotenoid values (r = .44, P < .001), indicating acceptable criterion validity. Milk, fat/cholesterol, diet quality, food security, and fruit/vegetable subscales showed significant correlations with dietary variables. Nineteen items have acceptable reliability. Twenty items showed no baseline differences by ethnic group. Eleven of the 15 items expected to show change following the intervention demonstrated sensitivity to change. Conclusions and Implications: This brief food behavior checklist (16 items) is easy to administer to a client group, has an elementary reading level (fourth grade), and has a low respondent burden in addition to meeting requirements for validity, reliability, and sensitivity to change. This study establishes a process that can be used by other researchers to develop and further refine instruments for use in community health promotion interventions. KEY WORDS: evaluation, food behaviors, Expanded Food and Nutrition Education Program (EFNEP), low income

Information on pre-natal care for pregnant teenagers was developed for use through Teletip, a telephone information system. A panel of teenagers was asked to help develop the system including the marketing mechanisms needed to disseminate the information effectively. The teenagers had definite ideas on how to educate their peers. They insisted on confidential information recommending that the posters be put up in restroom stalls in addition to other public places. The Teletip system proved to be an inexpensive and effective way of educating teenagers.