- Email: [email protected]
Focus on Snacks: Reliability and Validity
S132 USDA NIFA Poster Abstracts
Journal of Nutrition Education and Behavior Volume 48, Number 7S, 2016
NP54 We Don’t Know What We Don’t Know: Using Focus Groups to Tailor Nutrition Education in the Abriendo Caminos Community Intervention Margarita Teran-Garcia, PhD, MD, [email protected], University of Illinois at Urbana-Champaign, 905 South Goodwin Avenue, 437 Bevier Hall, MC-182, Urbana, IL 61801; A. R. Wiley, PhD; B. Hannon, BSc; E. Villegas, BSc; M. Cruz-Santiago, PhD Objective: To improve the Abriendo Caminos (AC2) nutrition intervention by learning about Hispanic mothers’ perceptions of barriers to improving diet using focus group data. Description: AC2 is a multistate, randomized control intervention to improve nutrition, physical activity, and family interactions among Hispanics. AC2 emphasizes increased consumption of nutrient-rich foods, reduction in unhealthy snack foods, and healthy changes to traditional recipes. Mothers (>1 child 6-18 yrs) in two Illinois focus groups (n¼12) discussed health-related family patterns, especially barriers and facilitators. Evaluation: Over 10 hours of transcribed data were subject to open-coding thematic analyses. Nutrition patterns are the current focus. In initial analyses, two emerging themes were lack of knowledge regarding portion size for family members of different sizes and ages, and types of fat in the diet. Conclusions and Implications: Focus groups allow indepth exploration/follow-up and are appropriate with this population. These IL data will underpin modification of existing curriculum to emphasize hands-on learning about portion sizes (especially of traditional foods) and healthy fats (including taste-tests and strategies for integrating healthier fats in traditional foods). Our goal is to promote healthy behaviors in Hispanic families in a culturally-sensitive way. Focus groups were an important tool in identifying which behaviors most needed modification thus allowing us to maximize curriculum efficiency and efficacy. The same process will occur at all study sites. Funding: USDA Grant #2015-68001-23248
NP55 Obesity Risk, Parenting and Diet Quality Assessment for Spanish-Speaking Families With Preschool Children: EFNEP, Head Start, Medical Clinic-Year 1 Marilyn Townsend, PhD, RD, [email protected], University of California Davis, 1 Shields Avenue, Meyer Hall, Davis, CA 95616; M. Shilts, PhD, California State University, Sacramento; L. Ontai, PhD, University of California Davis; C. Drake, PhD; L. Lanoue, PhD; D. Styne, MD; L. Allen, PhD, Western Human Nutrition Research Center; K. Diaz Rios, PhD, University of California, Merced; K. Panarella, MS, MPH, University of California Cooperative Extension Agricultural and Natural Resources
Objectives: Produce final versions of two validated obesity risk assessment tools for Spanish speaking parents; assess feasibility of these tools to the child's pediatrician; develop and validate a visual diet quality tool, and determine feasibility of an Expanded Food and Nutrition Education Program (EFNEP) intervention in a medical clinic. Description: The Healthy Kids (HK) and My Child at Meal Time (MCMT) tools were translated and cognitively tested (n¼30) with Head Start parents. To test the feasibility of EFNEP in a clinic setting, formal planning meetings (n¼5) have been conducted. A 22-item diet quality tool focusing on vegetable intake was developed and cognitively tested (n¼9). Lastly, the biomarker data sets were evaluated for accuracy, precision and reproducibility. Evaluation: For HK and MCMT, photographs, vocabulary, and response options were changed based on parent preferences. Parents’ preferred fresh fruit and vegetables and indicated that overall pictures should feature Hispanic families with some variety in ethnic groups. Two separate diet quality tools for English speaking and Spanish speaking parents with different vegetable photographs was determined. To assist with an EFNEP intervention in a medical clinic, referral sheets were developed. To date 24 patient referrals have been made but there has been difficulty enrolling patients. The biomarkers were ranked and summed for a specific index (Pro-Inflammatory, Anti-Inflammatory, Metabolic, Lipid, Carotenoids). Conclusions and Implications: Spanish language HK and MCMT are now ready for validity testing using logs, biomarkers, and anthropometrics. Although the physicians enthusiastically supported EFNEP in the clinic, the actual implementation faced hurdles and revised approaches are being developed. Funding: USDA Grant #2010-85215-20658
NP56 Focus on Snacks: Reliability and Validity Marilyn Townsend, PhD, RD, [email protected], University of California Davis, 1 Shields Avenue, Meyer Hall, Davis, CA 95616; M. Shilts, PhD, California State University, Sacramento; C. Drake, PhD, University of California Davis; L. Lanoue, PhD; F. Beatrice Objectives: Using behavioral items designed for low literate participants of USDA programs, our hypothesis was that Focus on Snacks scores would show consistency over time, relationships with dietary energy density and micronutrients, and predictive validity with BMI. Description: Low-income parents (n¼141) of preschool children provided self-administered Focus on Snacks at two times 5 weeks apart, and three child diet recalls. Children’s heights and weights were measured. Evaluation: Of the 141 children, 59 (41%) have had at least one sugar sweetened beverage (SSB) including soda during one or more of the snack times with a parent. Of the 510 reported snacking occurrences during the 3 days, Continued on page S133
Journal of Nutrition Education and Behavior Volume 48, Number 7S, 2016 NP56 (continued) 99 instances (19%) were from SSB. Test-retest reliability was more than adequate (r¼.71, p<.0001). Convergent validity using dietary energy density, vitamins A and C, potassium, sodium, fiber, and water was demonstrated (p<.05 -.01). Factor analysis confirmed two components, the first for healthful snacks and the second for other snacks. Child’s BMI percentile was marginally related to focus on snacks two years later (p¼.073) demonstrating some predictive validity. Conclusions and Implications: These findings support evidence for reliability and validity of the 13-item focus on snacks. This tool be useful in assessing the child’s snack behaviors that are under control of the parent. Funding: USDA Grant #2010-85215-20658
NP57 Detroit Child Health Incubator Research Project: Creating a Transformational Community Kerry Vachta, PhD, [email protected], Michigan State University, Health and Nutrition Institute, CHIRP Research Team, 2727 2nd Avenue, Suite 153, Detroit, MI 48201; M. Kweli, MPA; L. Campbell-Stewart, MPH, Building Movement Project - Detroit; P. Davis-Williams, MA, Creative Community Pathways; H. Adjuman, BA, Detroit Black Community Food Security Network; M. ThompsonCurtis, Feedom Freedom Growers; L. Spady, BFA, Just Creative; S. Adame, MA; A. Newsom, People's Kitchen Detroit; T. Petty, Michigan State University, CHIRP Research Team; R. Moore Objective: Building a learning community to address childhood obesity prevention through a food justice lens. Description: Reports on partners' creative collaborative strategies to create a web of relationships and community climate supporting healthful family lifestyles. Evaluation: Applying participatory methods to the formative and outcome evaluation of the CHIRP learning community and evaluation and dissemination of specific programs/activities. Conclusions and Implications: Through their increasingly collaborative efforts, the CHIRP community partners have fostered a web of resources and relationships that provide a supportive community climate which facilitates the transition to and maintenance of healthful lifestyles for families with young children. Funding: USDA Grant #2011-68001-23407
NP58 Implementation Feasibility of School Modules Designed to Enhance the EvidenceBased Switch Obesity Prevention Program Gregory Welk, PhD, [email protected], Iowa State University, 257 Forker Building, Department of Kinesiology, Ames, IA 50011; S. Chen, PhD; S. Vazou, PhD; L. Lanningham-Foster, PhD; D. Gentile, PhD; R. Rosenkranz, PhD, Kansas State University; D. Dzewaltowski, PhD
USDA NIFA Poster Abstracts S133
Objective: The purpose of this study was to evaluate the implementation feasibility of school modules designed to enhance school engagement and student involvement in the evidence-based Switch obesity prevention program. Description: The school-based Switch program promotes healthy lifestyles by helping youth to ‘‘switch what they do, view and chew’’. Six schools from three Iowa school districts involved in a Switch pilot study were recruited to evaluate three new school modules designed to enhance Switch integration in classroom, physical education, and lunchroom settings. Online training and support was provided to the school Switch teams but the implementation and the integration of the Switch modules was handled completely by the schools. Evaluation: The evaluation examined factors that influenced successful implementation of the integrated ‘Switch Classroom’, ‘Switch PE’, and ‘Switch Lunchroom’ modules by the school Switch teams. Detailed implementation measures were conducted throughout the program implementation process using daily report logs and a weekly implementation survey. Barriers, facilitators, motivations and perceptions of implementation were obtained from Switch school leaders at the end of programming using a survey of implementation drivers, the Self-Regulation for Educators Questionnaire, and questions that measured perceived competence, outcome expectations, training received, support, and satisfaction associated with the implementation of the Switch program. Implementation outcomes across schools, school lunchrooms, physical education classes, classrooms will be described. The association between drivers (barriers, facilitators, and motivations) and implementation outcomes will be estimated using multilevel linear models. Conclusions and Implications: The evaluation provides feedback of the utility of the Switch modules for enhancing school implementation of the Switch. Funding: USDA Grant #015-68001-23242
NP59 Classroom Teacher Impact on Student Physical Activity Linda Whent, PhD, [email protected], University of California, Davis, 328 D Street, Davis, CA 95616; L. Martinez; R. Gomez-Camacho; A. de la Torre, PhD Objectives: The objectives were to examine demographic and physical activity characteristics of preschool and elementary school teachers, and understand the impact of these characteristics on weekly minutes of physical activity offered to their students. Discuss strategies and barriers impacting school physical activity data collection. ~ os Sanos, Familia Sana (NSFS) was a Description: Nin multi-component intervention to prevent obesity in Mexican-Heritage children in rural California. Data collected on classroom physical activity was a dosage component of the NSFS study and included data from teachers in both the treatment and comparison communities. The sample included 57 preschool through 3rd Continued on page S134
Journal of Nutrition Education and Behavior Volume 48, Number 7S, 2016
NP54 We Don’t Know What We Don’t Know: Using Focus Groups to Tailor Nutrition Education in the Abriendo Caminos Community Intervention Margarita Teran-Garcia, PhD, MD, [email protected], University of Illinois at Urbana-Champaign, 905 South Goodwin Avenue, 437 Bevier Hall, MC-182, Urbana, IL 61801; A. R. Wiley, PhD; B. Hannon, BSc; E. Villegas, BSc; M. Cruz-Santiago, PhD Objective: To improve the Abriendo Caminos (AC2) nutrition intervention by learning about Hispanic mothers’ perceptions of barriers to improving diet using focus group data. Description: AC2 is a multistate, randomized control intervention to improve nutrition, physical activity, and family interactions among Hispanics. AC2 emphasizes increased consumption of nutrient-rich foods, reduction in unhealthy snack foods, and healthy changes to traditional recipes. Mothers (>1 child 6-18 yrs) in two Illinois focus groups (n¼12) discussed health-related family patterns, especially barriers and facilitators. Evaluation: Over 10 hours of transcribed data were subject to open-coding thematic analyses. Nutrition patterns are the current focus. In initial analyses, two emerging themes were lack of knowledge regarding portion size for family members of different sizes and ages, and types of fat in the diet. Conclusions and Implications: Focus groups allow indepth exploration/follow-up and are appropriate with this population. These IL data will underpin modification of existing curriculum to emphasize hands-on learning about portion sizes (especially of traditional foods) and healthy fats (including taste-tests and strategies for integrating healthier fats in traditional foods). Our goal is to promote healthy behaviors in Hispanic families in a culturally-sensitive way. Focus groups were an important tool in identifying which behaviors most needed modification thus allowing us to maximize curriculum efficiency and efficacy. The same process will occur at all study sites. Funding: USDA Grant #2015-68001-23248
NP55 Obesity Risk, Parenting and Diet Quality Assessment for Spanish-Speaking Families With Preschool Children: EFNEP, Head Start, Medical Clinic-Year 1 Marilyn Townsend, PhD, RD, [email protected], University of California Davis, 1 Shields Avenue, Meyer Hall, Davis, CA 95616; M. Shilts, PhD, California State University, Sacramento; L. Ontai, PhD, University of California Davis; C. Drake, PhD; L. Lanoue, PhD; D. Styne, MD; L. Allen, PhD, Western Human Nutrition Research Center; K. Diaz Rios, PhD, University of California, Merced; K. Panarella, MS, MPH, University of California Cooperative Extension Agricultural and Natural Resources
Objectives: Produce final versions of two validated obesity risk assessment tools for Spanish speaking parents; assess feasibility of these tools to the child's pediatrician; develop and validate a visual diet quality tool, and determine feasibility of an Expanded Food and Nutrition Education Program (EFNEP) intervention in a medical clinic. Description: The Healthy Kids (HK) and My Child at Meal Time (MCMT) tools were translated and cognitively tested (n¼30) with Head Start parents. To test the feasibility of EFNEP in a clinic setting, formal planning meetings (n¼5) have been conducted. A 22-item diet quality tool focusing on vegetable intake was developed and cognitively tested (n¼9). Lastly, the biomarker data sets were evaluated for accuracy, precision and reproducibility. Evaluation: For HK and MCMT, photographs, vocabulary, and response options were changed based on parent preferences. Parents’ preferred fresh fruit and vegetables and indicated that overall pictures should feature Hispanic families with some variety in ethnic groups. Two separate diet quality tools for English speaking and Spanish speaking parents with different vegetable photographs was determined. To assist with an EFNEP intervention in a medical clinic, referral sheets were developed. To date 24 patient referrals have been made but there has been difficulty enrolling patients. The biomarkers were ranked and summed for a specific index (Pro-Inflammatory, Anti-Inflammatory, Metabolic, Lipid, Carotenoids). Conclusions and Implications: Spanish language HK and MCMT are now ready for validity testing using logs, biomarkers, and anthropometrics. Although the physicians enthusiastically supported EFNEP in the clinic, the actual implementation faced hurdles and revised approaches are being developed. Funding: USDA Grant #2010-85215-20658
NP56 Focus on Snacks: Reliability and Validity Marilyn Townsend, PhD, RD, [email protected], University of California Davis, 1 Shields Avenue, Meyer Hall, Davis, CA 95616; M. Shilts, PhD, California State University, Sacramento; C. Drake, PhD, University of California Davis; L. Lanoue, PhD; F. Beatrice Objectives: Using behavioral items designed for low literate participants of USDA programs, our hypothesis was that Focus on Snacks scores would show consistency over time, relationships with dietary energy density and micronutrients, and predictive validity with BMI. Description: Low-income parents (n¼141) of preschool children provided self-administered Focus on Snacks at two times 5 weeks apart, and three child diet recalls. Children’s heights and weights were measured. Evaluation: Of the 141 children, 59 (41%) have had at least one sugar sweetened beverage (SSB) including soda during one or more of the snack times with a parent. Of the 510 reported snacking occurrences during the 3 days, Continued on page S133
Journal of Nutrition Education and Behavior Volume 48, Number 7S, 2016 NP56 (continued) 99 instances (19%) were from SSB. Test-retest reliability was more than adequate (r¼.71, p<.0001). Convergent validity using dietary energy density, vitamins A and C, potassium, sodium, fiber, and water was demonstrated (p<.05 -.01). Factor analysis confirmed two components, the first for healthful snacks and the second for other snacks. Child’s BMI percentile was marginally related to focus on snacks two years later (p¼.073) demonstrating some predictive validity. Conclusions and Implications: These findings support evidence for reliability and validity of the 13-item focus on snacks. This tool be useful in assessing the child’s snack behaviors that are under control of the parent. Funding: USDA Grant #2010-85215-20658
NP57 Detroit Child Health Incubator Research Project: Creating a Transformational Community Kerry Vachta, PhD, [email protected], Michigan State University, Health and Nutrition Institute, CHIRP Research Team, 2727 2nd Avenue, Suite 153, Detroit, MI 48201; M. Kweli, MPA; L. Campbell-Stewart, MPH, Building Movement Project - Detroit; P. Davis-Williams, MA, Creative Community Pathways; H. Adjuman, BA, Detroit Black Community Food Security Network; M. ThompsonCurtis, Feedom Freedom Growers; L. Spady, BFA, Just Creative; S. Adame, MA; A. Newsom, People's Kitchen Detroit; T. Petty, Michigan State University, CHIRP Research Team; R. Moore Objective: Building a learning community to address childhood obesity prevention through a food justice lens. Description: Reports on partners' creative collaborative strategies to create a web of relationships and community climate supporting healthful family lifestyles. Evaluation: Applying participatory methods to the formative and outcome evaluation of the CHIRP learning community and evaluation and dissemination of specific programs/activities. Conclusions and Implications: Through their increasingly collaborative efforts, the CHIRP community partners have fostered a web of resources and relationships that provide a supportive community climate which facilitates the transition to and maintenance of healthful lifestyles for families with young children. Funding: USDA Grant #2011-68001-23407
NP58 Implementation Feasibility of School Modules Designed to Enhance the EvidenceBased Switch Obesity Prevention Program Gregory Welk, PhD, [email protected], Iowa State University, 257 Forker Building, Department of Kinesiology, Ames, IA 50011; S. Chen, PhD; S. Vazou, PhD; L. Lanningham-Foster, PhD; D. Gentile, PhD; R. Rosenkranz, PhD, Kansas State University; D. Dzewaltowski, PhD
USDA NIFA Poster Abstracts S133
Objective: The purpose of this study was to evaluate the implementation feasibility of school modules designed to enhance school engagement and student involvement in the evidence-based Switch obesity prevention program. Description: The school-based Switch program promotes healthy lifestyles by helping youth to ‘‘switch what they do, view and chew’’. Six schools from three Iowa school districts involved in a Switch pilot study were recruited to evaluate three new school modules designed to enhance Switch integration in classroom, physical education, and lunchroom settings. Online training and support was provided to the school Switch teams but the implementation and the integration of the Switch modules was handled completely by the schools. Evaluation: The evaluation examined factors that influenced successful implementation of the integrated ‘Switch Classroom’, ‘Switch PE’, and ‘Switch Lunchroom’ modules by the school Switch teams. Detailed implementation measures were conducted throughout the program implementation process using daily report logs and a weekly implementation survey. Barriers, facilitators, motivations and perceptions of implementation were obtained from Switch school leaders at the end of programming using a survey of implementation drivers, the Self-Regulation for Educators Questionnaire, and questions that measured perceived competence, outcome expectations, training received, support, and satisfaction associated with the implementation of the Switch program. Implementation outcomes across schools, school lunchrooms, physical education classes, classrooms will be described. The association between drivers (barriers, facilitators, and motivations) and implementation outcomes will be estimated using multilevel linear models. Conclusions and Implications: The evaluation provides feedback of the utility of the Switch modules for enhancing school implementation of the Switch. Funding: USDA Grant #015-68001-23242
NP59 Classroom Teacher Impact on Student Physical Activity Linda Whent, PhD, [email protected], University of California, Davis, 328 D Street, Davis, CA 95616; L. Martinez; R. Gomez-Camacho; A. de la Torre, PhD Objectives: The objectives were to examine demographic and physical activity characteristics of preschool and elementary school teachers, and understand the impact of these characteristics on weekly minutes of physical activity offered to their students. Discuss strategies and barriers impacting school physical activity data collection. ~ os Sanos, Familia Sana (NSFS) was a Description: Nin multi-component intervention to prevent obesity in Mexican-Heritage children in rural California. Data collected on classroom physical activity was a dosage component of the NSFS study and included data from teachers in both the treatment and comparison communities. The sample included 57 preschool through 3rd Continued on page S134