- Email: [email protected]
Formative Evaluation of a Community-based Diabetes Program for Hispanics
Journal of Nutrition Education and Behavior Volume 41, Number 4S, 2009
P19 Behaviorally Focused Nutrition Education via P-Saurus Lessons Increased the Nutrition Knowledge of Preschoolers–a Preliminary Research Deepika Bangia, MS, [email protected], Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, 220 Davison Hall, New Brunswick, NJ 08901; Debrah M. Palmer, PhD, [email protected]. edu, Rutgers University; Audrey Adler, MS, RD, adler@ njaes.rutgers.edu, Rutgers New Jersey Agricultural Experiment Station; Kelly Ryan, [email protected]. edu, Department of Nutritional Sciences, Rutgers University Objective: Federal funds are used to provide nutrition education for a variety of target audiences, among which are pre-school children. Yet, few age-appropriate curricula are available to guide pre-school nutrition education. This study was done as a preliminary impact evaluation for a preschool curriculum currently under development, i.e., P-Saurus Activity Packs. Design, Setting and Participants: Eight lessons from the P-Saurus Supplemental Nutrition Education Assistance Program Education (SNAP-Ed) were taught to a culturally diverse (majority Hispanic) preschool class in New Brunswick. A class of 14 preschoolers was identified for the preliminary research. Outcome, Measures and Analysis: Pre and post individual interviews (n ¼ 14) were conducted by showing children the MyPyramid poster, and asking them to tell the researcher all that they could about it. Descriptive analyses were performed, and the correct number of statements made by each child counted. Results: Post intervention, most children named the MyPyramid for Kids poster (71%); and, more children could identify at least 1 of the food groups on MyPyramid (43%). Concepts, such as ‘‘energy’’, the importance of exercise, and ‘‘milk giving us strong bones,’’ were stated by 36% of the children. However, no improvements were observed among the 3-year-olds assessed. Conclusions and Implications: The P-Saurus lessons favorably impacted the nutrition knowledge of preschoolers; however, the sample size was very small. Since there was no improvement in the knowledge of the 3year-olds, if these findings are repeated, the value of providing nutrition education to this audience should be called into question. This work was funded by New Jersey Supplement Nutrition Assistance Program Education.
P20 Incorporating Physical Activity in Nutrition Education Classes for Adult LimitedResource Audiences Through Use of Walking DVD Programs–A Preliminary Study Audrey Adler, MS, RD, [email protected]; Debrah M. Palmer, PhD, [email protected]; Kirsten W. Corda, [email protected], Rutgers, The State University of New Jersey, 26 Nichol Avenue, Davison Hall, New Brunswick, NJ Objective: Obesity is best addressed by focusing on physical activity along with eating habits. Thus, Supplemental
Poster Abstracts S25
Nutrition Assistance Program Education (SNAP-Ed) and Expanded Food and Nutrition Program (EFNEP) educators are being charged with incorporating physical activity into their programming. However, few curricula exist to assist paraprofessional nutrition educators in this process; thus, walking program DVDs were tested with a sample of New Jersey EFNEP and SNAP-Ed adult class participants. Design, Setting and Participants: Short DVDs featuring walking with other simple low-impact movements were played at the end of nutrition education classes. Class members (n ¼ 22) were invited to participate in the activity with the educator. Outcome, Measures and Analysis: Pre- and post-tests, conducted by a researcher, assessed the participants perceptions of barriers to engaging in physical activity, as well as the acceptability of including these physical activity DVDs in SNAP-Ed and EFNEP classes. Analyses of participants’ changes in perceived barriers to exercise were conducted using paired t-test and descriptive statistics; acceptability was assessed via descriptive statistics. Results: Although no statistically significant pre- to posttest differences were found, mean barrier scores were lower in the post-test than in the pre-test. Regarding the acceptability of this program addition, 77% of the participants ‘‘liked’’ the walking programs, and 82% enjoyed doing them as part of the nutrition education classes. Conclusions and Implications: This preliminary study suggests that walking programs on DVDs may provide a venue for educating and encouraging limited-resource audiences to become more physically active. However, due to the small sample size of this work, additional research should be conducted. This project was funded by New Jersey Agricultural Experiment Station and New Jersey SNAP-Ed.
P21 Formative Evaluation of a Communitybased Diabetes Program for Hispanics Karina Diaz, MS, [email protected]; Miriam Miller, MPH, [email protected]; Eva Nava, MS, [email protected]; Karen Chapman-Novakofski, RD, PhD, [email protected], Division of Nutritional Sciences, and Illinois Extension Service, 238 Bevier Hall, 905 South Goodwin Avenue, Urbana, IL 61801 Objective: This project reflects a formative evaluation of the feasibility and impact of a 6-week community-based diabetes education program for Hispanic adults. Use of Theory or Research: Pre/post, post-post design for knowledge, food and activity behavior, and weight. Target Audience: Hispanic adults with diabetes in 2 northern counties. Description: Six classes focusing on meal planning, diabetes, and physical activity were developed pilot-tested and revised. Classes were taught in spring and fall. Demographic, anthropometric, dietary, physical activity, nutrition and health data were obtained along with acculturation and post-class process evaluation. Evaluation: Thirty-three persons participated in the program (females ¼ 23); 50% had diabetes, the rest had family members with the disease. More participants attended the Continued on page S26
S26 Poster Abstracts
Journal of Nutrition Education and Behavior Volume 41, Number 4S, 2009
P21 (continued) spring than the fall classes. There were no significant changes in mean anthropometric variables. Weight ranged from 113 to 264 baseline (n ¼ 30) and 116 to 230 post-program (n ¼ 13). Blood glucose values ranged from 82 to 278 mg% baseline (n ¼ 26) and 87 to 249 mg% post-intervention (n ¼ 12). Carbohydrate-containing food knowledge was significantly improved (p<.05). Activity-related questions were difficult for participants to understand. Follow-up for afterintervention participants was not optimal. Child care, travel, location, marketing, and holidays affected feasibility. Conclusions and Implications: Weight, blood glucose and knowledge level supported program need. Reach of the program was poor with follow-up assessments difficult. A shorter program may improve participation levels. Impact variables would need to be adjusted accordingly. This project was funded by University of Illinois Extension and CONACYT.
P22 Food Purchasing Choices of Supplemental Nutrition Assistance Program (SNAP) Participants in Greenville County, South Carolina Lindley Cone, [email protected]; Sylvia Smith, [email protected]; Alicia Powers, PhD, alicia. [email protected], Health and Exercise Science, Furman University, 3300 Poinsett Highway, Greenville, SC 29613 Objective: This study described food purchasing choices of SNAP participants in Greenville County, South Carolina. Design, Setting and Participants: A typical descriptive study was conducted using items purchased with any tender in March 2008 by SNAP participants at BiLoÒ stores in Greenville County, South Carolina. Outcome, Measures and Analysis: Food items were grouped according to MyPyramid food groups and subgroups. Nutrient content for a variety of nutrients was determined using the nutrition facts label for each food item. Results: About 93% of items purchased were food items. Within the food items purchased, 25.5% were discretionary calories, 21.8% were meats, 17.9% were grains, 12.5% were vegetables, 11.3% were dairy products and less than 5% were in each of the remaining groups. Within the discretionary calories group, more than 95% of products purchased contained less than 10% of the daily value per serving for vitamin A, calcium and iron and less than 5 grams of fiber per serving. Within the grains group, 94.8% of purchased products contained less than 5 grams of fiber per serving. Within the dairy and meats groups, 48.7% and 35.2% of purchases contained more than 3.5 grams of saturated fat per serving, respectively. Conclusions and Implications: With such a high percentage of food purchases from the less nutrient dense food groups and confirmation of lack of nutrient density through nutrient content analysis, it is evident that SNAP must continue educating its participants about healthy foods to purchase. Funding for this study was provided by Furman University.
P23 Strengthening Nutrition Education for Families: An Evidence-based Revision of Operation Frontline’s Side By Side Curricula Leigh Ann Edwards, RD, MPH, [email protected], Operation Frontline; Janet McLaughlin, MPA, [email protected], Operation Frontline; Laura Seman, MPH, [email protected], Operation Frontline, Share Our Strength’s Operation Frontline, 1730 M Street Northwest, Suite 700, Washington, DC 20036; Jill Panichelli, MHS, [email protected] Objective: To improve food security, nutrition, and household food environment of low-income families. Use of Theory or Research: Share Our Strength’s Operation Frontline’s Side By Side promotes family health by engaging parents and children together in chef-led nutrition education. Emerging research on family food choice, along with reported challenges in engaging parents and child Target Audience: Low-income families with school-age children. Description: Operation Frontline began revisions of Side by Side in June 2008 with the goals of ensuring that curriculum objectives connect clearly with proven determinants of healthy family food choice and incorporating facilitation techniques most effective for low-income parent-child dyads. A revised and expanded course piloted in 4 cities in spring 2009. Evaluation: Evaluation methods include participant surveys, focus groups, and interviews with participants and instructors. Expected results include positive behavior change related to healthy family food choice, improved self-efficacy for cooking and making healthy food choices, and greater engagement of families in lessons. Conclusions and Implications: Findings from formative research and pilot courses will guide Share Our Strength in ongoing implementation and can guide other familybased nutrition education programs. Operation Frontline is nationally sponsored by the ConAgra Foods Foundation.
P24 Preventing Diabetes with Meals and Movement Patty Case, MS, RD, [email protected], Oregon State University Extension Service, 3328 Vandenberg Road, Klamath Falls, OR 97603 Objective: To evaluate the effectiveness of diabetes prevention curriculum delivered by Extension paraprofessionals. Use of Theory or Research: This project employed a ‘‘train-the-trainer’’ approach to deliver community based education. Techniques and concepts were based on results from the Diabetes Prevention Program research and best practice precepts including the transtheoretical model of behavior change and motivational interviewing. Target Audience: Low income adults at risk for diabetes.
Continued on page S27
P19 Behaviorally Focused Nutrition Education via P-Saurus Lessons Increased the Nutrition Knowledge of Preschoolers–a Preliminary Research Deepika Bangia, MS, [email protected], Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, 220 Davison Hall, New Brunswick, NJ 08901; Debrah M. Palmer, PhD, [email protected]. edu, Rutgers University; Audrey Adler, MS, RD, adler@ njaes.rutgers.edu, Rutgers New Jersey Agricultural Experiment Station; Kelly Ryan, [email protected]. edu, Department of Nutritional Sciences, Rutgers University Objective: Federal funds are used to provide nutrition education for a variety of target audiences, among which are pre-school children. Yet, few age-appropriate curricula are available to guide pre-school nutrition education. This study was done as a preliminary impact evaluation for a preschool curriculum currently under development, i.e., P-Saurus Activity Packs. Design, Setting and Participants: Eight lessons from the P-Saurus Supplemental Nutrition Education Assistance Program Education (SNAP-Ed) were taught to a culturally diverse (majority Hispanic) preschool class in New Brunswick. A class of 14 preschoolers was identified for the preliminary research. Outcome, Measures and Analysis: Pre and post individual interviews (n ¼ 14) were conducted by showing children the MyPyramid poster, and asking them to tell the researcher all that they could about it. Descriptive analyses were performed, and the correct number of statements made by each child counted. Results: Post intervention, most children named the MyPyramid for Kids poster (71%); and, more children could identify at least 1 of the food groups on MyPyramid (43%). Concepts, such as ‘‘energy’’, the importance of exercise, and ‘‘milk giving us strong bones,’’ were stated by 36% of the children. However, no improvements were observed among the 3-year-olds assessed. Conclusions and Implications: The P-Saurus lessons favorably impacted the nutrition knowledge of preschoolers; however, the sample size was very small. Since there was no improvement in the knowledge of the 3year-olds, if these findings are repeated, the value of providing nutrition education to this audience should be called into question. This work was funded by New Jersey Supplement Nutrition Assistance Program Education.
P20 Incorporating Physical Activity in Nutrition Education Classes for Adult LimitedResource Audiences Through Use of Walking DVD Programs–A Preliminary Study Audrey Adler, MS, RD, [email protected]; Debrah M. Palmer, PhD, [email protected]; Kirsten W. Corda, [email protected], Rutgers, The State University of New Jersey, 26 Nichol Avenue, Davison Hall, New Brunswick, NJ Objective: Obesity is best addressed by focusing on physical activity along with eating habits. Thus, Supplemental
Poster Abstracts S25
Nutrition Assistance Program Education (SNAP-Ed) and Expanded Food and Nutrition Program (EFNEP) educators are being charged with incorporating physical activity into their programming. However, few curricula exist to assist paraprofessional nutrition educators in this process; thus, walking program DVDs were tested with a sample of New Jersey EFNEP and SNAP-Ed adult class participants. Design, Setting and Participants: Short DVDs featuring walking with other simple low-impact movements were played at the end of nutrition education classes. Class members (n ¼ 22) were invited to participate in the activity with the educator. Outcome, Measures and Analysis: Pre- and post-tests, conducted by a researcher, assessed the participants perceptions of barriers to engaging in physical activity, as well as the acceptability of including these physical activity DVDs in SNAP-Ed and EFNEP classes. Analyses of participants’ changes in perceived barriers to exercise were conducted using paired t-test and descriptive statistics; acceptability was assessed via descriptive statistics. Results: Although no statistically significant pre- to posttest differences were found, mean barrier scores were lower in the post-test than in the pre-test. Regarding the acceptability of this program addition, 77% of the participants ‘‘liked’’ the walking programs, and 82% enjoyed doing them as part of the nutrition education classes. Conclusions and Implications: This preliminary study suggests that walking programs on DVDs may provide a venue for educating and encouraging limited-resource audiences to become more physically active. However, due to the small sample size of this work, additional research should be conducted. This project was funded by New Jersey Agricultural Experiment Station and New Jersey SNAP-Ed.
P21 Formative Evaluation of a Communitybased Diabetes Program for Hispanics Karina Diaz, MS, [email protected]; Miriam Miller, MPH, [email protected]; Eva Nava, MS, [email protected]; Karen Chapman-Novakofski, RD, PhD, [email protected], Division of Nutritional Sciences, and Illinois Extension Service, 238 Bevier Hall, 905 South Goodwin Avenue, Urbana, IL 61801 Objective: This project reflects a formative evaluation of the feasibility and impact of a 6-week community-based diabetes education program for Hispanic adults. Use of Theory or Research: Pre/post, post-post design for knowledge, food and activity behavior, and weight. Target Audience: Hispanic adults with diabetes in 2 northern counties. Description: Six classes focusing on meal planning, diabetes, and physical activity were developed pilot-tested and revised. Classes were taught in spring and fall. Demographic, anthropometric, dietary, physical activity, nutrition and health data were obtained along with acculturation and post-class process evaluation. Evaluation: Thirty-three persons participated in the program (females ¼ 23); 50% had diabetes, the rest had family members with the disease. More participants attended the Continued on page S26
S26 Poster Abstracts
Journal of Nutrition Education and Behavior Volume 41, Number 4S, 2009
P21 (continued) spring than the fall classes. There were no significant changes in mean anthropometric variables. Weight ranged from 113 to 264 baseline (n ¼ 30) and 116 to 230 post-program (n ¼ 13). Blood glucose values ranged from 82 to 278 mg% baseline (n ¼ 26) and 87 to 249 mg% post-intervention (n ¼ 12). Carbohydrate-containing food knowledge was significantly improved (p<.05). Activity-related questions were difficult for participants to understand. Follow-up for afterintervention participants was not optimal. Child care, travel, location, marketing, and holidays affected feasibility. Conclusions and Implications: Weight, blood glucose and knowledge level supported program need. Reach of the program was poor with follow-up assessments difficult. A shorter program may improve participation levels. Impact variables would need to be adjusted accordingly. This project was funded by University of Illinois Extension and CONACYT.
P22 Food Purchasing Choices of Supplemental Nutrition Assistance Program (SNAP) Participants in Greenville County, South Carolina Lindley Cone, [email protected]; Sylvia Smith, [email protected]; Alicia Powers, PhD, alicia. [email protected], Health and Exercise Science, Furman University, 3300 Poinsett Highway, Greenville, SC 29613 Objective: This study described food purchasing choices of SNAP participants in Greenville County, South Carolina. Design, Setting and Participants: A typical descriptive study was conducted using items purchased with any tender in March 2008 by SNAP participants at BiLoÒ stores in Greenville County, South Carolina. Outcome, Measures and Analysis: Food items were grouped according to MyPyramid food groups and subgroups. Nutrient content for a variety of nutrients was determined using the nutrition facts label for each food item. Results: About 93% of items purchased were food items. Within the food items purchased, 25.5% were discretionary calories, 21.8% were meats, 17.9% were grains, 12.5% were vegetables, 11.3% were dairy products and less than 5% were in each of the remaining groups. Within the discretionary calories group, more than 95% of products purchased contained less than 10% of the daily value per serving for vitamin A, calcium and iron and less than 5 grams of fiber per serving. Within the grains group, 94.8% of purchased products contained less than 5 grams of fiber per serving. Within the dairy and meats groups, 48.7% and 35.2% of purchases contained more than 3.5 grams of saturated fat per serving, respectively. Conclusions and Implications: With such a high percentage of food purchases from the less nutrient dense food groups and confirmation of lack of nutrient density through nutrient content analysis, it is evident that SNAP must continue educating its participants about healthy foods to purchase. Funding for this study was provided by Furman University.
P23 Strengthening Nutrition Education for Families: An Evidence-based Revision of Operation Frontline’s Side By Side Curricula Leigh Ann Edwards, RD, MPH, [email protected], Operation Frontline; Janet McLaughlin, MPA, [email protected], Operation Frontline; Laura Seman, MPH, [email protected], Operation Frontline, Share Our Strength’s Operation Frontline, 1730 M Street Northwest, Suite 700, Washington, DC 20036; Jill Panichelli, MHS, [email protected] Objective: To improve food security, nutrition, and household food environment of low-income families. Use of Theory or Research: Share Our Strength’s Operation Frontline’s Side By Side promotes family health by engaging parents and children together in chef-led nutrition education. Emerging research on family food choice, along with reported challenges in engaging parents and child Target Audience: Low-income families with school-age children. Description: Operation Frontline began revisions of Side by Side in June 2008 with the goals of ensuring that curriculum objectives connect clearly with proven determinants of healthy family food choice and incorporating facilitation techniques most effective for low-income parent-child dyads. A revised and expanded course piloted in 4 cities in spring 2009. Evaluation: Evaluation methods include participant surveys, focus groups, and interviews with participants and instructors. Expected results include positive behavior change related to healthy family food choice, improved self-efficacy for cooking and making healthy food choices, and greater engagement of families in lessons. Conclusions and Implications: Findings from formative research and pilot courses will guide Share Our Strength in ongoing implementation and can guide other familybased nutrition education programs. Operation Frontline is nationally sponsored by the ConAgra Foods Foundation.
P24 Preventing Diabetes with Meals and Movement Patty Case, MS, RD, [email protected], Oregon State University Extension Service, 3328 Vandenberg Road, Klamath Falls, OR 97603 Objective: To evaluate the effectiveness of diabetes prevention curriculum delivered by Extension paraprofessionals. Use of Theory or Research: This project employed a ‘‘train-the-trainer’’ approach to deliver community based education. Techniques and concepts were based on results from the Diabetes Prevention Program research and best practice precepts including the transtheoretical model of behavior change and motivational interviewing. Target Audience: Low income adults at risk for diabetes.
Continued on page S27