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Journal of Nutrition Education and Behavior ● Volume 38, Number 4, July/August 2006 Supplement

P95 Validation of the Chinese Malnutrition Universal Screening Tool (C-MUST) in Newly Admitted Chinese Older Adult Hospital Patients Georgia Guldan, PhD, Food and Nutritional Sciences Programme, Department of Biochemistry, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, [email protected]; Anita Lai, Food and Nutritional Sciences Programme, Department of Biochemistry, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, [email protected]; Wendy Hui, MPH, RD, Dietetic and Food Services Department, Ruttonjee Hospital and Tang Shiu Kin Hospital (RHTSK), 266 Queen’s Road East, Wan Chai, Hong Kong, [email protected]; Helen Lee, MSc, SDR Dietetic and Food Services Department, Ruttonjee Hospital and Tang Shiu Kin Hospital (RHTSK), 266 Queen’s Road East, Wan Chai, Hong Kong; Rebecca PW Poon Bapp, Sc, PGDip (Gerontologic Nursing), MSc, Willie Leung, MBBS, MRCP, Department of Geriatrics, RHTSK; Angel SW Poon MPH, RPSGT, RN, Raymond Liu, MBBS, MRCP, FRCP, FHKAM Department of Respiratory Medicine, RHTSK The “Malnutrition Universal Screening Tool” (MUST), developed and validated in 2003 in the UK, is a first-line multidisciplinary strategy aiding early malnutrition diagnosis and dietary intervention in clinical settings. Reliable early detection tools for nutritionally at-risk elders in Hong Kong and elsewhere are needed. This study validated the locally modified “Chinese-MUST” (C-MUST) against dietitians’ assessment (the gold standard) among 115 geriatric patients admitted to a Hong Kong hospital between May and October 2005. Current BMI, unintentional weight loss, and acute disease effect score were the three independent criteria used to detect malnutrition. The concurrent validity was assessed against the gold standard. Sensitivity and specificity were calculated using an ROC curve. Moderate agreement (kappa ⫽ 0.49) with the gold standard was found. Of the three criteria, BMI score was the best malnutrition predictor (gamma ⫽ 0.81, P ⬍ .001). The C-MUST had better specificity than sensitivity, with a positive predictive value of 87.2%, and a negative predictive value 54.0%. The area under the ROC curve, 0.76, indicated moderate reliability. Lowering the cut-off value for referral from 2 to 1 would increase the sensitivity. According to the gold standard, 60% of the patients were malnourished to a certain degree, while the C-MUST identified 57.4%. Weight (P ⫽ .049) and serum albumin (P ⬍ .001) were significant nutritional predictors of C-MUST. Ten socio-demographic and physical characteristics were malnutrition risk factors malnutrition (P ⬍ .01). In conclusion, the C-MUST was valid and rapid in identifying elder patients at risk of malnutrition. This project was funded by The Chinese University of Hong Kong and the Hospital Authority.

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P96 Factors Affecting Motivation toward Following Dietary Recommendations for Whole Grain Intake among College Students Linda Knol, PhD, RD, The University of Alabama Department of Human Nutrition and Hospitality Management, Box 870158, Doster Hall, Room 206, Tuscaloosa, AL 35487-0158, [email protected]; Karen Lilly, MS, Nutritionist, Columbus Department of Public Health, 6400 Main Street, #17N, Columbus, GA 31929 The Motivational Nutrition Counseling Algorithm suggests tailoring nutrition interventions based on motivation toward a selected behavior. Using this approach, individuals are classified into three possible intervention levels. The 2005 Dietary Guidelines for Americans suggests that Americans consume half their intake from the grains group as whole grains or approximately 3 ounces of whole grains daily for a 2000 calorie diet. The purpose of this research is to assess factors that affect motivation toward this guideline. College students (n ⫽ 342) attending personal health and nutrition classes were asked to rank their level of motivation toward consuming half their servings of grains as whole grains on a scale of 1 (not at all) to 12 (very motivated). Based on their responses, students were assigned to 3 possible levels of motivation; not motivated (13%), unsure (38%), and motivated (49%). Gender (P ⫽ .02), desire to lose weight (P ⫽ .01), and motivation toward increasing intakes from the fruit (P ⬍ .001), vegetable (P ⬍ .001) and dairy (P ⬍ .001) food groups were significantly associated with motivation to increase whole grain intake while race/ethnicity (P ⫽ .53), weight status assessed using BMI (P ⫽ .73) and self-perception of weight status (P ⫽ .06) were not. Those college students, from this sample, with the greatest desire to increase intake of whole grains were female, wanted to lose weight, and were highly motivated to change other dietary behaviors. Students taking courses in personal health/general nutrition are highly motivated to change dietary behavior and could benefit from interventions/class assignments that address their motivation level.

P97 Self-Efficacy and Self-Esteem Are Associated with Dietary Quality among Newly Arrived, Low-income Latina Immigrants Stephanie Roney, BS, University of North Carolina at Greensboro, Department of Nutrition, 1000 Spring Garden Street, Greensboro, NC, 27402-6170, [email protected]; Lauren Haldeman, PhD, University of North Carolina at Greensboro, Department of Nutrition, 1000 Spring Garden Street, Greensboro, NC 27402-6170, [email protected] Continued on page S54

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Abstracts

P97 (continued) Migration and subsequent acculturation to the US brings about many unforeseen problems and challenges, specifically relating to chronic disease development and mental health. The purpose of this study was to examine associations between food security level, dietary quality and psychological well being among newly arrived Latinas (⬍6 years in US). Low income Latina (N ⫽ 92) caretakers of young children completed an in-depth, translated survey assessing demographic information; validated measures of anxiety, depression, self-esteem, and self-efficacy; diet using a 24-hour dietary recall; level of food insecurity; and body mass index (BMI) calculated using measured heights and weights. Participants were primarily Spanish speaking Latinas from Mexico with low education levels. Over half (51%) were identified as obese and 75% reported having gained weight since arriving in the US. Diet quality for most participants was categorized as poor/fair. The majority of participants reported minimal levels of depression (73%), and anxiety (68%) and moderate to high levels of self-esteem (75%) and food related self-efficacy (75%). Level of food security was positively associated self-efficacy (P ⫽ .003). Self-esteem was positively associated with dairy consumption (P ⫽ .054). Several trends toward improved diet quality with positive mental well-being were also noted. These results suggest that food security and positive mental well being are associated with improved diet quality. Because newly arrived immigrants are more susceptible to poor diets, food insecurity, poor mental well being and weight gain, nutrition education efforts should be targeted and tailored to these groups. This project was funded by the University of North Carolina at Greensboro.

P98 Public Knowledge, Awareness, and Sensory Perceptions of a Novel Plant Source of Omega-3 Fatty Acids: Camelina Sativa Tyson Weems, MS Candidate, Montana State University, 101 MH H & PE Complex, Bozeman MT 59717, [email protected]; Alison H. Harmon, PhD, RD, Montana State University, 101 MH H & PE Complex, Bozeman MT 59717, [email protected] Alpha-linolenic acid (ALA) is an essential fatty acid (FA) in human diets and represents 30-42% of oil derived from Camelina sativa. While research has linked multiple health benefits with replacing other dietary fatty acids with ALA and other n-3 FAs, n-3 FAs are scarce in most Americans’ diets. This one-year project explored potential consumer knowledge, attitudes, beliefs and behaviors related to existing dietary sources of n-3 FAs as well as culinary Camelina oil, a promising additional source. Researchers in Montana intend to use the results to facilitate introduction of Montana-produced culinary Camelina oil as a viable commercial product. Eighty athletes from the Greater Bozeman

area ages 13-57 years participated in focus group discussions and sensory evaluation tests. Researchers split participants into 2 groups for each age category (junior high, high school, college, and adult), yielding 8 groups of 10 participants each. Participants then engaged in focus group discussions concerning n-3-related knowledge, attitudes, beliefs and behaviors along with potential Camelina marketing approaches. Participants also evaluated dipping oils, vinaigrettes, and spreads containing different oils including culinary Camelina according to an affective scale of like or dislike. Participants expressed widely varying n-3related knowledge levels, attitudes, beliefs, behaviors, and sensory perceptions. The presentation will describe these as well as responses to proposed Camelina marketing approaches. Consumer feedback indicates Camelina to be a promising dietary source of n-3s. Focus group and sensory evaluation participant insights and responses should help guide continued Camelina product development. This research was funded by the Montana State University Biobased Institute.

P99 Motivation toward Consumer Messages from the Dietary Guidelines for Americans among College Students Andrea C. Kirkland, MS, RD, Health Education and Health Promotion Doctoral Student, University of Alabama, 4506 Rainwood Avenue, Northport, AL 35473, [email protected]; Linda Knol, PhD, RD, University of Alabama, Department of Human Nutrition and Hospitality Management, 206 Doster Hall, Box 870158, Tuscaloosa, AL 35487-0158, [email protected]; Karen Lilly, MS, Columbus Department Public Health, 6400 Main Street #17N, Columbus, GA 31909 The motivational interviewing process focuses on strategies to improve motivation and build commitment to behavior change. This process builds on the Stages of Change Model and has been used previously in nutrition interventions. The purpose of this research project was to explore motivation toward four statements from the 2005 Dietary Guidelines for Americans consumer pamphlet among college students, ages 18-30 years. Selected statements included: focus on fruits, vary your vegetables, get your calcium-rich foods, and make half your grains whole. Using a scale of 1 (not motivated) to 12 (highly motivated), 344 college students attending general health or nutrition classes were presented with each of the four statements and asked to describe their motivation toward each statement. Students were classified into 3 levels of motivation based on the Motivational Nutrition Counseling Algorithm; level 1 (not motivated/Pre-contemplation Stage), level 2 (unsure/ Contemplation Stage), and level 3 (motivated/ Preparation or Action Stage). The percentage of individuals falling into level 3 for the fruit, vegetable, whole grain, and calcium Continued on page S55