- Email: [email protected]
The Husky Byte Program: Delivering Nutrition Education One Sound Byte at a Time
GEM No. 489 The Husky Byte Program: Delivering Nutrition Education One Sound Byte at a Time Michelle B. Pierce, PhD, RD1; Kerrian A. Hudson, MD2; Karina R. Lora, PhD3; Erin K. Havens, MPA3; Ann M. Ferris, PhD, RD4 INTRODUCTION As food gatekeepers, parents have the opportunity to establish healthful eating patterns for their children.1 Nutrition education efforts directed toward parents will therefore have the most impact on family foodways.2 However, parents often have difficulty attending the traditional mode of education, nutrition classes, because of lack of child care, transportation, time, or motivation.3 At the University of Connecticut, the authors responded to this problem by creating the Husky Byte program, designed to deliver short, unambiguous nutrition education messages. This innovative program considers time constraints, employs principles of adult learning theory,4,5 and is easily accessible to adults in community settings.
PROGRAM DESCRIPTION AND IMPLEMENTATION The nutrition education modules use display boards presented by staff, college students, parents, or teachers following an orientation and subsequent 30-minute training for each board. The training reviews the facilitator guide that accompanies each board, including learning objectives, directions on implementing the activity, and background information on the topic. The trainer then
demonstrates the facilitator role and shows how to engage a participant in the learning activity and provide quick, relevant, objective facts. The interaction centers on a game that highlights a single behavioral skill, and the game is often paired with a low-cost ‘‘prize’’ that is specific to the take-home message. The portability and flexibility of this format is useful in agency waiting rooms, grocery stores, and other locations visited by members of the low-income, urban, minority target population. The Figure shows the portion size display. The objective is for participants to become aware of the large amount of sugar in drink containers that are typically presented as a single serving. Popular fast-food and convenience store drink containers are arranged on the table in front of the display board, which illustrates key points through pictures, figures, and words. The facilitator invites the participant to identify the container he or she typically chooses and informs the participant that he or she can win a prize, a measuring cup, by correctly guessing the number of 8-ounce servings in that container. The participant checks his or her guess by filling the container with dried beans, 1 cup at a time. Simultaneously, the facilitator shows the number of teaspoons of sugar per cup and overall for the filled container. Following the interest of the participant, the facilitator
1
Department of Medicine, Division of Public Health and Population Sciences, University of Connecticut Health Center, Storrs, CT 2 Family Medicine Residency Program, Middlesex Hospital, Middletown, CT 3 Center for Public Health and Health Policy, University of Connecticut, Storrs, CT 4 Center for Public Health and Health Policy, Department of Medicine, Division of Public Health and Population Sciences, University of Connecticut Health Center, Farmington, CT Address for correspondence: Michelle B. Pierce, PhD, RD, J. Ray Ryan Refectory, 2006 Hillside Road, Unit 1109, University of Connecticut, Storrs, CT 06269; Phone: (860) 486-5015; Fax: (860) 486-3348; E-mail: [email protected] J Nutr Educ Behav. 2011;43:135-136 Ó2011 SOCIETY FOR NUTRITION EDUCATION doi:10.1016/j.jneb.2010.08.003
Journal of Nutrition Education and Behavior Volume 43, Number 2, 2011
can extend the demonstration using information on the display board. All participants receive the prize and a handout explaining how to estimate serving sizes. Through this simple, direct learning experience, Knowles’ assumptions regarding adult learners, which underlie many adult learning theories, are addressed.4 Participants are expected to recognize how the topic is applicable to them; self-direct the flow of the lesson; complete a problem-centered, skill-building activity; and be responsible for decisions in this area, rather than being told. The boards can be used individually, such as at a health fair or open house, or they can be sequenced at a site visited multiple times, such as a daycare center. Currently the investigators have 2 series, 1 on beverages and the other on safe food temperatures. The authors have also created several uniquely themed boards, such as for National Nutrition Month each year, and to suit particular community events, such as a health walk or farmer’s market.
EVALUATION The authors have conducted both process and outcome evaluations. To determine aspects most valued by participants, the authors interviewed a convenience sample of 23 parents (14 female, 9 male) from 2 urban preschools. Eight were African American, 14 were Latino, and 1 was biracial African American/Latino. The open-ended interviews lasted approximately 5-10 minutes. Each interview was audiotaped and then fully transcribed. The authors analyzed the responses for parent perceptions of the visual display, presentation, relevance, participation, and impact. Parent comments indicated that clear visuals, enjoyment and gratification, and staff interaction were important. ‘‘I like the setup.pictures. They
135
136 Pierce et al
Journal of Nutrition Education and Behavior Volume 43, Number 2, 2011 encourage other educators to use this simple and adaptable format that appeals to adult learners and fits into their busy daily schedule.
NOTES
Figure. Interactive display board on portion size with a measuring activity. give you a lot of information.’’ Parents believed that the setting was appropriate. ‘‘Putting up boards in the day cares and schools [are] the best places to get parents’ attention.’’ Parents reported that the activities were a ‘‘fun way of learning.’’ They felt that the prizes encouraged parents ‘‘to look at the material in detail’’ and made participation ‘‘more attractive.’’ They appreciated staff interaction. ‘‘If I have any questions, I can ask her.’’ In a different group of respondents, the authors examined impact using pre- and posttest questionnaires. The sample of randomly selected adults participated in 1 of 4 topics: portion size, MyPyramid,6 hydration, or dairy. Prior to participation, each adult was asked 4 questions assessing knowledge (agree/disagree) and 1 behavior-based question specific to the topic. After participating in the learning activity, the questionnaire was repeated. Most of the 54 participants were minority, mainly Latino (n ¼ 22) or African American (n ¼ 16); female (n ¼ 39); single (n ¼ 32); employed full- (n ¼ 29) or part-time (n ¼ 14); and the average age was 38 years (range 18-79). Average score improved significantly from 45% to 63% correct pre- to posttest (Student t ¼ 3.38, P ¼ .001). Participants also demonstrated intent to change behavior. For instance, 7 of the 15 respondents
who participated in the portion size activity planned to choose a smaller drink in the future. The results are encouraging, given that this was a 1time exposure for as little as 3-5 minutes.
FUTURE APPLICATION Based on the results, the authors are improving existing modules and creating new ones by concentrating on (1) relevant, highly specific behavioral learning objectives; (2) colorful displays that convey the message primarily through pictures; (3) hands-on, adaptable activities that are quickly explained; and (4) facilitator training on techniques to actively engage participants. The authors are now examining the impact on beverage choices of parents who have participated in a series of modules rather than just a single occasion. A series provides the opportunity to build on skills and knowledge, as well as continued reinforcement.5 Requests for the boards have increased as individuals who participate at 1 site recognize their potential success in another forum. Last year the authors presented the boards at 23 sites and had 5,809 participants. Furthermore, the concept is now being expanded and adapted at North Carolina State University. The authors
Prior to implementing the evaluations, the University of Connecticut Health Center Institutional Review Board approved all methods. More information on the Healthy Communities Initiative and the Husky Programs at the University of Connecticut are available online.7 This project was supported by a National Research Initiative Grant from the USDA CSREES and a USDA/CT-DSS Supplemental Nutrition Assistance Program – Education Grant.
REFERENCES 1. Baranowski T. Families and health actors: personal and social determinants. In: Gochmen DS, ed. Handbook of Health Behavior Research. New York, NY: Kluwer; 1997:179-206. 2. Wansink B. Nutritional gatekeepers and the 72% solution. J Am Diet Assoc. 2006;106:1324-1327. 3. Russell S. An overview of adult-learning processes. Urol Nurs. 2006;26:349-352, 370. 4. Knowles MS, Holton EF, Swanson RA. The Adult Learner: The Definitive Classic in Adult Education and Human Resource Development. 6th ed. Burlington, MA: Elsevier; 2005:72. 5. Lieb S. Principles of Adult Learning. http:// honolulu.hawaii.edu/intranet/committees/ FacDevCom/guidebk/teachtip/adults-2. htm. Published 1991. Accessed September 10, 2010. 6. Haven J, Burns A, Herring D, Britten P. MyPyramid.gov provides consumers with practical nutrition information at their fingertips. J Nutr Educ Behav. 2006;38(6 suppl):S153-S154. 7. Center for Public Health and Health Policy. About the Healthy Communities Initiative. University of Connecticut Web site. http://publichealth.uconn.edu/ aboutus_HC.php. Accessed February 14, 2011.
PROGRAM DESCRIPTION AND IMPLEMENTATION The nutrition education modules use display boards presented by staff, college students, parents, or teachers following an orientation and subsequent 30-minute training for each board. The training reviews the facilitator guide that accompanies each board, including learning objectives, directions on implementing the activity, and background information on the topic. The trainer then
demonstrates the facilitator role and shows how to engage a participant in the learning activity and provide quick, relevant, objective facts. The interaction centers on a game that highlights a single behavioral skill, and the game is often paired with a low-cost ‘‘prize’’ that is specific to the take-home message. The portability and flexibility of this format is useful in agency waiting rooms, grocery stores, and other locations visited by members of the low-income, urban, minority target population. The Figure shows the portion size display. The objective is for participants to become aware of the large amount of sugar in drink containers that are typically presented as a single serving. Popular fast-food and convenience store drink containers are arranged on the table in front of the display board, which illustrates key points through pictures, figures, and words. The facilitator invites the participant to identify the container he or she typically chooses and informs the participant that he or she can win a prize, a measuring cup, by correctly guessing the number of 8-ounce servings in that container. The participant checks his or her guess by filling the container with dried beans, 1 cup at a time. Simultaneously, the facilitator shows the number of teaspoons of sugar per cup and overall for the filled container. Following the interest of the participant, the facilitator
1
Department of Medicine, Division of Public Health and Population Sciences, University of Connecticut Health Center, Storrs, CT 2 Family Medicine Residency Program, Middlesex Hospital, Middletown, CT 3 Center for Public Health and Health Policy, University of Connecticut, Storrs, CT 4 Center for Public Health and Health Policy, Department of Medicine, Division of Public Health and Population Sciences, University of Connecticut Health Center, Farmington, CT Address for correspondence: Michelle B. Pierce, PhD, RD, J. Ray Ryan Refectory, 2006 Hillside Road, Unit 1109, University of Connecticut, Storrs, CT 06269; Phone: (860) 486-5015; Fax: (860) 486-3348; E-mail: [email protected] J Nutr Educ Behav. 2011;43:135-136 Ó2011 SOCIETY FOR NUTRITION EDUCATION doi:10.1016/j.jneb.2010.08.003
Journal of Nutrition Education and Behavior Volume 43, Number 2, 2011
can extend the demonstration using information on the display board. All participants receive the prize and a handout explaining how to estimate serving sizes. Through this simple, direct learning experience, Knowles’ assumptions regarding adult learners, which underlie many adult learning theories, are addressed.4 Participants are expected to recognize how the topic is applicable to them; self-direct the flow of the lesson; complete a problem-centered, skill-building activity; and be responsible for decisions in this area, rather than being told. The boards can be used individually, such as at a health fair or open house, or they can be sequenced at a site visited multiple times, such as a daycare center. Currently the investigators have 2 series, 1 on beverages and the other on safe food temperatures. The authors have also created several uniquely themed boards, such as for National Nutrition Month each year, and to suit particular community events, such as a health walk or farmer’s market.
EVALUATION The authors have conducted both process and outcome evaluations. To determine aspects most valued by participants, the authors interviewed a convenience sample of 23 parents (14 female, 9 male) from 2 urban preschools. Eight were African American, 14 were Latino, and 1 was biracial African American/Latino. The open-ended interviews lasted approximately 5-10 minutes. Each interview was audiotaped and then fully transcribed. The authors analyzed the responses for parent perceptions of the visual display, presentation, relevance, participation, and impact. Parent comments indicated that clear visuals, enjoyment and gratification, and staff interaction were important. ‘‘I like the setup.pictures. They
135
136 Pierce et al
Journal of Nutrition Education and Behavior Volume 43, Number 2, 2011 encourage other educators to use this simple and adaptable format that appeals to adult learners and fits into their busy daily schedule.
NOTES
Figure. Interactive display board on portion size with a measuring activity. give you a lot of information.’’ Parents believed that the setting was appropriate. ‘‘Putting up boards in the day cares and schools [are] the best places to get parents’ attention.’’ Parents reported that the activities were a ‘‘fun way of learning.’’ They felt that the prizes encouraged parents ‘‘to look at the material in detail’’ and made participation ‘‘more attractive.’’ They appreciated staff interaction. ‘‘If I have any questions, I can ask her.’’ In a different group of respondents, the authors examined impact using pre- and posttest questionnaires. The sample of randomly selected adults participated in 1 of 4 topics: portion size, MyPyramid,6 hydration, or dairy. Prior to participation, each adult was asked 4 questions assessing knowledge (agree/disagree) and 1 behavior-based question specific to the topic. After participating in the learning activity, the questionnaire was repeated. Most of the 54 participants were minority, mainly Latino (n ¼ 22) or African American (n ¼ 16); female (n ¼ 39); single (n ¼ 32); employed full- (n ¼ 29) or part-time (n ¼ 14); and the average age was 38 years (range 18-79). Average score improved significantly from 45% to 63% correct pre- to posttest (Student t ¼ 3.38, P ¼ .001). Participants also demonstrated intent to change behavior. For instance, 7 of the 15 respondents
who participated in the portion size activity planned to choose a smaller drink in the future. The results are encouraging, given that this was a 1time exposure for as little as 3-5 minutes.
FUTURE APPLICATION Based on the results, the authors are improving existing modules and creating new ones by concentrating on (1) relevant, highly specific behavioral learning objectives; (2) colorful displays that convey the message primarily through pictures; (3) hands-on, adaptable activities that are quickly explained; and (4) facilitator training on techniques to actively engage participants. The authors are now examining the impact on beverage choices of parents who have participated in a series of modules rather than just a single occasion. A series provides the opportunity to build on skills and knowledge, as well as continued reinforcement.5 Requests for the boards have increased as individuals who participate at 1 site recognize their potential success in another forum. Last year the authors presented the boards at 23 sites and had 5,809 participants. Furthermore, the concept is now being expanded and adapted at North Carolina State University. The authors
Prior to implementing the evaluations, the University of Connecticut Health Center Institutional Review Board approved all methods. More information on the Healthy Communities Initiative and the Husky Programs at the University of Connecticut are available online.7 This project was supported by a National Research Initiative Grant from the USDA CSREES and a USDA/CT-DSS Supplemental Nutrition Assistance Program – Education Grant.
REFERENCES 1. Baranowski T. Families and health actors: personal and social determinants. In: Gochmen DS, ed. Handbook of Health Behavior Research. New York, NY: Kluwer; 1997:179-206. 2. Wansink B. Nutritional gatekeepers and the 72% solution. J Am Diet Assoc. 2006;106:1324-1327. 3. Russell S. An overview of adult-learning processes. Urol Nurs. 2006;26:349-352, 370. 4. Knowles MS, Holton EF, Swanson RA. The Adult Learner: The Definitive Classic in Adult Education and Human Resource Development. 6th ed. Burlington, MA: Elsevier; 2005:72. 5. Lieb S. Principles of Adult Learning. http:// honolulu.hawaii.edu/intranet/committees/ FacDevCom/guidebk/teachtip/adults-2. htm. Published 1991. Accessed September 10, 2010. 6. Haven J, Burns A, Herring D, Britten P. MyPyramid.gov provides consumers with practical nutrition information at their fingertips. J Nutr Educ Behav. 2006;38(6 suppl):S153-S154. 7. Center for Public Health and Health Policy. About the Healthy Communities Initiative. University of Connecticut Web site. http://publichealth.uconn.edu/ aboutus_HC.php. Accessed February 14, 2011.