In Defense of Food Curriculum: A Mixed Methods Outcome Evaluation in Afterschool

2019 ◽  
Vol 46 (4) ◽  
pp. 612-625
Author(s):  
Hiershenee B. Luesse ◽  
Joseph E. Luesse ◽  
Jordan Lawson ◽  
Pamela A. Koch ◽  
Isobel R. Contento

Background. Highly processed foods are inexpensive and abundant in our food supply, nutritionally poor, and disproportionately marketed to minority youth. This study is part of a curriculum development project to develop, implement, and evaluate the In Defense of Food (IDOF) curriculum designed to increase intake of whole/minimally processed foods and decrease intake of highly processed foods in youth. Aims. This pilot outcome evaluation was undertaken to assess initial effectiveness and to provide an in-depth understanding of changes in behavioral outcomes and psychosocial mediators. Methods. We used an explanatory mixed method approach, including a single-arm pretest–posttest of intervention effect, followed by a food rules assessment and in-depth interviews to describe participant responses to the intervention in more detail. The study was conducted in three afterschool classrooms in urban low-income neighborhoods with 32 multiethnic middle-school youth, receiving 10 weekly 2-hour sessions. Results. Two weeks postintervention, there was a large positive significant increase in whole/minimally processed food intake ( p < .01; d = 0.59) and a small decrease in consumption of highly-processed foods ( p = ns; d = 0.06), compared with baseline. Significant increases in psychosocial mediators: Self-efficacy and positive outcomes expectations were seen; others were not significant but changed in the desired direction. Qualitative assessments suggest that the intervention promoted skill building, but environmental barriers made these difficult to use. Discussion. The IDOF curriculum may be most effective for promoting consumption of fruits and vegetables, rather than decreasing intake of highly processed foods. In addition, in this young age-group, short actionable food rules may support self-regulation and behavior change. Conclusion. Among adolescent students in low-income urban neighborhoods, the IDOF afterschool curriculum may help promote self-efficacy and positive outcome expectancies and increase fruit and vegetable intake. Focusing on food processing and using “Food Rules” may be promising to elicit behavior change in youth; however, greater supports are needed to overcome social and environmental barriers.

2020 ◽  
Vol 29 (8) ◽  
pp. 2330-2341 ◽  
Author(s):  
Randi A. Bates ◽  
Pamela J. Salsberry ◽  
Laura M. Justice ◽  
Jaclyn M. Dynia ◽  
Jessica A. R. Logan ◽  
...  

2012 ◽  
Vol 7 (4) ◽  
pp. 92-108 ◽  
Author(s):  
Mical Kay Shilts ◽  
Marilyn S. Townsend

The efficacy of a youth development intervention on improving eating and physical activity(PA) self-efficacy, goal attainment scaling, goal effort, and behaviors was examined in a repeated measures, quasi-experimental field trial. Ethnically diverse students (n=64) from a low-income middle school participated in the 10-session intervention driven by the Social Cognitive Theory with a Goal Setting Theory emphasis. Participants, 13-14 years old, made significant changes in dietary behaviors (P=0.03) and PA self-efficacy (P=0.02) after receiving the intervention. Self-efficacy did not mediate dietary behavior change but did mediate the small changes made in PA. Goal effort was not a mediator of behavior change. After the intervention, more participants rated themselves as making one lasting improvement in eating (P


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Elizabeth Baumler ◽  
Jill Glassman ◽  
Susan Tortolero ◽  
Christine Markham ◽  
Ross Shegog ◽  
...  

A set of mediation analyses were carried out in this study using data from It’s Your Game. . .Keep It Real (IYG), a successful HIV/STI/pregnancy prevention program. The IYG study evaluated a skill and normbased. HIV/STI/pregnancy prevention program that was implemented from 2004 to 2007 among 907 urban low-income middle school youth in Houston, TX, USA. Analyses were carried out to investigate the degree to which a set of proposed psychosocial measures of behavioral knowledge, perceived self-efficacy, behavioral, and normative beliefs, and perceived risky situations, all targeted by the intervention, mediated the intervention’s effectiveness in reducing initiation of sex. The mediation process was assessed by examining the significance and size of the estimated effects from the mediating pathways. The findings from this study provide evidence that the majority of the psychosocial mediators targeted by the IYG intervention are indeed related to the desired behavior and provide evidence that the conceptual theory underlying the targeted psychosocial mediators in the intervention is appropriate. Two of the psychosocial mediators significantly mediated the intervention effect, knowledge of STI signs and symptoms and refusal self-efficacy. This study suggests that the underlying causal mechanisms of action of these interventions are complex and warrant further analyses.


2019 ◽  
Vol 22 (11) ◽  
pp. 1981-1988
Author(s):  
Bradley N Collins ◽  
Stephen J Lepore ◽  
Jonathan P Winickoff ◽  
David W Sosnowski

Abstract Introduction Compared with the general smoking population, low-income smokers face elevated challenges to success in evidence-based smoking cessation treatment. Moreover, their children bear increased disease burden. Understanding behavioral mechanisms related to successful reduction of child tobacco smoke exposure (TSE) could inform future smoking interventions in vulnerable, underserved populations. Methods Smoking parents were recruited from pediatric clinics in low-income communities and randomized into a multilevel intervention including a pediatric clinic intervention framed in best clinical practice guidelines (“Ask, Advise, Refer” [AAR]) plus individualized telephone counseling (AAR + counseling), or AAR + control. Mediation analysis included treatment condition (independent variable), 12-month child cotinine (TSE biomarker, criterion), and four mediators: 3-month end-of-treatment self-efficacy to protect children from TSE and smoking urge coping skills, and 12-month perceived program (intra-treatment) support and bioverified smoking abstinence. Analyses controlled for baseline nicotine dependence, depressive symptoms, child age, and presence of other residential smokers. Results Participants (n = 327) included 83% women and 83% African Americans. Multilevel AAR + counseling was associated with significantly higher levels of all four mediators (ps &lt; .05). Baseline nicotine dependence (p &lt; .05), 3-month self-efficacy (p &lt; .05) and 12-month bioverified smoking abstinence (p &lt; .001) related significantly to 12-month child cotinine outcome. The indirect effects of AAR + counseling intervention on cotinine via self-efficacy for child TSE protection and smoking abstinence (ps &lt; .05) suggested mediation through these pathways. Conclusions Compared with AAR + control, multilevel AAR + counseling improved all putative mediators. Findings suggest that fostering TSE protection self-efficacy during intervention and encouraging parental smoking abstinence may be key to promoting long-term child TSE-reduction in populations of smokers with elevated challenges to quitting smoking. Implications Pediatric harm reduction interventions to protect children of smokers from tobacco smoke have emerged to address tobacco-related health disparities in underserved populations. Low-income smokers experience greater tobacco-related disease burden and more difficulty with smoking behavior change in standard evidence-based interventions than the general population of smokers. Therefore, improving knowledge about putative behavioral mechanisms of smoking behavior change that results in lower child exposure risk could inform future intervention improvements.


2016 ◽  
Vol 29 (2) ◽  
pp. 173-183 ◽  
Author(s):  
Rafael Miranda TASSITANO ◽  
Clarice Maria de Lucena MARTINS ◽  
Poliana Coelho CABRAL ◽  
Jorge MOTA ◽  
Maria Cecíla Marinho TENÓRIO ◽  
...  

Objective: To analyze whether psychosocial factors and physical activity are predictors of fruit and vegetable intake in young adults attending college. Methods: This cross-sectional study included a representative sample of students from a public university in the Brazilian Northeast (n=717). Fruit and vegetable intake was measured by a Food Frequency Questionnaire containing 21 items. The psychosocial factors for behavior change, measured by a questionnaire, were: behavior change strategy, self-efficacy, perceived barriers and facilitators in decision making, and social support. The level of physical activity was measured by the International Physical Activity Questionnaire. Multiple linear regression was the intake prediction model using a significance level of 5% (p<0.05). Results: The median fruit and vegetable intake was 2.0 servings/day. In adjusted analysis, behavior change strategy (R²=0.31), self-efficacy (R²=0.03), friends' support (R²=0.02), and physical activity (R²=0.03) explained 39% of the fruit and vegetable intake variance in men. Behavior change strategy (R²=0.03), self-efficacy (R²=0.13), perceived barriers (R²=0.08), and physical activity (R²=0.02) explained 26% of the fruit and vegetable intake variance in women. Fruit and vegetable intake would increase by one serving for every extra 35 and 47 minutes of physical activity men and women, respectively, practice a day. Conclusion: The main predictors of fruit and vegetable intake are behavior change strategies, self-efficacy, and physical activity.


2012 ◽  
Vol 36 (1) ◽  
pp. 75-85 ◽  
Author(s):  
Carol L. Mansyur ◽  
Valory N. Pavlik ◽  
David J. Hyman ◽  
Wendell C. Taylor ◽  
G. Kenneth Goodrick

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 282-282
Author(s):  
Faika Zanjani ◽  
Annie Rhodes ◽  
Taylor Wilkerson ◽  
Jennifer Inker ◽  
Joann Richardson

Abstract Preclinical Alzheimer’s disease (AD) behavioral risk reduction needs to be more fully explored at the community-level. Connecting behavior change to AD can reduce individual-level helplessness for the disease. However, behavior change targeting AD prevention factors (e.g., alcohol, depression, physical inactivity, smoking, isolation, medication management) is extremely challenging for multiple reasons, including failures in connecting AD and health behavior risk, and due to individual-level motivational, self-efficacy, and knowledge barriers. Methods: As part of the Virginia Commonwealth University iCubed Health and Wellness in Aging Population Core, 20 diverse older adults (aged 60+) living in Richmond, VA, with incomes below $12,000/year and managing either diabetes/cardiovascular symptoms, were offered weekly telephone-based health coaching for 12-weeks, providing education, motivations, self-efficacy skills, and referral services, for AD behavioral risk factors. A patient preference health coaching behavioral change strategy was implemented, where the person decides which behavioral practices to target. All study subjects completed a behavioral-psychosocial baseline and 3-month follow-up assessment. Findings: The study demonstrated feasibility for implementing health coaching within low-income racially-diverse older adults. The study sample (n=20, mean age 69 years (range: 61-77 years) was 90% African American (n=18), and 55% males (n=11). Improvement in AD knowledge (F=4.19;p=.0565); cognitive functioning (memory (F=4.19;p=.0556); delayed memory (F=2.85;p=.1086); TrailsA (F=5.60;p=.0294)), alcohol-risk (F=3.33;p=.1108) and social isolation (F=4.11;p=.0569) trends were found at 3-month follow-up. Conclusions: The findings from this study exhibit positive trends in reducing AD risk. This study creates the impetus for future large-scale investigations and dissemination of findings to improve the lives of at-risk low-income aging adults.


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