Pilot Intervention Using Food Challenges and Video Technology for Promoting Fruit and Vegetable Consumption.

OBJECTIVE: To evaluate the feasibility of a Social Cognitive Theory-based intervention on cognitive, affective, and behavioral outcomes in a college nutrition course. DESIGN: A pre-post quasi-experimental design. SETTING: Large metropolitan university. PARTICIPANTS: College students (n = 138) aged 18-40 years. INTERVENTIONS: Students participated in weekly food challenges during a 15-week nutrition course to apply nutrition knowledge, develop self-efficacy and promote positive behavior change. Food challenges were implemented by a guided goal-setting strategy. Cooking videos, which modeled important nutrition-related skills, accompanied each challenge. Students independently selected 2-goal options to implement weekly and wrote a reflection about their experiences. MAIN OUTCOME MEASURES: Cognitive outcomes (nutrition and cooking self-efficacy), affective outcome (cooking attitudes), and behavioral outcomes (fruit and vegetable consumption). ANALYSIS: Descriptive statistics and paired sample t tests. RESULTS: Analyses showed significant increases in cognitive outcomes (produce consumption self-efficacy [P = 0.004], cooking self-efficacy [P = 0.002], using fruit/vegetables and seasoning self-efficacy [P = 0.001]) and behavioral outcomes (fruit consumption [P < 0.001], and vegetable consumption [P < 0.001]). CONCLUSION AND IMPLICATIONS: This pilot study suggested a framework for behavioral change, grounded in constructs central to Social Cognitive Theory, that simplified the goal-setting process (by using guided goal setting) and used video technology to decrease the cost of implementation.

Opposing Discourses Surrounding Type 2 Diabetes in Eastern Appalachian Kentucky.

Type 2 diabetes disproportionately affects individuals in Appalachia. This study investigated discourse among friends and family with different diabetes risk levels in Central Appalachia. Eighteen semistructured, in-depth interviews were conducted with Appalachian Kentuckians. Thematic analysis revealed 2 dialectic tensions centered on disease management (health as a personal problem vs diabetes management requiring social support) and disclosure (openness vs closedness). Health professionals should consider the powerful influence of speech with respect to family relations and support, along with the need to communicate early, clearly, and often in a manner that emphasizes family, friends, and connectedness.

Social Constructions of Stigmatizing Discourse Around Type 2 Diabetes Diagnoses in Appalachian Kentucky.

Type 2 diabetes is a growing problem among Appalachian Kentucky residents. Several issues contribute to diabetes disparities in the region, including lack of access to health care and geographic isolation. Previous studies also indicate that social stigma may be associated with type 2 diabetes. We used 28 semistructured interviews to explore how stigma is socially constructed across health status (diagnosed/undiagnosed). Perceived severity of the disease is high, yet the etiology of diabetes is not well understood. Thus, onset is perceived to occur "out of the blue," and a positive diagnosis is perceived as having life-threatening consequences. Diagnosed participants, who had learned more about the disease's etiology, prevention, and management, expressed intrapersonal stigma. In interpersonal situations, the visible indicators of a diabetes diagnosis (i.e., physical weight, insulin injection), rather than diagnosis status, tended to evoke stigmatizing interactions. These findings form the foundation for our recommendations for prevention messages in the region.