Measurement and Correlates of Food Selection Motivations in a United States Sample.

Background: In this study, we explored the factors that motivate food choice, and evaluated the psychometric properties and demographic correlates of the Eating Motivation (EATMOT) questionnaire in adults in the United States (US). Methods: This cross-sectional survey involved 905 adults in 6 sites across the US. The EATMOT questionnaire measures participants' self-reported motivations for food selection, demographic, and anthropometric data. Analyses included exploratory and confirmatory factor analyses, correlations, Welch's t-tests, and logistic regressions. Results: We established a 3-factor model (health-related, emotional, and environmental/political motivations) as the best fit to the data (CFI = .983, RMSEA = .049, SRMR = .054). Gender differences were found within the 3 factors, as well as in the intercorrelations between factors. Higher levels of health-related motivations (B = .10, SE = .04, OR = 1.11 (95% CI: 1.03, 1.19), p = .006) were associated with increased reports of weight loss dieting, whereas higher levels of environmental/political motivations (B = -.09, SE = .04, OR = 0.91, p = .02) were associated with fewer reports of weight-loss dieting. Conclusion: An abbreviated version of the EATMOT scale is appropriate for use in a US sample and identifies 3 categories of factors that impact dietary choices. These factors may be important in building interventions to improve diets.

Cooking Up Energy: A Culinary Education Program for Children with Parent Outreach.

Objectives: Culinary interventions show promise in preventing obesity. The Cooking Up Energy (CUE) program aimed to improve weight status and attitudes held about healthy foods, as well as increase cooking self-efficacy and frequency of meal preparation, in children 6-12 years of age. Methods: We provided 10 one-hour long culinary and nutrition education sessions. We took pre- and post-program surveys along with height, weight, and waist circumference measurements. We invited parents to 2 evening sessions. We analyzed results for the entire group, and a subgroup of children who were overweight or obese at baseline. Results: We analyzed matched data (N = 65; 52% female; >60% minority; 43% overweight or obese). Mean BMI percentile and BMI z-score did not change significantly following program completion. However, BMI z-score in those who were overweight or obese, remained favorably constant, rather than rising. We found an increase in participation in meal preparation for all meals, along with robust attendance and favorable program evaluations. Participant cooking self-efficacy and attitudes remained largely unchanged. Conclusion: Favorable results for several factors were evident; however, they did not reach statistical significance. The program holds promise in influencing food-related behaviors that can buffer obesity risk in children; however these findings warrant further investigation.

Correlations between quality ratings of skilled nursing facilities and multidrug-resistant urinary tract infections.

BACKGROUND: The purpose of this study was to determine risk factors for the acquisition of urinary tract infections (UTIs) and multidrug-resistant organisms (MDROs) in residents of skilled nursing facilities (SNFs). METHODS: Using the informational database provided by the Centers for Medicare and Medicaid Services (CMS), a retrospective logistic regression was performed on 1,523 urine cultures from 12 SNFs located in Long Island, New York. RESULTS: Of the 1,142 positive urine cultures, Escherichia coli was most prevalent. Additionally, 164 (14.4%) of the UTIs were attributed to an MDRO. In multivariate logistic regression, sex and overall quality rating predicted the occurrence of UTIs, whereas identification of MDROs was dependent on the level of nursing care received. The mean predicted probability of UTIs and receipt of contaminated samples was inversely dependent on the facility's rating, where the likelihood increased as overall quality ratings decreased. CONCLUSIONS: The CMS's quality rating system may provide some insight into the status of infection control practices in SNFs. The results of this study suggest that potential consumers should focus on the overall star ratings and the competency of the nursing staff in these facilities rather than on individual quality measures.

Cooking Up Energy with Predominately Latino Children during Afterschool Hours.

OBJECTIVES: We investigated the impact on body weight status and food-related behaviors following participation in the Cooking Up Energy® (CUE) Program. METHODS: Children 7-11 years old attended 10 cooking/nutrition education sessions. Baseline and post-program weight, height and waist circumference measurements, frequency of participation in meal preparation and food frequency questionnaires were obtained. Data were analyzed for the entire group as well as a subgroup of overweight and obese participants. RESULTS: Participants (N = 51) were predominately Latino (76%) and overweight (52%). Significant reduction in mean body mass index (BMI) percentile was found in the subgroup of overweight and obese participants (N = 27; p < .05). However, reduction in mean BMI z-score was non-significant. Reports of program enjoyment (98%) and an increased desire to cook more frequently at home (83%) were found; however, no significant increase in participation in meal preparation at home was found following program completion. CONCLUSION: The CUE program was well received by most participants, and there is indication that program participation has the potential to have a positive influence on body weight. However, more research is needed to explore ways to promote an increase in participation in food preparation at home by children.

A comparative analysis of vaccine administration in urban and non-urban skilled nursing facilities.

BACKGROUND: The U.S. population is aging at an unprecedented rate, resulting in an increased demand for skilled nursing facilities (SNFs) and long-term care. Residents of these facilities are at a high risk for pneumococcal disease or severe influenza-related illnesses and death. For these reasons, the Centers for Medicare and Medicaid Services use influenza and pneumococcal vaccination rates as a quality measure in the assessment of SNFs, as complications related to these infections increase morbidity and mortality rates. METHODS: Disparities have been reported amongst vaccination with increased rates in urban areas as compared to their non-urban counterparts. Statistical analyses were performed to compare influenza and pneumococcal vaccination in urban and non-urban SNFs to determine variables that may influence vaccination status. RESULTS: Of the 15,639 nursing homes included in the study, 10,107 were in urban areas, while 5532 were considered non-urban. We found the percent of eligible and willing residents with up-to-date influenza and pneumococcal vaccinations increased with overall five-star ratings of SNFs. Somewhat paradoxically, although urban SNFs had higher mean overall five-star ratings, they showed lower rates of influenza and pneumococcal vaccination compared to non-urban SNFs. Ordinary least squares regression analysis comparing overall ratings, type of ownership, and geographic location by region yielded statistically significant results in which the overall rating, ownership-type and certificate-type favored urban SNFs (p < 0.001). CONCLUSIONS: This is the first systematic and comparative analysis to use the Nursing Home Compare database to assess vaccine administration of urban and non-urban SNFs. The findings of this study may be used to encourage the development of programs to improve vaccination rates and the quality of care in these facilities.

Blending better beverage options: a nutrition education and experiential workshop for youths.

OBJECTIVE: To reduce intake of sugar-sweetened beverages (SSBs) in youths as a means to reduce obesity risk. METHODS: Youths 5-14 years old attending a summer program were given a two-hour workshop addressing the sugar content in SSBs, the health risks from drinking SSBs, and hands-on preparation as well as tastings of low-sugar beverage alternatives. Data on usual intake of SSBs was obtained at baseline, and pre- and postprogram surveys were conducted to gauge change in knowledge and/or attitudes regarding SSBs. RESULTS: There were 128 participants (63% male) in the program. SSBs were commonly consumed with over 80% reporting regular consumption (mean daily intake 17.9 ounces). Significant increase in knowledge regarding the sugar content of commonly consumed SSBs was achieved; however change in attitudes was not significant. The large majority of youths reported enjoying the workshop and intention to reduce intake of SSBs following program participation. CONCLUSION: SSBs are commonly consumed by youths. Knowledge regarding the sugar content of SSBs is easier to impart to youths than influencing attitudes held about these beverages. Long-term interventions that reach out to parents and address the widespread availability of SSBs are needed to influence resistant attitudes and beverage choosing behaviors in youths.

Toward a quantitative theory of food consumption choices and body weight.

We propose a calibrated dynamic model of food consumption choices and body weight to study changes in daily caloric intake, weight, and the away-from-home share of calories consumed by adult men and women in the U.S. during the period between 1971 and 2006. Calibration reveals substantial preference heterogeneity between men and women. For example, utility losses stemming from weight gains are ten times greater for women compared to men. Counterfactual experiments show that changes in food prices and household income account for half of the increase in weight of adult men, but only a small fraction of women's weight. We argue that quantitative models of food consumption choices and body weight have a unique role to play in future research in the economics of obesity.