Changes in a middle school food environment affect food behavior and food choices.

Increasing rates of obesity among children ages 12 to 19 years have led to recommendations to alter the school food environment. The purpose of this study was to determine whether there are associations between an altered school food environment and food choices of middle school students both in and outside of school. In a midsized western city, two of six middle schools allowed only bottled water in vending machines, only milk and fruit on à la carte menus, and offered a seasonal fruit and vegetable bar. Three years after the intervention was initiated, seventh- and eighth-grade students attending the two intervention schools and four control middle schools were surveyed about their food choices. A total of 2,292 surveys were completed. Self-reported frequency of consumption for nine food groups in the survey was low; consumption was higher outside than in school. Boys consumed more milk than girls although girls consumed more fruits and vegetables. Significant socioeconomic differences existed. Compared with students who paid the full lunch fee, students qualifying for free and reduced-price meals consumed more milk and juice in schools but less outside school; more candy and energy drinks in school; and more sweet drinks, candy, pastries, and energy drinks outside school. Students in intervention schools were 24% more likely to consume milk outside school, 27% less likely to consume juice in school, and 56% less likely to consume sweet pastries in school. There were no differences in fruit and vegetable consumption reported by children in control and intervention schools. Overall, there was a positive association between a modified school food environment and student food behavior in and outside school. Policies related to the school food environment are an important strategy to address the obesity epidemic in our country.

Dietary goal attainment measures and psychosocial factors among Mexican Americans and non-Hispanic whites with type 2 diabetes.

Diabetes education programs need improved measures of goal setting for dietary control of diabetes. Additionally, measures of patient experiences with dietary goal setting are needed to better prepare patients for diabetes self-management. Measures of dietary goals and strategies were investigated via survey of 100 Mexican Americans and non-Hispanic whites with type 2 diabetes at a community clinic. Analyses tested novel goal measures as stages of change and goal attainment with a food plan compared to a traditional measure of food plan adherence. Ethnic groups varied in some reported experiences with goal setting education and goal attainment, but did not differ in most clinical characteristics of diabetes. Results indicated that different measures of goal setting vary in their psychosocial predictors, suggesting changes in how health care providers use and monitor goal setting for patients. At the time this research was conducted, Dr. Briggs Early was a doctoral candidate in the Department of Food Science and Human Nutrition at Washington State University. She is currently an Assistant Professor of Biochemistry and Nutrition at Pacific Northwest University of Health Sciences - College of Osteopathic Medicine, and a certified diabetes educator, and insulin pump trainer in Yakima, Washington.

The process of curriculum development and implementation for an adolescent health project in middle schools.

Childhood obesity has reached epidemic levels in developed countries and is showing no signs of abating. The causes of obesity in adolescence are extremely complex, and therefore approaches to prevention and treatments must be multifaceted. Early adolescence is a developmental period when youth are becoming more independent, are influenced by peers, and are making more decisions related to their own health and lifestyles. The purpose of this article is to describe the development, implementation, and evaluation of a multilevel school-based intervention program for middle school students in the Teen Eating and Activity Mentoring in Schools (TEAMS) project. Critical components of success included an interdisciplinary approach, applying available curricula to meet contextual characteristics, and involvement of all stakeholders in planning, evaluating, and refining the program.

Goal setting education and counseling practices of diabetes educators.

PURPOSE: The purpose of this study was to identify goal setting education practices used by diabetes educators working with type 2 diabetes patients. METHODS: Data were collected by a mail questionnaire with 179 diabetes educators purposively selected from the 2008 American Association of Diabetes Educators membership listing. RESULTS: Many diabetes educators (52%) reported that more than 75% of their patients set goals for diabetes control. Independent factor patterns for the frequency of information collected from the patient for the first diabetes education session showed that educators either focused on patients' self-management practices (exercise and dietary practices, knowledge, and social impacts of diabetes) or issues with learning about self-management, such as understanding the patient's learning style and motivation for managing diabetes. Factor patterns overall showed diverse approaches to working with patients, including strategies used with patients struggling with dietary goals and the importance of tasks to complete during the first patient session. CONCLUSION: Although most educators reported practices that were largely patient centered as promoted by the American Diabetes Association (ADA) and models of chronic disease management, patterns of practice suggest that diabetes educators vary considerably in how they apply education practices, especially with dietary self-management education.

A logic model framework for community nutrition education.

Logic models are a practical method for systematically collecting impact data for community nutrition efforts, such as the Food Stamp Nutrition Education program. This report describes the process used to develop and test the Community Nutrition Education Logic Model and the results of a pilot study to determine whether national evaluation data could be captured without losing flexibility of programming and evaluation at the state level. The objectives were to develop an evaluation framework based on the Logic Model to include dietary quality, food safety, food security, and shopping behavior/food resource management and to develop a training mechanism for use. The portability feature of the model should allow application to a variety of community education programs.

Coping strategies and nutrition education needs among food pantry users.

In response to unexpectedly high rates of household food insecurity in Washington State, focus groups were conducted with food pantry users in nine locations across the state to explore access and barriers to food, strategies for coping with food insecurity, and nutrition education needs. All respondents had children and spoke English. Participants reported household food insecurity and concerns about feeding children and getting through the month. Stretching food dollars was the most requested topic for nutrition education. Nutrition educators need to be responsive to people's educational needs and the emotional demands associated with food insecurity at the program and community levels.