Responses of older adults to theory-based nutrition newsletters.

OBJECTIVE: To evaluate the effect of a theory-based newsletter on knowledge, attitude, and behavior change in older adults. DESIGN: Pretest-posttest, random assignment, and treatment-control design with 2 treatment groups: 1 that received newsletters only and 1 that received newsletters with follow-up telephone interviews. Control group completed pretest-posttest surveys only. SUBJECTS/SETTING: Four hundred eighty men and women, aged 60 to 74 years, were recruited to participate in a home-based educational intervention using a patient list generated from a rural tertiary care hospital database, Geisinger Medical Center in Danville, Pa. INTERVENTION: Five nutrition newsletters designed using the nutrition communication model and adult learning theory principles were mailed biweekly. Telephone interviews followed each of the 5 newsletters 10 to 14 days after distribution. OUTCOME MEASURES: Nutrition knowledge and interest, food behavior related to dietary fat, and stages of change for dietary fat and fiber. STATISTICAL ANALYSES PERFORMED: Analysis of covariance was used to determine group differences in posttest outcome measures using pretest as covariate. RESULTS: In addition to achieving higher scores than the control group, the treatment groups were significantly different from each other in correct and perceived nutrition knowledge at posttest. Those in the treatment group receiving telephone calls scored higher (mean change = 19.0% for correct and 20.3% for perceived) than those who received the newsletters only (mean change = 12.5% for correct and 14.3% for perceived; P < .05). Treatment groups also rated their interest in nutrition higher than the control group did; there was no between-treatment difference. Treatment groups performed significantly better than the control group for dietary fiber stage of change (P < .05). Those receiving only newsletters scored significantly better than the control for the "avoid fat" food behavior (P < .05). APPLICATIONS/CONCLUSIONS: This study provides an example of the incorporation of a theoretical model in development and evaluation of newsletters. Home-delivered nutrition newsletters based on this model can communicate health and nutrition information to older adults. Consumers today have more opportunities than ever before to access nutrition information quickly and inexpensively. Newsletters can help dietetics professionals filter and limit what consumers must process, saving clients time and improving the accuracy of information obtained. Dietetics professionals in both clinical and community practice are uniquely positioned to provide highly focused and understandable information to consumers via a newsletter format.

Family interaction and migration decision making.

Using data from the Residential Preference and Migration Survey, a panel study of Pennsylvania households on migration intention and behavior, the authors examine some aspects of the decision to migrate. "We first examine the impact of the presence or absence of household interaction on the desire to move, migration expectations, and actual migration behavior. We hypothesize that the presence of household interaction is associated with migration behavior, while the absence of household interaction on migration-related issues is a predictor of staying in the present residence. Second, we test an expanded residential satisfaction migration decision model.... The expanded model permits us to test the thesis that household interaction frequency and consensus/conflict are moderating factors in explaining and predicting the outcome of migration decision making."

Food purchase decision-making typologies of women with non-insulin-dependent diabetes mellitus.

Food selection is a key factor in the nutritional management of diabetes mellitus. Since up to 80% of food purchase decisions are made at the supermarket, the purpose of this study was to identify the criteria which influence point-of-purchase decision-making in women with NIDDM aged 40-60 years. A qualitative approach with individual interviews and in-store observations was used. Analysis of the interviews identified four decision-making typologies based on the extent nutrition, price and family needs were emphasized. The four typologies included (1) the Overloaded Shopper, (2) the Budget Shopper, (3) the Nutrition Savvy Shopper, and (4) the Out-of-Touch Shopper. Cluster analysis confirmed the typologies for 71% of the sample. Educators should classify shoppers according to a typology to determine their clients' personal needs and interests. Then, educators can tailor the educational or counseling message to meet those specific needs.

Oil-exporting status, quality of life, and fertility: a cross national study.

PIP: It has been suggested that unless the rapid increase in income in the oil-exporting countries is accompanied by more equitable distribution of modern goods and services, the impact on health, literacy, and fertility is likely to be negligible. This study represents an initial attempt to examine the possible effects of the oil-exporting status of nations on their income, quality of life, and fertility. Data from 150 countries were used, and the Physical Quality of Life Index (PQLI) was utilized instead of traditional measures of development. Some findings are: 1) the variable showing the strongest direct relationship to fertility was physical quality of life (p=-.756) which is consistent with the distributional hypothesis; 2) per capita gross national product (GNP) and oil-exporting status showed weaker paths to fertility and their signs were in opposite directions; 3) per capita GNP showed a moderate negative relationship to fertility (p=-.171) while oil-exporting status had a positive path of about the same size (p= .155), thus per capita income and oil-exporting status had only about 1/5 the net relationship to fertility as did physical quality of life; 4) the indirect relationship of income as channeled through PQLI was over twice as large as the measured direct relationship, so that the importance of per capita GNP for lower fertility is primarily through its influence on the physical quality of life within a nation; 5) oil-exporting status was associated with lower physical quality of life and the latter was strongly related to higher fertility; and 6) in the long run, the relationship between oil-exporting status and quality of life should be positive. If separate analyses are conducted, the division should be made along an oil-exporter/non-exporter dichotomy, rather than a more developed/less developed country categorization. It is concluded that nations with relatively high life expectancies high levels of literacy, and low levels of infant mortality exhibited lower fertility than did nations with poorer records on these dimensions. While higher per capita incomes were significantly related to lower fertility, the greater portion of the relationship was channeled through the quality of life. Once the effect of the oil-exporting nations is controlled, developed and underdeveloped countries do not differ widely in the relationships between per capita GNP, physical quality of life, and fertility.^ieng