Journal of the American Dietetic Association, 2006
Objective To examine if greater nutrition knowledge vs gains in knowledge promote more successful... more Objective To examine if greater nutrition knowledge vs gains in knowledge promote more successful weight loss in low-income, overweight and obese mothers with young children. Design A convenience sample of mothers and their children were measured for height and weight; mothers completed demographic and nutrition knowledge questionnaires pre-and postintervention. Subjects/setting Participants (Nϭ141) were recruited from government and public health clinics and elementary schools. Inclusion criteria for mothers were: family income Ͻ200% federal poverty level; overweight/obese; and Hispanic, African-American, or white race/ethnicity. Intervention Eight weekly weight-loss classes emphasizing diet, physical activity, and behavior modification based on Social Cognitive Theory were administered to mothers. Main outcome measures Improvements in maternal nutrition knowledge and weight loss. Statistical analyses performed Paired-samples t tests, repeated measures analysis of variance, analysis of covariance, Pearson correlations, and 2 statistics. Results Nutrition knowledge of mothers increased in all areas. Participants with weight loss Ն2.27 kg (responders) had greater knowledge than those who did not; however, the actual net gain was similar for those who lost and did not lose weight. Weight gainers only improved in two areas on the test, whereas weight-loss responders increased knowledge in all six. Responders appeared more cognizant of diet, weight loss, and health information. Conclusions Weight-management programs should include a strong component of nutrition education to alleviate knowledge inequalities and promote more effective weight control. In low-income mothers, greater initial knowledge may be more predictive of weight loss than gains in knowledge during an intervention.
The objective was to evaluate a multidisciplinary guideline-driven disease management program foc... more The objective was to evaluate a multidisciplinary guideline-driven disease management program focused on achievement of asthma control among sustained patients with confirmed asthma in Louisiana and to assess factors affecting achievement of asthma control. Data were extracted from the electronic health records of 1596 adults with confirmed asthma, sustained care for >1 year in the outpatient setting, and ≥2 recorded Asthma Control Test (ACT) scores. Multivariable logistic regression modeling was used to assess the association of demographic variables, comorbidities, and process measures with the best achieved asthma control as represented by the highest ACT score. Most subjects were female (81.1%) and African American (63.9%). Approximately half of them (48.9%) were able to achieve asthma control (ACT ≥20). The most prevalent comorbidities were hypertension (79.8%), rhinitis (55.3%), and obesity (50.5%). Most patients received pulmonary function testing (PFT) (88.6%), controller medication therapy (85.5%), or written asthma action plans (92.7%). Asthma control was positively associated with presence of PFT (OR = 1.63, 95% CI: 1.13, 2.37) and being a "never" smoker (OR = 1.49, 95% CI: 1.08, 2.04). Asthma control was less likely to be achieved by patients who were African American (OR = 0.68, 95% CI: 0.52, 0.87), had more comorbidities (OR = 0.89, 95% CI: 0.83, 0.96), or were on more medications (OR = 0.79, 95% CI: 0.72, 0.88). Asthma control was achieved in 48.9% of an adult, primarily African American population with the implementation of comprehensive guideline-driven care. Furthermore, this is the first study to observe that the presence of PFT may be associated with asthma control.
Farmers' markets are increasingly being promoted as a means to provide fresh produce to poor ... more Farmers' markets are increasingly being promoted as a means to provide fresh produce to poor and underserved communities. However, farmers' market (FM) use remains low among low-income patrons. The purpose of our study was to examine FM awareness and use, grocery shopping behaviors, and internet use among Supplemental Nutrition Assistance Program (SNAP) recipients. A descriptive analysis of preliminary data was performed to evaluate quantitative baseline data among SNAP recipients between June and August 2016 in New Orleans, Louisiana (N=51). Data were collected via a 42-item online survey that included demographics, internet use, FM awareness and use, health information seeking behaviors and fruit and vegetable purchasing behaviors. Less than half of the survey respondents (n=24) had ever been to a FM. Local grocery stores and Wal-Mart were most used for purchasing fruits and vegetables (88% and 84%, respectively). The most common sources of healthy eating information were ...
Journal of Health Care for the Poor and Underserved, 2012
Lack of health insurance is correlated with noncompliance in colorectal cancer screening. Louisia... more Lack of health insurance is correlated with noncompliance in colorectal cancer screening. Louisiana ranks 48th among all states in residents with health insurance. This paper describes initial results of Louisiana's first statewide colorectal cancer screening program. The program enhanced screening capacity of state hospitals by providing fecal immunochemical tests (FITs), colonoscopes, and funded patient navigators. The Social Ecological Model (SEM) was used as the framework for the program. Patient navigators distributed 975 FITs to adults 50 to 64 years (21% men, 78% women).The overall return rate was 66%. There was no association among return rates, race, or gender. Participants who were previously screened (10.7%) were more likely to return their FIT. The combination of patient navigation and providing patients with an easy-to-use CRC screening option proved to be an effective method that potential colorectal cancer screening programs can deploy in similar populations of un- and under-insured adults.
Personal and public health information are often obtained from studies of large population groups... more Personal and public health information are often obtained from studies of large population groups. Risk factors for nutrients, toxins, genetic variation, and more recently, nutrient-gene interactions are statistical estimates of the percentage reduction in disease in the population if the risk were to be avoided or the gene variant were not present. Because individuals differ in genetic makeup, lifestyle, and dietary patterns than those individuals in the study population, these risk factors are valuable guidelines, but may not apply to individuals. Intervention studies are likewise limited by small sample sizes, short time frames to assess physiological changes, and variable experimental designs that often preclude comparative or consensus analyses. A fundamental challenge for nutrigenomics will be to develop a means to sort individuals into metabolic groups, and eventually, develop risk factors for individuals. To reach the goal of personalizing medicine and nutrition, new experimental strategies are needed for human study designs. A promising approach for more complete analyses of the interaction of genetic makeups and environment relies on community-based participatory research (CBPR) methodologies. CBPR's central focus is developing a partnership among researchers and individuals in a community that allows for more in depth lifestyle analyses but also translational research that simultaneously helps improve the health of individuals and communities. The USDA-ARS Delta Nutrition Intervention Research program exemplifies CBPR providing a foundation for expanded personalized nutrition and medicine research for communities and individuals.
Progress in Community Health Partnerships: Research, Education, and Action, 2009
Although community-based participatory research (CBPR) principles stress the importance of &a... more Although community-based participatory research (CBPR) principles stress the importance of "equitable partnerships" and an "empowering and power-sharing process that attends to social inequalities," descriptions of actual projects often focus on the challenges confronted in academic-community partnerships. These challenges occur in the context of economic and power inequities and the frequently limited diversity of researchers. Less often does this discourse attend to the link between the principles of CBPR and their empowering potential for community members who internalize and use these principles to hold outside partners accountable to these ideals. This article documents the participatory development and implementation of a community research workshop, the community and organizational contexts, the content of the workshop, and lessons learned. Workshop objectives included increasing community knowledge of the research process, positively impacting community members' perceptions and attitudes about research, and improving researchers' understanding of community knowledge, perceptions, and experiences with research. This project was conducted as a part of the larger United States Department of Agriculture, Agriculture Research Service (USDA ARS) Delta Nutrition Intervention Research Initiative (Delta NIRI). The workshop was developed by a joint academic-community team in partnership with a community-based workshop advisory committee (WAC) and implemented in three rural communities of the lower Mississippi Delta. Development included a dry run with the WAC, a pilot workshop, and a focus group to refine the final content and format. Applying participatory principles to the development of the community research workshop resulted in the creation of a mutually acceptable workshop and co-learning experience that empowered community members in their involvement in other community research projects.
This paper describes the development and evaluation of the WillTry instrument, a psychometric too... more This paper describes the development and evaluation of the WillTry instrument, a psychometric tool designed to measure children's willingness to try fruits and vegetables. WillTry surveys were interviewer-administered to 284 children in an elementary school and summer day camps located in rural Mississippi and Arkansas (United States) communities. Factor analysis was used to determine construct dimensionality. Additional evaluation included internal consistency, test-retest reliability, and predictive validity. Factor analysis suggested a single dimension for the food items. The WillTry food scale had substantial reliability (intraclass correlation coefficients between 0.61 and 0.80) and sufficient internal consistency (Cronbach's a ! 0.70). Results of the regression analysis for percent consumption of foods offered on WillTry response confirmed the predictive validity of the instrument. The results of these analyses provide psychometric evidence for the use of the WillTry instrument as a measure of willingness to try fruits and vegetables in rural, southern US children 5-14 years of age.
Journal of The American Dietetic Association, 2007
This study tested the effectiveness of a pedometer program for increasing physical activity level... more This study tested the effectiveness of a pedometer program for increasing physical activity levels and reducing body weight in overweight and obese mothers of young children.Participants’ motivational readiness to exercise, exercise self-efficacy, pedometer steps, pedometer kilocalories, and anthropometrics were evaluated at week 0 and week 8; anthropometrics were reassessed at week 24. Healthful-weight mothers provided comparison data at baseline.A convenience sample of 93 intervention women (body mass index [calculated as kg/m2] ≥25) and 31 comparison women (body mass index <25) were recruited from public health clinics, community centers, and churches. Eligibility criteria included Hispanic, African-American, or white ethnicity and low income (<200% of the federal poverty index).An 8-week physical activity and dietary program was conducted.Motivational readiness to exercise, exercise self-efficacy, pedometer steps, and weight loss.Independent sample t tests, χ2 tests, paired t tests, Wilcoxon signed-ranks tests, repeated measures analysis of variance, and Pearson and Spearman correlations.Mothers enhanced their motivational readiness to exercise, exercise self-efficacy, pedometer steps, and pedometer kilocalories. Reductions in body weight, percent body fat, and waist circumference also were observed. Significant correlations were found between exercise self-efficacy and exercise readiness (r=0.28, P<0.01), pedometer steps (r=0.30, P<0.01), and pedometer kilocalories (r=0.28, P<0.05).This intervention successfully increased the physical activity levels and promoted weight loss in low-income mothers. Public health clinics may wish to incorporate elements of this intervention into their programs to improve the physical fitness of recipients.
Journal of the American Dietetic Association, 2006
Objective The purpose of this study was to identify attitudes about nutrition and their influence... more Objective The purpose of this study was to identify attitudes about nutrition and their influence on weight status in low-income mothers in the first year postpartum. Design Nutrition attitudes were assessed at 1.5, 6, and 12 months postpartum. Body weight was measured at each time point and height at 1.5 months to calculate body mass index. Nutrition attitudes at each time were compared with demographic variables and weight status. Subjects Subjects were 340 non-Hispanic white (31.3%), non-Hispanic black (25.1%), and Hispanic (43.7%) new mothers (mean ageϭ22.4 years) located in central Texas. Criteria for participation included good health at delivery and low income (Յ185% federal poverty guideline). Statistical analyses 2 tests were used to compare demographic groups to categorical variables. Multivariate analysis of variance was done to investigate the effect of demographic variables on instrument subscale scores. A repeated-measures analysis of variance was used to identify significant changes over time. Results Obese women had higher barriers to healthful eating subscale means at 1 year compared with normal and overweight subjects at 1.5 and 6 months, and had more barriers than overweight participants at 12 months. Obese individuals also had higher emotional eating subscale scores than did overweight women at 1.5 months and both normal and overweight subjects at 12 months.
Journal of the American Dietetic Association, 2007
Objective The purpose of this study was to identify attitudes about nutrition and their influence... more Objective The purpose of this study was to identify attitudes about nutrition and their influence on weight status in low-income mothers in the first year postpartum. Design Nutrition attitudes were assessed at 1.5, 6, and 12 months postpartum. Body weight was measured at each time point and height at 1.5 months to calculate body mass index. Nutrition attitudes at each time were compared with demographic variables and weight status. Subjects Subjects were 340 non-Hispanic white (31.3%), non-Hispanic black (25.1%), and Hispanic (43.7%) new mothers (mean ageϭ22.4 years) located in central Texas. Criteria for participation included good health at delivery and low income (Յ185% federal poverty guideline). Statistical analyses 2 tests were used to compare demographic groups to categorical variables. Multivariate analysis of variance was done to investigate the effect of demographic variables on instrument subscale scores. A repeated-measures analysis of variance was used to identify significant changes over time. Results Obese women had higher barriers to healthful eating subscale means at 1 year compared with normal and overweight subjects at 1.5 and 6 months, and had more barriers than overweight participants at 12 months. Obese individuals also had higher emotional eating subscale scores than did overweight women at 1.5 months and both normal and overweight subjects at 12 months.
Journal of the American Dietetic Association, 2007
Objective This study tested the effectiveness of a pedometer program for increasing physical acti... more Objective This study tested the effectiveness of a pedometer program for increasing physical activity levels and reducing body weight in overweight and obese mothers of young children. Design Participants' motivational readiness to exercise, exercise self-efficacy, pedometer steps, pedometer kilocalories, and anthropometrics were evaluated at week 0 and week 8; anthropometrics were reassessed at week 24. Healthfulweight mothers provided comparison data at baseline. Subjects/setting A convenience sample of 93 intervention women (body mass index [calculated as kg/m 2 ] Ն25) and 31 comparison women (body mass index Ͻ25) were recruited from public health clinics, community centers, and churches. Eligibility criteria included Hispanic, African-American, or white ethnicity and low income (Ͻ200% of the federal poverty index).
Journal of the American College of Nutrition, 2007
To examine the effects of a weight loss program for mothers on the diet and activity of mothers a... more To examine the effects of a weight loss program for mothers on the diet and activity of mothers and their 1-3 year old children.
The purpose of this study was to evaluate a nutrition and physical activity program for reducing ... more The purpose of this study was to evaluate a nutrition and physical activity program for reducing body weight and improving nutrition attitudes in mothers of young children. A convenience sample of 114 intervention mothers and 33 comparison mothers was recruited from public health clinics and community centers. Eligibility criteria included Hispanic, African American, or white ethnicity; body mass index of at least 25 kg/m2; low income (<200% of the federal poverty index); and youngest child aged 1 to 4 years. For intervention participants, height, weight, percentage of body fat, waist circumference, demographics, nutrition attitudes, and dietary intake were measured at weeks 0 and 8; height, weight, percentage of body fat, and waist circumference were reassessed at 6 months. Overweight mothers in the comparison group provided anthropometric and demographic data at weeks 0 and 8. Changes in anthropometrics, attitudes, and dietary intake were evaluated in intervention mothers. Anthropometric data of intervention vs comparison group mothers were examined. Differences in anthropometrics and attitude scores between weight loss responders (≥2.27 kg) and nonresponders (<2.27 kg) were assessed at week 8. Intervention participants lost weight (x = −2.7 kg; P < .001), whereas comparison mothers gained a slight amount of weight (x= 0.1 kg) by week 8. Weight loss responders had healthier eating attitudes (5.6 vs 5.2; P < .01) and fewer perceived barriers (2.4 vs 2.9; P < .05) than nonresponders postintervention. In conclusion, this dietary and physical activity curriculum is a valuable resource for weight management programs serving low-income women.
Journal of the American Dietetic Association, 2006
Objective To examine if greater nutrition knowledge vs gains in knowledge promote more successful... more Objective To examine if greater nutrition knowledge vs gains in knowledge promote more successful weight loss in low-income, overweight and obese mothers with young children. Design A convenience sample of mothers and their children were measured for height and weight; mothers completed demographic and nutrition knowledge questionnaires pre-and postintervention. Subjects/setting Participants (Nϭ141) were recruited from government and public health clinics and elementary schools. Inclusion criteria for mothers were: family income Ͻ200% federal poverty level; overweight/obese; and Hispanic, African-American, or white race/ethnicity. Intervention Eight weekly weight-loss classes emphasizing diet, physical activity, and behavior modification based on Social Cognitive Theory were administered to mothers. Main outcome measures Improvements in maternal nutrition knowledge and weight loss. Statistical analyses performed Paired-samples t tests, repeated measures analysis of variance, analysis of covariance, Pearson correlations, and 2 statistics. Results Nutrition knowledge of mothers increased in all areas. Participants with weight loss Ն2.27 kg (responders) had greater knowledge than those who did not; however, the actual net gain was similar for those who lost and did not lose weight. Weight gainers only improved in two areas on the test, whereas weight-loss responders increased knowledge in all six. Responders appeared more cognizant of diet, weight loss, and health information. Conclusions Weight-management programs should include a strong component of nutrition education to alleviate knowledge inequalities and promote more effective weight control. In low-income mothers, greater initial knowledge may be more predictive of weight loss than gains in knowledge during an intervention.
The objective was to evaluate a multidisciplinary guideline-driven disease management program foc... more The objective was to evaluate a multidisciplinary guideline-driven disease management program focused on achievement of asthma control among sustained patients with confirmed asthma in Louisiana and to assess factors affecting achievement of asthma control. Data were extracted from the electronic health records of 1596 adults with confirmed asthma, sustained care for >1 year in the outpatient setting, and ≥2 recorded Asthma Control Test (ACT) scores. Multivariable logistic regression modeling was used to assess the association of demographic variables, comorbidities, and process measures with the best achieved asthma control as represented by the highest ACT score. Most subjects were female (81.1%) and African American (63.9%). Approximately half of them (48.9%) were able to achieve asthma control (ACT ≥20). The most prevalent comorbidities were hypertension (79.8%), rhinitis (55.3%), and obesity (50.5%). Most patients received pulmonary function testing (PFT) (88.6%), controller medication therapy (85.5%), or written asthma action plans (92.7%). Asthma control was positively associated with presence of PFT (OR = 1.63, 95% CI: 1.13, 2.37) and being a "never" smoker (OR = 1.49, 95% CI: 1.08, 2.04). Asthma control was less likely to be achieved by patients who were African American (OR = 0.68, 95% CI: 0.52, 0.87), had more comorbidities (OR = 0.89, 95% CI: 0.83, 0.96), or were on more medications (OR = 0.79, 95% CI: 0.72, 0.88). Asthma control was achieved in 48.9% of an adult, primarily African American population with the implementation of comprehensive guideline-driven care. Furthermore, this is the first study to observe that the presence of PFT may be associated with asthma control.
Farmers' markets are increasingly being promoted as a means to provide fresh produce to poor ... more Farmers' markets are increasingly being promoted as a means to provide fresh produce to poor and underserved communities. However, farmers' market (FM) use remains low among low-income patrons. The purpose of our study was to examine FM awareness and use, grocery shopping behaviors, and internet use among Supplemental Nutrition Assistance Program (SNAP) recipients. A descriptive analysis of preliminary data was performed to evaluate quantitative baseline data among SNAP recipients between June and August 2016 in New Orleans, Louisiana (N=51). Data were collected via a 42-item online survey that included demographics, internet use, FM awareness and use, health information seeking behaviors and fruit and vegetable purchasing behaviors. Less than half of the survey respondents (n=24) had ever been to a FM. Local grocery stores and Wal-Mart were most used for purchasing fruits and vegetables (88% and 84%, respectively). The most common sources of healthy eating information were ...
Journal of Health Care for the Poor and Underserved, 2012
Lack of health insurance is correlated with noncompliance in colorectal cancer screening. Louisia... more Lack of health insurance is correlated with noncompliance in colorectal cancer screening. Louisiana ranks 48th among all states in residents with health insurance. This paper describes initial results of Louisiana&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s first statewide colorectal cancer screening program. The program enhanced screening capacity of state hospitals by providing fecal immunochemical tests (FITs), colonoscopes, and funded patient navigators. The Social Ecological Model (SEM) was used as the framework for the program. Patient navigators distributed 975 FITs to adults 50 to 64 years (21% men, 78% women).The overall return rate was 66%. There was no association among return rates, race, or gender. Participants who were previously screened (10.7%) were more likely to return their FIT. The combination of patient navigation and providing patients with an easy-to-use CRC screening option proved to be an effective method that potential colorectal cancer screening programs can deploy in similar populations of un- and under-insured adults.
Personal and public health information are often obtained from studies of large population groups... more Personal and public health information are often obtained from studies of large population groups. Risk factors for nutrients, toxins, genetic variation, and more recently, nutrient-gene interactions are statistical estimates of the percentage reduction in disease in the population if the risk were to be avoided or the gene variant were not present. Because individuals differ in genetic makeup, lifestyle, and dietary patterns than those individuals in the study population, these risk factors are valuable guidelines, but may not apply to individuals. Intervention studies are likewise limited by small sample sizes, short time frames to assess physiological changes, and variable experimental designs that often preclude comparative or consensus analyses. A fundamental challenge for nutrigenomics will be to develop a means to sort individuals into metabolic groups, and eventually, develop risk factors for individuals. To reach the goal of personalizing medicine and nutrition, new experimental strategies are needed for human study designs. A promising approach for more complete analyses of the interaction of genetic makeups and environment relies on community-based participatory research (CBPR) methodologies. CBPR's central focus is developing a partnership among researchers and individuals in a community that allows for more in depth lifestyle analyses but also translational research that simultaneously helps improve the health of individuals and communities. The USDA-ARS Delta Nutrition Intervention Research program exemplifies CBPR providing a foundation for expanded personalized nutrition and medicine research for communities and individuals.
Progress in Community Health Partnerships: Research, Education, and Action, 2009
Although community-based participatory research (CBPR) principles stress the importance of &a... more Although community-based participatory research (CBPR) principles stress the importance of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;equitable partnerships&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and an &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;empowering and power-sharing process that attends to social inequalities,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; descriptions of actual projects often focus on the challenges confronted in academic-community partnerships. These challenges occur in the context of economic and power inequities and the frequently limited diversity of researchers. Less often does this discourse attend to the link between the principles of CBPR and their empowering potential for community members who internalize and use these principles to hold outside partners accountable to these ideals. This article documents the participatory development and implementation of a community research workshop, the community and organizational contexts, the content of the workshop, and lessons learned. Workshop objectives included increasing community knowledge of the research process, positively impacting community members&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions and attitudes about research, and improving researchers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; understanding of community knowledge, perceptions, and experiences with research. This project was conducted as a part of the larger United States Department of Agriculture, Agriculture Research Service (USDA ARS) Delta Nutrition Intervention Research Initiative (Delta NIRI). The workshop was developed by a joint academic-community team in partnership with a community-based workshop advisory committee (WAC) and implemented in three rural communities of the lower Mississippi Delta. Development included a dry run with the WAC, a pilot workshop, and a focus group to refine the final content and format. Applying participatory principles to the development of the community research workshop resulted in the creation of a mutually acceptable workshop and co-learning experience that empowered community members in their involvement in other community research projects.
This paper describes the development and evaluation of the WillTry instrument, a psychometric too... more This paper describes the development and evaluation of the WillTry instrument, a psychometric tool designed to measure children's willingness to try fruits and vegetables. WillTry surveys were interviewer-administered to 284 children in an elementary school and summer day camps located in rural Mississippi and Arkansas (United States) communities. Factor analysis was used to determine construct dimensionality. Additional evaluation included internal consistency, test-retest reliability, and predictive validity. Factor analysis suggested a single dimension for the food items. The WillTry food scale had substantial reliability (intraclass correlation coefficients between 0.61 and 0.80) and sufficient internal consistency (Cronbach's a ! 0.70). Results of the regression analysis for percent consumption of foods offered on WillTry response confirmed the predictive validity of the instrument. The results of these analyses provide psychometric evidence for the use of the WillTry instrument as a measure of willingness to try fruits and vegetables in rural, southern US children 5-14 years of age.
Journal of The American Dietetic Association, 2007
This study tested the effectiveness of a pedometer program for increasing physical activity level... more This study tested the effectiveness of a pedometer program for increasing physical activity levels and reducing body weight in overweight and obese mothers of young children.Participants’ motivational readiness to exercise, exercise self-efficacy, pedometer steps, pedometer kilocalories, and anthropometrics were evaluated at week 0 and week 8; anthropometrics were reassessed at week 24. Healthful-weight mothers provided comparison data at baseline.A convenience sample of 93 intervention women (body mass index [calculated as kg/m2] ≥25) and 31 comparison women (body mass index <25) were recruited from public health clinics, community centers, and churches. Eligibility criteria included Hispanic, African-American, or white ethnicity and low income (<200% of the federal poverty index).An 8-week physical activity and dietary program was conducted.Motivational readiness to exercise, exercise self-efficacy, pedometer steps, and weight loss.Independent sample t tests, χ2 tests, paired t tests, Wilcoxon signed-ranks tests, repeated measures analysis of variance, and Pearson and Spearman correlations.Mothers enhanced their motivational readiness to exercise, exercise self-efficacy, pedometer steps, and pedometer kilocalories. Reductions in body weight, percent body fat, and waist circumference also were observed. Significant correlations were found between exercise self-efficacy and exercise readiness (r=0.28, P<0.01), pedometer steps (r=0.30, P<0.01), and pedometer kilocalories (r=0.28, P<0.05).This intervention successfully increased the physical activity levels and promoted weight loss in low-income mothers. Public health clinics may wish to incorporate elements of this intervention into their programs to improve the physical fitness of recipients.
Journal of the American Dietetic Association, 2006
Objective The purpose of this study was to identify attitudes about nutrition and their influence... more Objective The purpose of this study was to identify attitudes about nutrition and their influence on weight status in low-income mothers in the first year postpartum. Design Nutrition attitudes were assessed at 1.5, 6, and 12 months postpartum. Body weight was measured at each time point and height at 1.5 months to calculate body mass index. Nutrition attitudes at each time were compared with demographic variables and weight status. Subjects Subjects were 340 non-Hispanic white (31.3%), non-Hispanic black (25.1%), and Hispanic (43.7%) new mothers (mean ageϭ22.4 years) located in central Texas. Criteria for participation included good health at delivery and low income (Յ185% federal poverty guideline). Statistical analyses 2 tests were used to compare demographic groups to categorical variables. Multivariate analysis of variance was done to investigate the effect of demographic variables on instrument subscale scores. A repeated-measures analysis of variance was used to identify significant changes over time. Results Obese women had higher barriers to healthful eating subscale means at 1 year compared with normal and overweight subjects at 1.5 and 6 months, and had more barriers than overweight participants at 12 months. Obese individuals also had higher emotional eating subscale scores than did overweight women at 1.5 months and both normal and overweight subjects at 12 months.
Journal of the American Dietetic Association, 2007
Objective The purpose of this study was to identify attitudes about nutrition and their influence... more Objective The purpose of this study was to identify attitudes about nutrition and their influence on weight status in low-income mothers in the first year postpartum. Design Nutrition attitudes were assessed at 1.5, 6, and 12 months postpartum. Body weight was measured at each time point and height at 1.5 months to calculate body mass index. Nutrition attitudes at each time were compared with demographic variables and weight status. Subjects Subjects were 340 non-Hispanic white (31.3%), non-Hispanic black (25.1%), and Hispanic (43.7%) new mothers (mean ageϭ22.4 years) located in central Texas. Criteria for participation included good health at delivery and low income (Յ185% federal poverty guideline). Statistical analyses 2 tests were used to compare demographic groups to categorical variables. Multivariate analysis of variance was done to investigate the effect of demographic variables on instrument subscale scores. A repeated-measures analysis of variance was used to identify significant changes over time. Results Obese women had higher barriers to healthful eating subscale means at 1 year compared with normal and overweight subjects at 1.5 and 6 months, and had more barriers than overweight participants at 12 months. Obese individuals also had higher emotional eating subscale scores than did overweight women at 1.5 months and both normal and overweight subjects at 12 months.
Journal of the American Dietetic Association, 2007
Objective This study tested the effectiveness of a pedometer program for increasing physical acti... more Objective This study tested the effectiveness of a pedometer program for increasing physical activity levels and reducing body weight in overweight and obese mothers of young children. Design Participants' motivational readiness to exercise, exercise self-efficacy, pedometer steps, pedometer kilocalories, and anthropometrics were evaluated at week 0 and week 8; anthropometrics were reassessed at week 24. Healthfulweight mothers provided comparison data at baseline. Subjects/setting A convenience sample of 93 intervention women (body mass index [calculated as kg/m 2 ] Ն25) and 31 comparison women (body mass index Ͻ25) were recruited from public health clinics, community centers, and churches. Eligibility criteria included Hispanic, African-American, or white ethnicity and low income (Ͻ200% of the federal poverty index).
Journal of the American College of Nutrition, 2007
To examine the effects of a weight loss program for mothers on the diet and activity of mothers a... more To examine the effects of a weight loss program for mothers on the diet and activity of mothers and their 1-3 year old children.
The purpose of this study was to evaluate a nutrition and physical activity program for reducing ... more The purpose of this study was to evaluate a nutrition and physical activity program for reducing body weight and improving nutrition attitudes in mothers of young children. A convenience sample of 114 intervention mothers and 33 comparison mothers was recruited from public health clinics and community centers. Eligibility criteria included Hispanic, African American, or white ethnicity; body mass index of at least 25 kg/m2; low income (<200% of the federal poverty index); and youngest child aged 1 to 4 years. For intervention participants, height, weight, percentage of body fat, waist circumference, demographics, nutrition attitudes, and dietary intake were measured at weeks 0 and 8; height, weight, percentage of body fat, and waist circumference were reassessed at 6 months. Overweight mothers in the comparison group provided anthropometric and demographic data at weeks 0 and 8. Changes in anthropometrics, attitudes, and dietary intake were evaluated in intervention mothers. Anthropometric data of intervention vs comparison group mothers were examined. Differences in anthropometrics and attitude scores between weight loss responders (≥2.27 kg) and nonresponders (<2.27 kg) were assessed at week 8. Intervention participants lost weight (x = −2.7 kg; P < .001), whereas comparison mothers gained a slight amount of weight (x= 0.1 kg) by week 8. Weight loss responders had healthier eating attitudes (5.6 vs 5.2; P < .01) and fewer perceived barriers (2.4 vs 2.9; P < .05) than nonresponders postintervention. In conclusion, this dietary and physical activity curriculum is a valuable resource for weight management programs serving low-income women.
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Papers by Henry Nuss