Personal, proxy, and collective food agency among early adolescents.

Early adolescence is a critical time for health behavior development because agency increases during the transition from childhood to adolescence. This qualitative study sought to identify how early adolescent participants described food-related agency. One-on-one interviews were conducted with 30 early adolescents (10-13 years).

Evaluation of the Choose Health: Food, Fun, and Fitness 3rd- to 6th-Grade Curriculum: Changes in Obesity-Related Behaviors.

Background: Choose Health: Food, Fun, and Fitness (CHFFF) is aimed at 3rd to 6th graders, and uses experiential learning, food preparation, active games, goal setting, and a family newsletter to target behaviors shown to decrease childhood obesity and chronic disease risk. This study aimed to evaluate CHFFF as intended in low-income settings.

Methods: A quasi-experimental design with delayed intervention was used.

Early adolescent food routines: A photo-elicitation study.

Early adolescence (ages 10-14) encompasses a critical transition period in which food and nutrition decisions are shifting in important ways. Food routines are food-based activities that repeat across days, weeks, seasons, or lives. Examining routines can provide insight into how individuals are influenced in food choices.

Training Needs of Nutrition Educators Engaged in Policy, Systems, and Environmental Approaches.

Objective: Assess training needs of nutrition educators incorporating policy, systems, and environmental (PSE) approaches into their obesity prevention efforts, to identify content for online training.

Methods: Conducted a national, online survey of state and local Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program Education professionals engaged in PSE efforts.

Results: Respondents (n = 601) rated the importance of 24 training topics related to planning, implementing, and evaluating PSE approaches.

Child diet and health outcomes of the simple suppers program: a 10-week, 2-group quasi-experimental family meals trial.

Background: Racial minority children, particularly from low-income households, are at risk for obesity. Family meals have a protective effect on child nutritional health. However, the current evidence is limited in racial and socioeconomic diversity.

Life course influences on food provisioning among low-income, Mexican-born mothers with young children at risk of food insecurity.

Background: World migration shifts emphasize the necessity of framing health behavior in the context of life course. Mexican-born households in the U.S.

Trust in Physicians and Medical Experience Beliefs Differ Between Women With and Without Polycystic Ovary Syndrome.

Context: Women with polycystic ovary syndrome (PCOS) report dissatisfaction with their early medical care. Little is understood about factors that can encourage stronger patient-provider relationships and promote treatment adherence.

Objective: To compare trust in physicians and beliefs about social support from health care providers between women with and without PCOS.

Health-related knowledge, beliefs and self-efficacy in women with polycystic ovary syndrome.

Study Question: Do health-related knowledge, beliefs and self-efficacy differ between women with and without polycystic ovary syndrome (PCOS)?

Summary Answer: Women with PCOS felt at greater risk for adverse health outcomes, yet believed a healthy lifestyle was less beneficial to prevent weight gain relative to a comparison group.

What Is Known Already: Diet and physical activity are often used to treat PCOS, but there are high attrition rates and less engagement in self-help methods. It is unclear whether there are unique psychosocial considerations in PCOS that should be incorporated into these interventions.

Choose Health: Food, Fun, and Fitness Youth Curriculum Promotes Positive Behaviors.

Objective: Evaluate whether participation in Choose Health: Food, Fun, and Fitness (CHFFF), a hands-on, experiential curriculum aimed at third- to sixth-graders, resulted in improvements in the targeted obesity and chronic disease prevention behaviors.

Methods: The researchers evaluated CHFFF in low-income youth participating in 2 federal programs in New York State during 2013-2015. Food and activity behaviors were assessed using the Expanded Food and Nutrition Education Program third- through fifth- and sixth- through eighth-grade pre-post surveys, along with 2 sets of added CHFFF-specific items completed by subsamples.

The relationship between community nutritionists' use of policy, systems and environmental strategies to prevent obesity and its determinants depends on networking.

Objective: To apply the Theory of Planned Behaviour to examine the relationship between the constructs of background factors and beliefs towards using policy, systems and environmental (PSE) strategies and reported use of PSE strategies to prevent obesity by a group of professional nutrition educators.

Design: Cross-sectional study using self-reported survey.

Setting: Cooperative Extension in New York, USA.

Methods and design of a 10-week multi-component family meals intervention: a two group quasi-experimental effectiveness trial.

Background: Given the ongoing childhood obesity public health crisis and potential protective effect of family meals, there is need for additional family meals research, specifically experimental studies with expanded health outcomes that focus on the at-risk populations in highest need of intervention. Future research, specifically intervention work, would also benefit from an expansion of the target age range to include younger children, who are laying the foundation of their eating patterns and capable of participating in family meal preparations. The purpose of this paper is to address this research gap by presenting the objectives and research methods of a 10-week multi-component family meals intervention study aimed at eliciting positive changes in child diet and weight status.

Implementing Smarter Lunchrooms Makeovers in New York state middle schools: an initial process evaluation.

Background: This paper presents design and findings from the process evaluation of a randomized controlled trial (RCT) testing the effectiveness of Smarter Lunchrooms Movement (SLM) interventions to encourage consumption of either fruit, vegetables, or unflavored milk in middle school cafeterias (grades 6-8, typically children ages 10-14 years). Using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework adapted for environmental interventions, the process evaluation monitored fidelity to SLM protocol, determined barriers and facilitators influencing fidelity, and identified the training and support needs of implementers.

Methods: Under research team guidance, community partners (interventionists) assisted school food service staff (providers) with a six week implementation of protocol items in 13 public middle school cafeterias (two milk treatment, three vegetable treatment, four fruit treatment, and four control) in New York State during the 2013-2014 academic year.

What Does Evidence-Based Mean for Nutrition Educators? Best Practices for Choosing Nutrition Education Interventions Based on the Strength of the Evidence.

Funding agencies and professional organizations are increasingly requiring community-based nutrition education programs to be evidence-based. However, few nutrition education interventions have demonstrated efficacy, particularly for interventions that address the outer layers of the socioecological model (ie, organizational, community, and public policy). This article reviews the types of evidence available to assess the likelihood that a given intervention will deliver the desired outcomes and how these types of evidence might be applied to nutrition education, and then suggests an approach for nutrition educators to evaluate the evidence and adapt interventions if necessary.

Characteristics associated with the application of an ecological approach to preventing childhood obesity.

Objective: Applying an ecological approach to childhood obesity prevention requires a new way of thinking and working for many community-based practitioners who are used to focusing on individual behaviour change. The present study investigated individual and organizational characteristics associated with the application of an ecological approach by practitioners 6 months post-training.

Design: Individual and organizational characteristics and outcomes of a 6-week online training course were assessed at pre-course, post-course and 6-month follow-up.

Outcome effectiveness of the widely adopted EFNEP curriculum Eating Smart-Being Active.

Objective: To determine the effectiveness of the Expanded Food and Nutrition Education Program (EFNEP) curriculum Eating Smart-Being Active (ESBA).

Design And Setting: A quantitative, multi-state, nonequivalent comparison group pretest-posttest design was used to compare nutrition-related behavior changes in participants. ESBA was compared to previously used curricula for 3 different time periods in 5 states using the EFNEP evaluation tool.

Development and application of a framework to assess community nutritionists' use of environmental strategies to prevent obesity.

Objective: To develop and apply a framework exploring the extent of involvement in promoting environmental changes to prevent obesity by a group of nutrition educators (NE).

Design: Cross-sectional, mixed methods: qualitative interviews informed framework development; survey applied framework to describe NE's involvement in environmental changes.

Setting: Cooperative Extension in New York State.

Practice-based evidence of effectiveness in an integrated nutrition and parenting education intervention for low-income parents.

Research identifying associations between parental behaviors and children's food and activity choices and weight suggests that the integration of parenting and nutrition education holds promise for promoting healthful eating and activity in families. However, translational research leading to sustainable interventions lags behind. Development and testing of interventions within actual program contexts is needed to facilitate translation to full-scale implementation.

A randomized controlled trial of a community-based nutrition education program for low-income parents.

Objective: Assess effectiveness of the Expanded Food and Nutrition Education Program on nutrition behaviors post-education and longitudinally.

Design: Switching replications randomized experimental design. Participants randomly assigned to immediate education (IE) or delayed education (DE).

Nutrition program quality assurance through a formalized process of on-site program review.

A protocol for a systematic onsite review of the Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education was developed to support quality programming and ensure compliance with state guidelines and federal regulations. Onsite review of local nutrition program operations is one strategy to meet this goal. Observation and interaction with staff allow a comprehensive understanding of strengths, weaknesses, and emerging issues.

Developing a measure of behavior change in a program to help low-income parents prevent unhealthful weight gain in children.

Objective: To develop and test a brief measure of changes in eating, active play, and parenting practices after an intervention to help parents shape children's choices and home environments.

Design: Sequential phases of development and testing: expert panel review, cognitive testing interviews, field testing, test-retest study, and assessment of convergence with detailed previously validated instruments.

Setting And Participants: Expanded Food and Nutrition Education Program (EFNEP), New York State.

Online course increases nutrition professionals' knowledge, skills, and self-efficacy in using an ecological approach to prevent childhood obesity.

Objective: To assess the impact of an online continuing education course on the knowledge, skills, and self-efficacy of nutrition professionals to use an ecological approach to prevent childhood obesity.

Design: Quasi-experimental design using intervention and delayed intervention comparison groups with pre/post-course assessments.

Setting: Online continuing education course.

Enhancing the intrinsic work motivation of community nutrition educators: how supportive supervision and job design foster autonomy.

Mixed-methods research investigated the work motivation of paraprofessional community nutrition educators (CNEs) delivering a long-running public health nutrition program. In interviews, CNEs (n = 9) emphasized "freedom," supportive supervision, and "making a difference" as key sources of motivation. Community nutrition educator surveys (n = 115) confirmed high levels of autonomy, which was associated with supervisors' delegation and support, CNE decision-making on scheduling and curricula, and job satisfaction.