Publications by authors named "Karen W Cullen"

Background: Family conflict can reduce adolescent adherence to type 1 diabetes management tasks. The Family Teamwork in-person intervention was shown to be efficacious in reducing conflict and low adherence to diabetes-related tasks. Its reach and potential impact, however, were limited by the need to deliver the intervention sessions in person.

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School environments influence student food choices. À la carte foods and beverages are often low nutrient and energy dense. This study assessed how much money students spent for these foods, and the total kilocalories purchased per student during the 2012-2013 school year.

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Objective: To assess the agreement of posted menus with foods served to 3- to 5-year-old children attending federal Child and Adult Care Food Program (CACFP)-enrolled facilities, and the degree to which the facilities met the new meal patterns and best practices.

Design: On-site observations and menu coding.

Participants/setting: Nine early care and education centers.

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Objective: To evaluate the Kids Café Program (KCP) nutrition education and assess its impact on children's diet quality and body mass index (BMI) percentile.

Design: An experimental design consisting of pretest-posttest comparison groups using mixed methods to evaluate a 6-session nutrition education intervention.

Setting: Four Boys and Girls Club sites PARTICIPANTS: A total of 120 9- to 12-year-old children in the KCP (60 intervention and 60 comparison); 89% completed posttest evaluations.

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Objectives: Infants are at risk of overweight. Infant overweight predisposes child, adolescent, and adult to obesity. We hypothesized that parent education, initiated prenatally and provided in the home, would reduce the incidence of infant overweight at age 12 months.

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Objectives: We identified perceived barriers and facilitators to purchasing fruits and vegetables (FV) at farmers' markets, FV shopping practices, and reactions to a planned online lesson to promote farmers' market use among urban, inner-city WIC-enrolled women.

Methods: Thirteen focus groups were conducted with 3-5 participants each (N = 54).

Results: Common barriers were structural (transportation issues) and informational (not knowing the locations of markets).

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Background: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides participants seasonal Farmers' Market Nutrition Program (FMNP) vouchers to purchase fruits and vegetables (FV) at farmers' markets and monthly cash value vouchers (CVV) redeemable at farmers' markets. Despite the promise of FMNP vouchers and CVV for improving FV access among WIC participants, voucher redemption rates are low. This study evaluated WIC Fresh Start (WFS), a theory-driven, web-based lesson to promote FV intake, the redemption of CVV at farmers' markets, FMNP voucher redemption, and farmers' market-related knowledge, attitudes, and skills among women enrolled in WIC.

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Pediatric healthcare providers' perspectives on barriers to diabetes self-management among youth with type 1 diabetes and strategies to overcome them were explored qualitatively. Family conflict about diabetes care was viewed as a common problem, addressable by behavioral interventions to improve communication and promote family teamwork in diabetes management responsibilities.

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Objective: Diet and physical activity (PA) may vary by season.

Methods: Two 24-hour dietary recalls and 7 days of accelerometry were collected from 342 8-10 year-old African-American girls between January 2013 and October 2014. Season was based on time of data collection (fall, spring, winter, summer).

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To explore perspectives on barriers of eating healthy among food pantry clients. Food pantry clients participated in focus groups/interviews. Qualitative data were coded and analyzed using content analyses and grounded theory approach.

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In the United States, the National School Breakfast (SBP) and School Lunch Program (NSLP) meals are provided for free or at a reduced price to eligible children, and are a nutrition safety net for low income children. Consuming both meals could provide 58% of daily intake. This paper evaluates the contribution of SBP and NSLP meals to the dietary intakes of 5-18 year old children participating in the National Health and Nutrition Examination Surveys (NHANES) from 2007 through 2012.

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Background: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Fresh Start (WFS) is a randomized controlled trial of nutrition education to promote farmers' market fruit and vegetable (F/V) purchases and consumption among women enrolled in WIC.

Objectives: Using baseline data from WFS to examine associations between social desirability trait, the tendency to respond in a manner consistent with expected norms, and self-reported F/V intake and to determine whether associations, if found, are moderated by participant characteristics.

Design: Cross-sectional.

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Background: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Fresh Start (WFS) is a randomized controlled trial of nutrition education to promote farmers' market fruit and vegetable (F/V) purchases and consumption among women enrolled in WIC.

Objectives: To describe the baseline characteristics (demographics and F/V intake [including F/V juice]) of WFS participants, compare the characteristics with those of WIC participants in New Jersey and nationwide, and examine the baseline reliability of study measures.

Design: Cross-sectional.

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Introduction: The objective of this exploratory study was to determine whether fruit and vegetable consumption differed by race/ethnicity, by origin and nativity among Hispanics, and by language preference (as an indicator of acculturation) among foreign-born Hispanics.

Methods: We recruited 723 women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and orally administered a questionnaire containing demographic items, validated measures of food security status and social desirability trait, and the Behavioral Risk Factor Surveillance System fruit and vegetable module. Differences in intakes of 100% fruit juice, fruit, cooked or canned beans, and dark green, orange-colored, and other vegetables were assessed by using analysis of covariance with Bonferroni post hoc tests.

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Background: Physiological and environmental risk factors interact to undermine blood glucose control during early adolescence. This has been documented to be associated with family conflict and poor adherence to diabetes management tasks. Family Teamwork is an efficacious program demonstrated to enhance family communication and reduce conflict during this vulnerable period.

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Objective: Feasibility trials assess whether a behavior change program warrants a definite trial evaluation. This paper reports the feasibility of an intervention consisting of Self Determination Theory-informed text messages, pedometers, and goal prompts to increase adolescent physical activity.

Methods: A 4-group randomized design with baseline and immediate post-study assessments was used.

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Background: Children generally do not consume adequate amounts of fruits and vegetables (F/V). Eating more F/V can improve energy density and overall diet quality.

Objective: Our aim was to investigate whether improvements in F/V consumption were associated with improvements in energy density, total calories, and dietary components related to F/V.

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This article presents the results of a randomized clinical trial evaluating the eight-session Family Eats web-based intervention promoting healthy home food environments for African American families. African American families ( n = 126) with 8- to 12-year-old children completed online baseline questionnaires and were randomized into intervention or control groups. Data collection occurred at baseline, immediately postintervention (Post 1), and 4 months later (Post 2), for parents and children, separately.

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Objective: Squire's Quest! II: Saving the Kingdom of Fivealot, an online video game, promotes fruit and vegetable (FV) consumption. An evaluation study varied the type of implementation intentions used during the goal-setting process (none, action, coping, or both action and coping plans). Participants who created action plans reported higher FV consumption 6 months after baseline.

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Objective: We compared elementary students' school lunches selected and consumed before (Spring, 2011) and after (Spring, 2013) implementation of the new National School Lunch Program meal patterns in the fall of 2012.

Method: Students in eight elementary schools in one Southeast Texas school district were observed during lunch: foods selected/consumed were recorded. The percentage of students who selected each food group was compared between years, as were the differences in consumption and the percent of food consumed by year, for students who selected the food group.

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Background: Child fruit and vegetable intake is below recommended levels, increasing risk for chronic disease. Interventions to influence fruit and vegetable intake among youth have had mixed effects. Innovative, theory-driven interventions are needed.

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Fruit and vegetable (FV) attitudes and norms have been shown to influence intake in youth; yet research with low-income youth and studies supplementing self-report with objective measures of intake are lacking. Cross-sectional survey data on self-rated FV intake, FV attitudes, and FV norms were collected in a sample of 116 youth attending a residential summer camp serving low-income families. FV intake also was estimated by direct observation.

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Objective: To investigate changes in student food selection and consumption in response to the new National School Lunch Program meal patterns during fall 2011.

Design: Eight elementary and four intermediate schools in one Houston area school district were matched on free/reduced-price meal eligibility and randomized into control or intervention conditions.

Intervention: Both intervention and control school cafeterias served the same menu.

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