Sacramento, CA, United States
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Dunton G.F.,University of Southern California | Liao Y.,University of Southern California | Grana R.,University of California at San Francisco | Lagloire R.,Harder and Company Community Research | And 3 more authors.
Public Health Nutrition | Year: 2014

Abstract Objective The current study evaluated the overall public health impact of the 'Shaping Up My Choices' (SMC) programme, a 10-week school-based nutrition education curriculum developed for third-grade students, using the RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) framework. Design Randomized controlled trial to evaluate the programme and secondary analysis of archival data to describe dissemination. Data were collected from programme records, teacher surveys and student pre-, post- and 3-month follow-up surveys. Setting Public elementary schools in California. Subjects An evaluation sample (938 students and nineteen teachers) and a dissemination sample (195 245 students and 7359 teachers). Results In the evaluation sample, differences between the control and intervention groups were observed for nutrition knowledge, self-efficacy, outcome expectancies, and intakes of vegetables, fruit (girls only), soda, and low-nutrient high-energy foods from pre- to post-survey. Group differences in change in knowledge, outcome expectancies and vegetable intake were sustained through the 3-month follow-up (efficacy). One hundred per cent of intervention teachers in the evaluation sample implemented all of the lessons (implementation). The dissemination sample represented 42 % of third-grade students (reach) and 39 % of third-grade classrooms in public elementary schools in California during 2010-2011 (adoption). Thirty-seven per cent of third-grade teachers in the dissemination sample reordered SMC materials during the subsequent school year (2011-2012; maintenance). Conclusions The SMC programme demonstrates the potential for moderate to high public health impact. © The Authors 2012.


Mouttapa M.,California State University, Fullerton | Robertson T.P.,Dairy Council of California | McEligot A.J.,California State University, Fullerton | Weiss J.W.,California State University, Fullerton | And 3 more authors.
Journal of Nutrition Education and Behavior | Year: 2011

Objective: To conduct a dietary intervention using the Personal Nutrition Planner (PNP), an on-line nutrition intervention tool. Design: Randomized controlled trial with pretest, posttest, and 2-month follow-up self-report assessments. Setting: Web/on-line. Participants: Female university staff (n = 307; 59.1% Caucasian) recruited via e-mail. Retention rate was 85.0% (118 treatment; 143 comparison). Intervention: PNP on-line produces individualized nutrition feedback based on initial on-line assessment. Intervention lasted 5 weeks and included weekly e-mail reminders. Main Outcome Measures: Dietary intake frequencies, weight loss, opinions regarding intervention. Analysis: Repeated-measures analysis of variance to determine intervention effects on dietary intake and weight loss (P < .05). Results: Relative to the comparison group who received no program, the treatment group increased dairy intake frequency across the 3 assessments (F 2,304 = 3.15; P < .05). Among participants who wanted to lose weight, weight loss in the treatment group was significantly higher than that of the comparison group from pretest to posttest (F 1,92 = 4.50; P < .05). On a scale of 1-5, mean ratings of the PNP program characteristics ranged from 3-4. Conclusions and Implications: PNP produced significant increases in dairy intake and decreases in weight. Further revisions will tailor PNP to better fit individuals' dietary goals and increase motivation. © 2011 Society for Nutrition Education.


Larsen A.L.,University of Southern California | McArdle J.J.,University of Southern California | Robertson T.,Dairy Council of California | Dunton G.,University of Southern California
Journal of Nutrition Education and Behavior | Year: 2015

Objective: Evaluate the factor structure and stability of 4 dietary items (fruit, fruit juice, vegetables, and milk) from the School Physical Activity and Nutrition questionnaire-elementary school version. Methods: Secondary analysis of intervention data from third graders measured at pre-intervention, post-intervention (10 weeks), and 3-month follow-up. The researchers conducted structural equation modeling invariance analysis to test the stability of the factor structure of the 4 items. Results: Data from 1,147 students. Fit indices revealed good fit for a single factor remaining stable across time (χ2/degrees of freedom [DF] = 59.75/59, P = .45), gender (χ2/DF = 149.72/128, P = .09), and study groups (χ2/DF = 143.04/128, P = .17). Conclusions and Implications: A healthy food factor consisting of the 4 items can be used in future data analysis. This offers several advantages in analysis, including the use of latent change scores that are more powerful, more informative, and more easily interpreted than traditional approaches. © 2015 Society for Nutrition Education and Behavior.


Larsen A.L.,University of Southern California | Robertson T.,Dairy Council of California | Dunton G.,University of Southern California
Translational Behavioral Medicine | Year: 2015

Childhood overweight and obesity are major health problems. School-based programs enable intervening with large groups of children, but program overall health impact is rarely completely assessed. A RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) analysis tested the overall public health impact of the fourth-grade “Nutrition Pathfinders” school-based nutrition-education program. A randomized controlled trial in 47 fourth-grade California classrooms (1713 students) tested program efficacy, and a secondary analysis of archival data tested program dissemination. Desired effects were seen in child nutrition knowledge, attitudes, consumption of low-nutrient high-density foods, sugar-sweetened beverages, proteins, grains, and parent willingness to serve new foods. The program was disseminated to ∼25 % of public school fourth-grade classrooms in California and cost about $1.00 per student to implement. The Nutrition Pathfinders program demonstrates potential for moderate to high public health impact due to its wide dissemination, effectiveness in altering attitudes and behaviors, and its relatively inexpensive cost of implementation. © 2015, Society of Behavioral Medicine.


Buscemi J.,University of Illinois at Chicago | Odoms-Young A.,University of Illinois at Chicago | Yaroch A.L.,Gretchen Swanson Center for Nutrition | Hayman L.L.,University of Massachusetts Boston | And 2 more authors.
Translational Behavioral Medicine | Year: 2015

Schools are recognized as venues for population-based health promotion and chronic disease prevention initiatives targeting children, and the school food environment is a central component. The Healthy, Hunger-Free Kids Act of 2010 utilized research-based findings and expert recommendations to significantly improve school lunch standards in the kindergarten to twelfth grade (K-12) setting to enhance the nutritional intake and ultimately the health of children. The new guidelines include increasing the availability of whole grains, fruits, and vegetables; requiring children to select a fruit or vegetable daily; and restricting serving sizes. There is currently no evidence that the revised standards have increased school lunch plate waste. However, there is evidence that children are consuming more healthful foods. The Society of Behavioral Medicine (SBM) supports retaining current school lunch standards set by the Healthy, Hunger-Free Kids Act of 2010. SBM also supports increasing the evidence-based by evaluating the implementation and impact of the school lunch revisions. © 2015, Society of Behavioral Medicine.


Larsen A.L.,University of Southern California | McArdle J.J.,Dairy Council of California | Robertson T.,Dairy Council of California | Dunton G.F.,University of Southern California
Appetite | Year: 2015

Objective: To clarify the underlying relationship between nutrition self-efficacy and outcome expectations because the direction of the relationship (unidirectional vs bidirectional) is debated in the literature. Methods: Secondary data analysis of a 10-week, 10-lesson school-based nutrition education intervention among 3rd grade students (N = 952). Nutrition self-efficacy (7 items) and nutrition outcome expectations (9 items) were measured through student self-report at intervention pre- (time 1) and post- (time 2) assessments. A series of two time point, multi-group cross-lagged bivariate change score models were used to determine the direction of the relationship. Results: A cross lag from nutrition self-efficacy at time 1 predicting changes in nutrition outcome expectations at time 2 significantly improved the fit of the model (Model 3), whereas a cross lag from nutrition outcome expectations at time 1 to changes in nutrition self-efficacy at time 2 only slightly improved the fit of the model (Model 2). Furthermore, adding both cross lags (Model 4) did not improve model fit compared to the model with only the self-efficacy cross lag (Model 3). Lastly, the nutrition outcome expectations cross lag did not significantly predict changes in nutrition self-efficacy in any of the models. Conclusions: Data suggest that there is a unidirectional relationship between nutrition self-efficacy and outcome expectations, in which self-efficacy predicts outcome expectations. Therefore, theory-based nutrition interventions may consider focusing more resources on changing self-efficacy because it may also lead to changes in outcome expectations as well. © 2014 Elsevier Ltd.


PubMed | Dairy Council of California and University of Southern California
Type: Journal Article | Journal: Translational behavioral medicine | Year: 2015

Childhood overweight and obesity are major health problems. School-based programs enable intervening with large groups of children, but program overall health impact is rarely completely assessed. A RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) analysis tested the overall public health impact of the fourth-grade Nutrition Pathfinders school-based nutrition-education program. A randomized controlled trial in 47 fourth-grade California classrooms (1713 students) tested program efficacy, and a secondary analysis of archival data tested program dissemination. Desired effects were seen in child nutrition knowledge, attitudes, consumption of low-nutrient high-density foods, sugar-sweetened beverages, proteins, grains, and parent willingness to serve new foods. The program was disseminated to 25% of public school fourth-grade classrooms in California and cost about $1.00 per student to implement. The Nutrition Pathfinders program demonstrates potential for moderate to high public health impact due to its wide dissemination, effectiveness in altering attitudes and behaviors, and its relatively inexpensive cost of implementation.


PubMed | Gretchen Swanson Center for Nutrition, University of Massachusetts Boston, University of Illinois at Chicago and Dairy Council of California
Type: Journal Article | Journal: Translational behavioral medicine | Year: 2015

Schools are recognized as venues for population-based health promotion and chronic disease prevention initiatives targeting children, and the school food environment is a central component. The Healthy, Hunger-Free Kids Act of 2010 utilized research-based findings and expert recommendations to significantly improve school lunch standards in the kindergarten to twelfth grade (K-12) setting to enhance the nutritional intake and ultimately the health of children. The new guidelines include increasing the availability of whole grains, fruits, and vegetables; requiring children to select a fruit or vegetable daily; and restricting serving sizes. There is currently no evidence that the revised standards have increased school lunch plate waste. However, there is evidence that children are consuming more healthful foods. The Society of Behavioral Medicine (SBM) supports retaining current school lunch standards set by the Healthy, Hunger-Free Kids Act of 2010. SBM also supports increasing the evidence-based by evaluating the implementation and impact of the school lunch revisions.


PubMed | Dairy Council of California and University of Southern California
Type: Journal Article | Journal: Journal of nutrition education and behavior | Year: 2015

Evaluate the factor structure and stability of 4 dietary items (fruit, fruit juice, vegetables, and milk) from the School Physical Activity and Nutrition questionnaire-elementary school version.Secondary analysis of intervention data from third graders measured at pre-intervention, post-intervention (10 weeks), and 3-month follow-up. The researchers conducted structural equation modeling invariance analysis to test the stability of the factor structure of the 4 items.Data from 1,147 students. Fit indices revealed good fit for a single factor remaining stable across time ((2)/degrees of freedom [DF] = 59.75/59, P = .45), gender ((2)/DF = 149.72/128, P = .09), and study groups ((2)/DF = 143.04/128, P = .17).A healthy food factor consisting of the 4 items can be used in future data analysis. This offers several advantages in analysis, including the use of latent change scores that are more powerful, more informative, and more easily interpreted than traditional approaches.


PubMed | Dairy Council of California and University of Southern California
Type: | Journal: Appetite | Year: 2015

To clarify the underlying relationship between nutrition self-efficacy and outcome expectations because the direction of the relationship (unidirectional vs bidirectional) is debated in the literature.Secondary data analysis of a 10-week, 10-lesson school-based nutrition education intervention among 3rd grade students (N=952). Nutrition self-efficacy (7 items) and nutrition outcome expectations (9 items) were measured through student self-report at intervention pre- (time 1) and post- (time 2) assessments. A series of two time point, multi-group cross-lagged bivariate change score models were used to determine the direction of the relationship.A cross lag from nutrition self-efficacy at time 1 predicting changes in nutrition outcome expectations at time 2 significantly improved the fit of the model (Model 3), whereas a cross lag from nutrition outcome expectations at time 1 to changes in nutrition self-efficacy at time 2 only slightly improved the fit of the model (Model 2). Furthermore, adding both cross lags (Model 4) did not improve model fit compared to the model with only the self-efficacy cross lag (Model 3). Lastly, the nutrition outcome expectations cross lag did not significantly predict changes in nutrition self-efficacy in any of the models.Data suggest that there is a unidirectional relationship between nutrition self-efficacy and outcome expectations, in which self-efficacy predicts outcome expectations. Therefore, theory-based nutrition interventions may consider focusing more resources on changing self-efficacy because it may also lead to changes in outcome expectations as well.

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