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Stotz S, Mitchell E, Szczepaniak M, Akin J, Fricke H, Shanks CB. A Qualitative Exploration of Approaches Applied by Nutrition Educators Within Nutrition Incentive Programs. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:224-234. [PMID: 36894222 DOI: 10.1016/j.jneb.2022.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/15/2022] [Accepted: 11/27/2022] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To explore the approaches applied by nutrition educators who work with the US Department of Agriculture Gus Schumacher Nutrition Incentive Program (GusNIP), Nutrition Incentive (NI), and Produce Prescription (PPR) programs. METHODS Multiple data collection methods, including descriptive survey (n = 41), individual interviews (n = 25), and 1 focus group (n = 5). Interviewees were educators who deliver nutrition education as a component of GusNIP NI/PPR programs. Descriptive statistics were calculated from survey responses. Transcripts were coded using thematic qualitative analysis methods. RESULTS Four overarching themes emerged. First, educators have many roles and responsibilities beyond providing curriculum-based nutrition education. Second, interviewees emphasized participant-centered nutrition education and support. Third, partnerships with collaborating cross-sector organizations are essential. Fourth, there are common challenges to providing nutrition education within GusNIP NI/PPR programs, and educators proposed solutions to mitigate these challenges. CONCLUSIONS Nutrition educators promote multilevel solutions to improve dietary intake, and it is recommended they be included in conversations to improve GusNIP NI/PPR programs.
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Affiliation(s)
- Sarah Stotz
- Centers for American Indian and Alaska Native Health, Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | | | | | - Joanna Akin
- Gretchen Swanson Center for Nutrition, Omaha, NE
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Laing SS, Alsayid M, Christiansen K, Shannon Dorcy K. Technology's role in promoting physical activity and healthy eating in working rural women: A cross-sectional quantitative analysis. Avicenna J Med 2019; 10:76-82. [PMID: 32500046 PMCID: PMC7252614 DOI: 10.4103/ajm.ajm_175_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aims: This exploratory study evaluated sociodemographic predictors of healthy eating and physical activity (PA) in a sample of working rural women and their access to and interest in using technology for health promotion. Settings and Design: This study is a cross-sectional quantitative analysis. Materials and Methods: A 32-item questionnaire was administered to a convenience sample of N = 60 women, working at a regional healthcare facility in the Pacific Northwest. Statistical Analysis: Descriptive statistics characterized PA and healthy eating, barriers and support for PA and healthy eating, and perceived role of technology for health promotion. Chi-square tests for categorical variables evaluated relationships between PA and healthy eating support with behavioral engagement. Results: Only 23% and 25% followed recommended PA and fruit and vegetable consumption guidelines. Those likely to engage in preventive care had higher income and education. Fewer respondents reported barriers to PA than for healthy eating (47% vs. 57%), and those reporting barriers were likely to have lower income and less than a high-school education. Sixty percent reported social support for PA and only 52% for healthy eating. A significant relationship was evident between PA support and PA engagement (P = 0.015). Eighty-two percent used mobile phones to look up health information and 29% did so daily. Almost two-thirds (62%) reported likelihood of using online health information boards to support healthy eating and 45% for PA. Conclusion: Working rural women benefit from PA and healthy eating guidance. Attention to sociodemographic predictors may support a tailored digital healthcare approach to promote wellness in this community.
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Affiliation(s)
- Sharon S Laing
- School of Nursing and Healthcare Leadership, University of Washington Tacoma, Tacoma, Washington, USA
| | - Muhammad Alsayid
- Division of Digestive Diseases, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Katheryn Christiansen
- Clinical and Nursing Research, Education and Practice, Seattle Cancer Care Alliance, Seattle, Washington, USA
| | - Kathleen Shannon Dorcy
- Clinical and Nursing Research, Education and Practice, Seattle Cancer Care Alliance, Seattle, Washington, USA
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Differences in Physical Activity and Diet Patterns between Non-Rural and Rural Adults. Nutrients 2018; 10:nu10111601. [PMID: 30388741 PMCID: PMC6267585 DOI: 10.3390/nu10111601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/10/2018] [Accepted: 10/24/2018] [Indexed: 12/04/2022] Open
Abstract
Background: It is unclear how rural occupations and lifestyles may play a role in shaping physical activity and diet behaviors that contribute to the rural–urban obesity disparity. Methods: Data come from the prospective and observational South Dakota Rural Bone Health Study, which included adults aged 20–66 years in three groups: (1) non-rural non-Hutterite, (2) rural non-Hutterite, and (3) rural Hutterite. Physical activity data were collected using 7-day physical activity questionnaires, and hours per day in physical activity categories are reported. Diet data were collected using food frequency questionnaires, and food group servings per day (svg/day) are reported. Mixed models were generated to determine group differences in physical activity and diet outcomes, and marginal group means are presented. Results: Among females, both rural groups spent more time in moderate activity (4.8 ± 0.13 h/day and 4.7 ± 0.09 h/day vs. 3.5 ± 0.11 h/day, both p < 0.001) and vigorous activity (0.58 ± 0.03 h/day and 0.53 ± 0.02 h/day vs. 0.43 ± 0.03 h/day, both p < 0.01) and less time sitting (4.4 ± 0.13 h/day and 4.3 ± 0.09 h/day vs. 5.0 ± 0.11 h/day, both p < 0.001) on weekdays than non-rural groups. Hutterite females spent fewer hours in moderate activity (2.6 ± 0.08 h/day vs. 4.5 ± 0.11 h/day, p < 0.001) and vigorous activity (0.18 ± 0.02 h/day vs. 0.46 ± 0.02 h/day, p < 0.001) on weekend days compared to rural females. Hutterite females consumed more fruits (2.2 ± 0.06 svg/day vs. 1.7 ± 0.10 svg/day, p < 0.001) and vegetables (3.6 ± 0.08 svg/day vs. 2.7 ± 0.12 svg/day, p < 0.001) than rural females. Among males, both rural groups spent more time in moderate activity (4.9 ± 0.13 h/day and 6.1 ± 0.12 h/day vs. 3.0 ± 0.16 h/day, both p < 0.001) and less time sitting (4.1 ± 0.13 h/day and 3.4 ± 0.12 h/day vs. 6.0 ± 0.15 h/day, both p < 0.001) on weekdays compared to non-rural groups. Hutterite males spent less time in moderate activity (2.1 ± 0.10 h/day vs. 4.1 ± 0.11 h/day, p < 0.001) and vigorous activity (0.15 ± 0.04 h/day vs. 0.74 ± 0.04 h/day, p < 0.001) on weekend days compared to rural males. Hutterite males consumed more vegetables (3.0 ± 0.10 svg/day vs. 2.0 ± 0.11 svg/day, p < 0.001) than rural males. Conclusions: A rural occupation and lifestyle appear to contribute to differences in physical activity, while traditional rural lifestyle practices contribute to differences in diet.
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Hagues R, Stotz S, Childers A, Phua J, Hibbs J, Murray D, Lee JS. Social marketing nutrition education for low-income population. SOCIAL WORK IN PUBLIC HEALTH 2018; 33:317-328. [PMID: 29757116 DOI: 10.1080/19371918.2018.1469065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
As access to healthy food (or lack thereof) could be considered a social justice issue, social workers should be concerned about this issue and willing to collaborate with colleagues of various disciplines to address it. This study was a formative evaluation conducted to understand best practices, recommendations, and feasibility of a social-marketing-based nutrition education program tailored to the needs of adults with limited income. The authors report findings from focus groups conducted with Cooperative Extension Agents (CEAs) and region coordinators (n = 45) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) (n = 69) eligible participants to inform the development of a social marketing nutrition intervention for SNAP-Ed in Georgia. Barriers to healthy eating included cultural preferences, costs of healthy food, lack of time, and lack of availability. Social marketing has a potential to deliver effective and efficient SNAP-Ed targeted to large, limited-resource Georgians. Segmenting the low-income population based on geographical location as well as best methods for outreach can allow tailored messages to meet identified needs, lifestyles, and other variables that make these individuals most likely to respond to the program. Food security and nutrition education are topics of concern for all health care professionals interested in addressing complex health issues of many low-income adults.
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Affiliation(s)
- Rachel Hagues
- a Samford University , Department of Social Work , Birmingham , Alabama , USA
| | - Sarah Stotz
- b Department of Foods and Nutrition , The University of Georgia , Athens , Georgia , USA
| | - Austin Childers
- c Department of Foods and Nutrition & Cooperative Extension and Outreach , The University of Georgia , Athens , Georgia , USA
| | - Joe Phua
- d Department of Advertising & Public Relations , The University of Georgia , Athens , Georgia , USA
| | - Judy Hibbs
- c Department of Foods and Nutrition & Cooperative Extension and Outreach , The University of Georgia , Athens , Georgia , USA
| | - Deborah Murray
- e Cooperative Extension and Outreach , The University of Georgia , Athens , Georgia , USA
| | - Jung Sun Lee
- b Department of Foods and Nutrition , The University of Georgia , Athens , Georgia , USA
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Kanstrup AM, Bertelsen P, Jensen MB. Contradictions in digital health engagement: An activity tracker's ambiguous influence on vulnerable young adults' engagement in own health. Digit Health 2018; 4:2055207618775192. [PMID: 29942636 PMCID: PMC6016565 DOI: 10.1177/2055207618775192] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/14/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Activity trackers are designed to support individuals in monitoring and increasing their physical activity. The use of activity trackers among individuals diagnosed with depression and anxiety has not yet been examined. This pilot study investigates how this target group engages with an activity tracker during a 10-week health intervention aimed to increase their physical activity level and improve their physical and mental health. METHODS Two groups of 11 young adults (aged 18-29 years) diagnosed with depression or anxiety participated in the digital health intervention. The study used mixed methods to investigate the research question. Quantitative health data were used to assess the intervention's influence on the participants' health and qualitative data provided insights into the participants' digital health experience. RESULTS The study demonstrated an ambiguous influence from the use of an activity tracker with positive physical and mental health results, but a fading and even negative digital health engagement and counterproductive competition. CONCLUSIONS The ambiguous results identify a need for (1) developing strategies for health professionals to provide supervised use of activity trackers and support the target groups' abilities to convert health information about physical activity into positive health strategies, and (2) designing alternatives for health promoting IT targeted users who face challenges and need motivation beyond self-tracking and competition.
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Affiliation(s)
| | | | - Martin B Jensen
- Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Denmark
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Pinsk M, Nicholas D. Changing Needs for Information and Support in an Online System for Parents of Children With Kidney Disease. Can J Kidney Health Dis 2017; 4:2054358117714999. [PMID: 28717515 PMCID: PMC5502939 DOI: 10.1177/2054358117714999] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 05/12/2017] [Indexed: 11/17/2022] Open
Abstract
Background: Pediatric chronic kidney disease is psychologically, financially, and physically demanding on parents providing care. Parents often feel isolated because of the rarity of the condition, and geographic isolation often compounds this perception in Canada. Many parents seek assistance online for both information and social support. Objective: This study examines an online portal, titled “Ability Online,” which was designed to provide support and information to a diverse group of parents using chat facilities, bulletin boards, and e-mail. Specifically, we sought to identify how the technologies offered in this system related to the support and information seeking needs for parents. Secondary aims of determining possible reasons for attrition over time were explored as well. Design: Mixed methodology sequential exploratory design using the qualitative methodology of descriptive interpretation. Setting: Telephone interviews. Patients: Twenty parents of pediatric patients with chronic kidney disease from four Canadian centers who engaged in an online social support system “Ability Online.” Measurements: Interview transcripts generated from 20 taped phone conversations were reviewed from parents who engaged in the online system, and the themes derived from these transcripts served to generate semistructured interview questions that focused on their use of, and perceived benefit from, this technology for social support. Follow-up telephone interviews were then conducted with a 6-person subset of the original group in an effort to further define the impact of technology on their experience. This same smaller cohort provided data on social supports, caregiver satisfaction, and caregiver stress. Results: Many parents experience a progression through which their needs for knowledge and support change over time. Specifically, parents describe a transition from pure information seeking, to seeking parental interaction, mutual support and collaboration, and ultimately to advocacy. Parents described how technology could be used to address those needs. Limitations: Our cohort was slightly more educated and representative of more urban populations than published data reflecting the population of North American pediatric patients living with kidney disease. Conclusions: Our data suggest themes of technology use influencing the goals of online support seeking. While our findings are preliminary, further study may inform Web designers to identify the changing needs of participants in designing such online support networks, and minimize the reasons that participants fail to adopt, or terminate their online experiences.
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Affiliation(s)
- Maury Pinsk
- Section of Pediatric Nephrology, University of Manitoba, Winnipeg, Canada
| | - David Nicholas
- Department of Social Work, University of Calgary, Alberta, Canada
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Dlugonski D, Martin TR, Mailey EL, Pineda E. Motives and Barriers for Physical Activity among Low-Income Black Single Mothers. SEX ROLES 2016. [DOI: 10.1007/s11199-016-0718-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Stotz S, Lee JS, Rong H, Murray D. The Feasibility of an eLearning Nutrition Education Program for Low-Income Individuals. Health Promot Pract 2016; 18:150-157. [PMID: 27507265 DOI: 10.1177/1524839916661717] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Online eLearning may be an innovative, efficient, and cost-effective method of providing nutrition education to a diverse low-income audience. AIMS The intent of this project is to examine perceptions of nutrition educators regarding the feasibility of an eLearning nutrition education program tailored to low-income Georgians. METHOD Semistructured individual interviews were conducted, guided by the constructivist theory. The interview guide focused on three themes: accessibility, literacy, and content. A prototype of the program also served as a talking point. Interviews were conducted in two urban Georgian counties in a location chosen by each participant. We recruited a convenience sample of Georgian nutrition educators ( n = 10, 100% female, 50% Black). Interviews were transcribed and analyzed using constant comparative method. RESULTS AND DISCUSSION Motivation is considered the primary barrier to program feasibility. Neither access to the Internet nor literacy are considered significant barriers. Inclusion of skill-based, visual education methods such as cooking videos, recipes, and step-by-step teaching tools was highlighted. Nutrition educators perceived this program would be a feasible form of nutrition education for the priority audience. CONCLUSIONS Findings from this study will inform the user-centered development of the program.
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Affiliation(s)
- Sarah Stotz
- 1 The University of Georgia, Athens, GA, USA
| | | | - Hui Rong
- 1 The University of Georgia, Athens, GA, USA
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Olsen JM, Thorson D, Baisch MJ, Monsen KA. Using Omaha System Documentation to Understand Physical Activity among Rural Women. Public Health Nurs 2016; 34:31-41. [DOI: 10.1111/phn.12264] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Diane Thorson
- Otter Tail County Public Health Department; Fergus Falls Minnesota
| | - Mary Jo Baisch
- University of Wisconsin Milwaukee School of Nursing; Milwaukee Wisconsin
| | - Karen A. Monsen
- University of Minnesota School of Nursing; Minneapolis Minnesota
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Henning-Smith C, Kozhimannil KB. Availability of Child Care in Rural Communities: Implications for Workforce Recruitment and Retention. J Community Health 2015; 41:488-93. [DOI: 10.1007/s10900-015-0120-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Leak TM, Benavente L, Goodell LS, Lassiter A, Jones L, Bowen S. EFNEP graduates' perspectives on social media to supplement nutrition education: focus group findings from active users. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2014; 46:203-208. [PMID: 24613446 DOI: 10.1016/j.jneb.2014.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Revised: 01/25/2014] [Accepted: 01/26/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To identify ways to effectively use social media to communicate nutrition-related information to low-income populations. METHODS The authors conducted 4 focus groups with female Expanded Food and Nutrition Education Program graduates who used social media at least twice a week (n = 26 total). Transcripts were analyzed using the constant comparative method to identify key themes. RESULTS For participants, page content, page maintenance, and networking opportunities with others were important aspects of a nutrition education social media page. Trust emerged as a central theme, because participants expressed a need for reliable information from known, credible sources and safe places to share ideas. CONCLUSIONS AND IMPLICATIONS Using social media to provide nutrition-related messages may be an effective way to encourage sustained positive behavior changes resulting from educational programming and to engage participants beyond class time. Establishing the trustworthiness of the social media site is essential to its use among low-income participants.
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Affiliation(s)
- Tashara M Leak
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Saint Paul, MN; Department of 4-H Youth Development and Family and Consumer Sciences, North Carolina State University, Raleigh, NC.
| | - Lisa Benavente
- Department of 4-H Youth Development and Family and Consumer Sciences, North Carolina State University, Raleigh, NC
| | - L Suzanne Goodell
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, NC
| | - Annie Lassiter
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, NC
| | - Lorelei Jones
- Department of 4-H Youth Development and Family and Consumer Sciences, North Carolina State University, Raleigh, NC
| | - Sarah Bowen
- Department of Sociology and Anthropology, North Carolina State University, Raleigh, NC
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Bonevski B, Randell M, Paul C, Chapman K, Twyman L, Bryant J, Brozek I, Hughes C. Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups. BMC Med Res Methodol 2014; 14:42. [PMID: 24669751 PMCID: PMC3974746 DOI: 10.1186/1471-2288-14-42] [Citation(s) in RCA: 684] [Impact Index Per Article: 68.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 03/20/2014] [Indexed: 11/15/2022] Open
Abstract
Background This study aims to review the literature regarding the barriers to sampling, recruitment, participation, and retention of members of socioeconomically disadvantaged groups in health research and strategies for increasing the amount of health research conducted with socially disadvantaged groups. Methods A systematic review with narrative synthesis was conducted. Searches of electronic databases Medline, PsychInfo, EMBASE, Social Science Index via Web of Knowledge and CINHAL were conducted for English language articles published up to May 2013. Qualitative and quantitative studies as well as literature reviews were included. Articles were included if they reported attempts to increase disadvantaged group participation in research, or the barriers to research with disadvantaged groups. Groups of interest were those described as socially, culturally or financially disadvantaged compared to the majority of society. Eligible articles were categorised according to five phases of research: 1) sampling, 2) recruitment and gaining consent, 3) data collection and measurement, 4) intervention delivery and uptake, and 5) retention and attrition. Results In total, 116 papers from 115 studies met inclusion criteria and 31 previous literature reviews were included. A comprehensive summation of the major barriers to working with various disadvantaged groups is provided, along with proposed strategies for addressing each of the identified types of barriers. Most studies of strategies to address the barriers were of a descriptive nature and only nine studies reported the results of randomised trials. Conclusions To tackle the challenges of research with socially disadvantaged groups, and increase their representation in health and medical research, researchers and research institutions need to acknowledge extended timeframes, plan for higher resourcing costs and operate via community partnerships.
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Affiliation(s)
- Billie Bonevski
- School of Medicine & Public Health, Faculty of Health & Medicine, University of Newcastle, Callaghan, NSW, Australia.
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Lohse B, Arnold K, Wamboldt P. Evaluation of About Being Active, an online lesson about physical activity shows that perception of being physically active is higher in eating competent low-income women. BMC Womens Health 2013; 13:12. [PMID: 23496893 PMCID: PMC3635936 DOI: 10.1186/1472-6874-13-12] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 02/28/2013] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Eating competence (EC) has been associated with positive health outcomes such as reduced cardiovascular risk and higher diet quality. This study compared reported physical activity and EC in 512 low-income women participating in an online program that included a physical activity lesson and assessed response to this lesson. METHODS Educational intervention and surveys were completed online. EC was assessed with the Satter Eating Competence Inventory for Low-Income (ecSI/LI). RESULTS Participants were mostly white, <31 years, overweight/obese (60%), and food insecure (58%). EC was higher for those who self-reported being physically active (30.1 ± 8.3 vs. 24.9 ± 8.1; P<0.001) and were active for ≥ 30 minutes/day (29.9 ± 8.3 vs. 26.3 ± 8.6), even with age, weight satisfaction, and BMI controlled. EC of obese physically active persons was higher than normal weight, but physically inactive women. The physical activity module was well received with responses unrelated to time involved or physical activity level. CONCLUSIONS Low-income women were interested in learning about physical activity and responded positively to online delivery. Overall EC levels were low, but higher for physically active women, supporting efforts to enhance EC. Additional research is needed to determine if EC is associated with responses to physical activity education.
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Affiliation(s)
- Barbara Lohse
- Department of Nutritional Sciences, The Pennsylvania State University, 205 Chandlee Lab, University Park, PA, 16802, USA
| | - Kristen Arnold
- Department of Nutritional Sciences, The Pennsylvania State University, 306 Chandlee Lab, University Park, PA, 16802, USA
| | - Patricia Wamboldt
- Department of Nutritional Sciences, The Pennsylvania State University, 306 Chandlee Lab, University Park, PA, 16802, USA
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Olsen JM. An integrative review of literature on the determinants of physical activity among rural women. Public Health Nurs 2013; 30:288-311. [PMID: 23808855 DOI: 10.1111/phn.12023] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this integrative review is to analyze current, non-experimental literature to identify factors that influence physical activity levels in rural women with a goal of informing nurses and improving the effectiveness of future physical activity interventions in this population. DESIGN AND SAMPLE Whittemore and Knafl's (2005) integrative review methodology was used. The sample included 11 quantitative articles, seven qualitative studies, two studies that incorporated both methodologies, and one explanatory case study. MEASURES Each article was evaluated for quality using the American Association of Critical-Care Nurses revised evidence leveling system. Data were analyzed and then synthesized using the Matrix Method. RESULTS The terms "rural" and "physical activity" were diversely defined in the reviewed articles. The results revealed three categories of determinants: personal factors, socio-economic factors, and physical environment factors. CONCLUSIONS Effective nursing interventions to promote physical activity should address barriers and motivating factors in all three categories of determinants for maximum efficacy. Additional research that clearly defines and consistently applies the terms "rural" and "physical activity" is needed to strengthen knowledge in this area.
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Affiliation(s)
- Jeanette M Olsen
- Department of Allied Health, Wisconsin Indianhead Technical College, Rice Lake, Wisconsin, USA.
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Marshall ES, Bland H, Melton B. Perceived barriers to physical activity among pregnant women living in a rural community. Public Health Nurs 2012; 30:361-9. [PMID: 23808861 DOI: 10.1111/phn.12006] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The purpose of this research was to describe perceived barriers to physical activity among pregnant women living in a rural community. DESIGN AND SAMPLE The project followed a simple descriptive design. The sample included 88 healthy pregnant women from a rural community in the southeast United States. MEASURES The women completed the International Physical Activity Questionnaire (IPAQ) and an open-ended item seeking a description of personal barriers to engagement in regular physical activity. RESULTS Scores on the IPAQ were generally equally distributed across categories of low, moderate, and high activity. A total of 42 barriers was described from 34% of the women. Seven themes emerged among the reported barriers: (1) symptoms of pregnancy, (2) family and childrearing activities, (3) lack of personal motivation, (4) time and employment demands, (5) perceptions of sufficient activity from daily life, (6) fear of injury, and (7) lack of a habit of activity. CONCLUSIONS Barriers reported by the rural women were similar to those identified in other settings. Some perceptions confirmed myths about the health value of exercise during pregnancy, but did not confirm barriers commonly cited or assumed for reduced physical activity among rural residents.
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Affiliation(s)
- Elaine S Marshall
- Rural Health Research Institute, School of Nursing, Georgia Southern University, Statesboro, Georgia 30460, USA.
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Validation of a measure of the Satter eating competence model with low-income females. Int J Behav Nutr Phys Act 2011; 8:26. [PMID: 21473765 PMCID: PMC3094263 DOI: 10.1186/1479-5868-8-26] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Accepted: 04/07/2011] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to evaluate the construct validity of a version of the ecSatter Inventory (ecSI), a measure of eating competence (EC), as adapted for use in a low-income (LI) population. Methods Females (n = 507), aged 18 to 45 years, living in households with a history of participating in the Supplemental Nutrition Assistance Program completed a web-based survey that included the ecSI for LI (ecSI/LI) and valid measures of cognitive and affective eating behavior, food preference and practice, and food preparation. Results Most correlations and differences between eating competent and non-eating competent categories and among EC tertiles were compatible with hypothesized relationships. ecSI/LI scores were positively related with self-reported physical activity, food acceptance, fruit and vegetable intake, and food planning/resource management. ecSI/LI scores were negatively associated with body mass index, dissatisfaction with body weight, tendency to overeat in response to external or emotional stimuli, and indices of psychosocial attributes related to disordered eating. Conclusions The ecSI/LI is a valid measure of EC for low-income females and provides a tool for researchers and educators to assess intervention outcomes and further explore the EC construct.
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Atkinson NL, Desmond SM, Saperstein SL, Billing AS, Gold RS, Tournas-Hardt A. Assets, challenges, and the potential of technology for nutrition education in rural communities. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2010; 42:410-416. [PMID: 20813589 DOI: 10.1016/j.jneb.2009.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Revised: 09/01/2009] [Accepted: 09/28/2009] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To examine assets of and challenges to getting adequate nutrition and physical activity among low-income rural residents, and the potential for technology to provide health education. METHODS Environmental scans and community stakeholder interviews were conducted in 5 rural counties in Maryland. During environmental scans, stakeholders guided tours around each county to explore community services and resources for nutrition, physical activity and technology. In-depth interviews with stakeholders (n=58) focused on nutrition, physical activity, and technology issues. RESULTS Low-income residents both benefit from and face challenges in rural settings. Besides attitude and knowledge barriers, lack of affordable resources and public transportation contributed to inattention to nutrition and physical activity. Stakeholders' reactions to a proposed Internet-based intervention were mostly favorable, but questions emerged about providing computers and Internet to individual families. CONCLUSIONS AND IMPLICATIONS Internet-based education may be a viable option to help low-income rural residents overcome barriers to nutrition and physical activity.
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Affiliation(s)
- Nancy L Atkinson
- Department of Public and Community Health, University of Maryland, College Park, MD 20742, USA.
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Kaiser BL, Baumann LC. Perspectives on Healthy Behaviors Among Low-Income Latino and Non-Latino Adults in Two Rural Counties. Public Health Nurs 2010; 27:528-36. [DOI: 10.1111/j.1525-1446.2010.00893.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Given the Canadian Aboriginal People's colonial legacy of multiple deprivations, the discord between an Aboriginal worldview and the dominant neo-liberal culture in Canada, and the recognized disadvantage vulnerability of single mothers, this quantitative study was aimed at increasing the understanding of exclusion, specifically with reference to the domains of disadvantage of Saskatchewan Aboriginal/Non-Aboriginal single mothers. We conducted a self-administered survey (random selection) of Saskatchewan single mothers (ages 18-59) who had at least one child less than 18 years of age living with them. In our cross-sectional self-administered survey, we compared specific social aspects of life between groups of randomly selected Saskatchewan single mothers, Aboriginal and Non-Aboriginal. An exploratory factor analysis identified two factors identified as domains of disadvantage loaded in excess of .30. These two factors accounted for 43% of the common variance in the Aboriginal sample and 47% in the Non-Aboriginal one. What was especially noteworthy was the striking similarity of how these variables tend to cluster together in the two distinct groups from which they were derived. This research will hopefully lead to further studies which endeavor to determine whether such initiatives aimed at enhancing the levels of social inclusion of those regarded as disadvantaged ultimately also impacts their health and well being. Further studies of this nature would help to clarify whether or not the relationship among these measures of adjustment is causal.
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Affiliation(s)
- Randy Johner
- Faculty of Social Work, University of Regina, Regina, SK, S4S OA2, Canada.
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Atkinson NL, Saperstein SL, Desmond SM, Gold RS, Billing AS, Tian J. Rural eHealth nutrition education for limited-income families: an iterative and user-centered design approach. J Med Internet Res 2009; 11:e21. [PMID: 19632974 PMCID: PMC2762801 DOI: 10.2196/jmir.1148] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2008] [Revised: 01/05/2009] [Accepted: 01/17/2009] [Indexed: 11/25/2022] Open
Abstract
Background Adult women living in rural areas have high rates of obesity. Although rural populations have been deemed hard to reach, Internet-based programming is becoming a viable strategy as rural Internet access increases. However, when people are able to get online, they may not find information designed for them and their needs, especially harder to reach populations. This results in a “content gap” for many users. Objective User-centered design is a methodology that can be used to create appropriate online materials. This research was conducted to apply a user-centered approach to the design and development of a health promotion website for low-income mothers living in rural Maryland. Methods Three iterative rounds of concept testing were conducted to (1) identify the name and content needs of the site and assess concerns about registering on a health-related website; (2) determine the tone and look of the website and confirm content and functionality; and (3) determine usability and acceptability. The first two rounds involved focus group and small group discussions, and the third round involved usability testing with individual women as they used the prototype system. Results The formative research revealed that women with limited incomes were enthusiastic about a website providing nutrition and physical activity information targeted to their incomes and tailored to their personal goals and needs. Other priority content areas identified were budgeting, local resources and information, and content that could be used with their children. Women were able to use the prototype system effectively. Conclusions This research demonstrated that user-centered design strategies can help close the “content gap” for at-risk audiences.
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Affiliation(s)
- Nancy L Atkinson
- Department of Public and Community Health, School of Public Health, University of Maryland, College Park, MD 20742-2611, USA.
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Interviews with Low-Income Pennsylvanians Verify a Need to Enhance Eating Competence. ACTA ACUST UNITED AC 2009; 109:468-73. [DOI: 10.1016/j.jada.2008.11.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2008] [Accepted: 07/07/2008] [Indexed: 11/23/2022]
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