Formative assessment in the development of an obesity prevention component for the expanded food and nutrition education program in Texas

Perspectives of Black/African American and Hispanic Parents and Children Living in Under-Resourced Communities Regarding Factors That Influence Food Choices and Decisions: A Qualitative Investigation

Families living in under-resourced communities are at risk of obesity and obesity-related chronic diseases. To develop effective interventions, it is important to identify parent and child perspectives of factors that influence food-related choices and decisions. This paper reports qualitative findings from a larger mixed method study investigating this topic. Hybrid thematic analysis was used to code and analyze the interviews. Family-generated photographs of factors influencing food choices were discussed during the interviews. Qualitative findings were organized by the socio-ecological model. Verbatim quotes and photographs were used to support themes. Thirty-six interviews were conducted (18 parents, 18 children). Findings from parents revealed personal (e.g., culture, beliefs, time), family (e.g., mother, child, father, health, finances, cohesiveness), environmental (e.g., availability, convenience, cost), and other (e.g., school food) factors influenced food choices. Similarly, child-reported influences were personal (e.g., preferences, beliefs, taste), family (e.g., mother, family encouragement, father, family time), social (e.g., school, friends), environmental (e.g., availability), and other (e.g., media, sports). The socio-ecological model provided a useful framework for identifying factors that influence food choices and decisions of families living in under-resourced communities. A deeper understanding of these factors could enhance both responsiveness and effectiveness of interventions to enhance diet and reduce obesity risk in families living in under-resourced communities.

Does the Kids Café Program's Nutrition Education Improve Children's Dietary Intake? A Pilot Evaluation Study

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.

INTERVENTION

Trained KCP site staff taught the nutrition education curriculum at intervention sites.

MAIN OUTCOME MEASURES

Healthy Eating Index-2010 using 24-hour dietary recall data (primary) and BMI percentile (secondary) ANALYSIS: Repeated-measures mixed-effects modeling RESULTS: Mean age of children was 10.2 years; mean BMI percentile was about 79; 95% were from food-insecure households. The total Healthy Eating Index-2010 score for both groups at baseline and posttest ranged from 50 to 60. At posttest, compared with baseline scores, children from both groups scored significantly lower for total vegetables, and greens and beans; the intervention group children had significantly higher sodium scores. Process evaluation indicated that 60-minute lecture-based sessions were too long after children were in school all day.

CONCLUSION

This pilot study suggests that the KCP nutrition education curriculum needs improvement. Further research based on behavioral constructs is needed to refine the curriculum to encourage healthier food choices among children and using the MyPlate and the 2015-2020 Dietary Guidelines for Americans.

Whetting disadvantaged adults' appetite for nutrition education

OBJECTIVE

To identify the features of a nutrition education programme for disadvantaged adults deemed most attractive and useful by participants.

DESIGN

A two-year, multi-method, qualitative evaluation of pre and post data collected from programme participants. Data were imported into NVivo10 for coding to facilitate a thematic analysis.

SETTING

Western Australia. Participants Individuals attending the Western Australian FOODcents nutrition education programme that is designed to provide knowledge and skills needed to consume a healthy diet on a budget. Focus groups were conducted several weeks after course completion (five groups, forty-seven participants), observations were conducted during FOODcents sessions (thirty-one observation episodes, 237 participants), and open-ended questions were asked in pre-post hard-copy surveys administered in sessions (n 927) and an online survey administered on average six weeks after course completion (n 114).

RESULTS

The course attributes that were found to be especially important to participants were: (i) user-friendly, practical information that could be immediately translated to their daily lives; (ii) experiential learning that involved direct contact with food products; and (iii) opportunities for social interaction. These aspects of nutrition education were described as being highly influential in the decision to participate in the course, the application of the information in their subsequent food purchase and preparation activities, and their word-of-mouth communications with others about the course.

CONCLUSIONS

Incorporating aspects of most importance to participants into nutrition education programme delivery and promotion may increase joining rates, enjoyment, satisfaction with course content and, ultimately, the uptake of recommended behaviours.

The Yin and Yang of Formative Research in Designing Serious (Exer-)games

Despite its relevance, formative research on games may be an undervalued part of the game development process. At the 2014 International Society of Behavioral Nutrition and Physical Activity exergaming preconference satellite meeting, a roundtable discussion was held to assemble experiences and suggestions on enhancing the use of formative research in the development of active videogames (i.e., exergames). This article presents a summary of the concepts discussed. The discussants concluded that, although formative research may slightly expand the project timeline, the potential benefits include a game more in line with preferences of the intended users, with better operationalized theoretical constructs and broader stakeholder support, facilitating implementation and sustainability. It also improves the efficiency of other research parts because of a lower dropout rate of participants. Formative, qualitative research is thus a necessary complement to quantitative measurements of intervention outcomes, in a sort of Yin and Yang dynamic. An adapted version of formative research that casts a wider net may, however, be needed, involving both behavioral scientists and game developers, expanding the topics beyond the game's looks and soliciting the opinions of a larger group of stakeholders, such as implementers, gatekeepers, and funders.