Department of Food Science and Human Nutrition

Permanent URI for this communityhttps://hdl.handle.net/10217/100426

This digital collection includes theses and dissertations from the Department of Food Science and Human Nutrition.

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Open Access
Assessing the effectiveness of the America On the Move family program in a real-life setting through Colorado Extension
(Colorado State University. Libraries, 2013) Roark, Constance Mary, author; Anderson, Jennifer, advisor; Hill, James, committee member; Barrett, Karen, committee member; Bellows, Laura, committee member
Background: More than 30% of the U.S. adult population and 17% of children between the ages of 2-19 years are considered to be obese; representing 72 million adults and 12.5 million children [1, 2]. Although Colorado currently holds the leanest state in the nation status, with an obesity rate of 21% [3], the state is not exempt from increasing rates of obesity in its population. According to the Colorado Department of Public Health and Environment, more than 50% of the population is considered overweight and the percentage of obese adults has doubled since 1996 to 21.4% [4]. In addition, the state ranks 29th in the U.S. in childhood obesity, with one out of every eight children 2-14 years of age being obese, and an obesity rate of 14.2% for youth between the ages of 10-17 years [4-6]. Rural communities suffer from many of the same health challenges facing the rest of the country; however, differences in overweight and obesity may exist between rural and urban areas. In one study, the risk for becoming overweight or obese for children in rural communities was 25% higher as compared to their urban-living counterparts [7]. Significant challenges are associated with the large changes required to reverse overweight and obesity. An approach that is focused on prevention and based on small changes has been proposed. It is suggested that smaller changes may be more doable and sustainable to prevent weight gain from occurring initially or reducing further weight gain in those who are currently overweight and obese [8-12]. The health-related consequences of obesity are numerous and of particular concern is the potential relationship between body-mass index (BMI) in adolescence and health complications in adulthood. One of the most significant predictors of obesity in children is the obesity status of their parents [13]. While heredity may be a contributing factor, evidence suggests that the influence of parents and the home environment play significant roles [13-21]. It is suggested that family-based approaches to treating and preventing obesity are not only efficacious, but may be a necessary component for success [22-26]. The America On the Move (AOM) Family program is one such approach. The AOM Program is a free, self-administered web-based program in which individuals learn to take control of their health through small sustainable changes in their diet and exercise routines and to manage their weight through energy balance [27]. Objective: The focus of this research study was to address phase three of the USDA funded grant, The America On the Move (AOM) Family Program for Weight Gain Prevention, in which the AOM Family Program was disseminated to families in Colorado through Extension in order to evaluate its usefulness for participating families. Methods: Eleven Family and Consumer Science Extension agents recruited families from Colorado communities to participate in this study. Participating families were given the AOM Family Program Toolkit together with pedometers and were asked to follow the program over a six month period. Families provided self-reported baseline (month 1) and final (month 6) assessments that included height, weight and seven day step results in addition to pre- and post- questionnaires. Changes in step activity and weight status outcomes using BMI and BMI percentiles (BMIp) for adults and children, respectively, were determined from baseline to final assessment. Additionally, feedback from the participants and the Extension agents was collected and relationships between behaviors and weight status outcomes were assessed. Results: Thirty-six families from nine communities completed the study, including 50 adults and 55 children. At the end of the six month study the adults had achieved a statistically significant reduction in mean body weight and BMI and the children demonstrated no statistically significant changes in mean BMI percentile; consistent with the AOM Family Program objective of weight gain prevention. The majority of the participants (86%) rated the program as either good or better and would recommend it to others. In contrast, only half of the Extension agents rated the program as good and most would not continue to offer it in their communities without changes. Conclusions: With further exploration and adjustments it is feasible that the AOM Family Program could become a valued tool in support of a more healthful lifestyle for families living in Colorado, with Extension serving as the conduit within their respective communities.
Open Access
Assessing the outcomes and acceptability of healthy lifestyles for Youth Corps members: phase 2 of a multi-phase project
(Colorado State University. Libraries, 2011) Kissane, Katharine Roseanne, author; Anderson, Jennifer, advisor; Trumbo, Craig W., committee member; Bellows, Laura Leigh, committee member
Background: Obesity is a costly condition that can reduce quality of life and increase the risk of several chronic diseases. Obesity has a multi-factorial etiology, which includes genetic, behavioral, and environmental factors (Baranowski 2000). Such a complex disease needs a complex solution such as changing public policy and the environment. In addition, people must be given knowledge and self-efficacy to live healthy lifestyles. The obesity epidemic is not limited to adults. Childhood obesity is a growing problem. In 1980, 6.5% of children aged 12-19 years were obese and this number increased statistically to 19.6% in 2008 (CDC 2010). According to the 2007 National Survey of Childhood Health the obesity rate in Colorado for youth ages 10-17 is 14.2%. Children in Colorado are ranked 29th out of the 50 states for obesity (Trust for America's Health 2010). The committee on prevention of obesity in children and youth encourages the evaluation of interventions that focus on preventing an increase in obesity prevalence, improving dietary behaviors, increasing physical activity levels, and reducing sedentary behaviors (Koplan et al 2005). There are several obesity prevention and intervention programs targeting youth, however, most of these efforts have been school-based or limited to school-aged children. The Youth Conservation Corps is a population not reached though these efforts. Traditionally, many of the youth employed by the Youth Corps have been low-income, at-risk, and ethnic minorities. There are currently no prevention programs targeting this audience and there have been no previous efforts addressing the health outcome of Youth Conservation Corps members. Objective: The first objective of this project (phase 2) was to revise the Healthy Lifestyle for Youth Corps Members curriculum based upon the pilot test with 13 corps members of phase 1 of the project. The second objective for phase 2 of this project was to implement the Healthy Lifestyles for Youth Corps Members and analyze changes in knowledge, attitudes, and behaviors regarding healthy lifestyles. Methods: Revisions to the curriculum were made based on the data collected during the first phase of the project and from suggestions made by researchers at Colorado State University and the Colorado Youth Corps Association. Data used in assessing changes in knowledge, attitudes, and behavior was collected using a survey that was tested for validity and reliability prior to implementation. In addition, the acceptability of the program was assessed by feedback from the corps members provided via the post-survey and crew leaders' instructor notes pages, which were located at the end of each unit specifically for crew leaders to fill out and offer feedback. Implementation and control group sites included Western Colorado Conservation Corps, Mile High Youth Conservation Corps, Larimer County Youth Conservation Corps, Southwest Conservation Corps -Four Corners and Southwest conservation Corps- Las Valles. Results: One hundred corps members in Colorado completed the program, 58 from the implementation group and 42 from the control group. The average age of all the participants was 20 years. When testing for knowledge only two questions had significant results. Many of the knowledge questions had a ceiling effect, as the corps members already knew the answer leaving no room for improvement. In addition, many of the corps members were already engaging in healthy lifestyle behaviors prior to the implementation of the Healthy Lifestyles Curriculum. Feedback from the crew leaders and corps members suggested that the curriculum was too basic and they suggested that the curriculum should contain more in depth information. However, there were corps members who enjoyed the curriculum and the younger corps members generally rated the curriculum as more acceptable. Conclusions: The results of this study suggest that this sample of Colorado Youth Corps members in this study were not representative of all Colorado Youth Corps. The average age of participants in 2009 was 18 years and in our study, the average age was 20 years. In addition, in 2009 there was more ethnic diversity than the sample in phase 2. Many corps members in this study already had the knowledge about living healthy lifestyles. Changes to the curriculum could include combining units 2 and 3 and units 4 and 5. In addition, incorporating more in depth information could enhance the effectiveness of this curriculum in the future.
Open Access
Association of pet ownership with eating, exercise, nutritional status, and heart health of seniors
(Colorado State University. Libraries, 1995) Dembicki, Diane Florence, author; Anderson, Jennifer, advisor; Melby, Chris, advisor; Stallones, Lorann, committee member; Auld, Garry, committee member; Barber, Clif, committee member
The familiar adage "pets are good for your health" is an interesting but largely untested theory. Numerous anecdotal remarks on the health benefits of companion animals to the elderly refer to eating and exercise. Research is needed to examine if any health benefits result from pet ownership, and, if so, models must be developed to explain the reasons. An early empirical study found increased survival rate of heart patients due to pets (Freidmann et al., 1980). A theoretical framework is developing based on pet attachment and substitute social support (Stallones et al., 1990). Recent research investigated the effects of pets on risk factors for cardiovascular disease (Anderson et al., 1992). A new model was developed, based on pet ownership leads to better self care, to show possible associations between pet ownership with eating, exercise, nutritional status, and specific cardiovascular risk factors. The major hypotheses tested were pet owners have significantly lower serum total cholesterol, low-density lipoprotein cholesterol, and triglycerides, and higher high-density lipoprotein cholesterol than non-owners and these differences are explained by diet and physical activity. The experimental design was a cross-sectional, observational study of a self-selected convenience sample. Seniors aged sixty and above were solicited at senior congregate meals program sites in north-central Colorado (n=127). Instruments used were questionnaires on eating and exercise, emotional and physical health, social support, and pet attachment, biochemical analyses of diet and blood, and anthropometric and physiological measures. Statistical procedures included two-tailed t-tests, Chi-square, multivariate analysis, correlation coefficients and partial coefficients, and analysis of covariance ; a value of p <0. 05 was considered significant. There were few significant differences in diet, nutritional status, and risk factors for cardiovascular disease and no significant differences in number of exercise activities and duration of walking between pet and nonowners. Dog owners walked significantly longer than nonowners. Pet owners had significantly lower triglycerides than non-owners. It could not be concluded that pet ownership is associated with better diet and nutritional status, greater physical activity, and reduced cardiovascular risk compared to non-ownership in seniors.
Open Access
Development and evaluation of a weight control program for obese preadolescent children
(Colorado State University. Libraries, 1992) Hammarlund, Virginia Anne, author; Anderson, Jennifer, advisor; Stone, Martha, advisor; Bowden, David, committee member; Bechtel, Peter, committee member; Fettman, Martin J., committee member
Obesity is a common nutritional problem of American children. Health problems associated with childhood obesity and its continuation into adulthood underscore the need for effective weight control treatment for obese preadolescent children. The purpose of this study was to develop an effective weight control program that incorporated a structured low fat diet, regular exercise, behavior modification, family involvement and a fun learning environment. No weight control treatment for obese preadolescent children has incorporated these factors. The program was designed to teach obese preadolescent children methods to reduce their daily fat intake to between 25 and 30 percent of their total daily caloric intake. Thirty-two obese preadolescent children were recruited from the Cheyenne, Wyoming, area with the assistance of local health care practitioners. Children were randomly assigned to the special intervention group or the standard care group. Children assigned to the special intervention group participated in a newly designed ten week weight control program for obese preadolescent children. Children in the special intervention group changed the nutrient quality but not the fat quantity of their diets. These children, as indicated on their program evaluations and confirmed by nutrient analysis increased their consumption of fruits, vegetables, dairy products and meat. They did not use low fat food substitutions that were emphasized in the program. Analysis of activity factors confirmed that children in the special intervention group had increased their level of physical activity at weeks 10 and 22. Children in the standard care group received the nutritional counseling usually provided by a registered dietitian at the local medical clinic. Children in the standard care group exhibited a significant improvement (P [less than or equal to] 0.05) in relative weight and BMI at weeks 10 and 22. Changes in dietary fat intake of children in the standard care group were associated with changes in their weight status indicators. The greater success of the standard care group was related to the level of family functioning and the type of individualized counseling provided as usual care. Results of this study suggest that obese preadolescent children from dysfunctional families could achieve a greater level of weight control success with individualized care than with a group based program.
Open Access
Development and evaluation of the America On the Move program for university students
(Colorado State University. Libraries, 2013) Dadkhah, Maryam, author; Anderson, Jennifer, advisor; Hill, James, advisor; Melby, Christopher, committee member; Long, Marilee, committee member
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Open Access
Development and impact of a Stage of Change bilingual nutrition education program for Hispanics
(Colorado State University. Libraries, 1997) Taylor, Terry, author; Anderson, Jennifer, advisor; Chapman, Phillip, committee member; Auld, Garry, committee member; Kendall, Pat, committee member
A nutrition education program, entitled La Cocina Saludable - The Healthy Kitchen, was designed based on the Stage of Change Model for Behavior Change and implemented in 10 counties in southern Colorado. The objectives were to improve the nutrition related knowledge, skills, and behaviors that lead to healthy lifestyles in a low-income Hispanic and migrant farmworker population. The content of the program included nutrition information designed to help mothers of preschool children provide for their children's nutritional needs. Specifically, the content areas included 1) Make It Healthy - nutrition principles including the Food Guide Pyramid; 2) Make it Fun - making food fun for children using color, texture, size, and shape; 3) Make A Change - modifying recipes and meals to lower fat, lower salt, lower sugar, and increase fiber; 4) Make it Safe - food safety principles; and 5) Make A Plan - budgeting and shopping tips to help stretch food resources. This population presents many obstacles for nutrition educators including limited resources, child care, transportation, time, language, culture, literacy, education, health beliefs, and in some cases, the transient nature of the population. Previous studies suggest that low-income Hispanics often show low intakes of vitamins A and C, calcium, iron, and protein. It follows that they show high rates of diabetes, obesity, infections, and enteric diseases. This program attempted to overcome these barriers by incorporating the use of a flexible program format carried out by abuela (Hispanic grandmother) educators using appropriate processes described in the Stages of Change Model for Behavior Change. The Stage of Change Model categorizes changing individuals into five stages: precontemplation, contemplation, preparation, action, and maintenance. It is suggested that within each stage, individuals emphasize specific processes that help to move them to the next stage. The program design and materials were developed by thoughtful incorporation of these processes. The program was evaluated using a knowledge and skills pre-test, post-test, and six month follow-up survey which included selected elements from WIC and EFNEP program evaluations. An instrument for measuring movement through the five stages was also developed. Final results of the program's evaluation suggest that this type of program based on the Stages of Change Model and using abuela educators as peer educators is effective in changing selected nutrition related knowledge, skills, and behaviors leading to healthy lifestyles. Administration of similar programs should be thoughtfully planned and implemented. Additionally, development and use of a Stage of Change assessment tool suggests key considerations when attempting to measure stages relative to nutrition behaviors for this population.
Open Access
Dissemination and implementation of the Cooking with Kids tasting curriculum
(Colorado State University. Libraries, 2010) Diker, Ann, author; Cunningham-Sabo, Leslie Derry, advisor; Anderson, Jennifer, advisor; Baker, Susan S., committee member; Kaminski, Karen, committee member; Most, David E., committee member
Numerous school health education programs, including nutrition education curricula have been developed. To improve dissemination and implementation of nutrition education curricula in schools, research is needed to identify and measure factors that facilitate and hinder the dissemination and implementation processes. Therefore, this study was conducted to identify strategies and practices that aided dissemination, adoption, and implementation of the Cooking with Kids (CWK) tasting curriculum by paraprofessional Nutrition Educators (NE). The study used a mixed methods time-series design. Formative assessment data were collected from two web-based surveys (n=313) and 27 interviews. The assessment results and constructs of Diffusion of Innovations and Social Cognitive Theory were used to develop a three-hour training introducing CWK to NE and their supervisors. Intervention data were collected from paraprofessional NE (n=49) and their supervisors (n=21) using a series of surveys, interviews, and implementation reports. Quantitative data analysis included descriptive analysis, factor analysis, analysis of variance, paired samples t-tests, correlations, and multiple regression. Qualitative data were analyzed for themes. Formative assessment revealed active participation, lesson observation, and pilot-testing as essential features of effective paraprofessional NE training. From pre- to post-training, NE and supervisors reported improved knowledge about teaching the curriculum (t=5.12, p<0.01 and t=8.31, p<0.01, respectively), confidence (t=3.93, p<0.01 and t=3.62, p<0.01, respectively), motivation (t=3.71, p<0.01 and t=2.63, p<0.05, respectively), and information (t=7.17, p<0.01 and t=4.15, p<0.01, respectively) to teach the curriculum. Gains in NE knowledge, confidence, motivation, and communication skills were sustained eight months post-training. Gains in supervisor knowledge were sustained eight months post-training. Supervisor motivation to use CWK returned to pre-training levels, which were relatively high to begin with so there was limited room for improvement. Although supervisor confidence was higher at eight months post-training, it was not statistically different from pre-training levels. These results may be attributed to the fact that supervisors did not teach the tasting lessons. High levels of curriculum adoption and implementation by NE were attributed to strong implementation expectations, experiential and observational learning training elements, and perceived curriculum compatibility with existing programming. Environmental factors such as time constraints, personnel turnover and scheduling conflicts proved challenging. Study results underscore the importance of combining theory and formative assessment for successful development and implementation of training and, in turn, curriculum implementation. In addition, results indicate that perceived simplicity, compatibility, and trialability are important attributes that should be maximized when introducing new curricula to potential adopters.
Open Access
Using computer technology to deliver nutrition education to low income populations
(Colorado State University. Libraries, 1997) Gould, Susan Martin, author; Anderson, Jennifer, advisor; Chapman, Phillip, committee member; Auld, Garry, committee member; Kendall, Pat, committee member
Nutrition education has been found to be effective in improving knowledge, attitudes, and behavior, particularly when programs are behavioral oriented and based on theoretical frameworks such as Prochaska's Stages of Change Model, the Social- Cognitive Leaming Theory, and the Communication Theory/Model. Increased nutrition risk has been found to be associated with income level, some minority groups, and education level. A nutrition education program, La Cocina Saludable ("The Healthy Kitchen"), has been developed utilizing abuelas (Hispanic grandmothers) to address some of the nutrition education needs of low-income Hispanic women and children, especially among migrant farm working families. Computer technology provides the opportunity to explore new and creative methods to deliver nutrition education to participants receiving food assistance. If this delivery method is effective, more people can be reached with accurate and consistent messages with less of the recruiting and training challenges found with peer educators. A pictorial version of the Colorado WIC Program Allowable Foods List was created using scanning and desk-top publishing techniques to add pictures and increase the readability of the text. Formative evaluation provided feedback regarding content and design. A final evaluation was completed to determine the preference between the text and pictorial versions. Potential WIC clients preferred the pictorial version (both Spanish and English) by more than 80%. Twelve of 14 grocery store checkers preferred using the pictorial version at their registers. Over 80% of 42 WIC staff surveyed indicated they would use the pictorial version more often with clients and that clients would like them. Building upon these scanning techniques, two units of La Cocina Saludable, "Make It Healthy" and "Make A Change," were adapted to a bilingual interactive multimedia (IMM) program and evaluated. The program was designed to be delivered via touch screen computers to participants of food and other assistance programs. Repeated measures analysis of variance (ANOVA) was used to assess the knowledge gains and reported behavior changes among participants who completed La Cocina Saludable with a computer and those who completed it with an abuela. Significant knowledge gains (p < 0.05) were observed with both methods of delivery. Those who received "Make It Healthy" with the abuela, however, had significantly more gains (p < 0.05) for that outcome than those who used the computer. No significant differences were seen between the abuela and IMM when comparing within the "Make A Change" unit. A few differences were reported for fat and salt behaviors. IMM provides an opportunity to expose more participants to accurate and consistent nutrition education messages and learning activities. Use of a combination of IMM and nutrition educator methods may be an important consideration to increase contacts and optimize gains.

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