Theses and Dissertations

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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
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
Increasing fruit and vegetable consumption in grade-school children
(Colorado State University. Libraries, 1997) Ryan, Linda DeBell, author; Jennifer Anderson, advisor; Bechtel, Peter J., advisor; Kendall, Patricia, committee member; Keefe, Thomas, committee member; Jansen, Duane, committee member
Diets rich in fruits and vegetables have many health benefits. Nutrients in fruits and vegetables such as vitamins, minerals, and fiber help protect individuals from certain cancers and cardiovascular disease. Children in our nation are not meeting the national health objectives or recommendations to eat plenty of fruits and vegetables. This research assessed whether the provision of classroom nutrition education on the benefits of eating fruits and vegetables and providing more fresh fruits and fresh vegetables in the school lunch program increased consumption by grade-school children. This research was completed in three parts. The purpose of part one (The Nutrition Education Intervention Study) was to determine if providing nutrition education to grade-school children and the community increased fruit and vegetable consumption. In this study a nutrition education program was given to the grade-school children and community of Holyoke (experimental group). The effects of the nutrition education intervention were compared to the control group (i.e., the grade-school children and community of Haxtun), which received no intervention. A nutrition education program was developed and designed as a hands-on education program for the children and for the community. The intervention included nutrition education materials, demonstrations, and activities on increasing the consumption of fruits and vegetables and good nutrition. Fruit and vegetable consumption was measured by a 24-hour food recall (children only) and a pre- and post-questionnaire for the children and community. The results showed mean fruit and vegetable consumption increased by 1.37 servings per day (from 2.45 to 3.82) among the grade-school children using the 24-hour food recall assessment method and 0.93 (3.93 to 4.86) using a pre/post self-reported questionnaire (both at p[less than or equal to]0.05 ). The community's mean fruit and vegetable intake increased by 0.66 servings per day (3.28 to 3.94) from the pre to post questionnaire (p[less than or equal to]0.05 ). The purpose of part two (The Fresh Fruit and Vegetable Intervention Study) was to determine if providing quality fresh fruits and fresh vegetables increased consumption by grade-school children. In this study the Department of Defense (DOD) provided fresh fruits and vegetables to schools within Colorado. The schools receiving the fresh fruits and vegetables (experimental group) were compared to schools not receiving fresh produce (control group). The children in the experimental group were offered a variety of high quality of fresh fruits and vegetables in the school cafeteria with their school lunches. Fruit and vegetable consumption was measured by subtracting plate waste from the beginning weight for each fruit and vegetable served. The results were as follows: 1. The experimental group took on an average 2. 70 ounces combined fruits and vegetables per child, the control group took 3.14 ounces per child (p[greater than or equal to]0.05). 2. The children in the experimental group consumed a greater percentage (73%) of fruits and vegetables than the control group (61 %) (p[less than or equal to]0.05). 3. The children in both groups consumed more fruits than vegetables. In part three, the results of the two studies were completed. The results showed that there was no difference in the two approaches, both interventions increased consumption of fruits and vegetables in the grade-school children.
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.
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
Development and evaluation of a nutrition curriculum to prevent obesity in inner-city teens
(Colorado State University. Libraries, 1998) Taitano, Rachael Tatiana, author; Jennifer Anderson, advisor; Auld, Garry, committee member; Kreutzer, Jill, committee member; DeVoe, Dale, committee member; Hill, Jim, committee member
Obesity is a major health concern in the United States. Obese adolescents have been found, later in life, to be at increased risk for noninsulin dependent diabetes mellitus, cardiovascular disease, hypertension and certain cancers. NHANES III and HHANES data reveal that regardless of ethnicity, an estimated 21% of adolescents (12-17 years of age) in the United States are considered overweight or obese. Obese adolescent girls are at especially high risk for remaining obese in adulthood. Adolescence represents a crucial time for reversing and preventing obesity. The purpose of this study was two-fold: 1) to develop a nutrition education curriculum targeting sedentary, inner-city adolescents living in Denver, Colorado; and 2) to evaluate the effectiveness of this curriculum by assessing changes in knowledge, attitudes, self-efficacy, stage of change for exercise and fat intake behaviors, dietary behaviors, physical fitness indices, and certain physiological parameters. The goal of this course was to promote metabolic fitness by modifying food intake and increasing exercise frequency. In Denver Colorado, twenty-three treatment subjects were compared to fifty-three control subjects. The treatment subjects received two years of nutrition education, while the control subjects received none. Formative evaluations were used to establish course content, and the curriculum was developed utilizing Prochaska's Stages of Change along with Bandura's Self- Efficacy and Social Learning Theory. Promotion of behavior change and progression to the next stage of change was accomplished through instruction and activities focused on consciousness-raising, promotion of social support, environmental reevaluation, management of emotional arousal, self-monitoring and self-evaluation, goal-setting, and improving self-efficacy for selecting and eating healthier foods. After two years of intervention, only 36% of the developed curriculum had been delivered to treatment subjects due to instructor related problems. However, despite implementation difficulties, some positive results were seen. Treatment subjects reported significant improvements in: knowledge, their intentions to change fat intake and exercise behaviors (stages of change), their fat intake as measured by two food frequency questionnaires, and their waist-to-hip ratios. The lack of more positive results are most likely due to poor curriculum implementation.
Open Access
Independent validation of the Core Food Security Module with Asians and Pacific Islanders
(Colorado State University. Libraries, 1999) Derrickson, Joda P., author; Jennifer Anderson, advisor; Auld, Garry, committee member; Banning, Jim, committee member; Hall, Bruce, committee member
An independent validation of the national household food security measure-the Core Food Security Module (CFSM) and its categorical algorithm-was conducted with Asians and Pacific Islanders in Hawai’i. Research was conducted in three parts: 1) a qualitative study (n=61). 2) a pilot stability study (n=61), and 3) a study replicating methods used to develop the CFSM (n=1664). Caucasians, Hawaiians and part-Hawaiians, Filipinos and Samoans residing in Hawai’i comprised the ethnic groups of focus. Findings: • Confirmed the face validity of the CFSM with Asians and Pacific Islanders in Hawai’i. • Indicated "balanced meals" was most often perceived as a meal with "meat, starch and a vegetable"; • Indicated the CFSM yields valid and reliable scale measures among Asians and Pacific Islanders in Hawai'i, except possibly with American Samoans (n=23). • Suggest weak credibility, validity and stability of the CFSM categorical algorithm: 27% of 111 households identified as food secure with one or more affirmative reply responded affirmatively to "unable to eat balanced meals"; 50% of 64 households classified as experiencing moderate hunger responded affirmatively to "respondent hungry"; and only 62% were consistently classified in the same category over time. • A ''face valid" algorithm-in which one affirmative response is classified as "at risk of hunger" and those who responded affirmatively to Q10 or to the child hunger question (Q14) were classified as such, regardless of other responses, was a preferred algorithm. Compared to the national algorithm, this algorithm resulted in: a lower percentage classified as food secure (85% vs. 78%); a greater percentage who were classified consistently as food insecure without hunger over time (57% vs. 80%); improved face and concurrent validity. • In general, progressively deteriorating food security status as experienced in Hawai'i resulted in concurrent decreased vegetable intake, and increased reliance on Saimin and resource augmentation behaviors. Prudence must be utilized when extending findings to ethnic groups not studied. Findings warrant further investigation of a shorter household food security measure and reassessment of the CSFM categorical algorithm.
Open Access
Development and evaluation of a lifestyle physical activity intervention for obese sedentary women
(Colorado State University. Libraries, 2001) Byfield, Cynthia Louise, author; Jennifer Anderson, advisor; Sampson, David A, committee member; Hill, James O., committee member; Kennedy, Cathy, committee member
Physical inactivity has been established as an independent predictor of cardiovascular disease (CVD) mortality in both lean and obese individuals. Increasing physical activity and cardiorespiratory fitness (CRF) in obese individuals attenuates the comorbidities associated with obesity and the reduction in risk is comparable to that of smoking cessation. Despite the benefits of physical activity, prevalence of physical inactivity is high , particularly among obese women. Recent evidence indicates that lifestyle physical activity programs that are based on behavior change theory are an effective alternative to traditional exercise programs in promoting the adoption of physical activity in sedentary individuals. The primary aim of this study was two-fold : 1) Develop a 24-week, theory-based lifestyle physical activity intervention for obese sedentary women; 2) Evaluate the effectiveness of this intervention by assessing changes in physical activity and CRF after 24 weeks of intervention and 24 weeks of follow-up. Secondary aims were to examine the effect of the Lifestyle intervention on dietary practices, CVD risk factors, and psychological measures of behavior change. Fifty-eight obese sedentary women were randomized into the Lifestyle intervention developed for this study (n=29) or a "Usual Care" intervention (n=29). After 24 weeks, significant improvements in physical activity, CRF, Body Mass Index (BMI), diastolic blood pressure, self-efficacy, and eight of the 10 processes of change occurred among Lifestyle participants. No changes in these variables were observed among Usual Care participants. Attrition was significantly lower among Lifestyle participants than among Usual Care participants. After 48 weeks, levels of physical activity , CRF, and self-efficacy were significantly higher than baseline among Lifestyle participants but not among Usual Care participants. LDL-cholesterol levels were significantly lower in Lifestyle participants at 48 weeks but systolic blood pressure was significantly higher. BMI was significantly higher at 48 weeks than at baseline among Usual Care participants but not among Lifestyle participants. The Lifestyle intervention developed for this study was effective in producing significant improvements in physical activity, cardiorespiratory fitness, LDL-cholesterol, and self-efficacy among obese sedentary women.
Open Access
Efficacy of the transtheoretical model in improving exercise and dietary habits in enlisted Air Force personnel
(Colorado State University. Libraries, 2001) Veverka, Donald Victor, author; Jennifer Anderson, advisor; Auld, Garry, committee member; Coulter, Gary, committee member; Kennedy, Cathy, committee member; Chapman, Philip, committee member
As a means of maintaining a fit and ready force, the United States military establishment has always incorporated fitness and weight standards for its personnel. According to data obtained by the U.S. Air Force (USAF) Surgeon General's Office, most personnel pass their fitness tests. However, one particular segment, men between 30 to 44 years of age, have lower scores and appear to have more difficulty passing. Although the USAF has existing nutrition and exercise programs to assist efforts towards greater physical fitness levels and improved dietary habits, these programs may only be suited for individuals that are motivated to improve these behaviors. According to the literature, there are individuals that may need to improve dietary and physical activity behaviors but are not motivated to do so. A more effective approach, according to previous behavior change studies, is to implement a strategy, which uses stage-matched interventions based on the Transtheoretical model (TTM). In short, devise programs that correctly identify an individual's motivation for engaging in a health behavior (stage of readiness to improve) and then match the appropriate intervention for the individual. Using male enlisted Air Force personnel between the ages of 30-44 as the target population, focus groups were used to obtain qualitative information on diet and exercise habits to improve fitness scores. Results revealed that participants needed assistance in obtaining information concerning both diet and exercise in order to successfully define and implement a program which would lead to increased fitness . Further, participants selected various methods by which to receive this information. Specifically, to help increase their physical activity, participants needed further education on cycle ergometry, goal-setting, and ways to avoid injury during exercise. In order for test subjects to develop healthy eating habits, the group was provided information on how to sort out media misinformation, prepare healthy foods quickly, understand food labels and determine safety and efficacy of popular dietary supplements. Handout literature, web sites and seminar/discussion formats were the most effective ways for test subjects to receive information. Using the qualitative focus group data from the aforementioned target population, an intervention program based on the TTM was developed and provided via the worldwide web. Use of interactive technology such as computers and the Internet are strongly advocated by health promotion professionals as an effective means of reaching large numbers of at risk populations with specifically tailored information. There was no evidence that treatment group exposure to the web site program was effective in increasing fitness scores. The data suggest that the physical activity-tailored information content was not effective in encouraging greater exercise intensity which positively impacted fitness levels. However, the dietary-tailored information appears to have encouraged the adoption of more positive nutritional practices, as manifested by the beneficial effects seen in certain secondary outcomes. Stage progression was evident as more treatment subjects than controls advanced to higher stages of positive dietary and exercise behaviors. More treatment group subjects reported improved dietary behaviors than reported increases in exercise behaviors. Treatment subjects did not report any relapse in physical activity as opposed to control subjects who reported a high level of regression towards sedentary physical behaviors.
Open Access
Development and evaluation of a bilingual nutrition education computer program for Latino children
(Colorado State University. Libraries, 2001) Serrano, Elena Lidia, author; Jennifer Anderson, advisor; Kendall, Pat, committee member; Fritz, Janet, committee member; Zimmerman, Don, committee member; Auld, Garry, committee member
Interactive computer technology and multi-media have advanced in the past ten years as growing opportunities for nutrition education. Few nutrition education computer programs exist for school-aged children, particularly for Latinos. The overarching purpose of this research was to develop a computer nutrition program for low-income Mexican American children in Colorado. This research project spans all levels of software development -with formative evaluation , product development, and evaluation. Development of the CD-ROM program was driven by several theoretical models and results from the formative evaluation . The formative evaluation included focus groups with children and surveys with classroom teachers and media teachers in order to determine preferences for computer programs, particularly in classroom settings. We also sought to address dietary acculturation in the program. Food frequency questionnaires and acculturation scales were administered to children in largely Hispanic areas of Colorado. Several foods were found to be sensitive to change with increasing acculturation -- such as posole, corn tortillas, fresh corn , mangoes, Mexican cream, and beans - and sensitive to adoption . The final computer program contained a total of six components -- including educational modules, games, songs, and infomercials -- focusing on the Food Guide Pyramid and related topics. Foods included in the program were representative of different levels of acculturation (as determined by the dietary acculturation study) . Online evaluation was used to measure gains in knowledge, attitudes, and behavior intentions, as well as dietary choices. The program was implemented in a total of four schools -- two intervention schools and two matched control schools -- in southern Colorado. The computer nutrition education program proved to be highly effective in improving knowledge about the Food Guide Pyramid. The intervention group's knowledge of the Food Guide Pyramid increased by over 50% and was considered significantly higher than the control group at the p<.01 level. Self-efficacy related to using the Food Guide Pyramid to plan meals and snacks also increased significantly. Our findings demonstrated that games and songs were effective in strengthening knowledge about nutrition and the Food Guide Pyramid, regardless of acculturation level. Online data about dietary patterns confirmed findings from the preliminary dietary acculturation study.
Open Access
Examining the application of the transtheoretical model of change for fruit and vegetable consumption among college students
(Colorado State University. Libraries, 2002) de Oliveira, Maria do Carmo Fontes, author; Jennifer Anderson, advisor; Kendall, Patricia, committee member; Auld, Garry, committee member; Morgan, George, committee member
Nutrition education messages about the adequate amount of fruits and vegetables in the diet have the potential to disseminate information the optimum level of fruit and vegetable intake to the population. However, this potential will be effective, only if the audience incorporates these messages. To facilitate the acceptance of nutrition education messages, we need to understand the process of behavior change across different behaviors and cultural/ethnic groups. The main purpose of this study was to examine the applicability of the Transtheoretical Model for fruit and vegetable eating behavior in male North American, Latino and Asian college students at Colorado State University. First, a 40-item scale was developed to measure the processes of change. Second, stages of change for eating five fruits and vegetables a day were assessed. Third, the relationship between stages of change and processes of change constructs for fruit and vegetable consumption was examined. Results showed that the developed scale was reliable and valid for the target population. Most of the participants were classified as in the preparation or contemplation stages of change, and the stage classification was significantly related to the participant's cultural/ethnic background. North American and Latino participants were predominantly in preparation while Asian participants were in precontemplation. In addition, the North American and Latino groups used less processes of change (stimulus control, dramatic relief and environment reevaluation) than the Asian group. The relationship between stages of change and processes of change indicated that generally the processes of change scores for fruit and vegetable intake were lower in early stages of change than in later stages of change. The finding that each cognitive/experiential composite score was higher than behavioral composite scores across stages of change did not agree with most studies in smoking, but agreed with some studies on diet and exercise. Although more research needs to focus on the applicability of the stages of change and processes of change constructs, the present study provides partial evidence of the value of the Transtheoretical Model in fruit and vegetable eating behavior in the nutrition education arena.
Open Access
Sensory and functional properties of monosodium glutamate
(Colorado State University. Libraries, 2002) Giovanni, Maria Elizabeth, author; Stone, Martha B., advisor; Maga, Joseph A., advisor; Allen, Kenneth D., committee member; Kinnamon, Sue C., committee member
Flavor potentiators have been used for centuries to improve food flavor. However, neither the taste transduction mechanisms nor the behavior of flavor potentiators in food are fully understood. The objectives of this research were: 1. To determine the relationship between salivary glutamate and perception of MSG and NaCl; 2. To characterize the time-intensity profiles (TI) of flavor potentiators; and, 3. To determine the effects of heat treatment and pH on levels of L-glutamic acid in simple food systems. The first study consisted of collecting whole mouth saliva and determining thresholds to and perceived intensities of MSG and NaCl. A preliminary experiment indicated that perception of MSG may be influenced by salivary glutamate, gender, and ethnicity. The principal study with 60 subjects found no effect of ethnicity or gender on salivary glutamate or sodium levels. Female Asians had higher salivary sodium and rated the lower concentrations of NaCl as more intense. Psychophysical measures of MSG and NaCl were independent of salivary levels. Twenty subjects, trained in TI methods, evaluated 20 samples of MSG, IMP, and GMP, singly and in combination. The TI profiles generated were atypical of other taste modalities. Time to maximum intensity was brief, followed by a plateau phase at maximum intensity with a long aftertaste. Sample intensities varied significantly, with mixtures of 10 and 5 mM MSG and 2.5 mM IMP and GMP having highest intensity and duration. These results indicated that flavor potentiators may increase total flavor in the mouth. Synergism among flavor potentiators was demonstrated. To determine the effect of pH and heat on L-glutamic acid, 0.1% MSG was added to eleven simple food systems. Percent recovery was highest for tomatoes and lowest for beef broth. Fish broth and tomatoes had higher recoveries at pH 6 than pH 3; thus, pH altered L-glutamic acid levels. No effect of heat on L-glutamic acid levels was found. The sensory and functional behavior of MSG is governed, in part, by the individuality of the subject, its temporal response, and the food system in which it is used.
Open Access
Development and evaluation of a bilingual interactive multimedia computerized food recall
(Colorado State University. Libraries, 2004) Zoellner, Jamie Marie, author; Jennifer Anderson, advisor; Adams, Liz, committee member; Auld, Gerry, committee member; Middlemist, Dennis, committee member
The objective of this research was to utilize advancements in computer technology to develop and test a bilingual interactive multimedia (IMM) dietary assessment tool. During developmental testing 25 peer-reviewers rated characteristics of the program on a 5-point Likert scale. The mean score of each question received high ratings including introduction/directions helpful (M = 4.5), meal times understandable (M = 4.6), foods easy to identify (M = 3.9), portions easy to identify (M = 4.5), and computer food recall easy to use (M = 4.5). In the final format, the bilingual IMM recall represents a multiple-pass method in which users first report food choices from 167 graphically represented foods. After the development and formative evaluation, the IMM recall underwent comparative validity testing against an interview-administered dietary recall. This study was a two-period cross over design study with repeated measures. Subjects were randomly assigned to complete an IMM recall or interview-administered 24-hour recall first. The interview-administered recall was analyzed using the Food Intake Analysis System (FIRS) and the EFNEP Reporting System (ERS). The effect of substituting standardized portion sizes for reported portion sizes was examined. Of 80 adult Coloradoan participants, 71 (91%) were female, 45 (56%) had ≤12th grade education, 65 (81%) had ≤$15,000 annual income, and 21 (26%) completed the IMM recall in Spanish. Analysis of variance and unadjusted and energy-adjusted correlations were used for analysis. No significant group differences were found for order of administration or demographic characteristics. The only significant method effect found was between the IMM recall and FIRS for vitamin C (P = 0.025). The unadjusted correlations between the IMM recalls and interview-administered recalls analyzed using both FIRS and ERS were generally around 0.6. Energy-adjusted correlations consistently decreased. Substituting standardized portion sizes resulted in significant differences for six nutrients and caused all correlations to drop. Overall, the IMM recall was found to be valid for assessing dietary intake by groups of individuals. This IMM recall has been well received in the peer-review process and attracted the interest of nutrition educators. The results of comparative validity testing and positive reactions received from participants and nutrition educators indicate diet assessment utilizing IMM holds tremendous potential.
Open Access
The effectiveness of an Internet-based nutrition and fitness education program for senior military officers
(Colorado State University. Libraries, 2004) Sigrist, Lori D., author; Jennifer Anderson, advisor; DeVoe, Dale, committee member; Kennedy, Cathy, committee member; Auld, Garry, committee member
A six-month Internet-based nutrition and fitness education program, entitled Taking Command of Your Health, to improve diet and fitness behaviors and physiological measures in a group of senior military officers enrolled in the Distance Education course at the U.S. Army War College. The intervention was based on the Transtheoretical Model (TTM) for behavior change and was delivered via the Internet. A needs assessment survey assessed senior military officers' health concerns, educational preferences for nutrition and health topics, eating habits, and motivators and barriers for eating healthfully and exercising regularly. Survey results determined the content of the intervention. Participants were randomly assigned to either a control group that did not have access to the website intervention or to the treatment group that had access to the program. The program was designed in a monthly newsletter format which combined nutrition and fitness information. Staging algorithm surveys determined stage of change for diet and exercise for participants each month. Participants were provided with stage-matched education based on the diet algorithm and all participants received identical fitness information regardless of stage for exercise. To evaluate the program, treatment participants completed exit surveys at the end of the intervention. Results of the study indicate that an intervention based on the TTM did not result in statistically significant improvement in behavioral and physiological measures between treatment and control groups. The program was effective in significantly progressing treatment participants through the stages for diet behavior, but not for exercise behavior. Unfortunately, dietary behavior change was not maintained as participants regressed to earlier stages after the intervention. In the exit survey, participants reported that they liked receiving health information over the Internet and they would recommend a similar program to others in the military. Future research on the implementation of a theory-based intervention should focus on an individual's cognitive and behavioral processes that determine one's success and failure with behavior change, factors that determine participation and regular usage of a website program, and the impact of program duration and content on other military populations.
Open Access
Developing and evaluating a website on infant feeding, specifically breastfeeding, for child care providers
(Colorado State University. Libraries, 2006) Clark, Alena Michelle, author; Jennifer Anderson, advisor; Adams, Elizabeth, committee member; Baker, Susan, committee member; Barrett, Karen, committee member
Research studies have shown that breastfeeding provides a multitude of benefits to infants, mothers and communities. Yet, many women cease breastfeeding before the recommended times. A common reason women cease breastfeeding is because of returning to work or school. Because child care providers often provide care to these infants, further research on the role of child care providers on infant feeding practices, specifically breastfeeding, is warranted. This research project occurred in three phases. First, a needs assessment survey was conducted to determine the knowledge, attitudes, behaviors and training needs of child care providers on infant feeding, specifically breastfeeding, in child care centers. The most appropriate medium to integrate best practice information and provide educational tools to child care providers was also examined. Based on the first phase of this project, a website for child care providers on infant feeding, specifically breastfeeding, was determined to be the desired medium for child care providers. Because no other infant feeding website for child care providers was available, InfaNET Nutrition for Child Care Providers website was developed during the second phase of this project based upon the needs assessment results and facilitated group discussions' feedback. The Social Learning Theory was used as the theoretical framework for the development of the content information on the website. A process evaluation with infant feeding experts, child care providers and web design experts deemed the website ready to be tested. Thirdly, a quasi-experimental research design with a control and intervention group was completed. The target population viewed the website as a well-liked and effective means to provide infant feeding information. Results also showed that between the pre- and post-test intervention, the intervention group had more statistically significant positive changes in attitude and behaviors than the control group. Child care providers already possessed a desirable level of knowledge in regards to storing, preparing and feeding infants' breastmilk and formula, but not in distinguishing hunger cues or introducing solid foods. The behavior and attitude changes were not sustained at follow-up, but results showed there was a non-significant positive trend in knowledge for the intervention group.
Open Access
Evaluation of antioxidant and sensory properties of selected cultivars of Colorado-grown lettuce (Lactuca sativa L.)
(Colorado State University. Libraries, 2007) Bunning, Marisa, author; Kendall, Patricia, advisor; Stushnoff, Cecil, advisor
Epidemiological evidence has substantiated the health benefits associated with the consumption of vegetables, particularly leafy greens. Lettuce (Lactuca sativa L.) cultivars (varieties) have usually been selected based on shelf-life, transportability, and yield rather than nutritional or sensory traits. Information on the effects of seasonality and genetics on various characteristics of lettuce is limited. Nutritional, antioxidant, and sensory profiles of lettuce may vary considerably among cultivars and in response to environmental factors that may fluctuate widely throughout the growing season. Bitterness, an important flavor characteristic of lettuce, is generally thought to increase with higher growing season temperatures and may vary with phenolic content.
Open Access
Diabetes education in Oman: needs assessment and development of an intervention for health care professionals
(Colorado State University. Libraries, 2007) Al-Subhi, Lyutha Khalfan, author; Kendall, Patricia, advisor; Adams, Elizabeth, advisor
Oman is one of the countries faced with the challenge of an increasing rate of diabetes. The National Diabetes Control Program (NDCP), in Oman, aims to provide a suitable and quality health education to people with diabetes and the community. Diabetes management guidelines for Primary Health Care (PHC) in Oman point out that all members of the diabetes health care team share the responsibility of educating those with diabetes. Nevertheless, diabetes education has not been tackled systematically and the incidence of diabetes is on the rise in Oman. There is a pressing need for a diabetes education program for diabetes self management in the Sultanate of Oman.
Open Access
Assessment of nutrition education strategies to reduce cardiovascular disease in U.S. Army hospitals
(Colorado State University. Libraries, 2007) Bukhari, Asma Sultana, author; Jennifer Anderson, advisor; Kaminski, Karen, committee member; Gould, Susan, committee member
Cardiovascular disease (CVD) continues to be the leading cause of death in the United States with an estimated 79,400,000 adults diagnosed with this disease in 2004 and costs of $431.8 billion projected this year. As a result there is an increased emphasis on early detection and treatment of risk factors. Military personnel are vulnerable to this killer disease due to indulgence in unhealthy behaviors such as cigarette smoking, physical inactivity, poor nutrition, and increased stress. These behaviors can have a profound impact on the military readiness and mission accomplishment. The purpose of this study was to identify strategies to enhance nutrition education provided to the military personnel at US Anny hospitals to manage CVD. The results will be used to identify weaknesses and gaps in an existing program and facilitate improvement of CVD nutrition education. It was hypothesized that nutrition education can be enhanced by aligning the existing CVD management programs with evidenced based guidelines that will provide program consistency. The target audience for this study was Registered Dietitians in clinical leadership positions at U.S Anny hospitals and outpatient clinics. The study was approved by the Colorado State University Human Research Committee and the U.S Anny Medical Research and Material Command Human Research Protection Office. Survey validity was established by obtaining information from a review of literature and feedback from expert Army dietitians and CSU faculty. Survey reliability was established by a test and re-test during a pilot test on a subset of Army dietitians. The responses were analyzed using computer software and reported as mean, standard deviations and frequencies. The survey response rate was 70% (n=21). The primary educators of CVD risk reduction were dietitian. Sixty-two percent of the hospitals provided nutrition education based on current guidelines. The current program was rated either "very good" or "good" by 67% of the dietitians. Eighty-one percent of dietitians experienced variation in the program at their hospitals. Only 24% of the dietitians indicated a mechanism to reach deployed soldiers with hypercholesterolemia. A web-based resource center was selected by 43% of the dietitians followed by 23% who suggested development of a self-paced web-based education program for deployed or remotely located soldiers. Caution is advised while interpreting the results because the findings are based on dietitians' knowledge and opinions and may not have captured all the services offered to the patients. The survey provided insight into current program and suggestions for future program improvements. Cost effectiveness and improved patient satisfaction of medical nutrition therapy by Registered Dietitians is already established. Army dietitians need to take the lead in designing and implementing programs to reduce the CVD risks among military personnel. Such interventions will improve the quality of life of soldiers by providing long term health benefits; and that, in tum, will save resources from reduction in mortality and morbidity associated with CVD events. It is important to explore various communication media for information dissemination.
Open Access
Development and evaluation of Food friends get movin' with mighty moves™ : a physical activity program to prevent obesity in low-income preschoolers
(Colorado State University. Libraries, 2007) Bellows, Laura Leigh, author; Jennifer Anderson, advisor; Auld, Garry, committee member; Kennedy, Catherine, committee member; Davies, Patricia, committee member
The prevalence of overweight among preschool-aged children in the United States is increasing at an alarming rate. The preschool years provide an opportunity to establish healthful eating and physical activity behaviors which can lessen the growth of obesity. Unfortunately, preschoolers have been largely ignored when it comes to obesity prevention efforts. The overall objective of this project was to design, develop, and evaluate a physical activity program to compliment the Food Friends ® nutrition program in an effort to prevent overweight in young children. Food Friends Get Movin' with Mighty Moves™ is an 18 week program focusing on gross motor development, physical fitness, and physical activity in the classroom environment. This project utilized the steps of social marketing to develop the Mighty Moves™ program. Further, to enhance the likelihood that behavior change would occur, the Social Learning Theory was embedded within the social marketing framework. The Food Friends Get Movin' with Mighty Moves™ study was a randomized controlled trial of 3- to 5-year old children (n=201) enrolled in 8 Head Start centers in Colorado. On-site measures included height, weight, physical fitness (sit-ups, sit-n-reach, shuttle run, 3-minute run), and gross motor skill (Peabody Developmental Motor Scales) assessments. BMI, BMI z-score and BMI percentiles were calculated. Additionally, physical activity was assessed by pedometers over a 6-day timeframe (4 weekdays and 2 weekend days), and daily step counts were recorded by parents. Characteristics of the study population indicated a high prevalence of overweight, low physical activity levels, and average to below-average motor skills. The intervention did not have an effect on weight status but did improve gross motor skills and fitness levels. Lastly, no difference was found for physical activity by treatment. The success of Mighty Moves™ at increasing gross motor skills and physical fitness in preschoolers, in concert with the Food Friends® program's demonstrated ability to increase children's willingness to try new foods, has contributed to the establishment of healthful behaviors for proper growth and development in the early years. These behaviors serve as foundations to building healthy lifestyles, which may decrease the risk of overweight later in life.
Open Access
Post-harvest treatment effects on quality and safety characteristics of melons and tomatoes
(Colorado State University. Libraries, 2008) Troxell, Heather LeAnne, author; Kendall, Patricia, advisor
Production, processing, and transport of high quality, safe, and healthful produce presents a constant challenge. Calcium chloride (CaCl2) dips have been shown to help maintain fruit quality after harvest by delaying senescence, reducing postharvest decay, and controlling many physiological disorders in fruit. There is little research available, however, assessing the effects of CaCl2 on sensory, nutritional, and microbial qualities of fresh, whole produce, including melons and tomatoes. This research project evaluated the impact of post-harvest storage temperature and use of a CaCl 2 dip on selected organoleptic, nutritional, and microbiological qualities of organic and conventional Colorado-grown melons and tomatoes over time. Melons (cultivars 'Haogen' and 'Arava') were grown on conventional and certified organic plats and tomatoes (cultivar 'Early Girl') were grown on certified organic plots during summer 2007 with controlled pre-harvest, harvest, and post-harvest conditions. All produce was picked at peak maturity and either dipped in a CaCl2 solution or not treated, then stored at 10° ±1° or 21° ±1° C. A variety of sensory, nutritional, and microbial tests were conducted on the fruit after storage for 1, 5, and 10 days. Storage temperature significantly impacted many of the fruit characteristics evaluated. Melons stored at 10° C had less microbial growth and higher sensory scores compared to the melons stored at 21° C. For tomatoes, many of the sensory and nutritional qualities were higher when stored at 21° C, even at 10 days storage. Use of a CaCl 2 dip treatment positively influenced (p<0.05) sensory scores for melons (appearance, texture, and overall acceptability) and tomatoes (flavor and overall acceptability). Overall, CaCl2 did not affect the fruits' antioxidant contents. When storing organic melons at 21° C, the CaCl 2-dipped melons had lower (p<0.05) Enterobacteriaceae bacterial counts compared to non-dipped melons. Based on this study, a CaCl2 treatment shows promise for increasing some safety and sensory characteristics of fresh melons and tomatoes, especially for produce stored at room temperature (21° C). Additional research should be conducted to further explore the potential of CaCl2 to lessen post-harvest expenses and losses while maximizing the sensory, nutritional, and safety characteristics of fruit.