An evaluation of a point of purchase labeling intervention to improve health literacy and healthy eating choices

textObesity related employer healthcare costs increased 8% from 2010 to 2011 (PwC, 2012; Durden, 2008), which has spurred an increase in worksite weight management programs. Due to minimal success of individually focused programs (Anderson, 2009; Mhurchu, 2010), efforts have shifted to the potential impact of environmental interventions. The purpose of this study was to evaluate the influence of a red, yellow, and green (R/Y/G) point of purchase (POP) labeling system on perceived health literacy and purchasing behaviors at three on-campus eateries frequented by university faculty and staff. Foods were rated as red, yellow, or green based on the Nutrient Rich Food Index. All foods were labeled with stickers that looked like miniature traffic lights with the appropriate color light lit up through menu boards and nametags. Posters, emails and table tents were also used to communicate about the intervention. In order to provide various levels of exposure, the first eatery had the intervention for six weeks, the second for four weeks, and the last for two weeks. Eatery patrons (N=191 across the three locations) completed a paper and pencil pre-intervention survey assessing healthy eating intentions, knowledge, and behaviors. Post-intervention data collection was conducted via online survey (N=89), and consisted of the pre-test items and additional questions about label awareness and utilization. While the intervention did not appear to influence healthy eating intentions or knowledge, 41.6% of the patrons reported that the labels influenced their food choices. Patrons also reported being aware of, understanding, and using the labels. The average food sales for the six weeks prior to the intervention were compared to the average food sales during the intervention. Food sales data were compared by location and food category (R/Y/G). There was a significant increase in green food sales and a significant decrease in red food sales (r=-.375, p=.044). However, there were no significant differences between locations. These findings suggest that future research with the traffic light labeling is warranted.Kinesiology and Health Educatio

Hybrid semantic-document models

This thesis presents the concept of hybrid semantic-document models to aid information management when using standards for complex technical domains such as military data communication. These standards are traditionally text based documents for human interpretation, but prose sections can often be ambiguous and can lead to discrepancies and subsequent implementation problems. Many organisations produce semantic representations of the material to ensure common understanding and to exploit computer aided development. In developing these semantic representations, no relationship is maintained to the original prose. Maintaining relationships between the original prose and the semantic model has key benefits, including assessing conformance at a semantic level, and enabling original content authors to explicitly define their intentions, thus reducing ambiguity and facilitating computer aided functionality. Through the use of a case study method based on the military standard MIL-STD-6016C, a framework of relationships is proposed. These relationships can integrate with common document modelling techniques and provide the necessary functionality to allow semantic content to be mapped into document views. These relationships are then generalised for applicability to a wider context. Additionally, this framework is coupled with a templating approach which, for repeating sections, can improve consistency and further enhance quality. A reflective approach to model driven web rendering is presented and evaluated. This reflective approach uses self-inspection at runtime to read directly from the model, thus eliminating the need for any generative processes which result in data duplication across source used for different purpose

Anxiety and self-efficacy related to learning neuroanatomy in an integrated medical curriculum.

Medical student anxiety towards learning neuroanatomy — neurophobia, a key obstacle in medical education, is influencing medical student success and potentially swaying medical students away from neurology careers. This is particularly concerning with condensed neuroanatomy instructional hours from curriculum integration and the concurrent shortage of neurologists, combined with the rising prevalence of neurological disease, and medical students choosing neurological specialties at lower rates. Neuroanatomy education is one factor described in the literature as contributing toneurophobia, yet specific ways in which neuroanatomy education could be improved have not yet been explained. In this present work, we demonstrate four specific domains, namely content, instruction, communication, and organization, through which neuroanatomy education may be improved. We propose neuroanxiety may more accurately describe this phenomenon and developed a novel neuroanxiety scale. Our survey data show upper-class and female medical students exhibit greater neuroanxiety. Additionally, we demonstrate premedical neuroanatomy and/or neuroscience experience predicts a decrease in neuroanxiety. Another construct was explored as a way of potentially improving student task-specific confidence in neuroanatomy, namely — neuroanatomy self-efficacy. A novel neuroanatomy self-efficacy scale was developed and the effect of premedical neuroanatomy and/or neuroscience experiences on neuroanatomy self-efficacy was explored. Consistent with the literature on anatomy self-efficacy, our survey data revealed that premedical neuroanatomy experiences, especially with cadaveric dissection, improve neuroanatomy self-efficacy. Additionally, our data is trending towards female medical students showing a greater increase in neuroanatomy self-efficacy with premedical neuroscience and/or neuroanatomy exposure. Lastly, the exploration of developing a time-efficient learning intervention to be administered within an integrated curriculum led to the development of adaptive neuroanatomy eLearning intervention. Comparing the effects of the adaptive and non-adaptive eLearning interventions on medical student neuroanxiety and neuroanatomy self-efficacy demonstrated adaptive eLearning only significantly influenced neuroanatomy self- efficacy. This finding, together with our novel finding that premedical neuroanatomy and/or neuroscience experience also predicts lower neuroanxiety in medical school, suggests neuroanatomy self-efficacy may hold the key to mitigating the effects of neuroanxiety in neuroanatomy education

Swap the Meat, Save the Planet: A Community-Based Participatory Approach to Promoting Healthy, Sustainable Food in a University Setting

Current dietary patterns threaten human and planetary health. In the United States, individuals must shift to dietary patterns higher in plant-based foods and lower in animal-based foods to reduce chronic disease risk and maintain stability of the Earth system. Despite high scientific agreement that we can simultaneously improve health and environmental sustainability through dietary shifts, interventions targeting these dual outcomes remain understudied. This dissertation employed a community-based participatory research approach to investigate how academics and non-academic foodservice leaders can collaborate to address gaps in the development, implementation, and evaluation of interventions to promote healthier, more environmentally sustainable diets. Research was focused on the university setting and took place at the University of California, Los Angeles. Guided by the diffusion of innovation framework, Study One qualitatively described and examined the process of developing and implementing the Impossible™ Foodprint Project—an intervention to reduce animal-based protein consumption in university dining. Intervention components included: 1) the addition of new menu items with Impossible™ plant-based meat, and 2) a complementary social marketing campaign framed around climate change. Findings from Study One highlight the value of the university’s involvement in existing health and sustainability initiatives for intervention agenda-setting and collaboration among academics and non-academic partners. In addition, results suggest university foodservice leaders may be particularly open to strategies such as piloting new menu items and providing education—rather than taking existing menu options away. Furthermore, co-creation of intervention materials and feedback from multiple data sources enhanced capacity for foodservice leaders to expand efforts to promote low-carbon-footprint foods. Lack of coordination with restaurant operators emerged as a barrier to initial implementation of the social marketing campaign, while cost prevented scale-up of Impossible™ menu items beyond the pilot intervention restaurant. Study Two utilized routinely collected sales and nutritional data from FoodPro, a widely used foodservice data management platform. A natural experiment with a pre-post non-equivalent comparison group design was used to evaluate 1) whether the Impossible™ Foodprint Project intervention met foodservice leaders’ goal of reducing animal-based entr�e sales, and 2) the impact of the intervention on the healthfulness and environmental sustainability of entr�es sold. The analytic sample included 645,822 entr�es sold at the three study sites during the Fall 2018 (pre) and Fall 2019 (post) academic quarters. During the post period, new menu items with Impossible™ plant-based meat comprised over 11% of entr�e sales at the intervention site. At the same time, the proportion of animal-based entr�e sales decreased by 9% (raw change 7%, 83% to 76%), a significantly greater decrease than the two comparisons sites.Healthfulness was operationalized as a decrease in the proportion of red meat entr�es sold and improvement in the nutritional quality of entr�es sold. While the proportion of red meat entr�es sold significantly decreased by about 8% at the intervention site (raw change 4%, 45% to 41%), a similar decrease was observed at one of the comparison sites, resulting in an unclear intervention effect. Small but statistically significant nutritional changes were observed at the intervention site: On average, each entr�e sold contained 21.3 fewer calories (kcal) and lower quantities of nutrients of concern: 0.2 fewer g saturated fat and 26.9 fewer mg sodium. Quantities of other nutrients also decreased: 0.7 fewer g protein, 0.1 fewer g fiber, and 1.5 fewer g unsaturated fat. However, nutritional outcomes varied when stratifying by entr�e type (i.e., build-your-own vs. special), resulting in a conditional assessment of the intervention’s nutritional impacts, described within. Environmental sustainability was operationalized as reduction in climate impact level (low, medium, high) and carbon footprint of entr�es sold. There were clear positive intervention effects on these outcomes. For example, the proportion of low-impact entr�e sales increased by over 50% at the intervention site (raw change 7%, 14% to 21%), a significantly greater increase than the two comparison sites. This corresponded with an 8% decrease in the mean carbon footprint of each entr�e sold at the intervention site, from 1,522 to 1,405 g CO2-equivalent (117 g decrease). With 141,321 entr�es sold at the intervention site in Fall 2019, this equates to approximately 16.4 metric tons of CO2 saved—the equivalent of driving 42,000 miles. In line with foodservice leaders’ priorities, we also conducted a brief customer survey (n=215). Results suggest a diverse range of students was open to trying the new Impossible™ menu items, and customer satisfaction was high. In comparing one-time versus repeat consumers, we found significant differences across most behavioral and cognitive factors measured. In general, repeat consumers reported consuming less animal-based protein and were more likely to believe Impossible™ is delicious and a satisfying alternative to animal meat. We also found evidence that values and race/ethnicity may affect beliefs about the sensory experience of eating Impossible™, which in turn affects repeat consumption.Finally, Study Three utilized a true experiment through Qualtrics to test whether environmental sustainability framing is more effective than health framing in “nudging” university consumers to choose a plant-based menu option. Participants were randomly assigned to one of three menu framing conditions—control (no framing), health framing, and environmental sustainability framing—and given the choice between chicken enchiladas and plant-based tacos. Of the 450 participants recruited for the study, 437 were maintained in the analytic sample, including 352 (79%) undergraduate students and 85 (21%) university staff. There were no statistically significant differences in choice across menu framing conditions. Approximately 39% of participants chose the plant-based tacos in the control condition, 36% in the health framing condition, and 40% in the environmental sustainability framing condition. In short, we found no main or conditional effects of environmental sustainability framing, compared to control. In contrast, we found some evidence that, compared to control, health framing may have negative effects among some subgroups, including university staff. Despite observed null effects of environmental sustainability framing, this approach may still be preferable to health framing given potentially counteractive health framing effects. In ancillary analyses described within, we found that, compared to health framing, environmental sustainability framing may improve anticipated enjoyment of a plant-based dish—even if it does not affect choice. In sum, Study One sheds light on how and why interventions take shape, with an emphasis on collaboration between academic and non-academic foodservice partners. Study Two provides novel insight into the benefits and tradeoffs of promoting low-carbon-footprint foods and introducing new plant-based meat alternatives into institutional food environments. Experimental findings from Study Three suggest some nudges may be insufficient to affect choice of a plant-based menu item, while others may be counteractive. Taken together, results of this dissertation build capacity for academics and foodservice leaders to advance intervention action and research to improve human and planetary health through food

“The Good, The Bad, and the Minimum Tolerable”: Exploring Expectations of Institutional Food

There is a tendency towards greater expectations of consumer goods and services in society—what was once judged as ideal may now be a bare minimum. This presents a challenge for food providers in the upcoming decades. As the more demanding baby boomer cohort ages, health institutions of the future will face challenges meeting their food expectations. The purpose of this study was to explore expectation type dynamics and function with updated empirical material on aging consumers expectations of institutional food and advance our current understanding of how consumers evaluate their expectations. This qualitative study employed in-depth semi structured interviews with 14 informants between the age of 58–79. Content analysis was performed to capture the informants’ food expectations based on the expectation hierarchy proposed by Santos and Boote. Analyzing the content and relationship between different expectation types led to three main findings: expectation functions and content, interconnectedness, and the role of affect. Based on the findings, this study contributes by making several propositions for future research and proposes an updated expectancy–disconfirmation model. Importantly, this study provides novel knowledge that can help health institutions understand and meet aging consumers expectations of institutional food.publishedVersio

The design of 3D cyberspace as user interface: Advantages and limitations

Virtual reality propagandists, technologists and the Internet community have long debated the issue of the usability of online three-dimensional (3D) environments. A lot of work was published about the benefits of 3D spaces for human-computer interaction and information visualisation due to their realism (Anders, Kalawsky, Crossley, Davies, McGrath, Rejman-Greene, 1998, Hamit, 1993, Heim, 1992, Aukstakalnis, Blatner, Roth, 1992). This topic also receives continuous industry support including standardisation of Virtual Reality Modeling Language ( VRML, VRML Consortium, 1997) and the more recent Macromedia & Intel alliance to bring web 3D to the mainstream (200 1, Intel Corporation). The actual implementation of this technology is, however, still challenging (McCarthy & Descartes, 1998) and minimal because 3D is too new and waiting for good design to be discovered (Nielsen, 1998). The practical aim of this project is to fulfil the niche by creating a functional 3D interface for the access of two-dimensional (2D) information, such as text, using VRML. The theoretical aim is to contribute to further research into 3D usability by describing and analysing the design process in terms of possibilities, challenges and limitations

Human-computer interaction in e-business

E-business has brought much change to our daily life and will become a necessary part of business, economy, and society. At least for the foreseeable future, e-business will keep growing. Each study of this dissertation was devoted to human-computer interaction (HCI) in e-business to improve website usability. First, data input tools were compared and optimal design characteristics were suggested for usable web based interaction. When proper input tools are employed, higher usability can be achieved. Second, a practical design process and the use of web elements were studied through the simulation of an e-bookstore. Web design influences e-business traffic and sales. Third, a grid menu was designed and examined for situations in which a menu contains a larger number of options. The grid menu was observed to be both robust and efficient. Fourth, an interaction model for the pull-down menu, including perceptive, cognitive, and motor behavior processes, was studied. The resulting model fit the experimental data well. Fifth, problems with iconic interfaces on e-business websites were reported and a methodology suggested to improve user interface design

Exploring Bottled Water Purchase Intention via Trust in Advertising, Product Knowledge, Consumer Beliefs and Theory of Reasoned Action

As the bottled water market is projected to grow continuously worldwide, so is the plastic waste that pollutes the environment. The beverage industry’s marketing campaigns have played an important role in sustaining the popularity of bottled water. Social science theory-based empirical research examining how consumers make bottled water consumption decisions remains limited. To help fill this literature gap, the current study tested a conceptual framework to explore the influence of trust in bottled water advertising and perceived product knowledge on consumer beliefs about bottled water, in conjunction with theory of reasoned action. The study surveyed a sample of college students in the U.S. (N = 445). Findings showed that greater trust in bottled water advertising as well as more false knowledge and less factual knowledge were significantly related to consumer beliefs about bottled water’s product content and image. Furthermore, more favorable cognitive beliefs, affective beliefs, attitude and perceived subjective norms toward bottled water consumption were positively related to purchase intention. To reduce bottled water purchase among young adults, it would be beneficial to utilize marketing strategies to popularize and normalize carrying a reusable water bottle as an environmentally friendly habit and a preferred lifestyle choice