54 research outputs found
Caught in a ‘spiral’. Barriers to healthy eating and dietary health promotion needs from the perspective of unemployed young people and their service providers
NoThe number of young people in Europe who are not in education, employment or training (NEET) is increasing.
Given that young people from disadvantaged backgrounds tend to have diets of poor nutritional
quality, this exploratory study sought to understand barriers and facilitators to healthy eating and dietary
health promotion needs of unemployed young people aged 16–20 years. Three focus group discussions
were held with young people (n = 14). Six individual interviews and one paired interview with service
providers (n = 7). Data were recorded, transcribed verbatim and thematically content analysed. Themes
were then fitted to social cognitive theory (SCT). Despite understanding of the principles of healthy eating,
a ‘spiral’ of interrelated social, economic and associated psychological problems was perceived to render
food and health of little value and low priority for the young people. The story related by the young people
and corroborated by the service providers was of a lack of personal and vicarious experience with food.
The proliferation and proximity of fast food outlets and the high perceived cost of ‘healthy’ compared
to ‘junk’ food rendered the young people low in self-efficacy and perceived control to make healthier
food choices. Agency was instead expressed through consumption of junk food and drugs. Both the young
people and service providers agreed that for dietary health promotion efforts to succeed, social problems
needed to be addressed and agency encouraged through (individual and collective) active engagement
of the young people themselves
Factors determining the integration of nutritional genomics into clinical practice by registered dietitians
YesPersonalized nutrition has the potential to improve health, prevent disease and reduce healthcare expenditure. Whilst research hints at positive consumer attitudes towards personalized nutrition that draws upon lifestyle, phenotypic and genotypic data, little is known about the degree to which registered dietitians (RD) are engaged in the delivery of such services. This review sought to determine possible factors associated with the integration of the emerging science of Nutritional Genomics (NGx) into the clinical practice setting by practicing registered dietitians.
Scope
Search of online databases (Pubmed; National Library of Medicine; Cochrane Library; Ovid Medline) was conducted on material published from January 2000 to December 2014. Studies that sampled practicing dietitians and investigated integration or application of NGx and genetics knowledge into practice were eligible. Articles were assessed according to the American Dietetic Association Quality Criteria Checklist.
Key findings
Application of nutritional genomics in practice has been limited. Reluctance to integrate NGx into practice is associated with low awareness of NGx, a lack of confidence in the science surrounding NGx and skepticism toward Direct to consumer (DTC) products. Successful application to practice was associated with knowledge about NGx, having confidence in the science, a positive attitude toward NGx, access to DTC products, a supportive working environment, working in the clinical setting rather than the public health domain and being in private rather than public practice.
Conclusions
There is a need to provide RGs with a supportive working environment that provides ongoing training in NGx and which is integrated with clinical practice
Correlates of food choice in unemployed young people: The role of demographic factors, self-efficacy, food involvement, food poverty and physical activity.
yesAssociations between socio-demographic and psychological factors and food choice patterns were explored in unemployed young people who constitute a vulnerable group at risk of poor dietary health. Volunteers (N = 168), male (n = 97) and female (n = 71), aged 15–25 years were recruited through United Kingdom (UK) community-based organisations serving young people not in education training or employment (NEET). Survey questionnaire enquired on food poverty, physical activity and measured responses to the Food Involvement Scale (FIS), Food Self-Efficacy Scale (FSS) and a 19-item Food Frequency Questionnaire (FFQ). A path analysis was undertaken to explore associations between age, gender, food poverty, age at leaving school, food self-efficacy (FS-E), food involvement (FI) (kitchen; uninvolved; enjoyment), physical activity and the four food choice patterns (junk food; healthy; fast food; high fat). FS-E was strong in the model and increased with age. FS-E was positively associated with more frequent choice of healthy food and less frequent junk or high fat food (having controlled for age, gender and age at leaving school). FI (kitchen and enjoyment) increased with age. Higher FI (kitchen) was associated with less frequent junk food and fast food choice. Being uninvolved with food was associated with more frequent fast food choice. Those who left school after the age of 16 years reported more frequent physical activity. Of the indirect effects, younger individuals had lower FI (kitchen) which led to frequent junk and fast food choice. Females who were older had higher FI (enjoyment) which led to less frequent fast food choice. Those who had left school before the age of 16 had low food involvement (uninvolved) which led to frequent junk food choice. Multiple indices implied that data were a good fit to the model which indicated a need to enhance food self-efficacy and encourage food involvement in order to improve dietary health among these disadvantaged young people
Perceptions and experiences of early-adopting registered dietitians in integrating nutrigenomics into practice
yesPurpose - This research explores the perceptions and experiences of early adopters of the technology.
Design/Method/Approach - Registered Dietitians (RD´s) (N=14) were recruited from the UK, Canada, South-Africa, Australia, Mexico and Israel. Six qualitative interviews and two focus groups were conducted online using a conference calling platform. Data were recorded, transcribed and thematically analysed.
Findings - Early adopters of Nutrigenomics (NGx) were experienced, self-efficacious RD’s who actively sought knowledge of NGx through communication with one another and the broader scientific community. They considered NGx an extension of current practice and believed RD’s had the skills to deliver it. Perceived barriers to widening the application of NGx were linked to skepticism among the wider dietetics community. Proliferation of unregulated websites offering tests and diets was considered ‘pseudoscience’ and detrimental to dietetics fully embracing NGx. The lack of a sustainable public health model for the delivery of NGx was also perceived to hinder progress. Results are discussed with reference to ‘diffusion of innovation theory’.
Originality/Value - The views of RD’s who practice NGx have not been previously studied. These data highlight requirements for future dietetic training provision and more inclusive service delivery models. Regulation of NGx services and formal recognition by professional bodies is needed to address the research/practice translation gap
Association between nutrition self-efficacy, health locus of control and food choice motives in consumers in nine European countries
We investigated associations between food choice motives and psychological determinants of dietary health behaviour change (nutrition self-efficacy, NS-E, and health locus of control, HLoC) among 9381 participants (18 to 65 years, 49.4% females) from nine European countries. Price was the highest rated food choice motive. Higher importance of all motives was associated with higher NS-E and with higher Internal HLoC. Relationships between food choice motives and External HLoC were also in the expected direction in showing negative associations with Health, Natural Content, Weight Control, Mood and Sensory Appeal. Higher External HLoC was also associated with perceived greater importance of ‘external’ motives Ethical Concern, Familiarity and Convenience. Relationships between External HLoC and food choice motives were not all in the expected direction. Price was unrelated to External HLoC. Females rated the importance of all motives higher than males. People with less education ascribed greater importance to Price in motivating food choices. Together, these findings imply that self-efficacy and health locus of control should be considered along with motivations for food choice in dietary health promotion
Exploring the association between mental wellbeing, health-related quality of life, family affluence and food choice in adolescents
YesYoung people choose energy-dense, nutrient-poor diets, yet understanding of potential determinants is limited. Associations between food choices, mental wellbeing, health-related quality of life (HRQoL) and family affluence were explored to identify targets for intervention to promote dietary health and wellbeing in young people. Adolescents were recruited via post-primary schools in the UK and surveyed at two time-points when aged 13-14 years and 15-16 years. The questionnaire enquired about mental wellbeing using the Short Warwick-Edinburgh Mental Wellbeing Scale, HRQoL using the KIDSCREEN-10, socio-economic status using the Family Affluence Scale and food choice by Food Frequency Questionnaire (FFQ). With missing and anomalous cases excluded, the sample comprised 1208 cases. Factor analysis on the FFQ indicated five food choice factors: ‘Junk Food’; ‘Meat’; ‘Healthy Protein’; ‘Fruit/Vegetables’; ‘Bread/Dairy’. Multivariate regression analysis indicated that frequent consumption of Junk Food was associated with being male and lower mental wellbeing. Frequent Meat intake was associated with being male and with lower HRQoL. Frequent choice of Bread/Dairy foods was more common among males and associated with higher wellbeing and greater affluence. Those who consumed Fruit/Vegetables frequently were more likely to be female, have higher HRQoL, higher mental wellbeing, and greater family affluence. These direct associations endured between time points. The dietary factors were not mutually exclusive. Those who frequently chose Junk Food were less likely to choose Fruit/Vegetables. Frequent choice of Meat was associated with more frequent choice of Junk Food and Healthy Protein. Intervention to improve dietary and psychological health in young people should target males, those in less affluent households, seek to reduce consumption of ‘junk’ food, and increase fruit and vegetable intake.This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This ma-terial is based upon work conducted as part of the Wellbeing in Schools (WiSe) study which was financially supported by the Centre of Excel-lence for Public Health (Northern Ireland), and the Centre of Evidence and Social Innovation, at Queens University Belfast
Less screen time, more frequent fruit and vegetable intake, and physical activity are associated with greater mental wellbeing in adolescents
YesWellbeing declines during adolescence, for which the reasons are unclear. This analysis explored associations between wellbeing and multiple lifestyle, socioeconomic and school-level factors in young people. Data were collected as part of the Wellbeing in School (WiSe) survey of adolescent school children in Northern Ireland at age 13-14 years (N=1618; 49% female) and 15-16 years (N=1558; 50.5% female). Wellbeing was assessed using the short-form Warwick-Edinburgh Mental Wellbeing Scale (sWEMWBS), where scores declined between time one (13-14 years) and time two (15-16 years) in both sexes and were significantly lower in females at both timepoints. Multilevel, multivariate modelling was therefore undertaken separately for males and females with sWEMWBS scores as the dependent variable. Physical activity, family affluence, fruit and vegetable intake, social media use, sleep duration, school factors (size and type) and religion were independent variables. More frequent physical activity in both sexes at both timepoints was associated with higher sWEMWBS scores. In females, higher sWEMWBS scores were associated with less social media use at time one (and marginally at time two), greater family affluence at time two, and being Catholic at both timepoints. In males, higher sWEMWBS scores were associated with more frequent fruit and vegetable intake at time one. Mental wellbeing was unrelated to sleep duration or school factors in either sex, at both time points. Efforts to maximize mental wellbeing in adolescents should promote engagement in physical activity and implement sex-specific interventions.This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This material is based upon work conducted as part of the Wellbeing in Schools (WiSe) study which was financially supported by the Centre of Excellence for Public Health (Northern Ireland), and the Centre of Evidence and Social Innovation, at Queens University Belfast
Promoting healthy dietary behaviour through personalised nutrition: technology push or technology pull?
YesThe notion of educating the public through generic healthy eating messages has pervaded
dietary health promotion efforts over the years and continues to do so through various
media, despite little evidence for any enduring impact upon eating behaviour. There is growing
evidence, however, that tailored interventions such as those that could be delivered
online can be effective in bringing about healthy dietary behaviour change. The present
paper brings together evidence from qualitative and quantitative studies that have considered
the public perspective of genomics, nutrigenomics and personalised nutrition, including
those conducted as part of the EU-funded Food4Me project. Such studies have
consistently indicated that although the public hold positive views about nutrigenomics
and personalised nutrition, they have reservations about the service providers’ ability to ensure
the secure handling of health data. Technological innovation has driven the concept of
personalised nutrition forward and now a further technological leap is required to ensure the
privacy of online service delivery systems and to protect data gathered in the process of
designing personalised nutrition therapies
Food choice motives, attitudes toward and intention to adopt personalised nutrition
yesObjective: This study explored associations between food choice motives, attitudes towards,
5 and intention to adopt personalised nutrition in order to inform communication strategies
6 based on consumer priorities and concerns. Design and Setting: A survey was administered
7 online which included the food choice questionnaire (FCQ), and items assessing attitudes
8 towards and intention to adopt personalised nutrition. Participants: Nationally representative
9 samples were recruited in 9 EU countries (N=9381). Results: Structural equation modelling
10 indicated that the food choice motives, weight control, mood, health and ethical concern had
11 a positive association and price had a negative association with attitude towards, and
12 intention to adopt, personalised nutrition. Health was positively associated and familiarity
13 negatively associated with attitude toward personalised nutrition. The effects of weight
14 control, ethical concern, mood and price on intention to adopt personalised nutrition were
15 partially mediated by the attitude. The effects of health and familiarity were fully mediated
16 by attitude. Sensory appeal was negatively and directly associated with intention to adopt
17 personalised nutrition. Conclusion: Personalised nutrition providers may benefit from taking
18 into consideration the importance of underlying determinants of food choice, particularly
19 weight control, mood and price, in potential users when promoting services and in tailoring
20 communications that are motivationally relevant.Post peer-review accepted manuscript; changes are in red
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Application of behavior change techniques in a personalized nutrition Electronic Health intervention study: protocol for the web-based Food4Me randomized controlled trial
Background:
In order to determine the efficacy of behavior change techniques (BCT) applied in dietary and physical activity intervention studies, it is first necessary to record and describe techniques which have been used during such interventions. Published frameworks used in dietary and smoking cessation interventions undergo continuous development and most are not adapted for online delivery. The Food4Me study (N=1607) provided the opportunity to use existing frameworks to describe standardized online techniques employed in a large-scale internet-based intervention to change dietary behaviour and physical activity.
Objectives:
To describe techniques embedded in the Food4Me study design and explain the selection rationale. To demonstrate the use of behaviour change technique taxonomies, develop standard operating procedures for training, and identify strengths and limitations of the Food4Me framework that will inform its use in future studies.
Methods:
The 6-month randomized controlled trial took place simultaneously in 7 European countries, with participants receiving one of 4 levels of personalized advice (generalized, intake-based, intake+phenotype-based and intake+phenotype+gene-based). A 3-phase approach was taken: (I), existing taxonomies were reviewed and techniques were identified a priori for possible inclusion in the Food4Me study; (II) a standard operating procedure was developed to maintain consistency in the use of methods and techniques across research centers; (III) the Food4Me BCT framework was reviewed and updated post intervention. An analysis of excluded techniques was also conducted.
Results:
Of 46 techniques identified a priori as being applicable to Food4Me, 17 were embedded in the intervention design. Eleven were from a dietary taxonomy and 6 from a smoking cessation taxonomy. In addition, the 4-category smoking cessation framework structure was adopted for clarity of communication. Smoking cessation texts were adapted for dietary use where necessary. A posteriori, a further 9 techniques were included. Examination of excluded items highlighted the distinction between techniques considered appropriate for face-to-face vs internet-based delivery.
Conclusions:
The use of existing taxonomies facilitated the description and standardization of techniques used in Food4Me. We recommend that for complex studies of this nature, technique analysis should be conducted a priori to develop standardized procedures and training, and reviewed a posteriori to audit the techniques actually adopted. The present framework description makes a valuable contribution to future systematic reviews and meta-analyses which explore technique efficacy and underlying psychological constructs. This was a novel application of the behavior change taxonomies, and was the first internet-based personalized nutrition intervention to use such a framework remotely
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