Multilevel Structural Equation Modeling of Students’ Dietary Intentions/Behaviors, BMI, and the Healthfulness of Convenience Stores

When dietary behaviors are habitual, intentions are low, and environmental cues, such as the consumer food environment, might guide behavior. How might intentions to eat healthily and ultimately actual dietary behaviors, be influenced by the consumer food environment (including the availability and affordability of healthy foods) in convenience stores? This study will determine pathways between the healthfulness of convenience stores and college students' dietary intentions/behaviors, and body mass index (BMI)

Multilevel Structural Equation Modeling of Students\u27 Dietary Intentions/Behaviors, BMI, and the Healthfulness of Convenience Stores.

BACKGROUND: When dietary behaviors are habitual, intentions are low, and environmental cues, such as the consumer food environment, might guide behavior. How might intentions to eat healthily and ultimately actual dietary behaviors, be influenced by the consumer food environment (including the availability and affordability of healthy foods) in convenience stores? This study will determine pathways between the healthfulness of convenience stores and college students\u27 dietary intentions/behaviors, and body mass index (BMI).METHODS: Through multilevel structural equation modeling, a comparison was made of students\u27 healthful meal intentions (HMI); intake (fruits/vegetables, %kcal/fat, sugar-sweetened beverages (SSBs) and whole-grains); and measured BMI; as well as the healthfulness of convenience stores (fruits/vegetables availability/quality, healthy food availability/affordability). Data was collected on 1401 students and 41 convenience stores across 13 US college campuses.RESULTS: Controlling for gender, HMI was negatively associated with SSBs (β = -0.859) and %kcal/fat (β = -1.057) and positively with whole-grains (β = 0.186) and fruits/vegetables intake (β = 0.267); %Kcal/fat was positively (β = 0.098) and fruits/vegetables intake (β = -0.055) negatively associated with BMI. Campus level, fruits/vegetables availability were positively associated to HMI (β = 0.214, β = 0.129) and directly/negatively to BMI (β = -2.657, β = -1.124).CONCLUSIONS: HMI modifies dietary behaviors, with energy from fat and fruit/vegetable intake the most predictive of weight. Availability of fruit/vegetables in convenience stores make it easier for young adults to eat well

Use of Program Theory in a Nutrition Program for Grandchildren and Grandparents

Grandparents University ® (GPU) is a 2-day campus-based nutrition education program for grandparents and grandchildren based on constructs from Social Cognitive Theory and the Theory of Planned Behavior. This article describes how program theory was used to develop a working model, design activities, and select outcome measures of a 2-day nutrition program at GPU 2010 that fostered behavioral intention among intergenerational participants to eat more fruits and vegetables and become more physically active

Pseudo-Underage Students\u27 Access to Alcohol Surrounding Three College Campuses

The objective of this study was to determine underage college students\u27 ability to purchase alcohol in their immediate campus environment. Approximately 25% of off-site (e.g., liquor stores) and on-site (e.g., bars) outlets surrounding 3 college campuses were selected for this study. At each campus, one male and one female auditor, age 21 or 22 years, conducted alcohol access audits (audits) by attempting to purchase alcohol without identification. Audits resulted in the purchase of alcohol without identification at 2 to 15 off-site outlets (5%–13.9%) and 0 to 19 of on-site outlets (0%–21.6%), with no significant differences among campuses (P = .36 and P = .16), respectively. This is the first report of alcohol access in the college environment. The rate of successful purchase was lower than previously reported for other environments (range 26%–73%)

The marketing plan and outcome indicators for recruiting and retaining parents in the HomeStyles randomized controlled trial

Abstract Background Despite the critical importance of successful recruitment and retention to study integrity, reporting of recruitment and retention strategies along with factors associated with successful recruitment and retention of participants in health-related interventions remain rare, especially for health and obesity prevention programs. Thus, the purpose of this article is to retrospectively examine the recruitment and retention marketing plan used in the online HomeStyles randomized controlled trial (RCT) and discuss outcomes associated with completion of the intervention. Methods The HomeStyles RCT is an online intervention developed to motivate parents of young children to gain the skills and self-confidence needed to shape home environments and lifestyles to be protective against childhood obesity. Using the seven Ps of services marketing (i.e., people, place, product, physical evidence, price, promotion, and process), a comprehensive and systematic plan for recruitment and retention was implemented and outcomes assessed. Results A total of 489 parents with a young child aged 2 to < 6 years were eligible to participate, a final capture rate of 33%. Only 23% of Hispanic participants chose to use the Spanish-language version of HomeStyles intervention materials, below the demand anticipated. However, Hispanic enrollment overall was substantially higher than the U.S. population proportion (i.e., 17%). The number of participants prematurely leaving the study was similar in both treatment groups, indicating attrition was not differential. Completers reported high satisfaction of HomeStyles, using a 1–5 scale (strongly disagree to strongly agree) on guide attractiveness, interestingness, and usefulness. Despite all the retention efforts, the average monthly recruitment accrual rate of ~ 33 eligible enrolled participants at baseline (i.e., 489 participants/15-month recruitment period), declined to ~ 18, 11, 9, and 8 remaining recruited participants/month at midpoint, post, follow-up, and long-term follow-up surveys, respectively. In general, survey completers were significantly more likely to be female and perceived their child’s health status to be better, and they were significantly less likely to be restrictive of their child’s food intake. Conclusions The findings of the present study highlight the need for far-reaching, concentrated, and varied recruitment strategies; sufficient time in the research plan for recruitment and retention activities; and creative, tireless, flexible, persistent project staff for health-related interventions

Relationships of Cognitive Load on Eating and Weight-related Behaviors of Young Adults

Little is known about the relationship between weight-related behaviors and cognitive load (working memory available to complete mental activities like those required for planning meals, selecting foods, and other health-related decisions). Thus, the purpose of this study was to explore associations between cognitive load and eating behaviors, physical activity, body mass index (BMI), and waist circumference of college students. College students (n=1018) from 13 institutions completed an online survey assessing eating behaviors (e.g., routine and compensatory restraint, emotional eating, and fruit/vegetable intake), stress level, and physical activity level. BMI and waist circumference were measured by trained researchers. A cognitive load score was derived from stress level, time pressure/income needs, race and nationality. High cognitive load participants (n=425) were significantly(P \u3c 0.05) more likely to be female, older, and further along in school than those with low cognitive loads (n = 593). Compared to low cognitive load participants, high cognitive load participants were significantly more likely to eat \u3c 5 cups of fruits/vegetables/day, have greater routine and compensatory restraint, and greater susceptibility to eating in response to external cues and emotional eating. Both males and females with high cognitive load scores had a non-significant trend toward higher BMIs, waist circumferences, and drinking more alcohol than low cognitive load counterparts. In conclusion, cognitive load may be an important contributor to health behaviors. Understanding how cognitive load may affect eating and other weight-related behaviors could potentially lead to improvements in the effectiveness of obesity prevention and intervention programs

Development of the Intervention Materials for the HomeStyles Obesity Prevention Program for Parents of Preschoolers

Home environment is key to the development of obesity-preventing behaviors during childhood, yet few resources help preschool parents address factors at home associated with obesity risk. This paper describes creation of materials for an in-home intervention (HomeStyles) with this population. An advisory group of stakeholders and target audience members determined salient factors affecting childhood obesity to address in-home and developed program materials. The Social Cognitive Theory, Faith’s Core Behavior Change Strategies to Treat Childhood Obesity, Adult Learning Theory and motivational interviewing techniques guided development of 12 guides targeting strategies parents can use to shape the home environment. Interviews were conducted to determine effectiveness of the guides. Cognitive testing of guide design (n = 251) and content (n = 261) occurred in English and Spanish in New Jersey and Arizona with parents and home visitation staff who would present the guides. Interviews investigated perceptions of content usefulness and parent comprehension. Findings were also examined in light of theoretical underpinnings. Both home visitation staff and parents felt the guides were very readable and useful. Parents appreciated use of motivational interviewing techniques and Adult Learning Theory. Current research is testing these guides through an in-home, randomized control trial

Recruitment lessons learned from a tailored web-based health intervention project Y.E.A.H. (young adults eating and Active for health)

Purpose-Recruiting college students for research studies can be challenging. The purpose of this paper is to describe the lessons learned in the various recruitment strategies used for enrolling college students in a theory-based, tailored, and web-delivered health intervention at 13 US universities. Design/methodology/approach-The community-based participatory research (CBPR) model was used to develop a staged-tailored, web-based, randomized control trial, focussing on eating behavior, physical activity, and stress management. Participant feedback during baseline assessments was used to evaluate recruitment strategies. Findings-Findings from this feedback suggest that traditional recruitment strategies, such as newspaper ads and flyers, may not be the best approach for recruiting college students; instead, web-based efforts proved to be a better recruitment strategy. Research limitations/implications-This project included results from 13 US universities and thus may not be generalizable: more research is needed to determine successful recruitment methods for 18-24 years old college students. Originality/value-This paper lessens the gap regarding successful recruitment strategies for 18-24 years old college students

Evaluation of the Food Store Environment On and Near the Campus of 15 Postsecondary Institutions

PURPOSE: This study evaluated the food stores on and near postsecondary campuses varying in institutional size.DESIGN: The design of the study is an environmental audit survey.SETTING: Fifteen U.S. postsecondary education institutions participated in this study between 2009-2011.SUBJECTS: Eighty-one stores (44% grocery, 17% campus, and 39% convenience/drug) were evaluated.MEASURES: The Nutrition Environment Measures Survey for Stores was modified to evaluate food stores. Analysis. Analysis of variance with post hoc Tukey B and t-tests assessed differences between store types and by institutional size.RESULTS: Grocery stores had significantly higher scores than campus/convenience stores for healthy foods (19.5 ± 3.8 vs. 2.4 ± 1.7), and for the availability (19.5 ± 3.8 vs. 2.4 ± 1.7) and quality (5.9 ± 0.5 vs. 1.8 ± 2.2) of fruits/vegetables (p \u3c .001). Healthy foods and beverages were significantly more expensive (-0.6 ± 3.4 vs. 0.9 ± 2.0; p \u3c .031) than their less healthful alternatives in grocery stores, but not in convenience stores. There were no differences by institutional size for grocery stores; however, smaller institutions\u27 convenience stores had significantly lower availability and quality of fruits/vegetables and total food store environment scores.CONCLUSION: A college campus provides a food environment with an array of shopping venues, most of which are not consistent with dietary recommendations for obesity prevention. The limited quality of healthy food in on-campus and convenience stores and the exacerbated deficiencies for small postsecondary institutions provide evidence to support environmental and policy initiatives to improve the quality of campus food store environments