Assessing Face Validity of a Food Behavior Checklist for Limited-resource Filipinos

Diet-related chronic health conditions are prevalent in the Filipino American community; however, there is a lack of rigorously validated nutrition education evaluation tools in Tagalog for use in this population. This study aimed to develop and evaluate the face validity of a Tagalog-language food behavior checklist (FBC). A multi-step method was used, involving translation of questionnaire text from English to Tagalog by a team of professionals, creation of accompanying color photographs, cognitive testing with the target population, final review by the team of professionals, and assessment of readability. Subjects for cognitive testing were men (n=6) and women (n=14) 18 years or older in Hawai‘i who received or were eligible to receive Supplemental Nutrition Assistance Program (SNAP) benefits, self-identified as Filipino, and preferred Tagalog rather than English. Participants were recruited from churches, the Filipino Center, and other community sites. Cognitive interviews revealed several issues with text and photographs, such as preferences for specific terms, and images that did not adequately illustrate the text. Image changes were made to reflect items most commonly consumed. The team of professionals agreed with participant suggestions. Assessment of readability revealed a reading level appropriate for a low-literacy population of grade 5.9. The multi-step process, which allowed members of the target audience to reveal the appropriateness of the questionnaire, yielded a Tagalog-language FBC found to have adequate face validity. After further evaluation of validity and reliability, this tool may be used to evaluate behavior change resulting from the United States Department of Agriculture’s (USDA) nutrition education programs

Using Deliberative Pedagogy as a Tool for Critical Thinking and Career Preparation Among Undergraduate Public Health Students

Engagement of undergraduate public health students in active learning pedagogy has been identified as critical for recruitment, retention, and career preparation efforts. One such tool for engagement that has proven successful in STEM programs is deliberative pedagogy, where it is used to stimulate student interest in research and policy applications of technical course content. Broadly applied, deliberative pedagogy is a consensus model of decision-making, applied as an in-class exercise, where students work in small groups and model a community task force with assigned group roles. In these groups, students collect evidence from literature and media sources, and prepare a consensus response to an assigned question. Here we present an adaptation of this pedagogy to provide undergraduates with the tools needed to actively engage in public health policy and planning work groups. This adaptation is first applied during an introductory public health course, where it is used as a tool for engagement and excitement, and as a critical thinking exercise. It additionally serves as an opportunity for students to apply information literacy skills and engage with research and policy initiatives discussed in class. The same tool is reintroduced prior to graduation in a capstone course, where the emphasis shifts to application of research skills and analytical concepts. The activity is also an opportunity for students to apply professional skills needed for engagement in program development, program evaluation, institutional policy, and legislative advocacy. Through application of this pedagogical tool at two critical time points in an undergraduate curriculum, students develop skills necessary for early career professionals and are better prepared to actively engage in policy and planning as it relates to critical public health initiatives, both locally and globally

The role of social capital in changing dietary behavior in a low-income multi-ethnic community

D.P.H. University of Hawaii at Manoa 2012.Includes bibliographical references.Poor dietary quality contributes to health disparities experienced by low-income populations. Although prior studies have examined factors shaping dietary behavior among individual ethnic groups, there is little knowledge about structural factors shaping dietary decisions within multi-ethnic low-income communities. Low-income households have fewer resources for purchasing healthy food, and greater demands on the economic, time and labor resources required for meal preparation. With limited economic resources, families may rely on social capital resources to manage food within the household. However, social capital structures within a multi-ethnic community are likely to be complex. This dissertation explores the role of social capital in shaping dietary behavior in a multi-ethnic low-income Asian and Pacific Islander community in Hawaiʻi. The first study presents findings from a systematic literature review on the operationalization of social capital theory in nutrition research. This review identifies the primary theories of social capital underlying nutrition research, and the measures of social capital commonly used in this research. The second and third studies report on empirical research conducted in Kalihi, a low-income multi-ethnic neighborhood of Honolulu, Hawaiʻi. The second study uses qualitative methods to understand the dimensions of social capital within the community, and the ways that social capital affects household nutrition behaviors. The third study uses network analysis to assesses linkages between community organizations, mapping the structure of institutional social capital within the community. Together, these studies suggest that families in low-income multi-ethnic communities rely on social capital to provide resource for nutrition, and this reliance shapes dietary behavior. Social capital structures within this community, however, do not fit the theory and measures of social capital most commonly used in nutrition research. Improved theory and measure selection would strengthen the utility of social capital theory as a tool for understanding nutrition behavior. Individual social capital operates through extended family and ethnic group ties, not neighborhood geography. Access to bridging capital was primarily through family connections with childcare and faith-based institutions, but churches were poorly connected in the nutrition network. Building institutional social capital through increasing linkage between these organizations could provide support for improved nutrition across the community

Influences on eating: a qualitative study of adolescents in a periurban area in Lima, Peru

Background: Peruvian adolescents are at high nutritional risk, facing issues such as overweight and obesity, anemia, and pregnancy during a period of development. Research seeking to understand contextual factors that influence eating habits to inform the development of public health interventions is lacking in this population. This study aimed to understand socio-cultural influences on eating among adolescents in periurban Lima, Peru using qualitative methods. Methods: Semi-structured interviews and pile sort activities were conducted with 14 adolescents 15–17 years. The interview was designed to elicit information on influences on eating habits at four levels: individual (intrapersonal), social environmental (interpersonal), physical environmental (community settings), and macrosystem (societal). The pile sort activity required adolescents to place cards with food images into groups and then to describe the characteristics of the foods placed in each group. Content analysis was used to identify predominant themes of influencing factors in interviews. Multidimensional scaling and hierarchical clustering analysis was completed with pile sort data. Results: Individual influences on behavior included lack of financial resources to purchase food and concerns about body image. Nutrition-related knowledge also played a role; participants noted the importance of foods such as beans for anemia prevention. At the social environmental level, parents promoted healthy eating by providing advice on food selection and home-cooked meals. The physical environment also influenced intake, with foods available in schools being predominantly low-nutrient energy-dense. Macrosystem influences were evident, as adolescents used the Internet for nutrition information, which they viewed as credible. Conclusions: To address nutrition-related issues such as obesity and iron-deficiency anemia in Peruvian adolescents, further research is warranted to elucidate the roles of certain factors shaping behavior, particularly that of family, cited numerous times as having a positive influence. Addressing nutrition-related issues such as obesity and iron-deficiency anemia in this population requires consideration of the effect of social and environmental factors in the context of adolescent lifestyles on behavior. Nutrition education messages for adolescents should consider the cultural perceptions and importance of particular foods, taking into account the diverse factors that influence eating behaviors

Health Literacy in a Social Context: A Meta-Narrative Review

Pitt R, Davis T, Manganello J, et al. Health Literacy in a Social Context: A Meta-Narrative Review . In: Okan O, Bauer U, Levin-Zamir D, Pinheiro P, Sørensen K, eds. International Handbook of Health Literacy. Research, Practice and Policy across the Lifespan. Bristol: Policy Press; 2019: 665–688