INFLUENCING HEALTHY FOOD CHOICES IN THE MARINE CORPS

The purpose of this thesis is to create an influence campaign focused on improving nutritional choices of Marines across the Marine Corps. It explores the most current publications from the U.S. Departments of Agriculture and Health and Human Services, and the U.S. military to establish a healthy nutrition baseline and identify how the Marine Corps attempts to provide adequate nutrition to its Marines. It demonstrates how optimizing food nutrition equates to combat readiness of the force. It investigates how food affects the body and how nutrients and timing affect a tactical athlete's performance. Since Marines have to choose from the food selections provided, the thesis outlines principles of influence that are and/or could be used to change food behavior. Influencing Marines’ behavior in favor of healthier food types that optimize physical performance and longevity is a pursuit worthy of an organization that must be fit and ready for combat. The thesis culminates with an influence campaign outlining suggestions that would achieve this nutritional increase, and thus combat readiness, in the Marine Corps.Captain, United States Marine CorpsApproved for public release. Distribution is unlimited

The Privilege of Healthy Eating: A Qualitative Study Exploring the Local Food Choices of Low-Income Families from Appalachia

Using qualitative semi-structured interviews, 15 low-income women of different ages were asked to discuss their perceptions of healthy eating, local farmers’ markets, as well as their visitation of farmers’ markets. The participants were also asked to share what features of farmers’ markets they found appealing. The results showed that most of the participants had either a deep or moderate understanding of what it means to eat healthy. However, many of them also believed they could improve their own patterns of eating. The data also showed that the low-income women who took part in the study had positive attitudes overall toward local farmers’ markets, despite rather low levels of visitation (only 5 participants had visited farmers’ market at least once and only one of them visited farmers’ market on a regular basis). Lastly, participants discussed constraints that prevented them from visiting farmers’ markets more often and provided suggestions for possible facilitators to increase the frequency of their use of farmers’ markets

The Association Between Health Literacy and Diet Adherence Among Primary Care Patients with Hypertension

This study examines the association between health literacy and adherence to low-salt diet practices among individuals with hypertension. Health literacy is the ability of individuals to understand and utilize health information. We surveyed 238 patients with hypertension from a primary care clinic in Charlotte, NC. We assessed health literacy and self-reported low-salt diet. Logistic regression was used to model the relationship between health literacy and low-salt diet adherence. Respondents were primarily female (67.3%) and black (80%). Black Americans were less likely to have adequate health literacy as compared to white Americans (21.8% vs. 55.8%). The study found no association between adequate health literacy and adherence to a low-salt diet (OR = 1.06, 95% CI: 0.36-3.10) after adjusting for confounders. This study addresses the conflicting findings for health literacy in two related areas: chronic illness self-care, and nutrition/diet skills. Additional research is warranted among black Americans given their increased risk of hypertension, low rates of diet adherence and previous findings of positive associations between health literacy and nutrition skills

THE EFFECT ON DIETARY QUALITY OF PARTICIPATION IN THE FOOD STAMP AND WIC PROGRAMS

Participants in the Food Stamp Program consume more meats, added sugars, and total fats than they would in the absence of the program, while their consumption of fruits, vegetables, grains, and dairy products stays about the same. Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) consume significantly less added sugars, which may reflect the substitution of WIC-supplied juices and cereals in place of higher sugar soft drinks and cereals. These findings come from a study of low-income Americans using the Continuing Survey of Food Intake by Individuals.Nutrition assistance programs, food intake, dietary quality, Continuing Survey of Food Intake by Individuals (CSFII), Food Consumption/Nutrition/Food Safety, Food Security and Poverty,

Evaluating Nutrition Education Programming by Using a Dietary Screener

Short dietary assessment instruments known as screeners have potential for use in evaluating nutrition education programming because detecting change in dietary intake can demonstrate movement toward program goals. Using screeners results in objective dietary intake data but involves less administrative time, training, and cost than other evaluation methods. This article describes use of the Block Screener for Fruits, Vegetables, and Fiber (BSFVF) as a pre- and posteducation evaluation tool for an Extension nutrition education program. Findings showed that graduates’ intakes of fruits, vegetables, fiber, and certain nutrients significantly increased. Implications related to use of the BSFVF for evaluation of routine Extension nutrition education programming are discussed

Move! Development of a Wellness Program for 18-24 Year-old Adults

A capstone submitted in partial fulfillment of the requirements for the degree of Doctor of Education in the College of Education at Morehead State University by Tonia M. Socha-Mower on November 11, 2022

Examining General versus Condition-Specific Health Related Quality of Life across Weight Categories in an Adolescent Sample

Approximately 34% of adolescents are overweight or obese which can be accompanied by physical, psychosocial, and economic consequences. Increasingly, pediatric overweight/obesity research has focused on Health Related Quality of Life (HRQoL) as a health outcome. This study examined differences in HRQoL across weight categories in adolescents, specifically, the sensitivity of using a general versus condition-specific measure. Further, the influence of gender was explored. Data were extracted from Wave 2 of Team Up for Healthy Living, a school-based obesity prevention program targeting adolescents in Southern Appalachia. Participants (N = 918; 50% Female; 93% Caucasian; 90% 9th graders) completed the Pediatric Quality of Life (PedsQL) Inventory (general) and PedsQL Multidimensional Fatigue Scale (condition-specific) measures as part of a larger survey. Body mass index-for-age and -sex percentiles were calculated using actual height and weight, and students were classified as underweight, healthy weight, overweight, or obese according to Centers for Disease Control and Prevention (CDC) criteria. Two 4 (weight category: underweight vs. healthy weight vs. overweight vs. obese) x 2 (gender: male vs. female) factorial analyses of variance (ANOVAs) were calculated to compare mean scores of total HRQoL (both generic and condition-specific). Additionally, 7 factorial multivariate analyses of variance (MANOVAs) were conducted with each measure’s subdomains. Fisher’s Least Significant Difference post hoc analyses were run to assess differences between groups, at a significance level of p\u3c0.05. The current study revealed no interaction effect between total HRQoL (assessed via the generic or condition-specific measure) and weight category and gender; however, main effects were found for both weight category (assessed via a generic measure only) and gender (assessed via both generic and condition-specific measures). Additional research is needed to examine the impact of utilizing different measures and the potential role of gender as well as other factors that may influence HRQoL across weight categories. These issues are important as researchers to date utilize a variety of HRQoL measures making interpretation of findings difficult and often do not consider other variables such as gender that may influence findings

The National School Lunch Program: Local Implementation of Federal Reform

This research study examined the National School Lunch Program and local implementation of federal reform in public and private schools in Milwaukee County, Wisconsin. The survey participants were selected by the way of purposeful sampling; interviews were conducted over the telephone; and a 90-minute focus group was held. Major themes from the study consist of the need for well-balanced meals in schools, concern regarding childhood obesity, and barriers of local implementation of federal guidelines. Many advocates expressed their concern regarding the calorie restrictions, specifically to the 850 kcal maximum for physically active students. This study provides insight on how the most recent federal guidelines for school lunch programs have been implemented by Milwaukee area schools with the help of privatization and careful menu planning by employed dietitians

The role of attitude, control and intention to explain fruit and vegetable intake among racial/ethnic minority women with low socioeconomic status

OBJECTIVE: Fruit and Vegetable (FV) intake-a modi able risk factor for chronic diseases-is lower among racial/ethnic minorities and low Socio- Economic Status (SES) groups when compared to other populations. The Theory of Planned Behavior (TPB) is one theoretical model studied to explain and in uence individual health behaviors, including FV intake, in middle class populations, but not exclusively in diverse, low SES groups. This cross-sectional study evaluated the utility of select TPB variables to explain intention to consume and intake of FV in this population. DESIGN: Demographics, BMI, select TPB variables, and FV intake were measured via survey. Bivariate analyses were conducted to explore relationships between variables. Hierarchical regression analyses were used to t two models: one to explain intention and one to explain behavior with regard to FV vegetable intake. RESULTS: Participants (n=114) age 25-69 years and were mostly African American/Black and Hispanic (21.9% and 73%, respectively). The TPB variable perceived behavioral control was the only signi cant predictor of intention to consume FV (OR=2.55, 95% CI OR: 1.23, 5.27), and with BMI, FV intake (R2=0.08; F [2,130] =5.72, p=0.0042). CONCLUSION: Perceived behavioral control and BMI are the most signi cant predictors of FV intake but explain only 8% of the variability in intake in our cohort. Our results support prior research which suggests an attenuation of the intention-behavior relationship by SES, and may question the utility of the TPB as it is currently operationalized as a foundational model for future health behavior change research and programs in low SES racial/ethnic minorities