Intra-household differentials in women's status : household function and focus as determinants of children's illness management and care in rural Mali

In West Africa, health-seeking behaviour can be better understood by assessing how women differ from each other, rather than how they differ from men, in terms of their socioeconomic and political power within the domestic environment. Anthropological and demographic data were collected among rural Malian Fulani and Dogon populations who possess similar health beliefs and who live in the same ecological area. However, real differences between the two ethnic groups were reflected in variations in maternal status defined according to women’s support and/or autonomy in their households. When a child becomes sick, status obligations result in limited degrees of co-operation between marital female relatives. By contrast, on a day-to-day basis such assistance is rarely forthcoming and women rely on their own unmarried daughters or on external kin networks for surrogate child care. It is concluded that variations in health behaviour and mortality outcomes within these populations reflect not simply ‘ethnic’ differences in beliefs or culture, but rather real differences in mothers’ social positions within their family environments and in their access to household resources for children’s treatment and care

Cooking Frequency Associated With Dietary Quality in iCook-4H Youth Participants at Baseline

Background: Increased intakes of ready-made and fast foods paralleled with decreased homemade food consumption have been associated with increased rates of obesity. Researchers have shown associations between cooking self-efficacy (SE) and cooking frequency (CF) with dietary quality and weight status. Some cooking interventions have shown positive associations with dietary outcomes, such as increased fruit and vegetable intake and decreased fast food consumption. There is still much unknown about SE and CF, especially among youth. Objective: Determine baseline SE and CF and the associations with dietary quality and body mass index (BMI) of youth enrolled in iCook 4H. Methods: Youth (n=228, ages 9-10 years) completed online surveys assessing SE, CF, dietary quality, and demographics. Anthropometrics were collected to calculate BMI-for-age percentiles and weight categories. Descriptive statistics were completed for CF, SE, BMI categories, and demographics. Differences in CF and SE by sex, race, and participation in government assistance programs were determined through independent-sample t tests. Pearson correlations were used to assess the association between dietary quality and CF and SE. Associations between CF and dietary quality were assessed further through 2-way analyses of variance (ANOVAs) that included CF and sex and CF and race as independent variables. Associations between SE and CF and BMI were assessed through ANOVAs. Results: Thirty-seven percent of youth were overweight or obese. Females reported significantly higher CF than males (P=.042). Cooking frequency was positively associated with dietary quality (P \u3c .001), but BMI was not associated with dietary quality. SE was not associated with dietary quality or BMI. Conclusion: Based on results, CF was positively associated with dietary quality among youth. More research is needed to assess how different types of cooking relate to diet and BMI. Interventions are needed to determine whether increasing CF leads to better diet outcomes

Development and Validation of an Instrument Measuring Determinants of Bystander Intervention to Prevent Sexual Assault: An application of the Reasoned Action Approach

Bystander Intervention (BI) is an evidence-based approach that is considered the gold standard by governmental organizations to reduce sexual assault in college. Few survey instruments are available to measure the predispositions students have towards engaging in BI. Valid and reliable instruments are greatly needed, especially those tailored to BI. The purpose of this study was to develop and validate an instrument based on the reasoned action approach with college students at two U.S. universities. An elicitation of beliefs was accomplished to inform survey items (i.e., behavioral, normative, and control beliefs). Then, an initial draft was developed and sent to an expert panel to establish validity. The final instrument was administered to undergraduate students (n = 291), and further psychometric properties (construct validity and internal consistency reliability) were evaluated. Data were fit into two separate models to evaluate fit. In the first model, a four-factor solution was evaluated (intentions, attitudes, perceived norms, and perceived behavioral control), and while results were modest, the second seven-factor solution model contained a better fit (intentions, instrumental and experiential attitudes, injunctive and descriptive norms, capacity, and autonomy). Researchers and practitioners examining BI in college can use this instrument to measure theory-based determinants of BI to reduce sexual assault

Using Ripple Effects Maps to Identify Story Threads: A Framework to Link Private to Public Value

Extension professionals must demonstrate organizational value to garner public awareness and support. Measuring and communicating outcomes that have public value can be challenging. In this study, Ripple Effects Mapping incorporating the Community Capitals Framework was used to evaluate a childhood obesity prevention study, iCook 4-H, of youth-adult pairs in Maine. The objective was to describe the process of generating impact statements through story threads about program benefits to the participants and the potential benefits to nonparticipants, such as family members, friends, and other community members. Extension professionals can use storylines, or story threads, as a qualitative research technique to generate stories about private and public value from participants’ actions, experiences, and emotions following community programs. The story threads process can be used across disciplines to leverage community program data into public value messaging

Cooking Frequency Associated With Dietary Quality in iCook-4H Youth Participants at Baseline

Background: Increased intakes of ready-made and fast foods paralleled with decreased homemade food consumption have been associated with increased rates of obesity. Researchers have shown associations between cooking self-efficacy (SE) and cooking frequency (CF) with dietary quality and weight status. Some cooking interventions have shown positive associations with dietary outcomes, such as increased fruit and vegetable intake and decreased fast food consumption. There is still much unknown about SE and CF, especially among youth. Objective: Determine baseline SE and CF and the associations with dietary quality and body mass index (BMI) of youth enrolled in iCook 4H. Methods: Youth (n=228, ages 9-10 years) completed online surveys assessing SE, CF, dietary quality, and demographics. Anthropometrics were collected to calculate BMI-for-age percentiles and weight categories. Descriptive statistics were completed for CF, SE, BMI categories, and demographics. Differences in CF and SE by sex, race, and participation in government assistance programs were determined through independent-sample t tests. Pearson correlations were used to assess the association between dietary quality and CF and SE. Associations between CF and dietary quality were assessed further through 2-way analyses of variance (ANOVAs) that included CF and sex and CF and race as independent variables. Associations between SE and CF and BMI were assessed through ANOVAs. Results: Thirty-seven percent of youth were overweight or obese. Females reported significantly higher CF than males (P=.042). Cooking frequency was positively associated with dietary quality (P \u3c .001), but BMI was not associated with dietary quality. SE was not associated with dietary quality or BMI. Conclusion: Based on results, CF was positively associated with dietary quality among youth. More research is needed to assess how different types of cooking relate to diet and BMI. Interventions are needed to determine whether increasing CF leads to better diet outcomes

Teens Implementing a Childhood Obesity Prevention Program in the Community: Feasibility and Perceptions of a Partnership with HSTA and iCook 4-H.

High school student researchers and teen leaders from the Health Science Technology Academy (HSTA), under the supervision of HSTA teachers, led a childhood obesity prevention (COP) program (iCook 4-H). The objective was to evaluate the feasibility and perceptions of having teen leaders implement a COP program for dyads of youth (9⁻10 years old) and their primary adult food preparer. Behavior change and perceptions were assessed through surveys and open-ended interviews. Across eight HSTA organizations, 43 teen leaders participated in teaching the iCook 4-H program to 24 dyads. Increased frequency of culinary skills, physical activity and mealtime behavior were reported by youth. Almost all adults (93%) reported that their youth had learned kitchen skills and that the program provided youth-adult quality time and developed culinary skills. Youth echoed adult perceptions with additional themes of food safety and physical activity. HSTA teen leaders perceived the program to be successful and reported the training they received to implement the program was adequate 98% of the time. HSTA teachers found the program to be beneficial for HSTA students in improving leadership, confidence and responsibility. iCook 4-H was feasible to be disseminated through teen leaders in the HSTA program. This teen-led approach could serve as a model for youth health-related programming

Dissemination Using Infographic Reports Depicting Program Impact of a Community-Based Research Program: eB4CAST in iCook 4-H

Objective: To evaluate barriers to dissemination and implementation and perceptions of the Evidence- Based Forecast Capture, Assemble, Sustain, Timelessness (eB4CAST) dissemination infographic tool as part of iCook 4-H dissemination. Design: Online surveys and phone interviews. Participants: Experts (n = 35) in community research completed the survey; 13 completed the interview. Main Outcomes Measure: Experts’ perceptions of eB4CASTreports used for iCook 4-H dissemination. Analysis: Frequency and thematic analysis. Results: Survey respondents agreed (85%) that the eB4CAST infographic provided a clear understanding of iCook 4-H and relevant information (83%). Statistics included in the infographic were reported as easily understood (66%). Respondents (83%) stated that the infographic would be helpful to share outcomes with stakeholders. Thematic analysis showed that the majority of interviewees agreed that eB4CAST infographics might aid in overcoming barriers to dissemination and implementation including communication and community ownership. Conclusions and Implications: This study provides perceptions from experts regarding the value of using eB4CAST infographics as a tool to disseminate the impact of a community nutrition program

Development and Testing of Program Evaluation Instruments for the iCook 4-H Curriculum

Objective: To develop and test the validity of program outcome evaluation instruments for cooking, eating, and playing together for obesity prevention during iCook 4-H. Design: Instrument development for both youth and adults through pre-post testing of items newly constructed and compiled to address key curriculum constructs. Testing occurred throughout program intervention and dissemination to determine dimensionality, internal consistency and test-retest reliability, and validity. Setting: A 5-state out-of-school program in cooperative extension and other community sites. Participants: Youths aged 9−10 years; adults were main food preparers; the first phase involved 214 dyads and the second phase, 74 dyads. Main Outcome Measure(s): Youth measures were cooking skills, culinary self-efficacy, physical activity, and openness to new foods. Adult measures were cooking together, physical activity, and eating together. Analysis: Exploratory factor analysis to determine initial scale structure and confirmatory factor analysis to confirm factor structures. Longitudinal invariance tests to see whether the factor structure held over time. Test-retest reliability was determined by Pearson r and internal consistency was determined by coefficient V and Cronbach a. Validity testing was determined by Pearson r correlations. Results: Youth cooking skills, openness to new foods, and adult eating together and cooking together showed strong evidence for dimensionality, reliability, and validity. Youth physical activity and adult physical activity measures showed strong evidence for dimensionality and validity but not reliability. The youth culinary selfefficacy measure showed strong evidence for reliability and validity but weaker evidence for dimensionality. Conclusions and Implications: Program outcome evaluation instruments for youths and adults were developed and tested to accompany the iCook 4-H curriculum. Program leaders, stakeholders, and administrators may monitor outcomes within and across programs and generate consistent reporting

Health Disparities Score Composite of Youth and Parent Dyads from an Obesity Prevention Intervention: iCook 4-H.

iCook 4-H is a lifestyle intervention to improve diet, physical activity and mealtime behavior. Control and treatment dyads (adult primary meal preparer and a 9–10-year-old youth) completed surveys at baseline and 4, 12, and 24 months. A Health Disparity (HD) score composite was developed utilizing a series of 12 questions (maximum score = 12 with a higher score indicating a more severe health disparity). Questions came from the USDA short form U.S. Household Food Security Survey (5), participation in food assistance programs (1), food behavior (2), level of adult education completed (1), marital status (1), and race (1 adult and 1 child). There were 228 dyads (control n = 77; treatment n = 151) enrolled in the iCook 4-H study. Baseline HD scores were 3.00 ± 2.56 among control dyads and 2.97 ± 2.91 among treatment dyads, p = 0.6632. There was a significant decline in the HD score of the treatment group from baseline to 12 months (p = 0.0047) and baseline to 24 months (p = 0.0354). A treatment by 12-month time interaction was found (baseline mean 2.97 ± 2.91 vs. 12-month mean 1.78 ± 2.31; p = 0.0406). This study shows that behavioral change interventions for youth and adults can help improve factors that impact health equity; although, further research is needed to validate this HD score as a measure of health disparities across time

Cooking Frequency Associated With Dietary Quality in iCook-4H Youth Participants at Baseline

Background: Increased intakes of ready-made and fast foods paralleled with decreased homemade food consumption have been associated with increased rates of obesity. Researchers have shown associations between cooking self-efficacy (SE) and cooking frequency (CF) with dietary quality and weight status. Some cooking interventions have shown positive associations with dietary outcomes, such as increased fruit and vegetable intake and decreased fast food consumption. There is still much unknown about SE and CF, especially among youth. Objective: Determine baseline SE and CF and the associations with dietary quality and body mass index (BMI) of youth enrolled in iCook 4H. Methods: Youth (n = 228, ages 9-10 years) completed online surveys assessing SE, CF, dietary quality, and demographics. Anthropometrics were collected to calculate BMI-for-age percentiles and weight categories. Descriptive statistics were completed for CF, SE, BMI categories, and demographics. Differences in CF and SE by sex, race, and participation in government assistance programs were determined through independent-sample t tests. Pearson correlations were used to assess the association between dietary quality and CF and SE. Associations between CF and dietary quality were assessed further through 2-way analyses of variance (ANOVAs) that included CF and sex and CF and race as independent variables. Associations between SE and CF and BMI were assessed through ANOVAs. Results : Thirty-seven percent of youth were overweight or obese. Females reported significantly higher CF than males (P = .042). Cooking frequency was positively associated with dietary quality (P \u3c .001), but BMI was not associated with dietary quality. SE was not associated with dietary quality or BMI. Conclusion: Based on results, CF was positively associated with dietary quality among youth. More research is needed to assess how different types of cooking relate to diet and BMI. Interventions are needed to determine whether increasing CF leads to better diet outcomes