Source: CORNELL UNIVERSITY submitted to NRP
PREVENTATIVE HEALTH EDUCATION BASED UPON ENVIRONMENTAL ENGINEERING OF FOOD CONTEXTS
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
COMPLETE
Funding Source
Reporting Frequency
Annual
Accession No.
0208674
Grant No.
(N/A)
Cumulative Award Amt.
(N/A)
Proposal No.
(N/A)
Multistate No.
(N/A)
Project Start Date
Oct 1, 2006
Project End Date
Sep 30, 2009
Grant Year
(N/A)
Program Code
[(N/A)]- (N/A)
Recipient Organization
CORNELL UNIVERSITY
(N/A)
ITHACA,NY 14853
Performing Department
APPLIED ECONOMICS & MANAGEMENT
Non Technical Summary
Currently in New York State (NYS), 58 percent of the adult population is overweight or obese. This project seeks to provide environmental tools, which have been empirically shown to be efficacious, to New York State families that will allow them to overcome obstacles to eating better and maintaining good eating habits.
Animal Health Component
50%
Research Effort Categories
Basic
50%
Applied
50%
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
6076020302020%
6076020307015%
6076020308015%
7036020302020%
7036020307015%
7036020308015%
Goals / Objectives
Our primary objective is to promote and influence healthier food choices and habits of families through demonstration of behavioral strategies that can overcome poor eating habits, which has contributed greatly to the obesity epidemic in New York State and the United States. This primary objective will be accomplished through 5 supporting objectives: 1. We will determine what environmental factors are most influential in leading families to overeat. 2. We will determine what environmental factors are most influential in leading families to eat healthily. 3. We will determine what environmental factors hinder families from making positive changes in eating behavior. 4. We will determine what environmental factors help families make positive changes in eating behavior. 5. We will focus our educational efforts on parents, which are nutritional gatekeepers and are influential in changing and maintaining food habits of their respective families. We also will focus our educational efforts on other interested community groups.
Project Methods
The objectives of this project will be accomplished by conducting applied research, which will be used and transformed into educational materials and presentations to community organizations with the help of Cornell Cooperative Extension. Specifically, the project will be conducted in eight distinct phases. 1. The first phase involves gathering relevant academic literature to understand the environmental factors that are the most influential in leading people to overeat or eat healthily. (Objectives #1 & #2) 2. The second phase involves the creation of a survey that attempts to understand the factors that help or hinder the acceptance of behavioral change suggestions provided by the academic literature. (Objectives #3 & #4) 3. The third phase involves the pilot testing of the survey to New York State families through Cornell Cooperative Extension through their expanded food and nutrition program. Results of this pilot test will guide the creation of educational material and presentations. (Objectives #3 & #4) 4. The fourth phase involves creating educational materials and presentations, which are based upon the academic literature and results of the pilot test. 5. The fifth phase involves pilot testing the educational materials with both parent/teacher associations and Cornell Cooperative Extension through their Expanded Food and Nutrition Education Program (EFNEP). (Objective #5) 6. Once information is gathered from both parents and Cornell Cooperative Extension (EFNEP), the sixth phase will include the formal presentation of a program for behavioral change to community organizations. (Objective #5) 7. The seventh phase will involve the collecting of data regarding how well the educational efforts fare in terms of helping people gain and maintain healthy food related behaviors. (Objective #5) 8. The eighth phase will include report writing for university, federal, and publication outlets regarding the results of the project.

Progress 10/01/06 to 09/30/09

Outputs
OUTPUTS: The primary objective of this project is to promote and influence healthier food choices and habits of families. Progress during the period of this report is reflected in the work conducted with the creation of educational materials (phase 4), pilot testing of these materials (phase 5), formal presentation of a program for behavior change (phase 6), evaluation on how well educational efforts fare in helping people maintain behaviors (phase 7) and report writing (phase 8). Educational materials and strategies were further revised based upon evaluation by CCE nutrition program educators. Preliminary materials were presented at a poster presentation at the Eat Smart NY and Nutritional Concerns conferences in April, 2009. The educational materials were used to develop a 7-week wellness series that was implemented in conjunction with CCE at the Tompkins DSS offices. Topics included goal setting, food safety, food cravings, increasing healthier food consumption and food marketing. 21 adults participated in the series, and feedback was collected. In April, 2009 educational materials were presented during a three-day interactive workshop titled Consumer Camp with 75 community stakeholders. The Consumer Camp will be expanded to include 250 community stakeholders in 2010. Materials to support the Cornell Food and Brand Lab/CCE wellness program were designed and printed. Materials will be distributed to CCE organizations state-wide. Evaluation of the wellness series was conducted as well as evaluation of the Consumer Camp event. In addition, education materials were developed for a project funded by Robert Wood Johnson Foundation for pre-school and daycare teachers and for parents of pre-school children targeted towards incentivizing fruit and vegetable consumption in 3-5 year olds. The publication developed for parents was distributed to over 200 families. The publication developed for teachers was launched at a regional Headstart training, and is currently being utilized in 27 classrooms. Cartoons Names and Active Games was developed in conjunction with Head Start and Cornell Cooperative Extension. Results have been widely disseminated to the general public through numerous articles published in newspapers and magazines and on TV special programs and online blogs. These include Body and Soul, Delicious Living, Forbes.com, Psychology Today, Newsweek, US News and World Reports, USA Today, Chicago Tribune, Washington Post, San Francisco Chronicle, Oprah Magazine, Fitness Magazine, Mens Health, Womens Health, Prevention blog and MSNBC blog, Good Morning America, the Today Show, ABC News, NBC News, CNN, FOX News, and other local, regional and national television and printed media outlets. Outreach to the scientific and professional communities has been conducted through the publication of the academic papers referenced under publications and through presentations in annual conferences (or) symposia in 2008 and 2009 such as: the Society for Nutrition Education (SNE), the Association of Consumer Research (ACR), American Association of Family and Consumer Sciences (AAFCS), American Public Health Association (APHA), and American Dietetic Association (ADA). PARTICIPANTS: Brian Wansink was the PI/PD for the project and led the team in research, education and outreach. He designed the Mindless Eating Challenge and provided media coverage throughout the term of the project. Jennifer Noble was a research support specialist for the project and assisted in research development and outreach development. Laura Smith was a research support specialist for the project and assisted in the development of educational materials, dissemination of the materials and outreach efforts within CCE statewide. Partner Organizations included Cornell Cooperative Extension- Tompkins, the Tompkins County Coalition for Families, TCAction (Headstart Programs), and the Franziska Racker Centers. Partner organizations assisted in research, educational material development and dissemination of programming and materials. Collaborators included Jamie Dollahite, Professor, Division of Nutritional Sciences, Cornell University,Collin Payne, Assistant Professor of Marketing, University of New Mexico, Santa Cruz, and David Just, Associate Professor, Applied Economics and Management, Cornell University As a result of the project, we have developed a professional development program called Consumer Camp which utilizes the educational material developed within this project within a three-day workshop for professionals and consumers. A training opportunity on using educational materials in the classroom and with parents was provided for 75 employees related to the Head Start programming in September 2009. TARGET AUDIENCES: Target audiences for efforts (including Consumer Camp, Food and Brand Lab Workshop, and extension-style educational efforts) are low-income families (Head Start participants and CCE participants) and children within these population segments. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.

Impacts
Evaluation of the 7-week wellness series indicated that participants learned many new skills including substituting healthier ingredients, looking for the hidden sugar in foods and beverages, how to make snacks more enticing for kids, how to shop more economically, and modifying meals to make them healthier. One participant said, "Now, I think more often before I eat." Participants asked that we have a section focused specifically on weight-loss tips (the program was focused on wellness not on weight-loss). Participants also reported trying new recipes as a result of the class. Changes in behavior were reported as a result of the program. These changes include becoming more aware of portion sizes, reading labels, more thoughtful selection of beverages, increasing exercise, eating steamed vegetables. One participant noted that she was trying some of the "Mindless Eating Preventions" such as visualizing how much she had eaten and making the tempting foods more difficult to access. After Consumer Camp, 79% indicated that their participation increased "considerably" or "a great deal" their ability to understand how the environment affects what they eat and what to do about it. 71% indicated that their participation increased "considerably" or "a great deal" their ability to apply information learned about Small Changes - Mindless Eating Solutions into their own work. 82% indicated that their participation increased "considerably" or "a great deal" their ability to disseminate/communicate new information to audiences (students, parents, teachers, community members). 44% indicated they plan to use the information presented with students, colleagues, patients and others through workshops, seminars, lectures and talks. 36% indicated they will apply the information presented in their homes and also share it with their communities.

Publications

  • Wansink, Brian, David R. Just, and Collin R. Payne (2009), Mindless Eating and Healthy Heuristics for the Irrational, American Economic Review, 99:2 (May), 165-69.
  • Boscia, T. Consumer Camp Participants get the Skinny on Overeating. Cornell Chronicle, April 22, 2009
  • Smith, L. The Secret Wonders of Mindless Eating: Educational Materials for Adults and Children. Fall, 2009.
  • Cornell University Food & Brand Lab Newsletter. The Mindless Eater, Spring 2009


Progress 10/01/07 to 09/30/08

Outputs
OUTPUTS: Poor eating habits have contributed greatly to the obesity epidemic in the United States and specifically in New York State. The primary objective of this project is to promote and influence healthier food choices and habits of families. Progress during the period of this report is reflected in the work conducted to determine factors that hinder healthy change in families (milestone 3) and factors that lead to healthy changes in families (milestone 4) along with the creation of educational materials (phase 4) and pilot testing of these materials (phase 5). To identify factors which lead to or hinder healthy changes in families we analyzed data collected through the National Mindless Eating Challenge (MEC) survey for a sub-sample of 1,300 participants. Participants were randomly recommended three of about 300 literature-based tips on how to loose weight by altering their environment. Data for each participant included demographics and psychographics as well as the eating habits that they wanted to change (danger zones), compliance rates and self-reported weight loss. Effectiveness of the tips suggested was evaluated by analyzing differences in compliance and self-reported weight loss at one month. Characteristics of the type of individuals who are most likely to comply with web-based suggestions for making dietary-based changes were analyzed too. Educational materials and strategies for making positive changes in eating behavior focused on youth and their parents and were developed as either One Page Wonders or Full Class Modules. Drafts were presented for review to nutrition program educators at Cornell Cooperative Extension (CCE) in Tompkins County. The One Page Wonders are designed to fit into an existing lesson plan as the anchor or to apply within the 4A style. The full class modules were developed for use with middle school students in a classroom setting but can also be adapted for use with CCE nutrition and health classes. Recommendations focused on a strength-based approach and to fit into the existing 4A teaching style of CCE nutrition and health classes and were incorporated to the materials. Results have been widely disseminated to the general public through numerous articles and stories published in newspapers and magazines and on TV special programs and online blogs. These include USA Today, Time Magazine, Chicago Tribune, Washington Post, San Francisco Chronicle, Oprah Magazine, Fitness Magazine, Mens Health, Womens Health, Prevention blog and MSNBC blog, Good Morning America, the Today Show, ABC News, NBC News, CNN, FOX News, and other local, regional and national television and printed media outlets. Outreach to the scientific and professional communities has been conducted through the publication of the academic papers referenced under publications and through presentations in annual conferences (or) symposia in 2007 and 2008 such as: the North American Association for the Study of Obesity (NASSO), the Association of Consumer Research (ACR), American Association of Family and Consumer Sciences (AAFCS), American Public Health Association (APHA), American Dietetic Association (ADA) and Judgments in Decision Making (Chicago). PARTICIPANTS: Not relevant to this project. TARGET AUDIENCES: Not relevant to this project. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.

Impacts
The data analysis performed on the MEC survey data showed a strong relationship between compliance and weight loss and allowed for ranking of the most successful tips as they relate to weight loss for a one-month period. Analyses were performed for participants interested on incorporating meal-related environmental changes and snack-related environmental changes and tips were ranked according to compliance, easiness to implement and weight loss. The top 3 tips for meal-related changes were: 1) restrict your eating to the kitchen or dining room; 2) use an appetizer plate or bread plate for your main dish at dinner and 3) leave some food on your plate and cover it with a napkin. Top snack-related changes were: 1) before you eat a snack, wait 5 minutes; 2) exercise at a time when you usually snack and 3) allow yourself an afternoon snack only if you have eaten a piece of fruit. Analyses of the psychosocial factors highlighted the influence of the gatekeeper on promoting or hindering healthy changes in families. Furthermore, this influence was magnified by whether this individual exhibits high or low self-control. The gatekeeper is the individual who has direct control of the environment as it pertains to food. This data allows for profiling the type of individuals who are most likely to adhere to web-base recommendations for healthy changes and is of great value to both health practitioners and policy makers in developing the right strategies for specific target groups. Educators, extension agents and community leaders in Upstate New York and across the United States have been reached through numerous talks including: FNEC - Fit Kids in Upstate NY (Auburn), Society for Nutrition Education (SNE) and USDA/Food and Nutrition Services Cross Regional Conference. Given that on the third year, we will focus on educational outreach with parents and community groups as well as giving formal presentations of the educational material and evaluating their impact, during this second year we have worked on developing and cultivating relationships with community partners such as CCE-TC, the Tompkins County Coalition for Families, TCAction (Headstart programs), the Franziska Racker Centers, and the CCE-Fingerlakes Region which includes: Tompkins, Steuben, Onondaga, Tioga, Wayne, Schuyler, Cayuga, Yates, Seneca and Chemung counties. The MEC survey has had an impact on participants by making them aware of the environmental cues that influence their food choices and induce them to overeat. During the period covered by this report 2,912 individuals registered to participate in the survey, of which 1,824 completed at least 1 monthly survey and 54 have participated in the survey for 6 continuous months or more. We receive feedback from numerous participants in regards to their success with incorporating small changes that have allowed them to loose weight. Impact from this project will soon be enormously extended to a wider population through the training of Certified Facilitators and through the Wellness Programs of Corporations in New York State and nationwide, for which we are currently preparing training materials and curriculums based on the MEC survey results.

Publications

  • Wansink, B. and Van Ittersum, K. 2007. Portion Size Me: Downsizing our Consumption Norms. Journal of the American Dietetic Association, 107 (7):1103-1106
  • Van Ittersum, K. and Wansink, B. 2007. Do Children Really Prefer Large Portions Visual Illusions Bias their Estimates and Intake. Journal of the American Dietetic Association, 107 (7): 1107-110
  • Wansink, B., Payne, C. and North, J. 2007. Fine as North Dakota Wine: Sensory Expectations and the Intake of Companion Foods. Physiology & Behavior, 90: 712-716
  • Wansink, B., Payne, C. and Werle, C. 2008. Consequences of Belonging to the Clean Plate Club. Archives of Pediatric and Adolescent Medicine, 162 (10): 994-995
  • Wansink, B. 2008. Project MOM: Mothers & others & MyPyramid. Journal of the American Dietetic Association, 108 (8): 1302-1304
  • Cornell University Food & Brand Lab Newsletter. The Mindless Eater, Winter 2008
  • Cornell University Food & Brand Lab Newsletter. The Mindless Eater, Fall 2008


Progress 10/01/06 to 09/30/07

Outputs
Poor eating habits have contributed greatly to the obesity epidemic in the United States and specifically in New York State. The primary objective of this project is to promote and influence healthier food choices and habits of families through the identification of environmental, social and psychological factors that are most influential and the demonstration of behavioral change strategies that can overcome poor eating habits. Progress during the period of this report is reflected by the completion of the three initial phases proposed: 1) Gathering of relevant academic information to understand the environmental factors that are most influential in determining people eating habits, 2) Creation of a survey to understand the factors that help or hinder the acceptance of behavioral change strategies identified through the academic literature and 3) Pilot testing of the survey. A paper summarizing the findings from the multitude of academic papers that were reviewed in phase 1 to identify the environmental factors that are most influential in determining people eating habits was published in 2007 in Environment and Behavior, as referenced under publications. In phase two the National Mindless Eating Challenge (MEC), an online survey was created and made available through our website www.mindlesseating.org. The MEC online survey was pilot tested, adjusted rolled-out in January of 2007. Participation in the survey is free and available to anyone interested in developing healthier food choices and eating habits in New York State, across the United States and throughout the world. The results from this project have been widely disseminated to the public at large and tools and activities are made available to educators at all levels through our Mindless Eating website www.mindlesseating.org. Outreach to the scientific and professional communities has been conducted through the publication of the academic papers referenced in under publications and through presentations in annual conferences (or) symposia in 2006 and 2007 such as: the North American Association for the Study of Obesity (NASSO), the Association of Consumer Research (ACR), the Society for the Study of Ingestive Behavior (SSBI) and the American Public Health Association (APHA). Results have also been reported in numerous articles and stories published in newspapers and magazines and on TV special programs. These include the New York Times, USA Today, The Harvard Crimson, Time Magazine, Fitness Magazine, Mens Health, Womens Health, 20/20, the Discovery Channel and other local, regional and national television and printed media outlets. Educators, extension agents and community leaders in Upstate New York and across the United States have been reached through numerous talks. Among related events related to this project Consumer Camp 2007 a hands-on workshop on the Science of Snacking was held from April 13 to 15 in Ithaca, NY. The event was filled to capacity and participants included educators, nutritionists, community leaders, chefs and consumers from five States: New Jersey, New York, Connecticut, New Hampshire, and Indiana.

Impacts
Participation in the MEC online survey has had an impact on participants by making them aware of the traps that influence them to make poor choices and by empowering them to modify them in an easy way. Over 4,500 individuals nationwide have participated in the National MEC online survey since its roll-out in late January 2007. Participants enter basic demographic and psychographic information and identify the eating habits that they want to change. They get tips to make small changes to address them and are encouraged to select three small changes (the mindless three) to pursue each month. A daily checklist to follow up on their progress throughout the month can be downloaded from the website. Participants who choose so can get weekly reminder e-mail messages and all participants are asked to fill out a monthly survey for follow up purposes. Feedback received from numerous participants confirm that incorporating small changes into their daily lives, suggested as tips on a personalized basis, leads to positive changes in their eating habits Some participants have reported on their success in loosing and keeping off weight through these strategies, which they havent been successful doing through diets. A group of 12 undergraduate Cornell University students majoring in Nutrition, Food Science, Applied Economics and Management and Psychology acquired new knowledge and research skills through their participation in the activities and events conducted for this project during the academic year 2006-2007. The Cornell student community at large was reached through several in-class and special events on Mindless Eating and the project Foodology 101 geared to help freshmen avoid gaining the typical 15 pounds in the first year was rolled-out and is currently in operation.

Publications

  • Wansink, B. and Chandon, O. 2006. Nutritional Gatekeepers and the 72 Percent Solution. Journal of the American Dietetic Association, 106(9), 1324-1327.
  • Wansink, B., Painter, J.E. and Lee, Y. 2006. The Office Candy Dish: Proximitys Influence on Estimated and Actual Candy Consumption. International Journal of Obesity, 30(5), 871-875.
  • Wansink, B., van Ittersum, K. and Painter, J.E. 2006. Ice Cream Illusions: Bowl Size, Spoon Size, and Self-Served Portion Sizes. American Journal of Preventive Medicine, 31(3), 240-243.
  • Sobal, J. and Wansink, B. 2007. Kitchenscapes, Tablescapes, Platescapes, and Foodscapes. Influences of Microscale Built Environments on Food Intake. Environment and Behavior, 39(1), 124-142.
  • Wansink, B. and Sobal, J. 2007. Mindless Eating. The 200 Daily Decisions We Overlook. Environment and Behavior, 39(1), 106-123.
  • Garg, N., Wansink, B. and Inman, J. 2007. The Influence of Incidental Affect on Consumers Food Intake. Journal of Marketing, 71, 194-206.
  • Wansink, B. and Payne, C. 2007. Counting Bones: Environmental Cues that Decrease Food Intake. Perceptual and Motor Skills, 104, 273-276.
  • Wansink, B. 2007. Cornell University Food & Brand Newsletter. The Mindless Eater. Winter 2007.