Progress 10/01/08 to 09/30/09
Outputs
OUTPUTS: The purpose of this study is to develop and pre-test culturally appropriate, theoretically based nutrition education materials. The target audience for this formative research project is female, low income Latina/Hispanic immigrant caretakers in Guilford County This project serves as one phase of a larger study to develop a nutrition education intervention focusing on healthy eating for this target audience. Focus groups (N=6) and individual interviews (N=3), were held with Latina/Hispanic immigrant women (N=23 women total) to identify their key areas of interest, feasible approaches to providing nutrition information, and major concerns regarding their family's diet. Next, and the focus of this report, using the feedback obtained from the focus groups and interviews, culturally-appropriate materials and messages were developed and pretested with a small subgroup (n=6) of the target audience. Recipe cards and an informational brochure were developed as a result of this phase of the project. These materials have been disseminated on a limited basis at a health fair targeting low income, Latinos. These materials require further testing among the target audience, which will be the focus of the last phase of this study. Currently there is a request by community agencies for these materials for distribution to their respective clients. Findings from this study have been presented at the annual conference for the Society for Nutrition Education in July 2009 for which we were awarded the Public Health Division Nutrition Research Award. PARTICIPANTS: Project Director: Lauren Haldeman, PhD. Dr. Haldeman planned, trains and oversees all staff. Bilingual/bicultural interviewer: Soledad Morales recruited the target audience, translated and transcribed all tapes and written materials. Graduate Student: Meghan McQuerry. Meghan aided in the planning and implementation of all focus groups, answered all nutrition related questions from the target audience, content analyzedof all focus group transcripts, and developed all written nutrition education materials. Both the interviewer and graduate student did not receive any monetary support for their work on the project. Meghan presented her findings at the Annual Meeting for the Society for Nutrition Education in New Orleans, July 12-15, 2009. TARGET AUDIENCES: The target audience is low income, Latina caretakers of young chilren. Although no educational programs took place, materials were disseminated on a very small scale at a health fair targeting low income, Latinos. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
Focus group findings with low income, Latina caretakers of Guilford County, NC indicated that: they cannot identify healthy foods when shopping and wanted tips about how to do so; their most common challenge was persuading children to eat vegetables; they wanted healthy recipes that are child-friendly and include serving size information; Spanish translated, colorful recipe cards or brochures were needed; they wanted healthier recipes for traditional Hispanic dishes; and they were interested in a list of local food banks. It was evident that this low income group is very interested in providing healthy foods to their families and wants the skills to do so. In response to the high degree of interest participants expressed during the focus groups, we began to plan the development of recipe cards and brochures. The idea evolved into creating a "flip chart" of colorful recipe cards that could be kept conveniently in one place in the kitchen. These recipe cards were laminated to increase durability against any splatter or moisture present while preparing the meals and had a front side covered with a large color photo of the dish with the recipe and directions on the back side. The recipe cards were translated into Spanish, written at a readability level <= 5th grade, and provided seven to ten simple, culturally appropriate recipes based on the food preferences and concerns expressed by the target audience. A four panel, colorful brochure was also developed including a section about correct portion sizes, a sample meal plan, and healthy food shopping tips. A panel of "Action Plans" was also included to offer examples of how and what kinds of healthy lifestyle goals participants could set and also featured an area where the reader could write down their own goals for themselves as a way of making the material more interactive. The readability for this brochure was also <= 5th grade. Following the development of the materials, English and Spanish versions of both were presented to low-income Latina caretakers during a focus group (n=6) in order to assess their acceptability. Revisions were then made based on the participants' responses and feedback to develop the most appealing materials possible for this target audience. The response was very positive regarding the appearance, format, and content of the recipe card flip-chart. All of the women could read the recipes without problems, liked the ten Hispanic dishes that were chosen, and liked the colorful photographs of each dish. The only suggestion offered was to change the spelling of a dish name.
Publications
- McQuerry, M. and Haldeman, L. Development of Culturally Appropriate Nutrition Education Materials for Low Income Latina Immigrants in Guilford County, NC. Society for Nutrition Education 42nd Annual Meeting Proceedings, New Orleans, LA. July 12-15, 2009.
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Progress 10/01/07 to 09/30/08
Outputs
OUTPUTS: The purpose of this study is to develop culturally appropriate nutrition education materials for low income Latina caretakers of young children. This project serves as one phase in a larger study to develop a nutrition education intervention focusing on healthy eating for this target audience. Low income Latina (N=23) caretakers of young children were interviewed by a bilingual, bicultural community interviewer on the following topics: what types of nutrition education materials were most desirable, what topics should be covered in these materials, how should these materials be disseminated to the community, as well as others related to the development of materials. Participants were Spanish speaking Latinas from Mexico with low education levels. Findings from this phase of the study have not yet been disseminated yet findings from last year have been presented at the annual conference for the Society for Nutrition Education for which we won the Public Health Nutrition Research award. PARTICIPANTS: Project Director: Lauren Haldeman, PhD Dr. Haldeman plans the project, and trains and oversees all staff. Bilingual/Bicultural Community Interviewer: Soledad Morales Soledad recruited the target audience, conducted focus groups, translated and transcribed all audio tapes. She received a $2000 fee for services (~100 hours) Graduate Student: Meghan McQuerry Meghan aided in the planning and implementation of all focus groups, answered nutrition related questions from target audience members, content analyzed all transcripts, and is currently developing nutrition education materials based on her findings. She received no monetary support for this work. Meghan did participate in professional development as a result of this larger project as she presented her findings at the annual meeting for the Society for Nutrition Education. TARGET AUDIENCES: The target audience is low income Latina caretakers of young children. As this is a development project no educational programs took place. PROJECT MODIFICATIONS: No major changes have occurred.
Impacts
Findings revealed that many women admitted they do not understand which foods are healthy choices when grocery shopping at local stores and they felt that tips on how to select healthier foods would help improve their family's diet. Many of the caregivers were concerned about how to prevent diabetes or heart disease. When trying to provide healthy foods for their family the biggest challenge is reportedly persuading their children to eat vegetables and try new healthier recipes. Several remarked how accustomed the children have become to American fast foods such as pizza and burgers served at school. Mothers indicated they would benefit from tips on how to encourage their children to eat healthy foods like fruits and especially vegetables. The majority of participants requested healthy recipes that are also child-friendly and would help make their family's diet more nutritious. According to the Latinas interviewed, easy recipes cards or brochures would be the educational materials most helpful to them when trying to prepare healthier dishes for their families. Most felt these materials should be written in Spanish and five participants preferred bilingual printed materials. Also, many of the women would prefer materials to be printed in color rather than black and white and they would either like a mixture of pictures and text, or mostly pictures. Participants also indicated a desire for recipes of healthier versions of traditional Hispanic dishes they currently enjoy eating. The target audience was also asked what their favorite meals are to prepare for their families in an attempt to understand what types of dishes are considered culturally-acceptable for them to eat. The four most popular foods mentioned by the caregivers were roasted chicken, beans, rice, and fruit. Beef, fish, soup, quesadillas, and mole sauce were all second most popular, mentioned by three different participants each. Many of the women cited preparing salads, hotdogs, eggs, hamburgers, and various pasta dishes for their family. Other items that were mentioned as favorites at least one time each included pizza, chuleta, pozole, mashed potatoes, pork, shrimp, gorditas, tacos, empanadas, enchiladas, and tamales. In addition, participants were interested in a list of local food banks and similar organizations that could provide them with groceries. Women felt that transportation to such food banks is a concern for some women, and felt that information about bus routes and fares should be included in the materials developed. When asked how they feelt about eating foods often provided at shelters such as canned foods and boxed cereals, participants remarked they do not like eating canned foods and would prefer fresher options. The same number of participants did not see a problem with consuming canned or packaged foods and expressed appreciation for what was offered to them at no cost. Also notable, many women in this group requested more information about serving sizes and correct portions for foods in the tools to be developed without even being asked questions about such material. As a result of these findings material development is underway.
Publications
- McQuerry, Meghan and Lauren Haldeman. Shared Concerns of Family Food Insecurity Expressed by Low-Income Latina Caretakers Residing in Rural North Carolina: A Qualitative Study. Society for Nutrition Education 41st Annual Meeting Proceedings, Atlanta, GA. July 19-23, 2008.
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Progress 10/01/06 to 09/30/07
Outputs
The purpose of this study was to examine associations between food security level, dietary quality and psychological well being among newly arrived Latinas. Low income Latina (N=11) caretakers of young children completed an in-depth interview assessing family food needs; barriers to eating healthy and accessing adequate food; and strategies for meeting family food needs every month. These topics were initially chosen as a result of findings from the quantitative survey conducted the previous year with this target audience. Participants were Spanish speaking Latinas from Mexico with low education levels. Findings indicated that access to healthy food is difficult for this audience because of cost and availability. Many participants indicated that having their children in school results in less than healthy eating because of poor school food offerings. The difficulties of trying to have adequate and healthy food cause a great deal of strain on the caretakers. They
utilize strategies to alleviate these difficulties, such as shopping at large stores that cater to Hispanics, as well as some use of food banks. Studies are underway to better understand these findings and to address more clearly the mental health ramifications for these newly arrived Latina caretakers.
Impacts
These results suggest that food insecurity may be having a detrimental effect on the mental well being of these newly arrived immigrants. Because they are more susceptible to poor diets and poor health, nutrition education efforts should be targeted and tailored to this group. These findings have important implications for newly arrived Latina caretakers because development of chronic disease increases the longer an immigrant lives in the US. By identifying key determinants of diet quality and gaining a better understanding of the mental health consequences of moving to a new country, nutrition education interventions can be more effectively targeted to help prevent the development of these poor health outcomes.
Publications
- No publications reported this period
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Progress 10/01/05 to 09/30/06
Outputs
The purpose of this study was to examine associations between food security level, dietary quality and psychological well being among newly arrived Latinas (<6 years in US). Low income Latina (N=95) caretakers of young children completed an in-depth, translated survey assessing demographic information; validated measures of anxiety, depression, self-esteem, and self-efficacy; diet using a 24-hour dietary recall; level of food insecurity; and body mass index (BMI) calculated using measured heights and weights. Participants were primarily Spanish speaking Latinas from Mexico with low education levels. Almost half (48%) were identified as obese and 74% reported having gained weight since arriving in the US. Diet quality for most participants was categorized as poor/fair. The majority of participants reported minimal levels of depression (74%), and anxiety (67%) and moderate to high levels of self-esteem (75%) and food related self-efficacy (73%). Level of food security
was positively associated with self-efficacy, depression, and a trend towards association with self-esteem. Several trends toward improved diet quality with positive mental well-being were also noted. Studies are underway to better understand these associations and to design effective nutrition education interventions to address the mental health and nutritional status of newly arrived Latina immigrants.
Impacts
These results suggest that food security and positive mental well being are associated with improved diet quality. Because newly arrived immigrants are more susceptible to poor diets, food insecurity, poor mental well being and weight gain, nutrition education efforts should be targeted and tailored to these groups. These findings have important implications for newly arrived Latina caretakers because development of chronic disease increases the longer an immigrant lives in the US. By identifying key determinants of diet quality, nutrition education interventions can be more effectively targeted to help prevent the development of these poor health outcomes.
Publications
- RONEY, SB. 2006. Psychosocial Correlates of Low-Income Hispanic/Latino Immigrant Caregivers. M.S. Thesis.
- RONEY, SB., MORALES, SR, HALDEMAN, LA. 2006. Mental Health Status and Food Security Level Are Associated With Dietary Quality Among Newly Arrived, Low Income, Latina Immigrants. Society for Nutrition Education 39th Annual meeting, July 15-18.
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