Source: NORTH CAROLINA A&T STATE UNIV submitted to
ADOLESCENTS AND BARRIERS TO SELECTING MORE HEALTHY FOOD CHOICES
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
TERMINATED
Funding Source
Reporting Frequency
Annual
Accession No.
1000109
Grant No.
(N/A)
Project No.
NC.X284-5-14-170-1
Proposal No.
(N/A)
Multistate No.
(N/A)
Program Code
(N/A)
Project Start Date
Oct 1, 2013
Project End Date
Sep 30, 2016
Grant Year
(N/A)
Project Director
Cherry, CA.
Recipient Organization
NORTH CAROLINA A&T STATE UNIV
1601 EAST MARKET STREET
GREENSBORO,NC 27411
Performing Department
Family and Consumer Sciences
Non Technical Summary
It well known that childhood obesity has been identified as a priority area by the United States Department of Agriculture (USDA). It has been described as the number one nutrition-related problem in the United States. The primary long-term outcome associated with this challenge area is a reduction in the prevalence of overweight and obese in children and adolescents ages 2 -19 (USDA, 2013). It is also well known that although most adolescents know about healthy food choices they often do not select them. The reasons for this varies greatly, but can include influences such as personal preference, peer influence, cost (accessibility), availability, limited motivation to select alternatives, time, habit (family patterns), and limited familiarity with alternative options. For these reasons, the proposed study will examine these issues and provide stratgies for the population to make better choices as well as being self directed. This study will tencourage adolescents to make changes in their dietary patterns that involve either eating: (a) less of certain foods, (b) more of certain foods, (c) foods currently eaten but prepared in healthier ways, or (d) new foods as healthy food options and to track the results of their effects on their subsequent dietary patterns. The primary objectives are (1) Determine if the adoption of specific targeted dietary changes among older adolescents lead to eating healthier eating patterns and (2) Create and evaluate an intervention strategy to target dietary changes among older adolescents to promote healthier eating patterns and lower rates of obesity.
Animal Health Component
0%
Research Effort Categories
Basic
75%
Applied
25%
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
70360103080100%
Knowledge Area
703 - Nutrition Education and Behavior;

Subject Of Investigation
6010 - Individuals;

Field Of Science
3080 - Sociology;
Goals / Objectives
The goal of this project will be to determine if the adoption of specific targeted dietary changes can lead to eating healthier eating patterns among adolescents. Prevention programs that target self-efficacy for eating behaviors may be beneficial in improving dietary choices among adolescents. Because too many adolescents do not consume the recommended varieties and amounts of food (fruits and vegetables, dairy products, protein sources, etc.) more effective strategies and messaging are needed to address this disparity. Because taste, accessibility, and familiarity are important determinants of what adolescents eat and fail to eat, nutrition interventions for adolescents should provide opportunities for them to taste more food options; target both promoting healthy eating and decreasing unhealthy eating at the same time; involve self-monitoring of strategies to eat a healthier diet; and aim to change youths' dietary behavior by targeting self-efficacy, habit, and outcome expectations. To achieve this, the proposed study will investigate the efficacy of asking older adolescents to change specific dietary behaviors. Determining whether these changes can be achieved and maintained and if the process of adoption and maintenance of targeted dietary changes generalizes to other non-targeted dietary behaviors will be evaluated.
Project Methods
The study will use survey instruments to assess dietary behaviors of older adolescents assigned five food experience groups: 1. Consume fewer foods high in sugar/salt/fat 2. Consume more fruits and vegetables 3. Consume foods currently eaten, but prepared in healthier ways (i.e., grilled/baked versus fried) 4. Consume healthy food options (i.e., fruits and vegetables that have not previously been tried) 5. (Control) No change in diet During a focus group session, groups will be asked to report their ability to follow the suggested recommendations as listed in above (1-5). Study Intervention All participants will receive nutrition education (through a four week nutrition education curriculum - see below). At the completion of the course, participants in groups 1 through 4 will receive instruction on the specific food behavior that the group is being encouraged to adopt. This instruction will cover examples of foods they will be encouraged to consume and, if in groups 1, 2 or 3, foods/food preparations they would be encouraged not to consume. Strategies for consuming targeted foods also will be discussed. The control group (group 5) will also receive extra instruction following the last class, but they only will receive instructions on completing follow-up forms at 1 month and 5 months following the nutrition education classes. Nutrition Curriculum The curriculum will be developed by the researchers and will focus on topics such as fats and food labels, portion control and eating out, MyPlate and meal planning, and recipe modifications (Table 2). Material from the Power of Choice nutrition education curriculum developed by the United States Department of Agriculture. The classes will be experiential and last approximately 30-45 minutes. Adoption of Food Consumption Choices It is expected that by asking participants to make small changes in their food consumption choices this will in turn affect their cognitions about the target of the behavior change (food choices), their ability to make those choices (self-efficacy). SPSS will be used to analyze data appropriate statistical analytical tools for comparisons of means including analysis of variance, analysis of covariance, repeated measures and for count data Poisson regression and nonparametric statistics including chi-square and tests of association. In addition to ratings and count data, qualitative analyses will be performed to code and look for thematic patterns in participants' responses identifying barriers preventing or interfering with the recommendation and facilitators that encouraged or allowed for the targeted dietary behavior.

Progress 10/01/13 to 09/30/16

Outputs
Target Audience:The target audience for this study are students enrolled at North Carolina A&T State University who are 18- 19 years old; this population was selected in order to address the issue of childhood and adolescent obesity. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?Opportunities for training include teaching, program planning and implementation, data collection experience for 1 undergraduate student. The principal investigator participated in professional development conferences which contributed to increased nutrition knowledge, expertise, and skills (Society for Nutrition Education and Behavior (SNEB) Annual Conference: Encouraging Healthy Eating and Physical Activity: Using Policy, Systems and Environmental Change for Successful Community Nutrition Interventions; July 2016 and American Association for Family and Consumer Sciences (AAFCS): Improving the Health and Well-Being of a Changing Society; June 2016). How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals?Data collection is completed and dissemination efforts are ongoing to include manuscript completion and submission.

Impacts
What was accomplished under these goals? A total of 118 participants enrolled in the study. The aim of this study was to determine, if provided with a simple of instructions to eat healthier, would that result in young college students following those instructions and adopting healthier eating patterns. Five groups of students were given different food consumption instructions and in general the results are consistent with expectation that providing specific goals regarding food consumption can result in adoption of those goals. The results show that students asked to eat less fried food consumed less fried, to eat more fruits and vegetables ate more fruits and vegetables, or to try new food were willing to try new foods. The food consumption patterns of the group given the instruction to do all three of these goals reported progress but less so than the individual instruction set groups. A control group that was not instructed to purse any specific food consumption goal, for the most part, reported the least amount of positive food consumption change behavior. The following group codes are discussed below: CIG - Combination Instruction Group (eat more fruits and vegetables, eat less fried foods, and try new foods), FFG - Fried Foods Group (eat less fried foods), FVG - Fruit and Vegetable Group (eat more fruits and vegetables), NFG - New Food Group (try new foods options), and CNG - the Control or no specific instruction group. Fried Food Consumption For fried food consumption, the results show that the FFG was considerably more likely to eat less fried food than the CIG. The FFG and CIG both reported increased consumption of healthier prepared (grilled, baked, broiled) versions of the food they typically ate. However, the FFG reported over a 25% greater decrease in preference for fried foods and over a 30% increase in preference for grilled, baked or broiled foods in comparison with the CIG. It also was notable that the 75% of FFG's attitudes toward grilled, baked or broiled foods increased positively compared to no reported increase in favorable attitudes towards food prepared by these methods by CIG members. Fruits and Vegetables Consumption For fruits and vegetables consumption, the results revealed that over 85% of the FVG reported eating more fruits and vegetables compared with less than two-thirds of the CIG. This pattern was further reflected in other reported data. Fruit Consumption. Over 85% of the FVG reported eating on average three or more servings of fruits per week in comparison to just over two-thirds of the CIG and none of the CNG. Half of the FVG reported an increase in preference for fruit as compared with just a little over a third of the CIG and over a third of the FVG reported having a more positive attitude toward fruit following the intervention period. Vegetable Consumption. Over 92% of the FVG reported eating on average three or more servings of vegetables compared with a little over two-thirds of the CIG and CNG participants. Somewhat surprising was that only 12.5% of the CIG reported eating at on average least 6 servings of vegetables per week compared with 64.3% of the FVG and 41.1% of the CNG. This result is consistent with the finding that over half of the FVG reported an increase in preference for vegetables while less than 20% of the CIG reported having a greater preference for vegetables. Over half of the FVG also reported having more positive attitudes toward vegetables following their study experience. New Foods Consumption Trying new foods is widely acknowledged as a limited behavior among the age group in this study. The results were somewhat consistent with this observation. While a little less than three-fourths of the group reported trying one new food in the past 30 days, over a fourth had not attempted to eat an unfamiliar food. It also was the case that less than half of the group was not eating any of the new foods the participants had previously sampled. Moreover, a majority of the group appeared to have reported that their venture into new foods was over at follow-up based on the finding that almost three-fourths of the group reported that there were not foods they hadn't tried that they still wanted to try. This last finding is somewhat at odds with the fact that that over 40% of the group indicated their willingness to try new foods had increased. In comparison with other groups, over half of the NFG reported eating foods that they had eaten only a few times or had never previously eaten; this compared with less than half of the CIG and CNG. The CNG was the least likely to try new foods and was the most likely (over 25%) to indicate dislike for new foods they tried to due to how they were prepared. Several of the findings appear to suggest an inconsistency with the impact of the intervention. The greatest percentage of participants (82.3%) reporting themselves as being highly likely to change their attitudes toward eating healthy foods they have never eaten or eaten very rarely were in the CNG (82.3%) as compared with about two-thirds of the NFG and a little over half of the CIG. The percentage of CNG participants reported likelihood of making healthy food choices also was highest (70.6%) compared with a little over half of the CIG and less than half of the NFG. It is possible that participants in the CNG did not consider healthy foods as "new" but rather as prepared differently and were open to the possibility of trying them out. The NFG and CIG had already experienced eating new foods which may have been why their willingness to eat new foods was lower - they were already doing so. Similarly, the reported "lack" of increase in willingness to making healthier food choices may have been because participants in the CIG and NFG had made changes. It is also worth noting that for all of the groups the lowest level of likelihood of making changes fell within a moderate likelihood to change range. One final question that appears to be consistent with the above interpretation is that about half of all three groups reported similar levels of likelihood of overcoming barriers to making healthy food choices. Overall, the above results indicate that the intervention was successful in encouraging college students to adopt healthier eating patterns. These results also suggest the including a nutrition curriculum as a part of the first or second year collegiate learning experience could potentially be significantly impactful. Additionally, these results can be used for the development of nutrition education programs with younger adolescents.

Publications

  • Type: Conference Papers and Presentations Status: Other Year Published: 2016 Citation: Cherry,C. Porter, A. Faulkner, P., Gruber, K. Improving the Health and Well-Being of a Changing Society. AAFCS Conference, Bellevue, WA June 22 - 25, 2016.
  • Type: Conference Papers and Presentations Status: Other Year Published: 2016 Citation: Cherry,C. Porter, A. Faulkner, P., Gruber, K. First Year College Students And Barriers to Selecting More Healthy Food Choices. Encouraging Healthy Eating and Physical Activity: Using Policy, Systems and Environmental Change for Successful Community Nutrition Interventions. Society for Nutrition Education and Behavior (SNEB) Annual Conference. San Diego, CA. July 30 - August 2, 2016.


Progress 10/01/14 to 09/30/15

Outputs
Target Audience:The target audience for this study is students enrolled at North Carolina A&T State University who are 18- 19 years old. This population was selected in order to address the issue of childhood and adolescent obesity. The audience is a convenience sample that closely resembles the older adolescent population which we hope to influence with this research. A major outcome of this work is to gather data to facilitate the development of curricula or programming to influence the eating behaviors and habits of high-school-age adolescents. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?Opportunities for training include: teaching, program planning and implementation, and data collection experience for 1 graduate student and 1 undergraduate student. The principal investigator participated in a professional development conference which contributed to increased nutrition knowledge, expertise, and skills. The conference was the Food Nutrition Conference Expo (FNCE 2015) held October 3-6, 2015 in Nashville, TN. An abstract of this research is being prepared for submission for FNCE 2016. How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals?During this reporting period, data collection and analysis will be completed. Dissemination of results will also occur.

Impacts
What was accomplished under these goals? A total of 118 participants have enrolled in the study to date. The pilot group, as well as Groups A, B, C and D have completed the 5 month post study questionnaires. Groups E, F and Ghave completed the 1 month post study questionnaires; they will complete 5 month post study questionnaires during the time period of March 2016 through May 2016. The objectives of this study were to:1) Determine if the adoption of specific targeted dietary changes among older adolescents lead to eating healthier eating patterns. 2) Create and evaluate an intervention strategy to target dietary changes among older adolescents to promote healthier eating patterns and lower rates of obesity. Observations made during and after the nutrition intervention sessionsshow that the students are makingmore healthy food choices. In Group C, a student bought a blender to make healthy smoothies in the dorm. One student purchased ingredients for a turkey wrap and parfait, which were two of the healthy recipes demonstrated during the sessions, to make during spring break. He shared them with his college friends and they loved them. Another student reported eating more fruits and vegetables as a result of the sessions. At the end of session 4, Group G participants expressed that they have applied some of the tips from the study to their eating habits, including: controlling their portion sizes by putting less on their plates, balancing their meals with more fruits and vegetables, such as eating more tomatoes, and paying attention to food labels by looking for sugar content when grocery shopping. The data set is currently being analyzed for quantitative reporting.

Publications


    Progress 10/01/13 to 09/30/14

    Outputs
    Target Audience: The target audience for this study is students enrolled at North Carolina A&T State University who are 18- 19 years in age. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? Opportunities for training include teaching, program planning and implementation, data collection experience for 1 graduate student and 1 undergraduate student. How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

    Impacts
    What was accomplished under these goals? At this point in the study there is a total of 63 individuals have participated. Seventy-five percent of the pilot study group has completed the study. Groups A and B have completed the 1 month post-survey. Group C will begin on February 5, 2015. The objectives of this study were to: 1) Determine if the adoption of specific targeted dietary changes among older adolescents lead to eating healthier eating patterns. 2) Create and evaluate an intervention strategy to target dietary changes among older adolescents to promote healthier eating patterns and lower rates of obesity. At the end of the intervention sessions, students in the pilot group showed gained interest in eating healthier foods and desired more healthy food options in the cafeteria. Also, students reported eating healthier foods and more fruits and vegetables. In group A, one student stated that she purchased the yogurt Parfait food demonstration items to keep in her dorm to have a healthier breakfast or snack. It was also noted that a student was using "My Fitness Pal" on her phone to track the snack provided. After session 3, another student said the she was going to make the Herb Garden Pizza (a recipe provided in the study) in her room. She stated that she hated to making food and cooking, but she loved the pizza. She also called home and told her mom about the pizza and shared the recipe. In cohort B, students said that they are now trying to eat more vegetables. One student said that he didn't eat any vegetables before, but now he is trying to eat at least one serving every day. A different student said that she now will eat a salad every day. Students in Group B are also interested in healthier food options in the cafeteria. The observations made during and after the nutrition intervention sessions show that the students are making more healthy food choices. The data set is currently being analyzed for a quantitative analysis.

    Publications