RESUMEN
OBJECTIVE: To apply the Theory of Planned Behaviour to examine the relationship between the constructs of background factors and beliefs towards using policy, systems and environmental (PSE) strategies and reported use of PSE strategies to prevent obesity by a group of professional nutrition educators. DESIGN: Cross-sectional study using self-reported survey. SETTING: Cooperative Extension in New York, USA. SUBJECTS: Nutrition educators (n 58); survey response rate 100 %. RESULTS: Nutrition educators' reported use of PSE strategies to prevent obesity were positively associated with background factors of their community networking and number of staff they managed, their belief of other people's expectations of them to make PSE changes and the belief that their communities were ready to use PSE strategies; and negatively associated with their belief that individual-level factors contributed to obesity. The relationships among these variables were complicated and their use of PSE strategies occurred only when they utilized their professional networks at a moderately high level (above mean of 5·3 on a scale of 1-7), given that their community was also ready to use PSE strategies. CONCLUSIONS: Nutrition educators' use of PSE strategies depends on several internal and external factors. Community networking needs to be emphasized as one of the most significant factors contributing to nutrition educators' work in this area. Organizational and community support should be in place in order to facilitate nutrition educators' effective use of PSE strategies.
Asunto(s)
Política Nutricional , Nutricionistas , Obesidad/prevención & control , Medio Social , Red Social , Adulto , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Política de Salud , Humanos , Masculino , Persona de Mediana Edad , New York , Obesidad/psicologíaRESUMEN
OBJECTIVE: To develop and apply a framework exploring the extent of involvement in promoting environmental changes to prevent obesity by a group of nutrition educators (NE). DESIGN: Cross-sectional, mixed methods: qualitative interviews informed framework development; survey applied framework to describe NE's involvement in environmental changes. SETTING: Cooperative Extension in New York State. PARTICIPANTS: Interviewees (n = 7) selected to vary in environmental change activities and rural/urban location. Survey response rate was 100% (n = 58). PHENOMENON OF INTEREST/VARIABLES MEASURED: Dimensions and degree of NE's involvement in promoting environmental change. ANALYSIS: Thematic analysis of qualitative data, triangulated with descriptive analyses of NE's performance of tasks in various settings. RESULTS: NE's promotion of environmental changes was characterized using framework based on settings and tasks, dimensions that emerged from qualitative analysis. NE's actions varied across these dimensions and ranged from low to high intensity of collaboration and leadership for environmental change. Most NE surveyed reported actions limited to providing information and recommendations on healthy eating and physical activity. Few reported intensive engagement in developing, implementing, and evaluating plans to change environments for obesity prevention. CONCLUSIONS AND IMPLICATIONS: Framework identifies the levels of engagement in promoting environmental changes and supports future research and practice of community nutrition professionals by providing a roadmap for assessing their involvement on multiple levels to prevent obesity.
Asunto(s)
Servicios de Salud Comunitaria/métodos , Dieta/efectos adversos , Abastecimiento de Alimentos , Política Nutricional , Obesidad/prevención & control , Características de la Residencia , Agentes Comunitarios de Salud , Estudios Transversales , Dieta/economía , Asistencia Alimentaria , Abastecimiento de Alimentos/economía , Encuestas de Atención de la Salud , Humanos , Liderazgo , Actividad Motora , New York , Nutricionistas , Obesidad/etiología , Rol Profesional , Recursos HumanosRESUMEN
OBJECTIVE: To develop and test a brief measure of changes in eating, active play, and parenting practices after an intervention to help parents shape children's choices and home environments. DESIGN: Sequential phases of development and testing: expert panel review, cognitive testing interviews, field testing, test-retest study, and assessment of convergence with detailed previously validated instruments. SETTING AND PARTICIPANTS: Expanded Food and Nutrition Education Program (EFNEP), New York State. Low-income parents of 3- to 11-year-old children; Cooperative Extension nutrition and parenting educators. MAIN OUTCOME MEASURES: Questionnaire reliability, validity, respondent comprehension, and feasibility of use in program contexts. ANALYSIS: Qualitative analysis of item comprehension. Correlational analysis of test-retest reliability and convergent validity. RESULTS: A behavior checklist was developed to assess change in parent-reported family eating, physical activity, and parenting practices addressed by an intervention. The checklist was feasible for use in EFNEP and questions were understood as intended. Test-retest reliability was good (r = 0.83) and scores correlated significantly (range, 0.25 to -0.60; P < .05) with detailed measures of dietary habits, parental modeling, physical activity, and home environment. CONCLUSIONS AND IMPLICATIONS: Development and testing in a program context produced a tool community nutritionists can use to evaluate educational interventions aimed at helping parents promote healthful eating and activity.