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BACKGROUND: Iron deficiency, a pervasive problem among low-income women of childbearing age, threatens maternal health and pregnancy outcomes. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was designed to alleviate health problems and provides supplemental nutritious foods, nutrition education, and health care referrals. OBJECTIVES: The aim of this study was to examine the benefits associated with participation in WIC in terms of biochemical tests of postpartum iron status in nonlactating women. DESIGN: WIC participants (n = 57) and eligible nonparticipants (n = 53), matched by race and age, were followed bimonthly over 6 mo postpartum. Finger stick blood samples (500 microL) were collected for measurement of plasma ferritin, transferrin receptor (TfR), and hemoglobin (Hb). RESULTS: The mean (+/-SE) Hb concentration of participants exceeded that of nonparticipants from months 2 through 6. At 6 mo, the mean Hb concentration of participants was significantly higher than that of nonparticipants (8.01+/-0.12 and 7.63+/-0.12 mmol/L, respectively; P< 0.05) and the prevalence of anemia was significantly lower (17% and 51%, respectively; P<0.05). TfR and ferritin concentrations (consistently within the reference ranges) and dietary iron intakes did not differ significantly between participants and nonparticipants and were not correlated with Hb concentrations. CONCLUSIONS: Our results suggest that WIC participants were significantly less likely to become anemic if uninterrupted postpartum participation lasted for 6 mo. The lack of correlation among iron status indicators suggests that the lower mean Hb concentration in nonparticipants at 6 mo may not have been related to improved iron status in participants but to other nutrient deficiencies or differences in access to health care and health and nutrition education.

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In the previous report, we had shown that blockade and enhancement of GABAA receptors in the DMH of rats increased or decreased the level of anxiety, respectively, as measured by the elevated plus-maze test. The present study was conducted to assess the effects of enhancing GABAA neurotransmission in the DMH of rats on the physiological concomitants of anxiety such as increases in heart rate (HR), blood pressure (BP) and plasma norepinephrine (NE) levels while the animals were placed on the elevated plus-maze. Male Sprague-Dawley rats were equipped with arterial and venous catheters and stereotaxically implanted with microinjection cannulae in the cardiostimulatory region of the DMH where injection of bicuculline methiodide (BMI) elicited increases in heart rate under anesthesia. After recovery, rats were injected with either saline or the GABAA agonist muscimol and their HR, BP and plasma NE responses were measured when confined in the open or the closed arm of the elevated plus-maze. Injection of muscimol into the DMH reduced the increases seen in HR, BP and plasma NE when the rats were confined to either the closed or the open arms in addition to decreasing 'anxiety' in the plus-maze. Injection of muscimol into the areas of the hypothalamus surrounding the DMH did not significantly affect the changes in HR, BP and plasma NE in the plus-maze. Blocking the changes in HR and BP elicited by microinjecting GABAergic drugs into the DMH of rats, with systemic injections of a combination of atropine and the beta-blocker atenolol, did not block the behavioral effects of the GABAergic drugs in the plus-maze test.

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Social support has been identified as an important element for encouragement and success of lactation. The sources, types and amounts of perceived social support were determined for women during their third trimester of pregnancy and at four weeks of postpartum breastfeeding. Differences in social support were reported for women who stated an intention to breastfeed and those who planned to bottle feed. The tangible, emotional and informational functions of social support were measured as aggregate values across support sources. Tangible and emotional support were not significantly different between intended breast or bottle feeders. However, informational support was higher for women who intended to breastfeed compared to those who intended to bottle feed. Mean scores were then analyzed for specific individuals who might provide support. The baby's father was a more important source of tangible support for intended breastfeeders. Intended breastfeeders also indicated they received more emotional and informational support from the baby's father and prenatal classes. Tangible, emotional and information support did not change pre- and postnatally for women who breastfed. However, certain sources did provide more support postnatally. Finally, predictors such as level of education, a belief that breastfeeding was better for health and emotional closeness, fewer children, moderate tangible and emotional support and more informational support were identified for women who intended to breastfeed.

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We surveyed 218 county extension agents, 75 state extension specialists, 163 public health nutritionists, and 87 public health administrators in 16 states to compare the nutrition program characteristics of extension personnel with public health personnel. Public health personnel were most strongly influenced by funding regulations--more than 80% of public health nutritionists cited infant/preschool nutrition and nutrition for pregnant/lactating women as program topics. About half of the extension agents listed food preservation and preparation as the dominant topics provided. Public health personnel most frequently designed programs for pregnant and lactating women and low-income clientele; 91% of the nutritionists ranked one-to-one counseling as one of their three most important delivery methods. Extension personnel designed programs more often for homemakers/adults and youth and ranked a combination of group and media delivery methods as most important. Public health personnel use anthropometric measures and food intake records to evaluate their programs; extension personnel use written questionnaires and program records. More than 50% of the nutritionists ranked improving the health of their clients as one of the three most important impacts of their programs; more than 50% of the extension agents ranked increasing knowledge and improving skills as their most important impacts.

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The purpose of this research was to determine consumers' preferences for the content and design of nutrition print materials through the use of focus group interviews. Thirty-seven non-pregnant, non-nursing female consumers 20 to 50 years of age attended one of six focus group interviews. Existing nutrition print materials were used to stimulate discussion on content and graphic design features of the materials. Content features discussed included glossaries, quizzes, diet evaluation checklists, diet monitoring forms, and "factual" vs. "how to " information. Graphic design features discussed included color, format, size, organization, and general appearance. Participants were asked to discuss the personal impressions and practical considerations that formed the basis of their opinions regarding each feature and to elaborate on how the existing materials might be improved to meet their particular needs. Features that drew the most positive reactions were bright food colors, organizational cues, clear information and explanations, features that help personalize the issue being addressed, and "how to" information.

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Nutrition intervention programs are not always successful. In some cases, an insufficient understanding of the interrelationships among factors influencing health behaviors may be responsible for the failures. This study used social cognitive theory, a framework for studying behaviors, to structure the relationships between measurable factors important to the frequency of health-oriented food consumption. We developed a model that incorporated factors for social environment, reinforcement, commitment, behavior modeling, knowledge, and attitude relative to the frequency of consumption of four beverages (whole milk, low-fat/skin milk, regular soda, and diet soda). Four-hundred fifty-seven middle-aged adults (mean age, 47 years; 58% female) and 709 college students (mean age, 21 years; 50% female) responded to a written questionnaire designed as a self-report on frequency of consumption and measures for 10 social cognitive variables. For all four beverages, the model explained 35% or more of the variance in frequency of consumption, thus confirming its predictive power. We used the statistical approach known as path analysis to examine the relationships within the model. The analysis demonstrated that factors influencing the consumption varied between the two age groups (e.g., nutrition knowledge was related to attitude in adult soda-drinking models but not in student soda-drinking models) and between forms of the beverages (e.g., for student models, nutrition knowledge was related to taste enjoyment for low-fat/skim milk but not for whole milk).(ABSTRACT TRUNCATED AT 250 WORDS)

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The work of the past ten years in the field of nutrition education research is reviewed and analyzed. First, definitions of key concepts are provided. Second, the author reviews and assesses the influences from the five nutrition education research conferences held in the past. Presented are results from a survey conducted that asked nutrition educators about the usefulness of the five conferences. Third, results are presented from a review of research articles published since 1980 in JADA, JNE, and HERJ. Implications for designing nutrition education research studies are discussed. Fourth, direction is provided for the future of nutrition education research, with special attention given to the necessary link between researchers and practitioners, so that "right" questions get asked and "correct" answers get used.

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This study investigated the job satisfaction of public health nutrition personnel and examined specific factors related to that satisfaction. The 584 persons who responded to a mailed questionnaire were, on the whole, moderately satisfied with their positions in public health. Satisfaction with the "kind of work" they did and satisfaction with coworkers were the major factors contributing to overall job satisfaction. Of the job components examined, respondents were the least satisfied with the pay they received. Older respondents who had been in the profession a longer time were more satisfied with their jobs than their younger counterparts.

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This study investigated how public health nutrition directors and practitioners each rated the effectiveness of their professional performance. We examined the specific factors which were predictive of each set of effectiveness ratings. Eleven directors supplied the names and addresses of 226 practitioners, each of whom was mailed a questionnaire. The response rate to the mailing was 84 per cent. Director ratings of practitioners were not significantly related to the self-ratings. Results of multiple regression analysis revealed that the directors had based their evaluation on more "external" criteria, such as age, being a Registered Dietitian, and possessing an extroverted personality. In contrast, the nutritionists' self-ratings were based on more introspective qualities, including self-perceived innovativeness, and the number of competencies which they felt they were currently performing well. The roles of work environment, nature of supervision, and type of educational preparation need to be assessed in future research.

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A study was undertaken to examine nutrition surveillance activities and their usefulness in managing programs of nutrition intervention. Questionnaires were returned by 24 of 26 directors of nutrition units in State or metropolitan health departments participating in 1981 in the coordinated nutrition surveillance system of the Centers for Disease Control, which monitors high risk pediatric patients and pregnant women. The mean years of experience in surveillance activities among the agencies was 4. Only 25 percent of the responding departments reported a self-sufficient computerized surveillance system. Personnel most involved in the coordinating, analyzing, and interpreting of the data were nutritionists who spent an average of 17 hours per month. Major uses of surveillance data reported for purposes of the nutrition programs were to (a) identify collection sites with problems such as errors in measuring heights and weights and hematocrits warranting checks for quality control, (b) define the extent of nutrition-related disorders in the target populations, (c) provide objective local data to assist in decision-making and program planning, (d) enhance followup of specific clients, and (e) provide feedback to clinic staffs about the quality and relative impact of their services. The survey results yielded evidence that nutrition surveillance activities have important consequences for the planning, implementation, and evaluation of programs of nutritional intervention.

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A survey was conducted with 148 women patients (131 first-time mothers and 17 pregnant women) of ten physicians to determine their channels of information and specific sources within each channel on infant feeding and to examine where they receive their information in relation to their level of nutrition knowledge and selected nutrition-related attitudes and beliefs. It was shown that physicians are frequently used as a source of information on infant nutrition, but are not the women's primary source. Several information channels (formal, media, professional, and interpersonal) and different sources within each channel were used according to the type of information needed. Specific channels of nutrition information were related to whether the mothers breast-fed or bottle-fed their infants, their nutrition knowledge score, and to certain attitudes about nutrition and health.

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A comparison was made of the employment status of graduates of three types of programs in community nutrition. Graduates of community nutrition programs were less likely to be employed in dietetics or nutrition-related positions; were less likely to be registered dietitians or to have fulfilled requirements for professional registration; and were less likely to recommend the profession than were graduates of coordinated undergraduate programs or of programs in general dietetics or foods and nutrition. Implications for student counseling and professional accreditation are discussed.

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The Delphi Technique was used to elicit a number of essential competencies expected of the "entry-level" public health nutritionist from members of Graduate Faculties of Programs in Public Health Nutrition. Questionnaires composed of "competency statements" were constructed from these responses and sent to practitioners in public health nutrition. The questionnaire requested evaluation of the "necessity" of each competency. Responses served as the basis for "factor analysis" procedures, employed to obtain clusters of competency functions expected of the nutritionist. From the 109 competency items originally identified, 17 competency scales were derived from the factor analysis. A ranking from both faculties and practitioners revealed that both groups highly rated competencies to communicate, to counsel and deal with clients/patients, and to interpret scientific data in "lay language." Less important in the ranking were competencies which dealt with administrative abilities, program planning, legislative activism, and consumer advocacy. These findings have cimplications for the practitioner in public health nutrition as well as for academic groups who must plan and evaluate curricula in public health nutrition and in other fields of public health.

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One hundred thirty-one mothers who were patients of ten physicians were surveyed to determine their compliance with physician-recommended infant feeding practices. For a direct, self-reported measure, the rate of non-compliance was nearly 30 per cent. A second measure, a "compliance score," was computed by comparing mothers' responses to specific questions about the feeding of their babies with their physcians' recommendations for normal, healthy infants. The mean noncompliance rate on this measure was 44 per cent. Differing response patterns regarding specific feeding practices were found for breast-feeding and bottle feeding mothers. To determine selected psychologic factors associated with compliance, health-related attitude and belief scales were originated and validated. Attitudes that "nutrition is important" and a "concern for health" were significantly correlated with the compliance score for breast-feeding mothers.

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