Vending Machines in Australian Hospitals: Are They Meeting the Needs of the Consumer?The current report explores how well vending machines are meeting the needs of health care organizations and their staff and visitors in Australia. Hospital vending machines often provide the only source of food through the night to staff and visitors and traditionally offer less-healthy options. Findings presented in this report suggest that vending machines are not meeting current statewide policies and guidelines for healthier food environments in health care. This is despite widespread support for healthier refreshments in hospitals by staff, visitors, and patients.
Development of a Dissemination and Implementation Framework for an Early Childhood Obesity Prevention ProgramDissemination and implementation (D&I) science addresses the disconnect between evidence-based research and practical application in community settings. Early childhood education settings are ideal for the application of D&I research because of their widespread use for implementing health promotion interventions. A D&I framework was applied to the Culture of Wellness in Preschools program, a comprehensive early childhood obesity prevention program. The development and application of the Culture of Wellness in Preschools D&I framework can lead to a more comprehensive approach to program evaluation and quality improvement and can contribute more broadly to the body of evidence of nutrition-related health promotion programs.
Kindergarten to 12th Grade School-Based Nutrition Interventions: Putting Past Recommendations Into PracticeSchool-based nutrition interventions are used to improve dietary habits of schoolchildren and reverse trends on obesity. This article reports on kindergarten through 12th grade nutrition interventions published between 2009 and 2018 compared with interventions published between 2000 and 2008 based on (1) behaviorally focused, (2) multicomponent, (3) healthful food/school environment (4) family involvement, (5) self-assessments, (6) quantitative evaluation, (7) community involvement, (8) ethnic/heterogeneous groups, (9) multimedia technology, and (10) sequential and sufficient duration.
Best Practices in Curricula Revisions: Using the Evidence-Based Eating Smart • Being Active as an ExemplarThis article describes the processes employed to revise the widely used curriculum, Eating Smart • Being Active. Because of its popularity among nutrition education programs serving the low-income population, the curriculum developers felt it was important to share the revision process after the release of the 2015–2020 Dietary Guidelines for Americans. Extensive feedback during formative evaluation, updated content from the Dietary Guidelines for Americans, and a modern look resulted in a fully revised curriculum released in 2017.
How to Ensure That Teaching Kitchens Are Age-FriendlyHealth systems and community organizations have increasingly offered nutrition education through teaching kitchens. With an increasing number of older adults (>65 years) accessing these programs, teaching kitchens may consider age-friendly adaptations to their standard curriculum. Based on experiences with implementing Healthy Teaching Kitchens Across Veteran Affairs Health Care System, and by applying the 5M Geriatric Care Framework (Mind, Multicomplexity, Medications, Mobility, What Matters Most), several steps are proposed for teaching kitchens to be able to better accommodate older adults.
Identification of a Framework for Best Practices in Nutrition Education for Low-Income AudiencesTo promote effective low-income nutrition education programs, an expert panel of nutrition education and public health researchers built consensus around 28 best practices grouped into 5 domains (Program Design, Program Delivery, Educator Characteristics, Educator Training, and Evaluation) targeting direct delivery of nutrition education. These best practices can be used to assess program strengths, promote fidelity in delivery and evaluation, and design research to strengthen programs’ evidence base.
Implementing Culinary Medicine Training: Collaboratively Learning the Way ForwardThere is a documented substantial gap between the level of nutrition education for medical trainees and the need to provide nutrition counseling. Culinary medicine offers a solution, but there are multiple barriers and no guides to implementation. This article identifies core components and strategies to overcome barriers on the basis of experiences of multiple institutions. The outline forms a foundation to be built upon by future collaborators to empower more widespread implementation of culinary medicine education and improve medical nutrition education and ultimately, patient outcomes.
How Branded Marketing and Media Campaigns Can Support a Healthy Diet and Food Well-Being for Americans: Evidence for 13 Campaigns in the United StatesThis report summarizes the available evidence for strategies used in large-scale, branded marketing campaigns to promote healthy dietary behaviors to Americans between 1990 and 2016. An adapted health-branding framework guided the 3-step mixed-methods approach to identify evidence for campaigns using a scoping review, comprehensive literature review, and key-informant interviews (n = 11). Results show that industry, government, and nongovernmental organizations supported 13 campaigns that used various health-branding strategies.
Assessment of Specifications Grading in an Undergraduate Dietetics CourseAssessing student learning is an integral component of teaching undergraduate dietetics students. Traditional grading can be cumbersome for instructors, encouraging extrinsic motivation for students and hindering clear understanding of whether students have met course learning outcomes. Specifications grading is a reimagined assessment paradigm that empowers both students and instructors to focus on achievement of learning objectives. This report examines the deployment of specifications grading in an undergraduate dietetics course, using qualitative methods to determine the impact on students’ learning and experiences.
Implementation Science and Nutrition Education and Behavior: Opportunities for IntegrationImplementation science (IS) is the study of approaches designed to increase adoption and sustainability of research evidence into routine practice. This article provides an overview of IS and ideas for its integration with nutrition education and behavior practice and research. Implementation science application in nutrition education and behavior practice can inform real-word implementation efforts. Research opportunities include advancing common approaches to implementation measurement. In addition, the article provides suggestions for future studies (eg, comparative effectiveness trials comparing implementation strategies) to advance the knowledge base of both fields.
Barriers to Food Literacy: A Conceptual Model to Explore Factors Inhibiting ProficiencyFood literacy research typically conceptualizes food-related knowledge and skills as contributing to improved health and nutrition; however, there is limited research examining the process that leads to this improvement. This article reviews the literature reporting barriers to food literacy proficiency in order to examine the relationship between food-related knowledge, attitudes, and behaviors. Informed by these barrier types, its central objective is to develop a model of food literacy proficiency that highlights the relationship between nutrition education and health-related outcomes.
Creation of a Dual-Purpose Collegiate Athlete Nutrition Advising Program and Educational CurriculumThe intent of this article is to describe the process of creating a dual-purpose athlete nutrition advising program at the collegiate level. The first goal was to help student athletes enhance their performance through optimal fuel and hydration. The second goal was to provide experiential learning for nutrition students. This program provided a platform for nutrition students to gain hands-on experience assessing, monitoring, and educating athletes in relation to nutrition for performance. The implication for practice is based on recent growth and increased interest in the performance nutrition field that drives the need for more formal training programs.
Using a Marketing Evaluation Tool to Optimize a Social Marketing Campaign: Insights From a Copy Test of a You're the Mom Campaign AdA copy test is a business tool for assessing advertisements. This report provides an example of how copy test may be used within nutrition education practice and research. A public health nutrition advertisement for You're the Mom was copy tested with a market research firm. Mothers (n = 300) were aged 22-49 years, had a household income <$50,000 and ≥1 child aged 4–8 years and bought fast food ≥2–3 times/ mo. Compared with advertisements for for-profit goods, the advertisement scored high on impact (77th percentile) and moderate on persuasiveness (46th percentile) and communicated 2 key messages at higher rates than norms (51% and 46%) and a third at a lower rate (37%).
Increasing Sense of Community in Higher Education Nutrition Courses Using TechnologySense of community is integral across education formats and can affect achievement, interactivity, and retention. Factors shown to engage students and foster sense of community include the instructor focusing and directing discussions, encouraging open expression of opinions, responding to communications and feedback in a timely way, and giving the opportunity to build relationships. Technology has tremendous potential to enhance these activities at all levels of higher education. This article presents ways in which several technologies are used to enhance student experience in undergraduate and graduate nutrition course work across delivery formats.
Education for WIC Peer Counselors About Breastfeeding the Late Preterm InfantMothers of late preterm infants need ongoing support because they often find establishing breastfeeding (BF) to be complex and difficult. Special Supplemental Nutrition Program for Women, Infants and Children peer counselors provide BF information and emotional support to new mothers in many communities. However, their current training does not include education about BF for the late preterm infant. The purpose of this report is to present important information about BF and the late preterm infant that can enhance peer counselors' ability to offer appropriate support.
Securing a Stop to the Summer Setback: Policy Considerations in the Future Expansion of the Summer Electronic Benefit Transfer for ChildrenThe Summer Electronic Benefits Transfer for Children (SEBTC) has been proposed as a solution to address the problem of child food security during the summer. Initial SEBTC findings from a demonstration project show promise and the federal government has approved substantial funding for its continuation. This report reviews empirical assessments of SEBTC and Electronic Benefits Transfer research, and presents policy considerations in the program's future expansion.
Bringing Produce to the People: Implementing a Social Marketing Food Access Intervention in Rural Food DesertsThis study describes and evaluates the process of implementing a social marketing food access intervention for food desert communities in rural California. A case study approach used mixed-methods data from nationwide market comparisons, environmental assessment, and community informants. Lessons learned demonstrate room for improvement in implementing such strategies and underscore the importance of involving community in decision making; the strategic importance of operational decisions relating to intervention design, site and product selection, and distribution models; and the need to reconsider the problem of access in rural areas.
What Does Evidence-Based Mean for Nutrition Educators? Best Practices for Choosing Nutrition Education Interventions Based on the Strength of the EvidenceFunding agencies and professional organizations are increasingly requiring community-based nutrition education programs to be evidence-based. However, few nutrition education interventions have demonstrated efficacy, particularly for interventions that address the outer layers of the socioecological model (ie, organizational, community, and public policy). This article reviews the types of evidence available to assess the likelihood that a given intervention will deliver the desired outcomes and how these types of evidence might be applied to nutrition education, and then suggests an approach for nutrition educators to evaluate the evidence and adapt interventions if necessary.
Practical Qualitative Research Strategies: Training Interviewers and CodersThe increased emphasis on incorporating qualitative methodologies into nutrition education development and evaluation underscores the importance of using rigorous protocols to enhance the trustworthiness of the findings. A 5-phase protocol for training qualitative research assistants (data collectors and coders) was developed as an approach to increase the consistency of the data produced. This training provides exposure to the core principles of qualitative research and then asks the research assistant to apply those principles through practice in a setting structured on critical reflection.
Developing a Performance Nutrition Curriculum for Collegiate AthleticsThe purpose of this article is to provide a framework for developing a sports nutrition education program in a collegiate athletic department. A review of literature on student-athlete nutrition behaviors is combined with practical suggestions from personnel who wrote a sports nutrition curriculum at a large Midwestern university. There are 2 primary implications for practice. First, maintaining a written curriculum and conducting periodic evaluation are fundamental aspects of sports nutrition education programs.
Past, Present, and Future of eHealth and mHealth Research to Improve Physical Activity and Dietary BehaviorsBecause physical inactivity and unhealthy diets are highly prevalent, there is a need for cost-effective interventions that can reach large populations. Electronic health (eHealth) and mobile health (mHealth) solutions have shown promising outcomes and have expanded rapidly in the past decade. The purpose of this report is to provide an overview of the state of the evidence for the use of eHealth and mHealth in improving physical activity and nutrition behaviors in general and special populations.
Nutrition Content in a National Nutrition Education Program for Low-Income Adults: Content Analysis and Comparison With the 2010 Dietary Guidelines for AmericansThe purpose of this study was to identify nutrition-related content employed nationally by the Expanded Food and Nutrition Education Program (EFNEP) with adult participants. A content analysis was used to assess the type, frequency, and depth of nutrition content in adult curricula most used by EFNEP nationally compared with the 2010 Dietary Guidelines for Americans (2010 DGA). All EFNEP curricula reviewed employed the vast majority of the 2010 DGA nutrition recommendations, with differences in the frequency and depth of nutrition content.
Let's Go! School Nutrition Workgroups: Regional Partnerships for Improving School MealsThis report describes a regional approach for improving the nutritional quality of school meals and increasing the selection of healthier foods. Let's Go! is a childhood obesity prevention program that establishes regional workgroups to develop innovative solutions to improve school meal programs. Let's Go! fosters collaborative decision making, specifically addressing the feasibility of proposed strategies, differences in school environments, and level of readiness for change. This approach led to 77 schools achieving the HealthierUS School Challenge and 130 schools implementing Smarter Lunchrooms techniques in school year 2011–2012.
Strengthening Moral Reasoning Through Dedicated Ethics Training in Dietetic Preparatory ProgramsMoral reasoning skills, associated with the ability to make ethical decisions effectively, must be purposively fostered. Among health professionals, enhanced moral reasoning is linked to superior clinical performance. Research demonstrates that moral reasoning is enhanced through dedicated, discussion-based ethics education offered over a period of 3–12 weeks. Current dietetic students and practicing dietitians seeking to strengthen their moral reasoning skills can undertake elective ethics education.
Enhancing Student Engagement Using the Flipped ClassroomThe flipped classroom is an innovative pedagogical approach that focuses on learner-centered instruction. The purposes of this report were to illustrate how to implement the flipped classroom and to describe students' perceptions of this approach within 2 undergraduate nutrition courses. The template provided enables faculty to design before, during, and after class activities and assessments based on objectives using all levels of Bloom's taxonomy. The majority of the 142 students completing the evaluation preferred the flipped method compared with traditional pedagogical strategies.
Report of an EU–US Symposium on Understanding Nutrition-Related Consumer Behavior: Strategies to Promote a Lifetime of Healthy Food ChoicesThis report summarizes an EU–US Task Force on Biotechnology Research symposium on healthy food choices and nutrition-related purchasing behaviors. This meeting was unique in its transdisciplinary approach to obesity and in bringing together scientists from academia, government, and industry. Discussion relevant to funders and researchers centered on (1) increased use of public–private partnerships, (2) the complexity of food behaviors and obesity risk and multilevel aspects that must be considered, and (3) the importance of transatlantic cooperation and collaboration that could accelerate advances in this field.
Field Assessments for Obesity Prevention in Children and Adults: Physical Activity, Fitness, and Body CompositionNutrition and health educators work in community settings implementing lifestyle programs focused on obesity prevention and chronic disease risk reduction. These programs typically focus on improving diet and physical activity (PA) behaviors. Many nutrition educators may not be confident in their ability to select, administer, and interpret PA assessments to effectively evaluate their PA or lifestyle programs. This report will assist educators in identifying and selecting appropriate field-based assessments for measurement of PA, physical fitness, and body composition for children and adults.
Using National Data to Estimate Average Cost Effectiveness of EFNEP Outcomes by State/TerritoryThis report demonstrates how existing national data can be used to first calculate upper limits on the average cost per participant and per outcome per state/territory for the Expanded Food and Nutrition Education Program (EFNEP). These upper limits can then be used by state EFNEP administrators to obtain more precise estimates for their states, based on their state-specific knowledge. Across all states, EFNEP appears most cost effective in nutrition practices, followed by food resource management practices, and then food safety practices.
Exploring the Feasibility of an Academic Course That Provides Nutrition Education to Collegiate Student-AthletesThe purpose of this article is to explore the delivery of nutrition education to collegiate student-athletes through an academic course. Existing literature has established the need for nutrition education among collegiate athletes. This article considers the collaboration of the university and the athletic department to better serve this population. Academic wellness courses for student-athletes can be used as models. Finally, benefits, barriers, and proposed course objectives are considered. This report proposes a potential solution to provide consistent, sustainable nutrition education to collegiate student-athletes.
Nutrition Program Quality Assurance through a Formalized Process of On-site Program ReviewA protocol for a systematic onsite review of the Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program–Education was developed to support quality programming and ensure compliance with state guidelines and federal regulations. Onsite review of local nutrition program operations is one strategy to meet this goal. Observation and interaction with staff allow a comprehensive understanding of strengths, weaknesses, and emerging issues. This information provides managers with timely feedback to strengthen and improve all aspects of nutrition programming.
Obesity in Rural Youth: Looking Beyond Nutrition and Physical ActivityContributors to excessive obesity in rural youth include well-documented nutrition and physical activity behaviors. However, emerging research suggests that preventing excessive weight gain and smoking during pregnancy, teen pregnancy, and child abuse also could reduce obesity in this vulnerable population. These traditional and emerging, nontraditional factors need to be addressed within the confines of current challenges faced by rural communities. An enhanced ecological model provides a framework for combining traditional and nontraditional factors into a more comprehensive approach that addresses the complexity of the issues contributing to youth obesity.
Best Practices Models for Implementing, Sustaining, and Using Instructional School Gardens in CaliforniaTo ascertain best practices for schools implementing or sustaining instructional school gardens by interviewing key members in 10 schools with exemplary instructional school gardens programs in California. Practices of schools with exemplary instructional school gardens programs were analyzed by constant comparative analysis using qualitative data analysis software. Seven of the 10 schools had people from at least 3 of the following 4 groups: administrators, teachers, parent and community volunteers and garden coordinators.
Cost-Effectiveness Model for Youth EFNEP Programs: What Do We Measure and How Do We Do It?The Youth Expanded Food and Nutrition Education Program (EFNEP) is one of the United States Department of Agriculture's hallmark nutrition education programs for limited-resource youth. The objective of this study was to gather opinions from experts in EFNEP and related content areas to identify costs, effects (impacts), and related instruments to develop a cost-effectiveness model (instrument) for youth EFNEP, which does not exist. A cost-effectiveness model determines the economic or financial cost of producing an impact.