<p> The purpose of this project was to develop resources and recipes for a cookbook emphasizing produce that is fresh, locally sourced and specific to the spring, summer, fall, and winter seasons in Southern California as a tool to overcome barriers such as poor cooking skills and limited nutrition knowledge in order to impact low intake of fruits and vegetables among adults 20 years and older living in Southern California. </p><p> This cookbook was created to encourage cooking behaviors, strengthen cooking skills, promote intake of fruits and vegetables, provide nutrition education and increase awareness of how to obtain and prepare fresh and seasonal produce from local food systems in Southern California. The cookbook consists of 12 simple and original recipes using fresh, local and seasonal produce from Southern California. It also contains resources including a shopping guide, a crop calendar and a chart of daily fruit and vegetable recommendations for adults. A survey was developed and completed by 12 participants to measure the effectiveness of the project. An expert panel reviewed the cookbook and provided feedback.</p>

<p> The purpose of this study was to explore the impact of the Beach Community Wellness Program (BCWP) nutrition lessons on participants and student nutrition educators. Evaluations of nutrition education interventions have indicated effectiveness at promoting healthy dietary behaviors in culturally diverse and low-income communities. However, qualitative investigations of such interventions are needed to better understand factors that facilitate behavior change. A focus group interview with participants (<i>n</i>=8) and individuals interviews with student educators (<i>n</i>=2) were used to explore program impacts and the experiences they had in the nutrition lessons. Themes generated from the focus group include nutrition knowledge, thoughts about food, social benefits, exercise and nutrition complementation, successful program components, gratitude, and lasting change. Nutrition educator interviews elicited the themes applied learning, facilitators and barriers of nutrition education, enjoyable experience, and perceptions of community nutrition. Demonstration of new recipes was a major positive remark held by participants. The success of the BCWP nutrition lessons can support the use of a model utilizing nutrition students as educators in a diverse community.</p>

<p> The purpose of this study was to examine the relationships of acculturation [language(s) usually spoken at home, and length of residence in the United States (US)] of Mexican-American and other Hispanics to dietary intakes, as well as to chronic diseases such as overweight/obesity, diabetes, hypertension and coronary heart disease (CHD) risk.</p><p> The study was based on data extracted from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). A total of 860 Hispanic subjects aged 40 years or more were utilized in the study. Data were analyzed using SUDAAN statistical software. Statistical procedures used to address the study objectives were t-tests and chi-square tests.</p><p> The findings demonstrated that language usually spoken at home (English more than Spanish or only English) was associated with higher intakes of total fat, total saturated fat, total monounsaturated fat, total polyunsaturated fat and sodium compared with the other groups. However, greater length of residence in the US was associated with lower intakes of energy, total fat, saturated fat, and sodium; and higher fiber intakes. Overweight and obesity were associated with greater length of residence in the US and language spoken at home (English and Spanish equally). Diabetes and hypertension had no significant relationships with length of residence in the US or language usually spoken at home. Greater length of residence in the US was associated with greater risk of CHD.</p>

<p> Many Registered Dietitians (RD) have different perceptions of what a &ldquo;healthy&rdquo; weight is. Because of the diversity of counseling approaches, it is important to explore how RDs&rsquo; opinions on weight management influence how they counsel clients. This study sought to qualitatively investigate what RDs believe to be &ldquo;healthy&rdquo;, their opinions and approaches on weight control, and how their outlooks may affect how they counsel their patients on weight management. Ten RDs were recruited and interviews were analyzed for emerging themes. It was found that the RDs focused on making lifestyle changes when counseling clients on weight management, whether that is directed towards the goal of losing or maintaining weight. A majority of the RDs stressed the importance of individualized plans based on diet, physical activity, and behavioral strategies. However, RDs&rsquo; weight management approaches vary greatly as some endorse energy-restrictive dieting and others have adopted a &ldquo;Health at Every Size&rdquo; style.</p>

<p> The purpose of this thesis was to investigate perceptions of weight as a predictor of health among Arab Americans. This study investigated the relationship between A) Middle Eastern region of origin, B) presence of a chronic disease, C) degree of acculturation, D) body mass index, E) religious affiliation, F) income, G) education level, H) gender, I) fatalism perception of weight, and J) perception that is it hard to maintain a healthy weight on perceptions of weight as a predictor of health. A survey was created and distributed online through the investigator&rsquo;s social network and four professional groups geared towards Arab Americans.</p><p> The survey assessed the effect of these key demographic factors among 96 participants. Participants who were female and more acculturated to the United States were more likely to believe their weight affected their health. Further research is needed to capture a wider variety of demographics among Arab Americans to improve current knowledge base and health messages amongst healthcare professionals.</p>

<p> Congenital aglossia (CA) is a very rare condition in which a person is born without a tongue. This current study sought to investigate the taste function of an 11-year-old female with CA. In this randomized, double-blinded, controlled taste test trial, the participant was asked to identify different concentration levels of sweet, sour, salty, bitter, and umami tastant solutions. Responses were analyzed for correct identification. Out of the five stimuli, the participant correctly identified sour at 1.6 x 10^-4 M and umami at 5.0 x 10^-3 M. Sweet, salty, and bitter stimuli did not meet the accuracy identification threshold of 66.6% at any concentration level. Statistical significant association between taste identification accuracy and actual taste [<i>X&sup2;</i>(5) = 7.674, <i>p</i> = .175], individual stimuli concentration levels (sweet <i>p</i> = .645; sour <i>p</i> = .558; salty <i>p</i> = .484; umami <i> p</i> = .061), and presentation order [<i>X&sup2;</i>(5) = 55.000, <i>p</i> = .437] could not be determined using Chi-square testing. Findings suggest an alteration in taste function in individuals with CA.</p>

<p> Currently there is limited research investigating parental perceptions regarding snack items provided to participants of organized youth sports. The current study investigated parental perceptions towards typical snacks offered by parents to teams in youth sports, and parental receptiveness to a snack guideline that would promote healthy snacking after youth sport events. This study focused on analyzing seven open ended questions included in the survey, which explored perceived importance of guidelines to promote healthy snacks, changes in snacks resulting from the guidelines, and additional informational needs. Survey responses for each open ended question were analyzed for a priori themes and emergent themes by two independent reviewers, using the sensitizing concepts approach. Responses across survey questions indicated that participants related snacking guidelines in youth sports with improved health. Many of the respondents gave answers that revolved around general health, bringing less candy, adding more fruits and vegetables, and basic nutrition facts and values. Another common theme was that the guidelines provided some form of structure to the snacking process, and can help guide parents with selection appropriate snack choices. Through qualitative analysis of the survey responses, it became clear that having nutritional guidelines to promote healthy snacks was valued by the participants of the current study, and resulted in some behavioral changes. This study is a step towards understanding practices that affect food consumption and food selection of youth involved in sports, both physically and nutritionally. Youth sports is a promising setting to promote physical activity and dietary habits, but considerable room for improvement exists for promoting healthful eating in the youth sports setting.</p>

The majority of U.S. children do not meet recommendations for fruit and vegetable (FV) consumption. FV confer numerous health benefits including intake of critical shortfall nutrients, reduced risk of chronic diseases, and maintenance of healthy weights. Identifying both policy and behavioral approaches to increase children's consumption of a variety of FVs has become a public health priority. When evaluating policy and interventions it is integral to apply validated dietary assessment methods to measure FV selection, consumption, and waste. The three aims of this dissertation addressed the feasibility of dietary assessment methods and their application to evaluate policy change and behavioral interventions. Aim 1: Apply validated dietary assessment methods to evaluate the effect of national school lunch policy change on elementary school children's FV consumption. As of the 2012 school year, the United States Department of Agriculture (USDA) requires school children to select either a fruit or a vegetable with a reimbursable meal. The objective of the first study was to compare children's FV choices in two school cafeteria environments a year before these new USDA regulations took effect. Elementary school (grades 3-5) children's FV choices were measured during Spring 2011 at two northeast elementary schools (NES-A and NES-B). NES-A had a self-serve salad bar, whereas NES-B served pre-portioned FV and pizza daily. Of 555 trays assessed (n=284 NES-A, n=271 NES-B), 15.3% (n=85) had no FV selected. A higher percentage of trays from NES-A had no FV (23.6%, n=67) in comparison to NES-B (6.6%, n=18) (P<0.0001). On average children selected more processed FV (PFV) (80.8g) than whole FV (WFV) (40.5g, P<0.001). The mean amount of FV selected was lower in NES-A (111.4g) than NES-B (131.5g, P<0.01). When trays without a FV were removed, quantities selected were not significantly different between schools (P=0.46). For PFV, 100% fruit juice was on 41.4% of trays (n=230) and pizza was on 42.1% of NES-B trays (n=114). Trays with pizza or 100% fruit juice were less likely to have a WFV (P<0.001, P<0.0001 respectively). In the second study, elementary school children's FV selection, consumption and waste were compared in two northeast elementary schools before the USDA rule in spring 2012 (10 school visits, tray observations n=498) and following the USDA rule in spring 2013 (11 school visits, tray observations n=944). More children selected FVs in higher amounts when FVs were required compared to when they were optional (0.69 cups vs. 0.89 cups, P<0.001); however, consumption decreased slightly (0.51 cups vs. 0.45 cups, P=0.01) and waste increased (0.25 cups vs. 0.39 cups, P<0.001). Aim 2: Address the feasibility of non-research volunteers (teachers and parents) collecting digital imaging (DI) dietary assessment data in a sample of elementary schools. Two Northeast Elementary Schools (NES-A and NES-B) were recruited and a parent-based dietary assessment team (PDAT, n=5) and teacher based dietary assessment team (TDAT, n=4) were formed. We compared data collected by the PDAT and TDAT with the university-based dietary assessment team (UDAT). Feasibility was measured based on the total number of DI pairs collected out of the total number of eligible DI pairs across all data collection days for each of the three teams. Using binary logistic regression, at NES-A, the PDAT was less proficient at collecting DI pairs (74.1%, n=218 of 294 LD) than the UDAT (81.9%, n=262 of 320 LD, P<0.05). At NES-B, the TDAT was better able to capture DI pairs (95.9%, n=257 of 268 LD) than the UDAT (91.3%, n=366 of 401 LD, P<0.05). Aim 3: Apply weighed plate waste (WPW) as a validated dietary assessment method to evaluate a behavioral intervention addressing pre-school aged children's FV consumption during afternoon snack time using older elementary school children as 'FV Mentors'. Two Northeast pre-school classrooms (NEPC-A and NEPC-B) at the Burlington, VT YMCA were recruited for the study. Children in grades 3-5 who participated in the Live Y'ers Afterschool program were recruited to model FV consumption and use FV verbal cues during the intervention period in addition to teacher FV verbal cues. In NEPC-A (n=15) based on a repeated measures ANOVA with mixed design analysis, there was a significant main effect of time on FV consumption as measured by the mean amount of cups of FVs consumed [F(2,10)=7.89, P=0.009] across study periods. Mean consumption was lowest at baseline at 0.16 cups (95% CI: 0.10-0.22) and increased during both the intervention period (M=0.26 cups, 95% CI: 0.17-0.36) and the follow-up period (M=0.33 cups, 95% CI=0.28-0.38). The main effect of time (study period) was qualified by a significant interaction between time and type of FVs consumed [F(8,10)=3.10, P=0.049] indicating that the effect of study period on FV consumption depended on the type of FVs consumed. In NEPC-B (n=16) there was not a significant main effect of time on FV consumption [F(2,10)=1.10, P=0.372].

Background: The PRECEDE-PROCEED Model is an effective and adaptable program planning tool that has been widely used in the design, implementation and evaluation of health promotion programs. Objective: To retrospectively apply the constructs of the PRECEDE-PROCEED Model to a community-based youth fitness and nutrition summer camp program (Champ Camp) and to identify and describe how the program can be improved based on the findings of the PRECEDE-PROCEED Model evaluation. Design: A systematic application of the nine phases of the PRECEDE-PROCEED Model applied retrospectively to evaluate and improve the Champ Camp program. Setting: Children participating in Champ Camp offered through a seven-week summer camp coordinated by Burlington Parks, Recreation and Waterfront of Burlington, Vermont. The summer camp served as a licensed childcare program for children entering first through fifth grade. Measures: Improvements in nutrition knowledge and fitness scores measured biweekly. Additionally, the retrospective application of the planning model determined valuable demographic, behavioral, environmental, and policy information about the community. Statistical Analysis: A repeated measures analysis of variance was conducted to determine if there was a statistically significant change over time in nutrition knowledge and physical fitness. Statistical analysis was also performed to determine if there were potential correlations between nutrition knowledge and performance on each fitness assessment individually. Results: The Champ Camp program significantly improved nutrition assessment scores for males. Additionally, there were statistically significant improvements in the fitness assessment scores for the ball throw within third through fifth grade males and females across the seven-week program. The retrospective application of the PRECEDE-PROCEED Model proved to be successful in identifying the demographic, behavioral and environmental influences, and resources and invested parties of the target population. Most importantly the model emphasized the use of SMART program goals and objectives within successful health promotion programs. The model also stressed the necessity for appropriate and validated nutrition and fitness assessment tools that would offer more generalizable data. Moreover, the model also emphasized the need for stronger program evaluation by including more process evaluative measures and defining the determinants in which the programs' effectiveness and efficiency would be measured. Conclusions: The unique application proved to be a valuable and fruitful method for evaluating and identifying areas for improvement within a community-based youth fitness and nutrition summer camp program. This research not only serves to improve the existing Champ Camp program but to highlight the importance of program planning models and the critical components of successful health promotion programs.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.