Objective: The aim of this study was to develop and evaluate a 12-week multi-faceted, child-focused intervention that included a point-of-purchase kiosk featuring fresh fruits, vegetables, and healthy grab-and-go snacks; and a sampling pod, comprised of food items from the kiosk. Design: An observational uninterrupted time-series design was used in one intervention grocery store. The intervention consisted of two components, a Healthy Kids Kiosk and food sampling. Subjects/Setting: Patrons of Ukrop's Inc. Grocery store in Roanoke, Virginia. May-September 2009 Measures: The study measures consist of three components: 1) examination of changes in sales data for featured products, provided by the grocery chain; 2) candid, unobtrusive, blind observations of customers near and around the intervention; and 3) brief questionnaires of customers, who engaged at some level with the Kiosk and sampling pod. Results: The results yielded an overall increase in the proportion of the sales of the featured items to total store sales during the intervention period. Individual items that increased sales during the intervention period, included whole-wheat mini bagels, bananas, radishes, honey, sunflower, baked tortilla chips, and almond butter (p<.05). Parents whose children were arguing, crying/whining, or not in the shopping cart, had higher levels of engagement with the kiosk. Almost two-thirds (61.7%) of the patrons interviewed noticed the healthy kids kiosk, with about one-quarter (28.7%) indicating that they purchased at least one item. Fifty-eight percent reported that the kiosk encouraged them to buy healthier foods. Conclusion: Promoting healthy foods at point-of purchase locations can result in increased purchases of these foods among families with young children. Application: These findings have provided insight into the effectiveness of grocery store interventions on purchasing patterns and behaviors of families with young children. / Master of Science

Yes / Supermarkets, with vast product ranges and relatively low prices, are an established solution to problems of availability of healthy foodstuffs in areas of limited retail access. However, where they may indeed raise consumption of desirable goods they also open up new opportunities to buy less healthful items for less, a situation which potentially undermines their ability to improve diet. Using under-reported diary data from the Seacroft Intervention Study in the United Kingdom takes this paper beyond the extant fruit and vegetable focus, giving it scope to explore the full effect of supermarkets. Quantile regressions show existing behaviours are reinforced, and intervention stores may do little to improve diet. Switching to Tesco Seacroft is shown to increase the portions of unhealthy food consumed by almost 1 portion per day for the least healthy. Managing demand through promoting balanced diets and restricting offers on unhealthy items will be more effective than intervention, and is an essential accompaniment to new large format retailers if they are not to entrench dietary inequality further. Policymakers and practitioners alike should avoided being distracted by aggregate conclusions if food deserts are to be truly tackled.

2 pp. / Food labels are designed to help consumers to make healthy food choices. Yet Nutrition Facts label is not always easy to understand due to a lot of technical information. The step-by-step approach in this publication is easy to follow, and may help consumers to build skills how to read and use the information on a Nutrition Facts label more easily and effectively for their needs. The 2-pages information sheet is useful, especially when a nutrition educator teaches a lay person those tricky foods labeling terms and recommends healthy alternative in his/her diet.

INTRODUÇÃO: a introdução de esquemas antirretrovirais altamente potentes, no tratamento da Aids pode estar associada ao aparecimento de alterações metabólicas em pacientes com HIV/Aids. Além da terapia antirretroviral, outros fatores, como a dieta podem contribuir para o aparecimento dessas alterações em adolescentes com HIV/Aids. Assim, faz-se necessária a avaliação da qualidade da dieta de indivíduos dessa população. OBJETIVO: analisar a qualidade da dieta de adolescentes com HIV/Aids. MÉTODOS: Trata-se de um estudo transversal aninhado a uma coorte de pacientes com HIV/Aids atendidos pela Unidade de Infectologia do Instituto da Criança (ICr-São Paulo). Foram avaliados 88 adolescentes (10 a 19 anos). Informações sobre o histórico da doença e uso de medicamentos foram obtidas a partir de prontuários médicos. Os adolescentes responderam a dois recordatórios de 24 horas e um questionário sobre atividade física habitual. Peso, altura e circunferência da cintura foram medidos em duplicata. A qualidade da dieta foi avaliada por meio do Índice de Qualidade da Dieta (IQD-R). O IQD-R é composto de 12 itens e a pontuação final varia de 0 a 100 pontos. Foram calculados os coeficientes de correlação de Pearson entre o IQD-R e as variáveis independentes. Também foram feitas as comparações das médias do IQD-R segundo as variáveis independentes pelo teste t-Student ou Mann-Whitney. RESULTADOS: a média para o IQD-R foi 51,90 pontos (EP=0,90 pontos). Os componentes que apresentaram menores médias foram cereais integrais e sódio. Os componentes que tiveram maiores médias foram cereais totais e óleos. Adolescentes moradores de casas de apoio tiveram média maior para fruta total e menor para carnes e leguminosas, quando comparados aos adolescentes que moravam com a família. Meninas apresentaram média maior para leite e derivados e menor para calorias provenientes de gorduras sólidas, bebidas alcoólicas e açúcares adicionados quando comparadas com meninos. CONCLUSÃO: os adolescentes com HIV/Aids avaliados apresentaram padrão de consumo alimentar semelhante ao de adolescentes da população geral: alto consumo de açúcar, gordura saturada e sódio e consumo insuficiente de cereais integrais e frutas. Atenção especial deve ser dada à dieta de adolescentes com HIV/Aids, pois eles estão em maior risco de desenvolver doenças cardiovasculares ou outras doenças crônicas. / INTRODUCTION: the introduction of the highly active antiretroviral therapy in the treatment of AIDS might be associated with the emergence of metabolic disturbances in patients with HIV/AIDS. Apart from the antiretroviral therapy, other factors, such as diet may contribute to the emergence of these disturbances in adolescents with HIV/Aids. Therefore, it is necessary to evaluate diet quality of individuals from this population. OBJECTIVE: to assess diet quality among adolescents with HIV/AIDS. METHODS: in a cross-sectional study nested in a cohort of patients with HIV/AIDS treated at the Infectious Disease Unity of the Instituto da Criança (ICr-São Paulo) 88 adolescents (10 to 19 years old) were assessed. Information on disease history and use of medication were obtained from medical records. Adolescents responded to two 24-hour recalls and one questionnaire on habitual physical activity. Weight, height and waist circumference were measured twice. Diet quality was assessed by means of the Healthy Eating Index-2005 (HEI-2005). The HEI-2005 is composed of 12 items and the final score ranges from 0 to 100 points. Pearson´s correlation coefficients between the HEI-2005 and the independent variables were calculated. HEI-2005 means were also compared according to the independent variables by means of Student´s t-test or Mann-Whitney test. RESULTS: The mean for the HEI-2005 was 51.90 points (SE=0.90 points). The components with the lowest means were whole grains and sodium. The components with highest means were total grains and oils. Adolescents living in foster homes had higher mean for total fruit and lower mean for meats and beans when compared to adolescents living with their families. Girls had higher mean for milk and dairy products and lower for calories from solid fats, alcoholic beverages, and added sugars when compared to boys. CONCLUSION: Adolescents with HIV/Aids showed an eating pattern similar to the adolescents from the general population: high consumption of added sugar, saturated fat and sodium and inadequate ingestion of whole grains and fruits. Special attention should be paid to the diet of adolescents with HIV/AIDS, because they are at higher risk of developing cardiovascular and other chronic diseases.

Despite widespread health promotion and nutrition education efforts, gaps between official healthy eating messages and people’s actual eating practices persist. There is increasing recognition that emphasizing individual responsibility for eating may have limited applicability in improving people’s health. Many experts advocate that future research on healthy eating should involve exploration of how food practices are shaped by social structures (or determinants) and individual agency. The purpose of this study was to explore the ways in which people engage with food structures to construct everyday notions of healthy eating. ‘Food structures’ draws on the concept of ‘structure,’ described by the social theorist Anthony Giddens, to refer to the range of food rules and resources people draw on. The research was conducted as part of a qualitative study on family food decision-making that included 144 participants from 13 African Nova Scotian, 10 European Nova Scotian, 12 Punjabi British Columbian and 11 European British Columbian families. These groups were chosen for their potential differences in perspectives based on place, ethnocultural background and histories of immigration to Canada. Data collection consisted of individual interviews with three or more family members aged 13 and older, and, with each family, observation of a grocery shopping trip and a family meal. Analysis followed common qualitative procedures including coding, memoing and thematic analysis. Together, the analyses support views that the gaps between official healthy eating messages and people’s eating practices may not be closed by further education about how to eat. Drawing on the theoretical concepts of Anthony Giddens and Michael Foucault, the findings suggest that one way to understand why people eat the way they do and how changes in eating habits occur is to think about the constant exposure to change through everyday, taken-for-granted practices. The findings also suggest that further healthy eating discourses may require more reflection with respect to the roles of nutrition educators and the social roles/autonomy of people in goals for health and well-being. Dietary goals for the population cannot be considered as isolated scientific objectives without taking into consideration how healthy eating discourses provide social standards beyond messages about healthy eating.

While it has been long known that the behaviour of others can influence individual behaviour, norms (the views and behaviours of others) are not generally reported as strong motivators of physical activity. Using the theory of normative social behaviour as a guiding framework, the purpose of this research was to examine if descriptive norms (the perceived prevalence of others behaviour) would be more important in predicting activity than previously suspected. A secondary purpose was to extend this examination to another health behaviour, healthy eating. Three independent studies were conducted. The first two studies examined what individuals thought motivated their physical activity (Study 1) and eating (Study 2) as well as the relationship between descriptive norms and participants own activity behaviour and healthy eating intentions. Results revealed that, despite being rated by participants as less motivating, descriptive norms were stronger predictors of activity behaviour and healthy eating intentions than other well-established non-normative reasons. It also was found that descriptive norm perceptions about a group proposed to be high in group identity (i.e., friends) was most related to physical activity behaviour and healthy eating intentions. To extend these results, a third study manipulated normative and non-normative messages to examine effects on physical activity. Participants were grouped into one of four conditions (descriptive norm, health, appearance, and control) and received motivation-based email messages specific to their condition encouraging them to be active. It was hypothesized that participants in the descriptive norm condition would experience the greatest increase in physical activity but results did not support this hypothesis, as participants across all conditions significantly increased total physical activity after receiving the messages. A secondary hypothesis examining the focal nature of the targeted behaviours was supported in that responses to normative messages were greatest with the most focal behaviour (using the stairs). Taken together, the results of the first two studies provide preliminary evidence to suggest that the relationships between both descriptive norms and physical activity and descriptive norms and healthy eating may be going undetected. In light of the results of the third study, however, future studies are needed.

While it has been long known that the behaviour of others can influence individual behaviour, norms (the views and behaviours of others) are not generally reported as strong motivators of physical activity. Using the theory of normative social behaviour as a guiding framework, the purpose of this research was to examine if descriptive norms (the perceived prevalence of others behaviour) would be more important in predicting activity than previously suspected. A secondary purpose was to extend this examination to another health behaviour, healthy eating. Three independent studies were conducted. The first two studies examined what individuals thought motivated their physical activity (Study 1) and eating (Study 2) as well as the relationship between descriptive norms and participants own activity behaviour and healthy eating intentions. Results revealed that, despite being rated by participants as less motivating, descriptive norms were stronger predictors of activity behaviour and healthy eating intentions than other well-established non-normative reasons. It also was found that descriptive norm perceptions about a group proposed to be high in group identity (i.e., friends) was most related to physical activity behaviour and healthy eating intentions. To extend these results, a third study manipulated normative and non-normative messages to examine effects on physical activity. Participants were grouped into one of four conditions (descriptive norm, health, appearance, and control) and received motivation-based email messages specific to their condition encouraging them to be active. It was hypothesized that participants in the descriptive norm condition would experience the greatest increase in physical activity but results did not support this hypothesis, as participants across all conditions significantly increased total physical activity after receiving the messages. A secondary hypothesis examining the focal nature of the targeted behaviours was supported in that responses to normative messages were greatest with the most focal behaviour (using the stairs). Taken together, the results of the first two studies provide preliminary evidence to suggest that the relationships between both descriptive norms and physical activity and descriptive norms and healthy eating may be going undetected. In light of the results of the third study, however, future studies are needed.

Despite widespread health promotion and nutrition education efforts, gaps between official healthy eating messages and people’s actual eating practices persist. There is increasing recognition that emphasizing individual responsibility for eating may have limited applicability in improving people’s health. Many experts advocate that future research on healthy eating should involve exploration of how food practices are shaped by social structures (or determinants) and individual agency. The purpose of this study was to explore the ways in which people engage with food structures to construct everyday notions of healthy eating. ‘Food structures’ draws on the concept of ‘structure,’ described by the social theorist Anthony Giddens, to refer to the range of food rules and resources people draw on. The research was conducted as part of a qualitative study on family food decision-making that included 144 participants from 13 African Nova Scotian, 10 European Nova Scotian, 12 Punjabi British Columbian and 11 European British Columbian families. These groups were chosen for their potential differences in perspectives based on place, ethnocultural background and histories of immigration to Canada. Data collection consisted of individual interviews with three or more family members aged 13 and older, and, with each family, observation of a grocery shopping trip and a family meal. Analysis followed common qualitative procedures including coding, memoing and thematic analysis. Together, the analyses support views that the gaps between official healthy eating messages and people’s eating practices may not be closed by further education about how to eat. Drawing on the theoretical concepts of Anthony Giddens and Michael Foucault, the findings suggest that one way to understand why people eat the way they do and how changes in eating habits occur is to think about the constant exposure to change through everyday, taken-for-granted practices. The findings also suggest that further healthy eating discourses may require more reflection with respect to the roles of nutrition educators and the social roles/autonomy of people in goals for health and well-being. Dietary goals for the population cannot be considered as isolated scientific objectives without taking into consideration how healthy eating discourses provide social standards beyond messages about healthy eating.

The prevention of chronic disease requires understanding and intervention related to both individual and environmental level determinants. However, traditional approaches to chronic disease prevention and management have primarily been focused at the individual level, with limited attention toward environmental level influences on health behaviour. This lack of comprehensiveness is partially due to a paucity of complex theoretical frameworks for clarifying the influences of personal cognitive, and broader environmental, variables on a range of health behaviours. Therefore, the purpose of this research was to expand and test a popular health behaviour theory, Social Cognitive Theory (SCT), to include influences of the perceived food environment on healthy eating behaviour. This study involved two phases. Phase 1 expanded SCT to include a perceived food environment construct through review of the food environment literature. Phase 2 conducted a cross-sectional study of 201 adults (age 35 to 69 years) using an online survey to test the expanded SCT informed by phase 1. Data analysis included descriptive statistics and structural equation modeling (SEM) to compare the traditional and expanded SCT model. Results demonstrated no significant model fit, with no improvement in oveall fit with the inclusion of the perceived food environment. However, the expansion of SCT to include perceived food environment attributes altered the pathways of influence within the social cognitive model, suggesting that the presence of perceived environment measures is important for understanding how perceived environments might mediate the effect of personal cognitive influences on eating behaviour. These findings have implications for food environment research, the development of ecological theories, the field of health promotion and the prevention of chronic disease.

Scant research on food advertising and purchase decisions has examined the moderating role of social constructs such as power. In this research, I investigate how consumers’ sense of power influences the persuasiveness of message assertiveness in food advertising. The agentic–communal framework of sense of power and findings suggests that high-power individuals are more likely to adopt and be receptive to strong, competent information and communication strategies than low-power individuals in interpersonal communication. In this research, I propose a new theoretical framework that predicts how message recipients’ sense of power enables or weakens the persuasiveness of the assertive message such as, “You must buy [the name of the advertised food].” More specifically, I looked at the likelihood of purchasing ‘vice’ versus ‘virtue' foods after viewing the ad. I argue that for high-power individuals, an assertive tone in the food ads would increase the purchase of a vice food and decrease the purchase intent of a virtue food. However, for low-power individuals, an assertive tone in the food ads would decrease the purchase of a vice food but increase the purchase intent of a virtue food. Low power is less congruent with assertive messages but more congruent with non-assertive messages. Across three studies, I provide empirical support for the predictions and the congruence mechanism. The results show that high-power consumers process assertive messages more fluently than non-assertive messages. Low-power consumers process assertive messages less fluently than non-assertive messages. Processing fluency increases the relative focus on tastiness in food evaluation, but process dis-fluency increases the relative focus on healthiness in food evaluation. The findings of this research have important implications for developing effective marketing communications and promoting healthy eating.