This research examines the effect of a nutrition education intervention to change attitudes and other factors associated with eating breakfast and consuming low-fat dairy and whole-grains. Adolescents (n = 106) 11 to 15 years old were recruited from afterschool programs in Los Angeles County, California. Participants in the treatment group (n = 57) met once weekly for 60 minutes during seven weeks. The curriculum focused on changing attitudes, subjective norms, and perceived behavioral control toward eating breakfast along with including low-fat dairy and whole grains. The first three lessons focused on basic nutrition concepts. The later lessons focused on identifying barriers and overcoming barriers, goal-setting, and identifying methods to stay motivated. Questionnaires were administered at baseline and post-intervention. Data were analyzed using SAS statistical analysis program (v. 9.2). Eighty-eight percent of participants were Hispanic, 55% were girls, and mean age was 12 years. One-hundred six adolescents completed the questionnaire at baseline and 75 completed it at post-intervention. Cronbach alpha statistic for subjective norms and attitudes toward eating breakfast, consuming low-fat dairy and whole-grains were 0.67 and higher for each dependant variable. Intention was significantly predicted by attitudes, subjective norms, and perceived behavioral control; however, as these models do not differentiate change, additional models were run with interactions between group (treatment versus control) and the change variables. Significant changes in perceived behavioral control were observed among participants in the treatment group regarding drinking skim milk, 1% milk, and 2% milk respectively (p < .05; p < .001; p < .001) and attitude (p < .05). No change was observed in breakfast eating or consumption of wholegrains

College students engage in poor dietary behaviors which put them at risk of weight gain and subsequent future health problems. This necessitates implementation of nutrition interventions which target dietary behaviors in college students so that healthy dietary patterns can be adopted and maintained through adulthood. Dairy intake is one of the many dietary behaviors which has declined substantially in young adults (18-30 years of age) - a period which includes the college age population. According to 2005 dietary guidelines for Americans three or more than three servings of low-fat/fat-free dairy foods is recommended for young adults, which is associated with overall nutrient quality of the diet and several health benefits. Still dairy consumption in this age group is below two serving per day. As emerging adults, college students may be more receptive to health advice than young adults older than traditional college years whose health habits are more established; nutrition intervention to improve dairy intake may be well received. Psycho-socio variables from Social Cognitive Theory (self regulation, social support, self-efficacy and outcome expectations) have been associated with adoption of healthy eating habits in college students and are associated with dairy consumption in adolescents. A series of studies were conducted to assess and improve dairy intake in college students by changing the mediating psycho social variables from Social Cognitive Theory (SCT) of behavior change including social support, self efficacy, outcome expectations and self regulation. A pilot web based nutrition education intervention was conducted to improve dairy intake in college students using SCT. The aim of this study was to evaluate the effect of the intervention on self efficacy, outcome expectations, self regulation, behavior and dairy product intake. Two hundred and ninety four students participated in the study and data on dairy intake and SCT variables were collected using 7 day food records and questionnaires. A 5 week electronic mail intervention was conducted. The intervention improved some social cognitive factors such as self regulation and self efficacy regarding increased dairy intake in college students, though dairy intake did not change. Next, to understand factors associated with dairy intake in college students, qualitative data were collected using focus group discussions (n=3), elicitation interviews (n=13) and online asynchronous discussion forums (n=3) using identical questions. Fifty students participated in the study and the aim was to identify relevant barriers, motivators and facilitators to dairy and low-fat dairy consumption. The results indicated that there was widespread lack of clarity regarding amount of dairy/calcium required and whether students felt they were getting enough. Major barriers to consuming dairy foods included short shelf life, storage issues, taste and accessibility to dairy foods on campus. Major facilitators included constant reminders, knowing immediate benefits, more accessibility and breakfast consumption. The aim of the final study was to improve social support, self efficacy, outcome expectations, self regulation and behavior related to dairy intake in college students using Social Cognitive Theory (SCT). One hundred and ninety one students participated in the study which included 8 week electronic mail intervention. Data collected included 7 day food records and for dairy intake and questionnaires for SCT variables. The intervention resulted in significant improvement in total dairy intake and use of self regulation strategies by college students. Taken together, these results suggest that theory-based nutrition education interventions can improve nutrition behavior in college students, a population prone to poor dietary habits. Developing mastery experiences to improve self efficacy may enhance self regulatory skills like goal setting, planning and monitoring to improve dairy intake in college students. Health care providers should aim at dietary behavior modification via theory based intervention. / Ph. D.

Cardiovascular disease (CVD) is a leading cause of mortality and morbidity in the United States. The prevalence of CVD will increase in conjunction with the rise in obesity and type 2 diabetes and decrease in physical activity, due to the adverse effects of adiposity and atherosclerosis associated with these syndromes. Excellent inpatient, outpatient, and community-based program s are available to educate and direct healthy behavioral changes, yet the number of programs available is not sufficient for the volume of patients, nor widely distributed in all areas (particularly rural areas). There is a lack of comprehensive education programs for adults directed toward decreasing CVD with an emphasis on food portioning skills; cooking skills; low-fat cooking techniques; increasing fruits , vegetables, and dairy products in the diet; and increasing exercise. The Cooperative Extension Healthy Beat education program and curriculum was developed and evaluated to improve the cardiovascular health of Utah residents. This curriculum focused on improving nutrition knowledge, food portioning skill, food preparation/cooking skills, regular exercise, lipid panel, anthropometric indices, and blood pressure. The program was distributed in CD format to 59 extension agents; identical CDs were used by instructors of live sessions for 43 participants in Sanpete, Washington, and Beaver counties. The CDs were also used by the instructor of a third group, consisting of 16 nutrition education assistants from the Expanded Food and Nutrition Education Program, who were also taught in a live session setting. The evaluation was done through measurement of nutrition knowledge, cooking skills, lipid panel biochemical indices, weight loss, blood pressure, and waist and hip circumferences. This study demonstrated that on completion of the heart healthy curriculum, those with CVD or those at risk for CVD appropriately altered their risk factors for a myocardial infarction (decrease in one or more of the following: serum total cholesterol, LDL cholesterol, blood pressure, weight, body mass index, and waist and hip circumferences).