Topical Research and Evaluation
Research Conducted for the Network
Banna JC, Vera Becerra LE, Kaiser LL, Townsend MS. Using qualitative methods to improve questionnaires for Spanish speakers: assessing face validity of a food behavior checklist. J Am Diet Assoc. 2010 Jan;110(1):80-90.
This article describes the steps that were taken to develop a Spanish language version of the Food Behavior Checklist (FBC) in preparation for validity testing. The FBC is an evaluation instrument developed for low income, low literacy populations receiving nutrition education. Steps included translation with back translation, photo modification, cognitive interviews, additional modification, and readability scoring. The research was funded by the Network. http://www.adajournal.org/article/S0002-8223(09)01678-2/abstract
The Economic Costs of Physical Inactivity, Obesity, and Overweight in California Adults: Heath Care, Workers’ Compensation, and Lost Productivity
This topline report, released by the California Department of Health Services, examines the link between physical inactivity, obesity, and overweight as it relates to heath care, workers’ compensation, and lost productivity. The findings highlight the rapid increase in costs related to physical inactivity, obesity, and overweight among California adults and identifies the potential for significant cost savings.
Does 5-a-day Pay? by Karen M. Jetter, James A. Chalfant and Daniel A. Sumner.
This Agricultural Issues Center brief (PDF) reports results from a larger study developed for DHS and the California Nutrition Network. The brief examines the potential gains to growers should California consumers adopt the 5-a-day recommendation for fruits and vegetables, the 7-a-day recommendation and the 7-a-day specific commodity subgroup recommendations for a cancer prevention diet.
Other California Research and Evaluation
Center for Advanced Studies in Nutrition and Social Marketing
Center for Advanced Studies in Nutrition and Social Marketing
The Center conducts research to increase the effectiveness of nutrition and physical activity social marketing campaigns; it’s work also includes training of and technical support for community practitioners and oversight of mini-grants related to social marketing. The Center maintains a library of survey instruments for measuring dietary, physical activity, and food insecurity behavior, environments, and related information. http://socialmarketing-nutrition.ucdavis.edu/tools/somarktools.php. Initially funded by the Cancer Research program, the Center is now an ongoing project, and its work has resulted in multiple scholarly publications on topics of interest to the Network for a Healthy California and its partners.
Cassady D, Mohan V. Doing well by doing good? A supermarket shuttle feasibility study. J Nutr Educ Behav. 2004 Mar-Apr;36(2):67-70.
An investigation whether supermarket-sponsored shuttles can be self-supporting or make a profit in low-income urban areas.
Cassady D, Housemann R, Dagher C. Measuring cues for healthy choices on restaurant menus: development and testing of a measurement instrument. Am J Health Promot. 2004 Jul-Aug;18(6):444-9.
The development and testing of the Menu Checklist, an instrument intended for use by community members to assess cues for healthy choices in restaurants
Bell RA, Berger CR, Cassady D, Townsend MS. Portrayals of food practices and exercise behavior in popular American films. J Nutr Educ Behav. 2005 Jan-Feb;37(1):27-32.
A content analysis of food, alcohol, and exercise and sport as portrayed in the 10 top-grossing films each year from 1991 to 2000
Cassady D, Townsend MS, Bell RA, Watnik M. Portrayals of branded soft drinks in popular American movies: a content analysis. Int J Behav Nutr Phys Act. 2006 Mar 9;3:4.
An examination of how product placement may relate to marketing branded soft drinks in the global market based on a content analysis of America's top-ten grossing films from 1991 through 2000 that included portrayals of beverages
Cassady D, Jetter KM, Culp J. Is price a barrier to eating more fruits and vegetables for low-income families? J Am Diet Assoc. 2007 Nov;107(11):1909-15. Epub 2007 Oct 18.
A comparison of the average cost of a market basket of fruits and vegetables from the Thrifty Food Plan and the Dietary Guidelines for Americans 2005, investigating variations in price by neighborhood income and by type of supermarket, and estimating the influence of a 2005 Dietary Guidelines fruit and vegetable basket on the food budget of a low-income family.
Cancer Research Program
Project Oversight of Cancer Research Program (CRP) Projects: In addition to providing the seed money for the Center for Advanced Studies in Nutrition and Social Marketing, the California Department of Health Services’ Cancer Research Program funded a number of Diet and Behavior Change Studies:
--All studies were monitored by CPNS unless otherwise specified.
Herman DR, Harrison GG, Afifi AA, Jenks E. Effect of a targeted subsidy on intake of fruits and vegetables among low-income women in the Special Supplemental Nutrition Program for Women, Infants, and Children (Not monitored by CPNS). Am J Public Health. 2008 Jan;98(1):98-105. Epub 2007 Nov 29.
Researchers investigated if providing WIC clients a financial incentive in the form of a voucher for fruit and vegetable purchase at farmers’ market or supermarkets for a six-month period would result in increased produce consumption. Participants were followed for an additional six months after the voucher distribution ended. From baseline to the end of the six months, supermarket participants were consuming 0.8 more servings/day of fruit and vegetables per 1000 kcal, and farmers’ market participants were consuming 1.4 more servings/day. Increased consumption was sustained after six months, and consumption was significantly higher than that of women in a control group. The findings suggest that changes implemented to the WIC food package to add fruits and vegetables will have a positive effect on consumption among this population.
CDPS Dietary Instrument Validation
Validation of the CDPS fruit and vegetable module by comparing the limited 24-hour recall CDPS telephone-administered survey instrument to a face to face full 24-hour recall interview with food models used as a gold standard (comparison methodology is utilized in the National Nutrition Monitoring System). Completed
California Fruit and Vegetable Intake Calibration Study
Examination of ethnic/racial differences, gender differences, income differences and seasonal differences in fruit and vegetable consumption, as well as calibration of a less expensive, short form version of the fruit and vegetable module against the full fruit and vegetable module used in the CDPS. The study found no major month-to-month seasonality effects evident in the CDPS for total fruit and vegetable consumption or for either alone for adult Californians as a whole, for white adults or for Latino adults, in particular high-acculturation adults. Results are inconclusive for low-acculturation Latino adults. The African-American seasonality variation identified was mostly attributed to the month of December with its large and significant intakes of servings of total fruits and vegetables and of vegetables alone. However, this variation would not affect interpretation of CDPS data as it is not collected during December. Completed.
Cancer Prevention for African Americans in Los Angeles
Jetter KM, Cassady DL. The availability and cost of healthier food alternatives (PDF). Am J Prev Med. 2006 Jan;30(1):38-44.
Investigation of healthy food availability in a low-income, African-American neighborhood in Los Angeles; Goal is was to increase availability of lowfat foods, fruits, and vegetables in grocery stores and restaurants using a community advocacy strategy and identify feasible, cost-effective community level indicators as proxies for consumption change. Pilot is completed; funded to expand project.
Findings from this study demonstrated that in low-income neighborhoods, a "healthier" food basket was more expensive than the standard and targeted healthier foods were less available.
Examination of Communication Factors Affecting Policymakers
McDermott RJ, Berends V, McCormack Brown KR, Agron P, Black KM, Pitt Barnes S. Impact of the California Project LEAN school board member social marketing campaign (PDF) . Social Marketing Quarterly. XI (2):18-40, Summer 2005.
Examination of communication factors affecting policy makers in the school system; goal is was to determine of how policy makers should be educated about school district policies that support healthy eating for low-income teens. (Pilot and full award; Monitored by CRP and CPNS) The case study publication describes the extensive formative research and subsequent extensive social marketing campaign among school board members Completed.
Online Nutrition and Screening
Piloted an online nutrition assessment and screening tool. The long-range goal of this project provided simple, inexpensive methods for universal nutrition screening and counseling to individuals through insurers, worksites, schools and similar locations. The primary project outcome was a 12-week behavior-change program, delivered via email, to promote increased fruit and vegetable and reduced fat intake. Analyses of the worksite pilot results indicated substantial success. After twelve weeks, participants reported significant improvements in their food choices. Fifty-one percent reported eating more fruit, 47% reported eating more vegetables, 36% reported eating more salad, 47% indicated eating fewer hotdogs, and 51% reported eating fewer doughnuts by the end of the program. Completed.
The next step of this project was the applying the methodology to a low-income audience and developing the Little by Little CD-ROM. A randomized trial was designed to evaluate the effectiveness of the one-time interactive experience of the Little by Little CD-ROM to increase fruit and vegetable intake among low-income women.
Block G, Wakimoto P, Metz D, Fujii ML, Feldman N, Mandel R, et al. A randomized trial of the Little by Little CD-ROM: demonstrated effectiveness in increasing fruit and vegetable intake in a low-income population (PDF). Prev Chronic Dis [serial online] 2004 Jul [date cited].
Restaurant Nutrition Program: Implementation and Evaluation: TREAT Yourself Well
Conduction of a social marketing campaign to increase low-fat food and fruit and vegetable consumption in restaurants; goals were to raise awareness and improve consumer attitudes to healthy menu items. Results showed significant improvements in consumers’ awareness, beliefs and positive attitudes towards ordering the healthier menu selections during the course of the TREAT Yourself Well campaign. The sales data also demonstrated that consumers’ ordering behavior can be modified by implementing different promotions; for example, the waitstaff incentive programs increased monthly sales of the targeted items as much as eightfold in one chain. Overall, the most cost-effective interventions were the waitstaff promotions, the restaurants’ customer database mailings, gift certificates to health professionals, and the brochures. Completed.
Nutrition Education Among Low-income Vietnamese Americans in California (Not monitored by CPNS)
Conduction of formative research on cancer risk factor knowledge, attitudes and behavior among low-income Vietnamese Americans in California; including development and testing of culturally-sensitive healthy diet and cancer risk factor reduction curriculum and training bilingual, bicultural community educators (Monitored by CRP). The five-lesson curriculum covers the topics of exercise, dietary recommendations and traditional foods, reducing dietary fat, fruits and vegetables, and alcohol and tobacco. Completed.
What Will I Fix to Eat: Exploring Meal Planning and Food Choices
Identification of sociological factors contributing to food choice processes of low-income California Latinas, including meal planning, factors contributing to an observed decline in fruit/vegetable consumption, and influencers of food shopping behavior. In-depth interviews were conducted with 30 Latinas in the greater Los Angeles area. Eight women were observed over a six-month period to explore in-store factors that influence shopping. Findings indicate that the participants perceived themselves as nurturers and protectors of the family. Food, food beliefs, meal planning, and meal preparation were dictated largely by what their children and spouses preferred. These preferences, however, were tempered by the money that was available for food, the participants' desire to provide nutritious meals for their families, and their repertoire (meals that they already knew how to prepare). Results also show that although the participants knew about the need to eat 5 A Day, they believed that the recommendation did not apply to them, but instead applied to younger people, older people, or some special group of people (those on diets, athletes). Despite this perception, the participants attributed health benefits to the consumption of fruits and vegetables, especially illness prevention.