Walking into the “Developing Healthy Eating and Physical Activity Behaviors through Education, Extension or Technology” session sponsored by the ASN Nutrition Education and Behavioral Sciences RIS, you could feel the energy in the room as everyone waited in anticipation for the oral sessions to begin.
The session began with a presentation by Gabriella McLoughlin, University of Illinois at Urbana Champaign, on “School Lunch and Physical Activity During Recess: Interactive Effects of Health Behaviors in the School Setting.” Her presentation focused on how the timing of lunch affects food intake during lunch and physical activity during recess for 4th– and 5th-grade students. Her study found that students who ate lunch before recess were more physically active during recess and consumed more vegetables. Further, engaging in moderate-to-vigorous physical activity was inversely associated with lower intakes of carbohydrate, fat, sugar, and overall calories. However, students who ate lunch after recess ate more and had greater intakes of carbohydrate and fat.
Laura Adam, University of Alberta, followed with her presentation on “Sense of Weight Control Prior to Pregnancy Could Help Predict Women at Risk for Excessive Gestational Weight Gain.” Her analysis sought to understand if differing amounts of lifestyle support provided by a Registered Dietitian (RD) during pregnancy could help women achieve appropriate gestational weight gain. Participants were randomized into the control or intervention group. The intervention group received two visits from an RD during pregnancy, while the control group did not. No difference was found for total gestational weight gain, rate of weight gain, and adherence to the gestational weight guidelines between the groups. However, she found that more women with BMIs in the obese and overweight category exceeded the recommended gestational weight gain, as compared to women with a normal BMI. Further, women who felt more in control of their weight before pregnancy were more likely to adhere to the gestational weight gain guidelines.
James Roemmich, Grand Forks Human Nutrition Research Center, next shared a unique perspective for how to motivate people to be active during his talk on “Increasing Discomfort Tolerance Predicts Incentive Sensitization of Exercise Reinforcement: Preliminary Results from a Randomized Controlled Intervention to Increase the Reinforcing Value of Exercise in Adults.” His work uses the Incentive Sensitization Theory, which is usually used to describe how people become addicted to drugs. This theory postulates that neuroadaptations in the brain increase craving of a behavior causing the object to become more motivating, so the individual wants to consume the stimulus. Roemmich applies this theory to physical activity to determine if tolerance for exercise discomfort is related to relative reinforcing value of exercise. He conducted a 3-arm, randomized, controlled trial over the course of 6 weeks with two exercise arms (expending 150 or 300 kcals during cardio-type exercise 3 days/wk) and a control group. He found that those who exercised more intensely increased their tolerance to exercise and those with more tolerance had greater relative reinforcing value of exercise. He recommends the focus be on guidelines to increase motivation for exercise, so it becomes a habit.
Jacqueline Vernarelli, Fairfield University, explored the relationship between energy density and enjoyment of physical activity for her presentation on “Early development of healthy habits: Children who enjoy physical activity have healthier diets than children who do not.” She used data from NHANES: 2012 National Youth Fitness Survey (NYFS) with a sample of 1,640 children between 3-15 years old. Children were asked if they liked recess using a 5-point likert scale. She found that children who strongly liked recess had lower energy dense diets. Vernarelli recommends focusing on future strategies to examine ways to increase enjoyment of physical activity to encourage children and adolescents to be active.
Sofia Segura-Pérez, Hispanic Health Council, examined a novel way to reach a Latino audience during her talk on “Development and Validation of a Culturally Appropriate Heart Disease Prevention Fotonovela among Spanish Speaking Low-income Latinos.” She employed Community Based Participatory Research to develop a fotonovela (a form of sequential storytelling that uses photographs in the form of photo comics) about heart disease prevention. Through a series of focus groups, she identified common barriers to eating healthy, exercising, and smoking cessation and was able to create messages to encourage healthier behaviors. After her final focus group, she found participants increased knowledge following reading the fotonovela and wanted to be more active, eat better, and stop smoking. Her research shows that fotonovelas are culturally and literacy appropriate educational instruments to use for Latinos.
Sarah Stotz, University of Georgia, took the podium next to share how she developed an eLearning nutrition program to encourage Supplemental Nutrition Assistance Program Education (SNAP-Ed) eligible participants to make healthier choices during her talk on “Expectations and Recommendations from Low-Income Adults Regarding an eLearning Nutrition Education Program Prior to Program Use.” With increased access to the Internet, online learning can be used to address the barrier to attending nutrition education sessions in-person. Further, online learning is self-directed, which capitalizes on adult learning principles. Stotz developed the Food eTalk eLearning Program, which was adapted from the validated nutrition education program, Food Talk. To gauge how her intended audience would respond to the program, she conducted a focus group series (n = 45) and individual interviews (n = 19) to see what participants wanted in an online education program. She uncovered three common themes: 1) Participants used their phones a lot; 2) Participants had low expectations for an online program; and 3) Even though they were unprompted, participants wanted to share that they know they should eat healthier, but “it’s just hard.” Based on this information, Stotz learned to make the eLearning program mobile-friendly, create short learning modules (~10 minutes), identify specific learning topics, and make the lessons entertaining and video-based.
Sharon Kirkpatrick, University of Waterloo, discussed her findings from using a web-based dietary assessment tool during her presentation on “Evaluation of the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24) for use with children: An observational feeding study.” ASA24 is an online, self-administered dietary recall tool that follows a format based on the Automated Multiple-Pass Method used in the National Health and Nutrition Examination Survey (NHANES). Dietary assessment, particularly among children, is a challenge since it’s subjected to many biases. Kirkpatrick conducted a study to determine how precise ASA24 was with children in 5th-8th grade. She provided each child with lunch that was weighed before and after consumption. The next day, the children were given time to complete ASA24 during class independently. She found most children reported the main lunch item well, but recall was lower for side dishes and the lowest for condiments, such as dip. Kirkpatrick also found that the younger children had more difficulty completing ASA24. Overall, she found that ASA24 performed relatively well, but younger children need more time and help to complete the recall. She suggests accompanying ASA24 and similar technologies with a training, tailored help, and/or supplementary sources of information, such as including menus.
The session concluded with a presentation by Soghra Jarvandi, University of Tennessee Extension, on “Goal Setting, Past Performance and Behavioral Outcomes in a Worksite Wellness Program.” Jarvandi used the Walk Across Tennessee program, a team-based walking program, as a platform for using goal setting as a strategy for facilitating behavior change. Before the study, participants completed the International Physical Activity Questionnaire – short form (IPAQ-short) to assess their initial physical activity level. Participants also self-selected a walking goal and during the study received weekly feedback through a visual graph depicting how much they walked compared to their initial goal. Jarvandi used the IPAQ-short questionnaire to divide the participants into high activity (compliers) and low activity (non-compliers) to see if they had differences in their activity and goal setting during the study. After the study concluded, she found no difference between compliers and non-compliers in terms of their activity habits and goal setting. However, she suggests participants with low levels of physical activity may benefit from behavioral strategies that improve motivation.