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Biomedical subjects

Christine M Olson

Publications and source records attributed to Christine M Olson.

11 recordsLinked to original sources

Obesity in low-income rural women: qualitative insights about physical activity and eating patterns.

Body weight is inversely related to socioeconomic status (SES) in women in the United States (U.S.). Reasons for the social differential in weight are poorly understood. This investigation sought to understand overweight and obesity from the perspective of low-income mothers living in rural New York State, focusing in particular on challenges to maintaining a healthy weight that may be unique to rural poverty. In-depth interviews with 28 women, who were interviewed 3 times over a 3-year period, were audiotaped, transcribed, and analyzed using the constant comparative method. Findings suggest that transportation difficulties confined some women to their homes, which were physical settings offering little opportunity for physical activity. Food insecurity and associated fluctuating household food supplies contributed to disordered eating patterns and to perceptions of dietary deprivation that affected food intake. Rural isolation contributed to negative emotional states that some women alleviated by eating. This research elucidates factors contributing to obesity among rural, economically disadvantaged women, highlighting the interplay between the structural constraints imposed by rural poverty and women's physical activity, eating patterns, body image, and weight. These insights further the understanding of social inequalities in health and could inform the design of future research aimed at improving the health status of low-income women and families.

Adult↗

Parity and body weight in the United States: differences by race and size of place of residence.

OBJECTIVE: In women, parity has been studied in relation to body weights. This study examined whether and how relationships between parity and body weight differ by race and size of place of residence, adjusting for sociodemographic factors (age, income, education, working status, and marital status) and health behaviors (alcohol consumption, birth control pills, diet, physical activity, and smoking). RESEARCH METHODS AND PROCEDURES: A U.S. national sample of 3398 white and black women from the Third National Health and Nutrition Examination Survey was used to study the relationships using multiple linear regression analysis. RESULTS: The parity-weight relationships varied by race and size of place of residence. After adjusting for the covariates, significant relationships between parity and body weight were found only in black women in metropolitan areas and white women in non-metropolitan areas. Compared with women with no children, white women with two children living in non-metropolitan areas tended to have lower BMIs, whereas black women in metropolitan areas with one or two children showed higher BMIs. DISCUSSION: Overall, the parity-weight relationships in these groups of women were not strong or linear. The parity-weight relationships of black women in non-metropolitan areas warrant further examination.

Adult↗

Meanings of targeting from program workers.

Program workers have a critical role in targeting in nutrition programs, but little has been studied about the concept and the operation of targeting from their perspectives. This paper introduces and compares meanings of targeting from the perspectives of program workers in food assistance programs in the United States. There exist some variations in perceptions of targeting and actual operational procedures adopted by program workers at the local and federal levels. Regardless, program workers' perspectives on targeting suggest a new framework of targeting, which consists of key components (program access, service, and evaluation) and issues in need of careful attention in targeting nutrition programs. The success of targeting depends on how well these components and related issues can be translated into targeting policy, rules, and procedures. With increased devolution to the state and local levels in the United States, it is even more critical for federal policy makers and administrators to understand how frontline program workers perceive and implement targeting. The new framework based on the perspectives of program workers may contribute to developing a conceptual definition as well as practical guidance for targeting that can be used to formulate better ways of targeting in nutrition programs.

Aged↗

Understanding targeting from the perspective of program providers in the elderly nutrition program.

Providers' perspectives on need, strategies, and challenges are critical in targeting of programs. This study was undertaken to understand the meanings and challenges of targeting from the perspectives of program providers in the Elderly Nutrition Program (ENP). Qualitative in-depth interviews were done with a sample of 36 local ENP providers from six counties in upstate New York. Each interview was tape-recorded, transcribed, and analyzed. Qualitative analysis revealed four distinct meanings of targeting including maximum outreach, reaching out to the most needy, serving only the most needy, and evaluating coverage. Regardless of the meaning or type of targeting, local providers reported universal challenges for outreach, need assessment, and resources in implementing targeting. Understanding these different meanings about targeting could contribute to crafting better targeting policies and program procedures to deliver adequate nutrition service to elders in need in the community.

Adult↗

Conceptualizing and assessing nutrition needs: perspectives of local program providers.

This study aimed to understand how local Older American Acts Nutrition Program (OAANP) providers perceive and assess client need for the OAANP. Qualitative in-depth interviews were done with a sample of 36 local OAANP providers in upstate New York. Providers' perceptions of needs for the OAANP were determined by comprehensive understanding of the extent to which an elderly person has problems eating properly to maintain good nutritional and health status. Need was determined by various aging and environmental factors including food insecurity of the elderly, rather than by a single characteristic of problems of elders. Efforts to better understand and meet the needs of elders will enable nutrition programs to respond to heterogeneous needs in ever increasing older population.

Adult↗

Efficacy of an intervention to prevent excessive gestational weight gain.

OBJECTIVE: This study was undertaken to evaluate the efficacy of an intervention directed at preventing excessive gestational weight gain. STUDY DESIGN: Healthy pregnant women with normal and overweight early pregnancy body mass index were monitored from early pregnancy until 1-year postpartum. One hundred seventy-nine women in the intervention group had their gestational weight gains monitored by health care providers and also received by-mail patient education. Three hundred eighty-one women formed an historical control group. The proportions in each group gaining more weight in pregnancy than is recommended and retaining more than 2.27 kg at 1-year postpartum were compared using logistic regression analysis. RESULTS: Low-income women who received the intervention had a significantly reduced risk of excessive gestational weight gain (odds ratio [OR]=0.41, 95% CI=0.20-0.81). Overweight women within this income subgroup were at significantly reduced risk of retaining more than 2.27 kg (OR=0.24, 95% CI=0.07-0.89). CONCLUSION: The intervention appeared to reduce the risk of excessive gestational weight gain only in the low-income subgroup.

Adolescent↗

Modifiable behavioral factors in a biopsychosocial model predict inadequate and excessive gestational weight gain.

OBJECTIVE: The research addresses two questions: Are potentially modifiable psychosocial and behavioral factors related to gestational weight gain? Do the same factors relate to both excessive and insufficient weight gain? DESIGN: Prospective cohort study that followed women from early pregnancy until two years postpartum. Data were collected through mailed questionnaires and an audit of the medical record. Subjects/setting The sample included 622 healthy adult women who gave birth to live singleton infants. Subjects were recruited from all women who registered for prenatal care in a hospital and primary care clinic system serving a 10-county area of Upstate New York. Statistical analyses performed Multiple linear and logistic regression with adjustment for timing of measurements and length of gestation were performed. RESULTS: Only 38% of women gained an amount of weight in pregnancy that was within the range recommended by the Institute of Medicine. Valid and easily implemented measures of change in food intake and physical activity from prepregnancy and cigarette smoking during pregnancy were each significantly (P<.05) and independently related to gestational weight gain. Along with other variables in a biopsychosocial regression model, these variables accounted for 27% of the variance in gestational weight gain and were also significantly related to risk of inadequate and excessive gain. APPLICATIONS/CONCLUSIONS: The findings facilitate the design of more effective nutrition interventions to promote appropriate gestational weight gain and the long-term health of women and their infants.

Adaptation, Psychological↗

Position of the American Dietetic Association: domestic food and nutrition security.

In 2000, over 10% of United States (US) households, including more than 33 million people, experienced food insecurity. Food insecurity negatively affects the dietary intake and nutritional status of adults leading to poor health and increased risk for the development of chronic diseases. Food insecurity also negatively affects children's health, psychological and cognitive functioning, and their academic achievement. It is the position of the American Dietetic Association that systematic and sustained action is needed to bring an end to domestic food insecurity and hunger and to achieve food and nutrition security for all in the US. Immediate and long-range interventions, including adequate funding for and increased utilization of food and nutrition assistance programs, the inclusion of food and nutrition education in all programs providing food and nutrition assistance, and innovative programs to promote and support the economic self-sufficiency of individuals and families, are key to ending domestic food insecurity. Dietetics professionals can play a key role in ending food insecurity not only through competent and collaborative practice, but also through advocacy efforts at the local, state, regional, and national levels.

Dietetics↗

Family food insufficiency, but not low family income, is positively associated with dysthymia and suicide symptoms in adolescents.

Food insufficiency has been shown to be associated with poor health, academic and psychosocial outcomes in American children, but the relationship between food insufficiency and depressive disorders in U.S. adolescents has not been studied. Further, there are no national estimates of the prevalence of depressive disorders for U.S. adolescents, nor investigation of associations with sociodemographic characteristics using national data. Therefore, we analyzed data for 15- and 16-y-old adolescents from the Third National Health and Nutrition Examination Survey (NHANES III). Depressive disorders and suicidal symptoms were assessed using the Diagnostic Interview Schedule. Adolescents were classified as "food insufficient" if a family respondent reported that the family sometimes or often did not have enough to eat. The prevalence of depression outcomes is reported by sociodemographic characteristics. Odds ratios for associations with food insufficiency are reported, adjusted for sociodemographic factors. Overall, lifetime prevalence of major depressive disorder was 6.3% and of dysthymia, 5.4%. Almost 5% of 15- to 16-y-old adolescents reported that they had ever attempted suicide and 38.8% reported at least one suicidal symptom. Female adolescents were significantly more likely than males to have had dysthymia, any depressive disorder and all symptoms of suicide. Low income adolescents were less likely to report suicide ideation than high income adolescents, but there were no other differences by family income. Food-insufficient adolescents were significantly more likely to have had dysthymia, thoughts of death, a desire to die and have attempted suicide. There is a strong association between food insufficiency and depressive disorder and suicidal symptoms in U.S. adolescents.

Adolescent↗

Perspectives of volunteers in emergency feeding programs on hunger, its causes, and solutions.

OBJECTIVE: To understand the social beliefs of volunteers in emergency feeding programs (EFPs) regarding hunger and whether volunteer experiences broadened understanding of hunger. DESIGN: An interpretivist paradigm and qualitative methods were used. SUBJECTS: Seventeen volunteers were recruited and interviewed from three EFPs. ANALYSIS: Interviews were analyzed using the constant comparative method. RESULTS: Volunteering in EFPs increased volunteers' awareness of the prevalence of hunger in their communities. More involved volunteers had a greater understanding of the life situations of the hungry. The volunteers felt that increasing self-sufficiency and private responses were appropriate solutions to hunger. The volunteers' attitudes and social beliefs were similar to those of the general public. IMPLICATIONS: Interventions that facilitate interaction between volunteers and clients, promote reflection on volunteer experiences, and provide alternative viewpoints on poverty are needed to broaden volunteers' understanding of hunger and food insecurity.

Aged↗

Tracking of food choices across the transition to motherhood.

OBJECTIVE: This research addresses 2 questions: What are the patterns in selected food choice behaviors across the transition to motherhood? and Do the patterns vary by mothers' social location, particularly parity, family income, and breast-feeding behavior? DESIGN: A prospective cohort study with healthy, adult women followed from midpregnancy until 2 years postpartum. Data were collected through mailed questionnaires for prepregnancy and pregnancy, at 6 months, at 1 and 2 years postpartum, and through an audit of the women's medical records. SETTING: A hospital and primary care clinic system serving a 10-county area of rural upstate New York. PARTICIPANTS: 360 women of the 622 in the cohort provided data for all time points. VARIABLES MEASURED: Three food choice behaviors served as categorical dependent variables at each of the 5 time points: drinking > or = 2 cups of milk per day, consuming > or = 3 servings of fruits and vegetables per day, and eating breakfast every day. Three social location variables were used as independent variables for the second research question: parity (nulliparous vs primi- and multiparous), family income (low [< or = 185% of federal poverty level] vs higher), and breast-feeding (> or = 1 year vs less). ANALYSIS: McNemar's test was used to compare proportions of women at or above the cutoff value for each food choice behavior across time, and the Fisher exact test was used to compare proportions between groups for each social location variable at each time point. P < or = .05 was considered significant. RESULTS: The proportion of women drinking 2 or more cups of milk per day at 2 years postpartum was not different from prepregnancy, but the proportions consuming 3 or more fruits and vegetables and eating breakfast every day were significantly higher at 2 years postpartum than prior to pregnancy. The pattern of change varied by categories within the social location variables and differed by food choice behavior. CONCLUSIONS AND IMPLICATIONS: The transition to motherhood was associated with a positive change in some food choice behaviors. Women making this transition for the first time showed the most consistent positive changes and should be a target audience for nutrition education.

Adult↗