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Biomedical subjects

Kim M Gans

Publications and source records attributed to Kim M Gans.

7 recordsLinked to original sources
PubMed2005

Using qualitative and quantitative formative research to develop tailored nutrition intervention materials for a diverse low-income audience.

More effective nutrition education to reach low-income and ethnic minority populations is needed. As part of a project to develop a tailored nutrition education intervention to meet the needs of low-income Hispanics and non-Hispanics, complementary, mixed methods of formative research were used to determine specific characteristics of the target population. The aim was to ensure that the full array of nutrition messages would be comprehensive enough to effectively tailor to the level of the individual. Barriers to healthy eating were delineated for three main dietary behaviors (number of items delineated in parentheses): lowering fat (11), increasing fruit (8) and increasing vegetables (6). Information was also collected regarding motivators for healthy eating (5), situational barriers to making healthy choices (4), other nutrition-related interests (8) and typical eating habits and food-related choices of the target audience.

Feeding Behavior↗
PubMed2003

The development of SisterTalk: a cable TV-delivered weight control program for black women.

Overweight and obesity have reached epidemic proportions in the United States, with black women disproportionately affected. SisterTalk is a weight control program designed specifically for delivery to black women via cable TV. The theoretical and conceptual frameworks and formative research that guided the development and cultural tailoring of SisterTalk are described. Social Action Theory was applied in the development of SisterTalk along with a detailed behavioral analysis of the way that black women view weight and weight loss within the context of their cultural and social realities. The entire intervention development process was framed using this information, rather than by changing only superficial aspects of program delivery. Community networking and both qualitative and quantitative interview techniques from the fields of social marketing and cultural anthropology were used to involve black women from Boston in the design and implementation of a program that would be practical, appealing, and culturally sensitive. Also discussed are strategies for evaluating the program, and lessons learned that might have broader applicability are highlighted. The development of the SisterTalk program could provide a useful starting point for development of successful weight control programs for black women in other parts of the United States as well as for other ethnic and racial groups.

Black People↗
PubMed2003

Baseline fat-related dietary behaviors of white, Hispanic, and black participants in a cholesterol screening and education project in New England.

OBJECTIVE: To examine baseline fat-related dietary behaviors of white, Hispanic, and black participants in Minimal Contact Education for Cholesterol Change, a National Institutes for Health-funded cholesterol screening and education project conducted in New England. SUBJECTS: A sample of 9,803 participants who joined the study at baseline (n=7,817 white; n=1,425 Hispanic; and n=561 black). METHODS: Participants completed baseline questionnaires that included demographic and psychosocial items as well as the Food Habits Questionnaire, a dietary assessment tool measuring fat-related dietary behaviors. They also had their blood cholesterol level and height and weight measured. STATISTICAL ANALYSES: Analysis of variance (ANOVA) was used to compare racial/ethnic groups on continuous demographic variables, and the chi(2) test of association was used to compare groups on demographic categorical variables. Multivariate analysis of variance (MANOVA) was used to compare mean differences between racial/ethnic groups on six behavioral subscales (Fat Factors) differentiating domains of behavior related to fat intake and to compare 27 individual fat-related dietary behaviors. RESULTS: After adjusting for sex, age, marital status, education, employment status, and percent time lived in the United States, white participants had the lowest Food Habits Questionnaire summary score (2.44) (indicating a lower fat diet), followed by Hispanic (2.61) and black (2.68) participants. The three ethnic groups also differed on the prevalence of Fat Factors and specific fat-related dietary behaviors. White participants were more likely to use lower-fat alternatives, to avoid frying, to replace meat, and to modify meat to make it lower in fat. However, they were least likely to eat fruits and vegetables for snacks and desserts. Hispanic participants were more likely to engage in fat-avoidance behaviors and to eat fruits and vegetables for snacks and desserts. Black participants were less likely to eat meatless meals and modify meats to make them lower in fat. Black and Hispanic participants were more likely than white participants to fry foods. Hispanics were less likely to read food labels for nutrition information. The most and least prevalent fat-related behaviors also differed by each ethnic group, showing that different behaviors were more and less easily implemented by each ethnic group. CONCLUSIONS/APPLICATIONS: The results of this study suggest that there is a need for improvement in dietary behaviors related to fat intake, especially for blacks and Hispanics, and that the specific dietary behavior issues differ widely by ethnicity. These results can be used by nutrition educators and researchers to help them decide what messages to emphasize in dietary counseling, nutrition education programs, and materials. The results can also be used to help design better dietary assessment tools and more effective interventions for culturally diverse populations.

Black or African American↗
PubMed2003

REAP and WAVE: new tools to rapidly assess/discuss nutrition with patients.

Dietary changes can be helpful in preventing or treating a variety of prevalent health problems. Physicians can be helpful in helping patients make positive dietary changes, be physically active and lose weight, but, for a variety of reasons, many physicians do little nutrition counseling. There is a need for brief, user-friendly tools to enable physicians to rapidly and accurately assess patients' diets and exercise habits as well as provide information to aid the physician in delivering effective nutrition counseling. The purpose of this paper is to discuss two new tools, WAVE and REAP, that have been developed by the Nutrition Academic Award to help physicians and other health care providers conduct nutrition assessment and counseling with their patients in a practical and effective manner. The WAVE acronym and tool is designed to encourage provider/patient dialogue about the pros and cons of the patients' current status related to Weight, Activity, Variety and Excess. The Rapid Eating and Activity Assessment for Patients (REAP) is a brief validated questionnaire that is designed to aid providers in performing a brief assessment of diet and physical activity. An accompanying Physician Key aids the provider in discussing the patient's answers and counseling them appropriately. REAP and WAVE can be helpful tools to facilitate nutrition assessment and counseling in the provider office. Depending on patients' health priorities and how much time is available, these tools can be used in a variety of ways to discuss nutrition with patients during a clinical encounter in 1-9 min.

Adult↗
PubMedDate not supplied

Development and evaluation of the nutrition component of the Rapid Eating and Activity Assessment for Patients (REAP): a new tool for primary care providers.

OBJECTIVES: 1. To describe the development of a dietary assessment tool (Rapid Eating and Activity Assessment for Patients [REAP]) that quickly assesses a patient's diet and physical activity and facilitates brief counselling by a primary care provider, and 2. To describe the evaluation of the REAP in terms of its reliability, validity, and ease of use by primary care providers. DESIGN, SETTING AND PARTICIPANTS: The evaluation of REAP included: 1) an implementation feasibility study conducted with 61 medical students and practicing physicians in practice settings at various medical schools; 2) a calibration study with 44 Brown University Medical School students; 3) cognitive assessment testing with 31 consumers in Rhode Island; and 4) a reliability and calibration study of the revised tool with 94 consumers in Rhode Island and Massachusetts. RESULTS: The feasibility study revealed moderately high rankings on usefulness, ease, practicality, and helpfulness. The calibration studies demonstrated that REAP has excellent test-retest reliability (r = 0.86, P < .0001), is correlated with the Healthy Eating Index score (r = 0.49, P = .0007), and is significantly associated with intake of most nutrients studied. CONCLUSIONS AND IMPLICATIONS: REAP has adequate reliability and validity to be used in primary care practices for nutrition assessment and counselling, and is also user-friendly for providers.

Cognition↗
PubMedDate not supplied

Comparison of baseline fat-related eating behaviors of Puerto Rican, Dominican, Colombian, and Guatemalan participants who joined a cholesterol education project.

OBJECTIVE: The objective is to compare baseline fat-related eating behaviors among Hispanic subgroups who joined a cholesterol education research project in New England. DESIGN: Participants attended baseline screenings as part of the study. They had their height, weight, and blood cholesterol measured and completed baseline surveys with demographic, risk factor, dietary, and psychosocial questions. PARTICIPANTS: A total of 370 Puerto Rican, 210 Colombian, 357 Dominican, and 102 Guatemalan subjects participated in the baseline. MAIN OUTCOME MEASURES: Dietary behavior was measured using the Food Habits Questionnaire (FHQ), which was originally developed to assess food choices and preparation patterns related to adopting a low-fat diet. Measures include FHQ fat summary scores (a reflection of total fat intake), fat behavior subscales, and individual fat-related behaviors. ANALYSIS: Analysis of variance was used to compare FHQ fat summary scores and multivariate analysis of variance was used to compare fat behavior scores and individual food item scores for the 4 Hispanic subgroups. Age and gender were covariates in the models. RESULTS: Puerto Rican participants had a significantly higher mean FHQ fat summary score than Dominicans and Guatemalans and a higher prevalence of many fat-related eating behaviors. Although there were some differences by subgroup, the 4 most prevalent fat-related behaviors were similar: cooking with fat/oil, eating higher-fat sweets, eating higher-fat snacks, and eating dinners with meat. CONCLUSIONS AND IMPLICATIONS: Future educational programs and materials for diverse Hispanic audiences in the northeastern United States should include the above issues; however, educational materials and programs ought to be tailored to individuals whenever possible. Efforts may need to focus on Puerto Ricans, who had a higher prevalence of many fat-related behaviors in this study.

Adult↗