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Biomedical subjects

Marilyn S Townsend

Publications and source records attributed to Marilyn S Townsend.

15 recordsLinked to original sources
PubMed2005

Low mineral intake is associated with high systolic blood pressure in the Third and Fourth National Health and Nutrition Examination Surveys: could we all be right?

Analysis of the first National Health and Nutrition Examination Survey (NHANES) in 1984 revealed that a dietary pattern low in mineral intake, specifically calcium, potassium, and magnesium, was associated with hypertension in American adults. Using more recent survey data from NHANES III and NHANES IV, we re-examined the validity of this relationship. Blood pressure (BP) and nutrient intake data from 10,033 adult participants in NHANES III and 2311 adults in NHANES IV revealed findings similar to those of the earlier analysis, demonstrating that the association between inadequate mineral consumption and higher BP is valid and has persisted over two decades. Exploring this relationship further, we separated untreated hypertensive persons by hypertension type (systolic, diastolic, or both), and observed that the BP effect of low mineral intake was most pronounced in those with only systolic hypertension. We also observed that sodium intake was significantly lower in the systolic hypertension group and significantly higher in the diastolic hypertension group compared with the other groups. The nutrient pattern in the combined hypertension group was similar to that of the normotensive group. These findings may help to explain the inconsistent responses generally observed in dietary intervention studies, and they highlight the possible importance of tailored nutritional recommendations for hypertension based on hypertension category and individual dietary practices. Although randomized controlled trials are needed to characterize further the relationship between nutrient intake and hypertension type, these findings indicate that dietary management of hypertension may be more effective if the focus is on the overall nutritional profile rather than single-nutrient intake as currently recommended for most patients.

Adult↗
PubMed2004

Choice of instrument influences relations between food insecurity and obesity in Latino women.

BACKGROUND: The results of studies examining food insecurity and obesity in adults are conflicting. Discrepancies could be due to the use of different instruments or to cultural factors that influence response patterns. OBJECTIVE: The goal was to examine the relation of food insecurity to weight status in low-income Latino women. DESIGN: A cross-sectional survey was conducted among 559 low-income Latino women selected by convenience sampling. The survey included the 18-item US Household Food Security Scale, 2 items related to current and past food insufficiency, demographic information, and measured heights and weights. Data were collected between February and May 2001 in 6 California counties. The main outcomes were frequency of overweight and obesity, defined by a body mass index (in kg/m(2)) of 25-29.9 (overweight) and >30 (obese). Data analysis included analysis of variance, Mantel-Haenszel chi-square test, and logistic regression. RESULTS: The prevalence of food insecurity was 50-60%, and that of obesity was 37.4%. Controlling for years spent in the United States, per capita income, and parity, food insecurity with hunger, measured by the 10-item adult scale of the Food Security Scale, was significantly related to obesity (OR: 1.98; 95% CI: 1.14, 3.53). No interaction between years spent in the United States and current food insecurity was observed. Current food insufficiency, as measured by a single item, was not related to obesity. However, severe past food insufficiency was related to obesity in the US-born population only. CONCLUSION: Food insecurity appears to be related to obesity in Latino women, but choice of instruments might influence the results.

Adult↗
PubMedDate not supplied

Evaluating food stamp nutrition education: process for development and validation of evaluation measures.

The purpose of this paper is to describe a process for developing and validating outcome measures relevant to dietary quality behaviors targeted by Food Stamp Nutrition Education (FSNE). The ultimate goal is a measure that is valid, reliable, sensitive to change, and practical for use for a wide variety of FSNE evaluation purposes. The development process has incorporated input from FSNE stakeholders at the federal and state level and follows a systematic, research-driven approach that incorporates both qualitative and quantitative research and includes methods for identification of subject domains, selection of evaluation items, initial pretesting, and reduction of items. This type of research establishes the trustworthiness of new evaluation measures.

Community Health Services↗
PubMedDate not supplied

Evaluation of a USDA nutrition education program for low-income youth.

OBJECTIVE: Examine effectiveness of a state's Youth Expanded Food and Nutrition Education Program (EFNEP) and assess the validity of the federal impact indicator method for reporting program outcomes. DESIGN: A randomized, controlled field trial of 229 groups with 5,111 youth, 9-12 years old, in community settings. INTERVENTION: 6- to 8- hour, 7-lesson education experience with food preparation and tasting, an education experience typical of EFNEP in California. OUTCOME MEASURES: US Department of Agriculture (USDA) impact indicators: nutrition knowledge, eating a variety of foods, food selection, and food preparation and safety practices. ANALYSIS: Analysis of covariance model controlling for pretest, gender, age, and ethnicity, with group nested in condition. RESULTS: Organizing responses by impact indicators, treatment participants made significant gains on the posttest compared to controls for 3 of 4 indicators (P < .008 to P < .0001). Gains were made by 34 to 68% of youth participants for 4 indicators. The impact indicator method for federal reporting compared favorably with results from a randomized controlled trial with groups nested in conditions. CONCLUSION AND IMPLICATIONS: This is the first report in the literature of (1) a large evaluation study of Youth EFNEP and (2) an estimate of the validity of the USDA impact indicator method for reporting program outcomes.

Age Distribution↗
PubMedDate not supplied

Development of a tool to assess past food insecurity of immigrant latino mothers.

OBJECTIVE: The purpose is to describe the development and validation of a tool to measure the degree of past food insecurity in an immigrant US population. DESIGN: Focus group discussions and a structured interview. As a first step, focus group discussions were conducted among immigrant Latino mothers. Based on these discussions, an 8-item tool was developed and pilot-tested in a convenience sample of mothers. SETTING: California. PARTICIPANTS: Twenty-two low-income Latino mothers with children, ages 4 to 5 years, in the focus groups and 85 low-income Latino and white mothers of young children in the structured interviews. ANALYSES: Constant comparative analysis, Cronbach alpha, Spearman correlations, Chi-square, and Kruskal-Wallis test. RESULTS: Internal consistency of the remaining 7 items was good (Cronbach alpha = 0.84). Evidence of convergent validity included significant correlations between past food insecurity and maternal education (r = -0.45, p < .0001), crowding in the mother's childhood household (r = +0.30, p < .006), and past food insufficiency (r = +0.74, p < .0001). Foreign-born Latino mothers reported significantly greater levels of past food insecurity than US-born mothers, demonstrating discriminant validity (p < .01). CONCLUSIONS AND IMPLICATIONS: This tool may be useful to determine how past deprivation influences current food choices and other nutrition-related behaviors in low-income Latino immigrants.

Adult↗
PubMedDate not supplied

Selecting items for a food behavior checklist for a limited-resource audience.

OBJECTIVE: To report 6 psychometric properties of food behavior checklist (FBC) items and then to use these properties to systematically reduce the number of items on this evaluation tool. DESIGN: Random assignment to the intervention and control groups. SETTING: Low-income communities. PARTICIPANTS: Women (N = 132) from limited-resource families. MAIN OUTCOME MEASURES: Reliability, internal consistency, baseline differences by ethnicity, sensitivity to change, and criterion and convergent validity of subscales. RESULTS: The fruit and vegetable subscale showed a significant correlation with serum carotenoid values (r =.44, P <.001), indicating acceptable criterion validity. Milk, fat/cholesterol, diet quality, food security, and fruit/vegetable subscales showed significant correlations with dietary variables. Nineteen items have acceptable reliability. Twenty items showed no baseline differences by ethnic group. Eleven of the 15 items expected to show change following the intervention demonstrated sensitivity to change. CONCLUSIONS AND IMPLICATIONS: This brief food behavior checklist (16 items) is easy to administer to a client group, has an elementary reading level (fourth grade), and has a low respondent burden in addition to meeting requirements for validity, reliability, and sensitivity to change. This study establishes a process that can be used by other researchers to develop and further refine instruments for use in community health promotion interventions.

Adult↗
PubMedDate not supplied

Food insecurity and food supplies in Latino households with young children.

OBJECTIVE: To examine the relationship between food insecurity and food supplies in Latino households. DESIGN: Cross-sectional survey, conducted February to May 2001. SETTING: Six California counties. PARTICIPANTS: Convenience sampling was used to recruit 274 low-income Latino families with preschool children from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), Head Start, and other community-based organizations. Complete data were available for 256 families. VARIABLES MEASURED: Food security, household food scores. ANALYSIS: Pearson correlations, Kruskal-Wallis test, and logistics regression. Significance level at P <.05. RESULTS: Controlling for maternal education, food insecurity over the past 3 months was associated with lower household food supplies: dairy, r = -.18, P <.01; fruit, r = -.36, P <.001; grains, r = -.27, P <.0001; meats, r = -.22, P <.001; snack foods, r = -.23, P <.001; and vegetables, r = -.29, P <.001. CONCLUSIONS AND IMPLICATIONS: In Latino households, greater food insecurity is associated with a lower variety of most foods, particularly fruits and vegetables. Future research in Latino households should explore the effects of seasonal food insecurity and household food shortages on food intake of individual household members, especially young children.

Adult↗
PubMedDate not supplied

Development of a tool to assess psychosocial indicators of fruit and vegetable intake for 2 federal programs.

OBJECTIVE: Development of an evaluation tool of psychosocial constructs for use by participants in 2 federal programs, Food Stamp Nutrition Education and the Expanded Food and Nutrition Education Program. DESIGN: Cross-sectional data from a longitudinal study. PARTICIPANTS: Limited-resource women (n = 111) living in low-income communities. MEASURES: Test-retest reliability, internal consistency, ethnic differences, convergent validity. ANALYSIS: Spearman rank order correlation, analysis of variance, principal components analysis. RESULTS: Reliability coefficients ranged from a low of r = .18 (not significant) to r = .74 (P < .0001). Two items were deleted for not meeting criteria for reliability and 2 for redundancy. Ethnic differences at baseline were significant for 1 item. Domain constructs loaded on 4 to 5 factors for the biopsychosocial framework. Estimates of convergent validity of 9 constructs led to the deletion of 3 (ie, perceived barriers, social support, and perceived norms), with retention of perceived benefits, perceived control, self-efficacy, readiness to eat more fruit, readiness to eat more vegetables, and perceived diet quality. As an estimate of convergent validity, the final version of the tool with 6 constructs remaining showed significant correlations with indicators of diet quality: serum carotenoid values (r = .38, P < .001); hypothesized nutrients calculated from the mean of 3 24-hour dietary recalls (vitamin C, r = .47, P < .0001; vitamin A, r = .39, P < .0001; folate, r = .37, P < .0001; beta-carotene, r =.31, P < .001; and fiber, r = .46, P < .0001); fruit and vegetable servings (r = 0.55, P < .0001); Healthy Eating Index (r = .27, P < .05); and a fruit and vegetable behavioral scale (r = .60, P < .0001). CONCLUSION AND IMPLICATIONS: This systematic process yielded a fruit and vegetable evaluation tool useful for practitioners and researchers. This is the first validation study of this type to estimate convergent validity with 5 indicators of diet quality, including a biomarker.

Adult↗
PubMedDate not supplied

Portrayals of food practices and exercise behavior in popular American films.

OBJECTIVE: To describe depictions of food, alcohol, and exercise and sport in popular films. DESIGN: Content analysis of the 10 top-grossing films each year from 1991 to 2000 (N = 100 films). ANALYSIS: Coding reliabilities were assessed with Cohen's kappa. Research questions were addressed with basic descriptive statistics. Associations among variables were examined through a cross-tabulation procedure that corrects for the clustering of exercise and food depictions within movies. RESULTS: Food and drink appeared regularly in the films analyzed, typically as a background element or prop. On average, food appeared on the screen once every 4.2 minutes. The foods shown were most likely to be fats, oils, and sweets; fruits, vegetables, and dairy products were rarely seen. More than 20% of the food items shown were alcoholic beverages, which were nearly 2 times more likely to be ingested as nonalcohol food items. Planned exercise and sports appeared at a rate of about 2 incidents per hour. These activities rarely received explicit evaluation by characters. CONCLUSIONS AND IMPLICATION: Films frequently portray foods and exercise. These depictions have the potential to cultivate beliefs about normative eating and exercise behavior, suggesting a need for public health professionals to encourage the media to offer healthier images.

Alcohol Drinking↗
PubMedDate not supplied

Using a theory-driven approach to design a professional development workshop.

The objective of this study was to show how a theory- driven approach to program planning was used to design and evaluate a professional development workshop. Our method was to demonstrate modeling of theory use as a teaching strategy. The Theory of Planned Behavior was used to structure all components of a 6-hour workshop. This workshop significantly increased participants' intention to use theory in designing programs (P <.0001). Educators can apply the methods demonstrated here to systematically use theory in the development, implementation, and evaluation of their workshops, staff training, and curricular materials for professionals and consumers.

Humans↗
PubMedDate not supplied

Goal setting as a strategy for dietary and physical activity behavior change: a review of the literature.

OBJECTIVE: Estimate effectiveness of goal setting for nutrition and physical activity behavior change, review the effect of goal-setting characteristics on behavior change, and investigate effectiveness of interventions containing goal setting. DATA SOURCE: For this review, a literature search was conducted for the period January 1977 through December 2003 that included a Current Contents, Biosis Previews, Medline, PubMed, PsycINFO, and ERIC search of databases and a reference list search. Key words were goal, goal setting, nutrition, diet, dietary, physical activity, exercise, behavior change, interventions, and fitness. STUDY INCLUSION AND EXCLUSION CRITERIA: The search identified 144 studies, of which 28 met inclusion criteria for being published in a peer reviewed journal and using goal setting in an intervention to modify dietary or physical activity behaviors. Excluded from this review were those studies that (1) evaluated goal setting cross-sectionally without an intervention; (2) used goal setting for behavioral disorders, to improve academic achievement, or in sports performance; (3) were reviews. DATA EXTRACTION AND SYNTHESIS: The articles were categorized by target audience and secondarily by research focus. Data extracted included outcome measure, research rating, purpose, sample, sample description, assignment, findings, and goal-setting support. RESULTS: Thirteen of the 23 adult studies used a goal-setting effectiveness study design and eight produced positive results supporting goal setting. No adolescent or child studies used this design. The results were inconclusive for the studies investigating goal-setting characteristics (n = 7). Four adult and four child intervention evaluation studies showed positive outcomes. No studies reported power calculations, and only 32% of the studies were rated as fully supporting goal setting. CONCLUSIONS: Goal setting has shown some promise in promoting dietary and physical activity behavior change among adults, but methodological issues still need to be resolved. The literature with adolescents and children is limited, and the authors are not aware of any published studies with this audience investigating the independent effect of goal setting on dietary or physical activity behavior. Although, goal setting is widely used with children and adolescents in nutrition interventions, its effectiveness has yet to be reported.

Diet↗