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Biomedical subjects

Marla Reicks

Publications and source records attributed to Marla Reicks.

At least 19 recordsLinked to original sources
PubMed2006

Associations of decisional balance, processes of change, and self-efficacy with stages of change for increased fruit and vegetable intake among low-income, African-American mothers.

OBJECTIVE: To determine the relationship between stage of change and decisional balance, processes of change, and self-efficacy variables of the Transtheoretical Model to increase fruit and vegetable consumption by low-income, African-American mothers, and to assess the usefulness of the model for intervention efforts. DESIGN: We used a cross-sectional questionnaire design with a food frequency questionnaire and a staging algorithm to classify women by stage of change before enrollment. We used scaled questionnaire items based on think-aloud data to measure self-efficacy, processes of change, and pros and cons to increasing fruit and vegetable intake and variety. SUBJECTS/SETTING: We recruited a convenience sample of low-income, African-American mothers (n=420) aged 18 to 45 years with children <12 years of age to complete questionnaires at community-based sites. STATISTICAL ANALYSES PERFORMED: Analysis of variance, principal component analysis, chi(2) tests, correlation, and regression analyses were conducted. RESULTS: Perceptions of benefits for health and planning meals were stronger for women in later stages compared with earlier stages. The same relationship was observed for the use of processes of change related to becoming aware of health benefits and engaging in enabling behaviors, and variety of fruits and vegetables consumed. Self-efficacy based on eating fruits and vegetables for various eating occasions and in difficult situations was greater for women in later stages compared to earlier stages. CONCLUSIONS: Interventions for women in earlier stages should include making women aware of health benefits, increasing self-efficacy, and improving ability to make plans and engage in behaviors to increase intake.

Adolescent↗
PubMed2006

Continuing education needs of registered dietitians regarding nutrigenomics.

The purpose of this study was to assess continuing education needs for registered dietitians regarding application of the science of nutritional genomics in clinical settings. A cross-sectional survey was mailed to a random national sample of 2,500 registered dietitians with a 40% response rate (n=995). The survey assessed knowledge; attitudes related to benefits and barriers to application; perceptions of consumer motivators and barriers; attitudes regarding ethical, legal, and social issues; and preferences for continuing education. Differences were determined according to year of registration using nonparametric Kruskal-Wallis tests. Survey respondents had little previous exposure to nutrigenomics, had not applied nutrigenomics in their practice in the past year, and were not confident in their ability to apply nutrigenomics in a clinical setting, but were interested in learning more about its application. Few differences existed in attitudes about benefits and barriers to application of nutrigenomics by year of registration. The most favored learning activity for continuing education was seminars/workshops. The most important content areas for continuing education were foundational knowledge, application, and communication to the lay public. Continuing education should focus on these content areas to allow application based on the supporting science and ways to effectively communicate the information to consumers.

Cross-Sectional Studies↗
PubMed2006

The relationship between maternal child-feeding practices and overweight in Hmong preschool children.

OBJECTIVE: Maternal child-feeding practices have been linked to overweight in several studies. Overweight is a prevalent condition in Hmong preschool children in the United States, therefore, the purpose of this study was to determine whether maternal child-feeding attitudes and practices were associated with overweight in Hmong preschool children. DESIGN: The Child-Feeding Questionnaire (CFQ) was revised and administered to Hmong mothers with normal-weight and overweight children. SETTING: Women, Infant, and Children Supplemental Food Program (WIC) clinics and community centers in the Minneapolis-St. Paul metropolitan area. PARTICIPANTS: Hmong mothers of normal-weight (n=45) and overweight (n=35) children. MAIN OUTCOME MEASURES: Relationships between maternal perceptions of child's weight, practices in child feeding, including monitoring, restriction, and pressure to eat, and overweight status in children. RESULTS: No association was found between maternal attitudes and practices in child feeding and body mass index (BMI) of the child except for mother's perception of her child's weight. Mother's perception of her child's weight was also associated with maternal restriction of certain foods. Mother's education and children's weight status were weakly positively associated. Mothers with more education tended to be younger and to work outside the home. CONCLUSION: The lack of a relationship between maternal child-feeding practices and children's weight status may be due to factors such as mother's education, role of other caregivers, and cultural factors.

Adolescent↗
PubMed2004

Child-feeding strategies of African American women according to stage of change for fruit and vegetable consumption.

OBJECTIVE: To examine the relationship between child-feeding strategies and the stage of change for fruit and vegetable consumption of low-income African American women. DESIGN: Mothers were asked to think aloud as they shopped for groceries and prepared a meal for their family. Verbalisations were audio-taped and transcribed. Transcripts were coded. Coded segments were sorted according to stage of change of the women who made the verbalisation. Themes were identified and analysed for differences across the stages of change. Child-feeding strategies and factors influencing provision of fruits and vegetables to children were identified through content analysis procedures. SETTING/SUBJECTS: Seventy women, aged 18 to 45 years, were classified by stage of change (10 to 18 per stage) based on self-reported intakes of fruits and vegetables and intention to increase intake. Women on average had two to three children less than 12 years of age and tended to be single heads of households, with about half having some college or technical training. RESULTS: According to the women's comments, food preferences of children were important considerations for women in all stages regarding their food choice behaviours. Women in the later stages reported using more positive child-feeding strategies to promote the intake of fruit and vegetables, including positive role-modelling and methods related to food purchasing, preparation and meal planning. CONCLUSIONS: Promoting mothers' movement to more advanced stages of change for fruit and vegetable intake may result in the use of more positive child-feeding strategies and therefore contribute to increased fruit and vegetable intake by children.

Adolescent↗
PubMed2004

Becoming Proactive With the Whole-Grains Message.

Whole-grain foods have always been considered a healthy part of the diet. Only recently have epidemiologic and other data shown that whole grains have a role in preventing cardiovascular disease, diabetes, some types of cancer, and even obesity. What nearly all consumers and most health professionals fail to realize is that whole grains deliver as many if not more phytochemicals and antioxidants than do fruits and vegetables. Healthy People 2010 (DHHS) recommends 3 servings of whole grains per day. Because the average intake in the United States is less than 1 serving per day, health professionals must mount an active campaign to help consumers better understand the important health benefits of whole grains and work to increase their intake in the diet.

Journal Article↗
PubMed2004

Applying the theory of planned behavior to fruit and vegetable consumption by older adults.

This study applied the Theory of Planned Behavior to fruit and vegetable intake among older adults. A cross-sectional questionnaire was administered to older adults (N = 205, mean age = 77 years) at senior centers. Most were women (74%), white (77%), and had >/= 12 years of education. Regression analyses showed that the theory constructs explained more than 40% and 18% (p < 0.0001) of the variance in intention and reported intake of fruits and vegetables, respectively. Perceived behavioral control was most important in explaining both intention and intake, followed by attitudes and subjective norms. Important control beliefs were related to convenience, preferences, time, and availability when eating out. These beliefs should be addressed in education for older adults to increase fruit and vegetable intake.

Aged↗
PubMed2003

Environmental and behavioral factors are associated with the calcium intake of low-income adolescent girls.

Based on social cognitive theory, the purpose of this study was to determine whether selected environmental and behavioral factors were associated with the calcium intake of low-income adolescent girls. Teachers in three public middle schools administered a written survey resulting in data from 105 girls (the majority were Asian American). Calcium intake was lower than recommended and was associated with eating breakfast, number of children in the household, availability of some high-calcium foods, and seeing important others drink milk or being encouraged to drink milk. Educational interventions should be targeted to parents in relation to making affordable sources of calcium available and modeling adequate intake to adolescents.

Adolescent↗
PubMed2003

Applying the theory of planned behavior to promotion of whole-grain foods by dietitians.

The objective of this preliminary study was to apply the theory of planned behavior to explain dietitians' intentions to promote whole-grain foods. Surveys were mailed to a random national sample of registered dietitians to assess knowledge and attitudinal, normative, and control beliefs regarding intention to promote whole-grain foods, with a 39% return rate (n=776, with 628 usable surveys from those working in direct patient care). About half of the respondents had a master's degree, and 58% had substantial experience in the dietetics field. The theory of planned behavior explained intention to promote whole grains to a moderate extent (df=3, F=74.5, R(2)=0.278, P<.001). Most were positive about the health benefits, and few perceived barriers to promotion. However, many had low levels of knowledge and self-efficacy regarding ability to help clients consume more whole-grain foods. Continuing education for dietitians should use strategies that enhance self-efficacy regarding ability to promote whole-grain foods.

Clinical Competence↗
PubMed2003

Identification of factors affecting purchasing and preparation of fruit and vegetables by stage of change for low-income African American mothers using the think-aloud method.

The objective of this study was to identify factors affecting the purchase and preparation of fruits and vegetables according to stage of change for low-income African American women with young children. The think-aloud method was used to collect verbalization data in grocery stores as women shopped (N=70) and in their homes during meal preparation (N=68). Audiotaped verbalizations were transcribed verbatim before encoding. Content analysis procedures were used to identify common themes by stage of change. Factors affecting decision making that varied by stage of change were preferences and specific needs (eg, for meals, for family members). Preferences regarding variety, quantity, color, and liking were more often expressed by women in later stages. Women in the later stages also often used meal-planning skills to include fruits and vegetables in meals. Interventions could be tailored according to selected factors regarding purchase and preparation of fruits and vegetables by stage of change to contribute to greater changes in intake.

Adult↗
PubMed2003

Use of the think-aloud method to identify factors influencing purchase of bread and cereals by low-income African American women and implications for whole-grain education.

The think-aloud method was used to determine factors influencing bread and cereal purchase by low-income African American women that have implications for whole-grain education. Women (N=70) were audiotaped as they thought aloud while purchasing groceries. Because bread and cereal account for the majority of whole-grain products consumed, transcribed verbalizations regarding purchase of bread and cereals were analyzed using content analysis procedures. Cost, preferences, eating and buying habits, and nutrition were the most important factors that influenced purchase. Nutrition issues included a general desire to eat healthy foods and specific concerns about fat, calcium, and calories, but no mention of wanting to purchase whole-grain products. Whole-grain education should focus on identification of whole-grain products, health benefits, and low-cost and tasty whole-grain options for mothers and children.

Adolescent↗
PubMed2002

Behavior change outcomes in an outpatient cardiac rehabilitation program.

OBJECTIVE: To evaluate the effectiveness of nutrition education within an outpatient cardiac rehabilitation program. DESIGN: Subjects were assigned, according to participation in cardiac rehabilitation programs in two community hospitals within an integrated healthcare system, to either a treatment (n=54), or a control group (n=50). SUBJECTS/SETTING: One hundred four men and women, age range 35 to 85 years, participating in a 6-week cardiac rehabilitation program. Most were men (80%) and overweight. The majority presented with the diagnosis of myocardial infarction followed by coronary artery bypass surgery or percutaneous transluminal coronary angiography procedure. INTERVENTION: Subjects in the control group received usual nonindividualized nutrition education from cardiac rehabilitation therapists. Subjects in the treatment group attended two group nutrition education classes and one individual diet counseling session, all led by the same dietitian. MAIN OUTCOME MEASURES: Changes in fat, saturated fat, cholesterol, and carbohydrate intake, and restaurant eating habits as assessed by the Diet Habit Survey; changes in cardiac diet self-efficacy; and changes in health-related quality of life. Statistical analyses performed Group-by-time analysis of variance with repeated measures, chi2 test. RESULTS: The treatment group had greater improvement in Restaurant and Recipes scores on the Diet Habit Survey (2.6 vs 1.0) and a greater cardiac diet self-efficacy mean score (4.3) compared with the control group (3.8), with the greatest change in items related to eating in restaurants, away from home, or when alone. From entry into the program to discharge, the cholesterol-saturated fat index decreased significantly in the control group (from 57 to 48), and in the treatment group (from 51 to 42). The percent of energy from carbohydrate increased significantly in the control group (from 51% to 55%) and in the treatment group (from 53% to 57%). There were no differences between groups over the 3 time periods (baseline, 6 weeks, and 3-month follow-up) (n=39 for control group and n=47 for treatment group for all 3 time periods). APPLICATIONS/CONCLUSIONS: Nutrition education within an outpatient cardiac rehabilitation program can improve dietary choices at restaurants and boost self confidence in the ability to adhere to a lipid-lowering diet.

Adult↗
PubMedDate not supplied

Perceptions of children, parents, and teachers regarding whole-grain foods, and implications for a school-based intervention.

OBJECTIVE: To identify perceptions of whole-grain foods and factors influencing intake by children, parents, and teachers as the basis for increasing intake by children within a school-based intervention. DESIGN: Focus group interviews with questions based on Social Cognitive Theory. SETTING: After-school care programs in 4 elementary schools in a large metropolitan district in St. Paul, Minn. PARTICIPANTS: Seven, three and two focus group interviews with children (n = 40; grades K-6), parents (n = 18), and teachers (n = 11), respectively. PHENOMENON OF INTEREST: Child and adult factors influencing intake of whole-grain foods, with a tasting activity to stimulate discussion. ANALYSIS: Qualitative data analysis procedures to generate common themes from encoded transcripts. RESULTS: Adults and children were positive about sensory characteristics of whole-grain products. Knowledge of ways to identify these foods was limited. Taste preferences strongly influenced selection of bread and cereals. Children suggested that new school foods should look and taste good, be familiar, and be promoted through sampling, peer influence, and incentives. Adults suggested a gradual increase in whole-grain content of school meals. IMPLICATIONS FOR RESEARCH AND PRACTICE: Focus groups were useful in understanding perceptions regarding whole-grain foods and yielded valuable insight toward design of a school-based intervention.

Adult↗
PubMedDate not supplied

Qualitative study of spirituality in a weight loss program: contribution to self-efficacy and locus of control.

OBJECTIVE: The purpose of this qualitative study was to examine how spirituality affects intrapersonal characteristics associated with a weight loss program. DESIGN: A series of 5 focus group interviews was conducted with women who were past participants of the Weigh Down Workshop, a spiritually based weight loss program. SETTING: Three churches in the Minneapolis/St. Paul, Minnesota, metropolitan area. PARTICIPANTS: Focus group participants (N = 32) were white, fairly well educated, with moderate income levels. Their mean age was 50 years. PHENOMENA OF INTEREST: Behavior changes, factors affecting self-efficacy for performing the behaviors, and locus of control. ANALYSIS: Sessions were audiotaped and transcribed. Transcribed text was coded and analyzed using qualitative data analysis procedures. RESULTS: Major changes in self-reported eating behaviors included eating only when experiencing true physiological hunger and stopping when sensing a feeling of fullness. Self-efficacy for these behaviors was reported to be enhanced by observing weight loss for themselves or others. Support from other group members, the simplicity of the program, and spiritual benefits through prayer and scripture reading were also reported to enhance confidence. Women indicated that they relied on an internal locus of control based on a sense of self-discipline. CONCLUSIONS AND IMPLICATIONS: Traditional means to enhance self-efficacy were important for all women; however, for some women, spirituality was also an important aspect of adhering to program principles.

Adult↗
PubMedDate not supplied

Use of the think aloud method to examine fruit and vegetable purchasing behaviors among low-income African American women.

The purpose of this report is to describe the development and implementation of the think aloud method in relation to fruit and vegetable purchasing behaviors of low-income African American mothers. Women (n = 70) were audiotaped as they thought aloud while selecting fruits and vegetables during a routine shopping trip. Audiotapes were transcribed, text was coded, and coded text was sorted using a database software program. Data were analyzed using content analysis procedures. The method was found to be useful in its ability to provide verbalization data for the majority of the women in the sample that reflected a typical shopping experience, were not excessively affected by the presence of the investigator, and captured information processing in relation to salient factors that influenced food purchasing decisions. Because a few women indicated that the method itself may have influenced behavior, future research is needed to test the reactivity of the think aloud method and its relationship to final choice of products.

Adult↗
PubMedDate not supplied

Children's perceived benefits and barriers in relation to eating breakfast in schools with or without Universal School Breakfast.

OBJECTIVE: The purpose of this study was to identify and compare perceived benefits and barriers related to breakfast consumption and concerns about weight among children in schools with or without a Universal School Breakfast Program (USBP). DESIGN: Teacher-administered survey at the end of a 3-year pilot program. SUBJECTS/SETTINGS: Fourth-, fifth-, and sixth-grade students in six USBP pilot schools (n = 827) and four control schools (n = 615). Control and pilot sites were matched by geographic location and socioeconomic status of students. Response rates were > 70%. VARIABLES MEASURED: Perceptions of benefits and barriers related to breakfast consumption and weight-related concerns. STATISTICAL ANALYSES PERFORMED: Chi-square tests were used to assess statistical differences in categorical responses to survey items. RESULTS: The majority of students perceived that eating breakfast provides benefits of increased energy and ability to pay attention in school. Commonly held perceptions of barriers to eating breakfast were lack of time and not being hungry in the morning. Compared with children in non-USBP schools, those in the USBP schools were less likely to wish they were thinner, to go on a diet, or skip breakfast because it might make them fat and more likely to believe that eating breakfast will give them energy and help them pay attention. IMPLICATIONS: Based on the results of this study, nutrition educators may find it helpful to develop educational materials and programs based on the reciprocal determinism construct of Social Learning Theory to promote breakfast consumption. The focus should be on practical strategies to address barriers and encourage behavioral changes for both children and their parents.

Body Weight↗
PubMedDate not supplied

Exercise as a gateway behavior for healthful eating among older adults: an exploratory study.

CONTEXT: The relationship between eating and exercise behavior change may influence effectiveness of interventions for older adults. OBJECTIVE: To determine whether exercise is a potential gateway behavior for healthful eating behavior among older adults. DESIGN: The Transtheoretical Model was applied to eating and exercise behaviors through the administration of a cross-sectional survey. SETTING/PARTICIPANTS: 205 older adults (the majority were white women) participating in congregate dining programs in a large Midwestern city. VARIABLES MEASURED: Perceived benefits and barriers, self-efficacy, and stage of change related to exercise and eating habits. ANALYSIS: Differences in responses to survey items based on stage of change were determined by analysis of variance, P <.05. RESULTS: Subjects in later stages for exercise behavior were also likely to be in later stages for eating adequate servings of fruit and dairy products but not for vegetables and avoiding fat. CONCLUSIONS AND IMPLICATIONS: Exercise is a potential gateway behavior for some dietary behaviors for older adults, justifying further controlled, longitudinal research.

Aged↗
PubMedDate not supplied

Attitudes and behaviors of food donors and perceived needs and wants of food shelf clients.

OBJECTIVE: Explore the attitudes and behaviors of individuals who donate foods to food shelves and the perceived needs of the clientele using the food shelves in terms of cultural, health, and nutritional concerns. DESIGN: Qualitative methods (focus group interviews). SETTING: Focus groups (5 client and 7 donor) were conducted at food shelves, churches, and community centers. PARTICIPANTS: Client focus group members (n = 31) were mostly middle-aged and elderly individuals of mixed ethnicity and donor focus group members (n = 64) were mostly white and well educated and had incomes > $50 000. MAIN OUTCOME MEASURE(S): In-depth focus groups were conducted to obtain information regarding attitudes and beliefs of individuals who donate food and perceptions of needs among food shelf clients. ANALYSIS: Transcripts were analyzed systematically by coding comments according to categories and examining for common themes. RESULTS: Food donations did not match client needs for people with different ethnic backgrounds or age groups and food safety concerns. CONCLUSIONS AND IMPLICATIONS: This study demonstrates the need for nutrition educators to work with food shelf and food bank directors regarding the education of staff and general population on appropriate food donations.

Adolescent↗