Objectives This study aimed to develop evaluation criteria for the elementary-school-based health promotion program using the RE-AIM framework and to examine their feasibility. Methods Previous evaluation studies on health interventions for elementary-school students using the RE-AIM framework were reviewed systematically to identify appropriate evaluation criteria. A diet and physical activity intervention based on the transtheoretical model was implemented in a pilot study using the “Happy Me” application. The feasibility of using the RE-AIM framework to evaluate it was examined. Results The review yielded the following evaluation criteria: “reach,” the ratio of participants out of the total target population; “efficacy/effectiveness,” the difference in outcomes between the intervention and control groups, or between a pre- and post-test; “adoption,” the rate of use of the program and participation in the next stage of the program; “implementation,” the progress on the program components; “maintenance,” the participants’ and teachers’ intention to continue using the program. The pilot study reached 76.6% of the targeted population. The intake of sugar-sweetened beverages decreased (P < 0.0001), and the duration of walking increased (P < 0.0001). Other indicators could not be evaluated; therefore, potential indicators were suggested. Conclusions This study produced feasible evaluation criteria for elementary-school-based health promotion using the RE-AIM framework. Nevertheless, the feasibility needs to be validated with a broader range of studies and long-term interventions.
Objectives Recent epidemiological data reported that young adults in their 20 ~ 30s are a vulnerable population with unhealthy dietary practices and a few signs of deteriorated health indicators. However, there are no dietary guidelines that are specifically developed for the young adult population. This study introduces some data collection tools that are mostly used in the service design field, and demonstrates how these tools can be used in nutrition research for developing dietary guidelines for specific target groups. Methods To understand the context of food choices among young people, 39 people were enrolled to complete a probes booklet. Thematic analysis and word cloud were performed to capture the main themes from the probes and a persona was developed based on the findings. Results Data from the probes enabled us to grasp the various contextual meanings of eating practices among young people. Most participants understand what a healthy diet is and often have a willingness to practice it. However, there were very few participants who were following the practices. We created four types of persona for developing dietary guidelines: healthy eating, emotional eating, convenient eating, and trendy eating. Conclusions Probes and persona were used in order to understand the lives of young adults and develop targeted messages. We hope that this introduction will be helpful to researchers who are looking for new ways of understanding their target population in the field of community nutrition.
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Objectives Standardized guidelines and reference points for a food security policy are necessary to guarantee that basic social safety nets work properly. Therefore, this study aimed to explore the basic concepts and detailed dimensions of food security, including the potential relevant indicators, and sought to establish standardized well-being baselines. Methods A literature review and 14 expert roundtable discussions were carried out to analyze and extract the key concepts of food security. After determining these concepts and detailed dimensions of food security, a conceptual framework was modeled. Then, indicators for each local government that could be monitored and evaluated for each sub-area were suggested. Results The concept of food security was defined as follows: Individuals should be provided with sufficient, safe, and quality food, which should be accessible to the community and available for use to achieve health and well-being. In addition, food security should be ensured sustainably in a changing environment. Four dimensions were suggested while conceptualizing food security. First, sufficient food, which means sufficient food supply in quantity, quality, and safety. Second, equitable food which includes creating environments in which high-quality and safe food can be purchased at an appropriate price and can be provided regardless of the socioeconomic gap. Third, healthy food which should be provided to promote people’s health and happiness through the eco-friendly consumption of food.
Fourth, sustainable food, which can be supplied in a sustainable manner and as part of an eco-friendly food system that considers the conservation of natural environments. Conclusions The basic concepts and detailed areas of food security including the potential indicators proposed in this study, may be useful for developing and implementing various policies and programs to support food and nutrition security in the future.
Objectives Food literacy (FL) can be an important concept that embodies the nutritional capabilities of individuals. The purpose of this study was to introduce the definition and core elements of FL from previous literature, to summarize measurement tools and intervention programs with FL, and to suggest the direction of future research and programs to integrate the concept of FL.
Methods: The literature review was conducted through PubMed and Google Scholar databases by combining the search term ‘food literacy’ with ‘definition’, ‘measurement’, ‘questionnaire’, ‘intervention’, and ‘program’. Among the 94 papers primarily reviewed 31 manuscripts that suited the purpose of the study were used for analyses.
Results: There is no consensus on the definition of FL that encompasses the multidimensional aspects of the concept. The definitions of FL were slightly different depending on the authors, and the interpretation of the core elements also varied. Based on the review, we propose a framework of FL that is in line with the current discussion among international researchers. This focuses on the core elements adapted from health literacy, namely functional, interactive, and critical FL. Specifically, we suggest some detailed elements for interactive and critical FL, which were often the subject of divergent views among researchers in previous literature. We found that most of the tools in the reviewed literature provided information on validity and reliability and were developed for a specific target population. Also, most of the tools were focused on functional FL. Similarly, most of the interventions targeted functional FL.
Conclusions: This study reviewed the definition and core elements of FL, available measurement tools, and intervention programs using validated tools. We propose the development of tools with sound reliability and validity that encompass the three core elements of FL for different age groups. This will help to understand whether improving food literacy can translate into better nutritional intake and health status among individuals and communities.
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Objectives This study was performed to identify the current barriers of obesity management for children using Community Child Care Centers and their caregivers (parents and teachers working in the Centers). Further, this study explored the possibility of utilizing a mobile phone application for tailored obesity prevention and management programs to overcome the current difficulties associated with children's obesity management. Methods The qualitative data were collected through in-depth interviews with 20 obese and overweight children or children who wanted to participate in this study using Community Child Care Centers, 12 teachers working at the Centers, and a focus group interview with five parents of children using the Centers. Data were analyzed with a thematic approach categorizing themes and sub-themes based on the transcripts. Results The current barriers of obesity management of obese and overweight children using Community Child Care Centers were lack of self-directed motivation regarding obesity management (chronic obesity-induced lifestyles and reduced self-confidence due to stigma) and lack of support from households and Community Child Care Centers (latchkey child, inconsistency in dietary guidance between the Center and household, repetitive pressure to eat, and absence of regular nutrition education). Mobile phone applications may have potential to overcome the current barriers by providing handy and interesting obesity management based on visual media (real-time tracking of lifestyles using behavior records and social support using gamification), environmental support (supplementation of parental care and network-based education between the Community Child Care Center and household), and individualized intervention (encouragement of tailored and gradual changes in eating habits and tailored goal setting). It is predicted that the real-time mobile phone program will provide information for improving nutritional knowledge and behavioral skills as well as lead to sustainable children’s coping strategies regarding obesity management. In addition, it is expected that environmental factors may be improved by network-based education between the Community Child Care Centers and households using the characteristics of mobile phones, which are free from space and time constraints. Conclusions The tailored education program for children using Community Child Care Centers based on mobile phones may prevent and reduce childhood obesity by overcoming the current barriers of obesity management for children, providing environmental and individualized support to promote healthy lifestyles and quality of life in the future.
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Objectives This study explored the community food environmental factors affecting food purchasing using a qualitative research methodology for the elderly as well as the various food environments under their socioeconomic diversity. Methods For the qualitative data collection, this study interviewed 20 elderly people aged 65 years or more, who participated in a public health program or lunch services operated by the senior welfare center in Seoul. Five dimensions, such as availability, physical accessibility, affordability, acceptability, and accommodation suggested in previous studies, were used to identify the community food environmental factors. Results The elderly participants showed overall similarities to the concepts derived from existing studies on the five dimensions of food accessibility environment. In addition, other important food accessibility environmental factors that were not present in previous studies, such as acceptability for a product of domestic origin, delivery service to home, and small-packaged food sales, were derived. On the other hand, the concept of some subjects differed depending on the household income and specifically for the physical accessibility concept. This showed that the close distance factor from a grocery store at home might not apply to older adults in low-income households in Korea. Conclusions This study found that five dimensions of the food environment suggested by previous studies could also be applied to vulnerable older adults in Korea. On the other hand, the socioeconomic characteristics of individuals and households would affect the perspectives of their local food environments differently. The findings of this study could help in the development of tools for evaluating the community food environment.
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OBJECTIVES The objective of this study was to examine whether dietary quality varies among different age groups and geographic areas, and whether the difference between geographic areas varies across several age groups in Korea. METHODS The subjects were 14,170 subjects who participated in the 2013–2015 Korea National Health and Nutrition Examination Survey. The dietary quality was assessed using the Korean Health Eating Index (KHEI). Age groups were categorized into six groupings, and areas were categorized into urban and rural according to their administrative districts. The effect of area on the KHEI score was analyzed by multiple linear regression analysis. RESULTS The KHEI was the lowest in the 20-30s group (57.7 ± 0.4 score for 20s and 61.2 ± 0.3 score for 30s) and increased with age (p<0.001), showing the highest score in the 60s (67.9 ± 0.3 score), and then decreased again in the 70s and older (64.6 ± 0.3 score). As a result of comparing the KHEI score by area, the urban areas had higher KHEI scores than did the rural areas (63.5 ± 0.2 score for urban area and 62.2 ± 0.4 score for rural area, p=0.002). The difference between areas was dependent on the age group, showing a significant difference for subjects who were aged from 50s and older (p=0.002 for 50s, p<0.001 for 60s and p<0.001 for 70s and older). After adjusting for confounding factors, the effect of area on the KHEI score was only shown for those subjects in the over 60 years old group (p=0.035 for 60s and p<0.001 for 70s and older). CONCLUSIONS The dietary quality differed according to the age group and geographic area. The dietary quality was lower for younger people than that for older people, and in rural areas compared to that in urban areas, and especially for older adults. The area factor was a very important factor for the dietary quality.
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OBJECTIVES This study was conducted to investigate the current difficulties surrounding children's obesity management and evaluate the application of a mobile phone as a tool to overcome such difficulties of obesity management from the perspective of main caregivers of elementary school students. METHODS The qualitative data were collected through 3 focus group interviews including 6 full-time housewives, 7 mothers with overweight children, and 4 working mothers. Data were analyzed using a thematic approach. RESULTS The limitations of current children's obesity management included difficulty in diet management and exercise as well as challenges of setting goals and lack of support at the household and school levels. Mobile technology may be useful to overcome the current problems by providing real-time knowledge on diet management and physical activity, online compensation scheme according to goal setting, and interactive environmental supports at both household and school levels for promoting overall health. CONCLUSIONS The mobile-based multiple support program may assist in overcoming the current limitations of child obesity management by providing tailored information and by creating a more supportive environment.
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OBJECTIVES The current survey environment is changing and participation rates in national nutrition surveys are decreasing. Therefore, the purpose of this study was to develop strategies for improving the nutrition survey system in the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS To develop an alternative system for conducting the KNHANES nutritional survey, we conducted focus group interviews with stakeholders of the survey, SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis, and expert reviews. In addition, spatial analysis of potential sites for conducting surveys instead of relying on household visits was performed, and the perception of nutritional surveys in the population eligible for KNHANES was evaluated. RESULTS Based on the results of the focus group interviews, SWOT analysis, and expert reviews, we propose two options for survey sites: vehicles specifically prepared for nutritional surveys and public facilities such as community service centers or public health centers. Among public facilities, community service centers were found to be more appropriate sites than public health centers because they were considered more accessible. About 90% of respondents would participate in the survey in public facilities and about 74% would in vehicles. CONCLUSIONS Conducting national nutrition surveys in specially designed vehicles and public facilities could be a viable alternative to home visits. Next, the validity of these newly proposed nutrition survey methods needs to be compared to the results of the current national nutrition survey.
OBJECTIVES This study was conducted to investigate the current status and to suggest future directions for health management of teenagers who use healthy school tuck shops to improve teenagers' eating habits while reducing and preventing obesity. METHODS A total of 29 students (16 middle school students and 13 high school students) took part in the interview for this study, and the interview was conducted for each school's focus group by using qualitative research methodology. RESULTS The current status of using healthy school tuck shops and suggested future directions were divided into two categories. Personal barriers such as discrepancies between personal perceptions and behaviors and lack of food choice suitable to individual tastes can be solved by rebuilding the operating system to provide intuitive promotion of behavior and customized products through improvements in existing products and new product development. A lack of consistent management from low utilization convenience and difficulty in maintaining a constant purchase price can be handled by establishing a solution to restricted physical access for products, as well as seeking profit by improving distribution costs via continuous cooperation between the school and community. CONCLUSIONS Continuous funding and a system that reflects the needs and preferences of healthy school tuck shop users should be applied for sustainable operation of healthy school tuck shops to improve teenagers' eating habits.
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Food Insecurity and Related Risk Factors in the Elderly: Korea National Health and Nutrition Examination Survey 2013 Data Hye-Sang Lee Journal of the Korean Dietetic Association.2015; 21(4): 308. CrossRef
Flavonoid intake according to food security in Korean adults: Based on the Korea National Health and Nutrition Examination Survey 2007~2012 Shinyoung Jun, Eunju Hong, Hyojee Joung Journal of Nutrition and Health.2015; 48(6): 507. CrossRef
A Study on the Living Conditions of Rural Women and the Determinants of Their Life Satisfaction Jeong In Bae, Ung Im Park, Hye Sang Lee, Geun Mee Ahn, Woon Seon Jeong The Korean Journal of Community Living Science.2013; 24(4): 485. CrossRef
This study was conducted to assess the nutrient intake patterns among urban and rural adolescents and to investigate the effects due to parent's socioeconomic status and other factors, such as mother's job, family type and regular exercise on that pattern. 2,455 middle and high school students living in Seoul and Yangpong, Kyounffi-Do participated in a self-administered questionnaire that was used to collect data. The one-day dietary intake was surveyed through a 24-hour recall method. The factors significantly different between urban and rural adolescents according to monthly income, parent's education level, mother's job, family type and exercise. Income, the parents' education level and regular exercise were associated with the patterns of nutrient intakes as a percent of the RDA. So, when adjusted for parental income, the father's and mother's education level and regular exercise, there were no signifcant differences within the patterns of nutritional intake between urban and rural adolescents. The results provided the information regarding the determinants of nutrient status among adolescents and were expected to be helpful for planning school health promotion programs.