OBJECTIVES This study investigates the current state of consuming breakfast among elementary school students residing in Malang, East Java, Indonesia, and to identify factors that influence breakfast behavior. METHODS The research model was set up as per the health belief model, and slightly modified by adding the subjective normative factors of the theory of planned behavior. The survey was conducted from July 17 to August 15, 2017 using a questionnaire, after receiving the permission PNU IRB (2017_60_HR). RESULTS The subjects were 77 boys (49.4%) and 79 girls (50.6%) suffering from malnutrition with anemia (21.2%) and stunting ratio of Height for Age Z Score (HAZ) (11.5%). Furthermore, moderate weakness (14.8%) and overweight and obesity (12.3%) by Body Mass Index for Age Z Score (BMIZ) were coexistent. According to the results obtained for breakfast, 21.8% did not eat breakfast before school, with 18.8% of the reasons for skipping breakfast being attributed to lack of food. Even for subjects partaking breakfast, only about 10% had a good balanced diet. The average score of behavioral intention on eating breakfast was 2.60 ± 0.58. The perceived sensitivity, perceived severity, perceived benefits, and self-efficacy of the health belief model correlated with breakfast behavior. Of these, self-efficacy (β=0.447, R²=0.200) and perceived sensitivity (β=0.373, R²=0.139) had the greatest effect on breakfast behavior. Mother was the largest impact person among children. CONCLUSIONS In order to increase the level of breakfast behavior intention among children surveyed in Indonesia, we determined the effectiveness by focus on education which helps the children recognize to be more likely to get sick when they don't have breakfast, and increase their confidence in ability to have breakfast on their own. We believe there is a necessity to seek ways to provide indirect intervention through mothers, as well as impart direct nutrition education to children.
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OBJECTIVES The purpose of this study was to develop a systematic and standardized「The Survey on School Foodservice Programã€that can identify the current status of school meals on the nationwide level. METHODS This study was carried out in six steps of the analysis of report/investigation data related to school foodservice in metropolitan and provincial offices of education, analysis of preceding research related to the actual status of school foodservice, field verification of the actual condition of the school foodservice site, development of a draft of「The Survey on School Foodservice Programã€, pilot study of a draft of 「The Survey on School Foodservice Programã€, and suggestions of a final model of「The Survey on School Foodservice Programã€from August to December, 2017. Statistical analysis was performed for frequency analysis and descriptive analysis using the SPSS program ver. 23. RESULTS A draft of「The Survey on School Foodservice Programã€was developed by analyzing the current status of report/research data on school meals in metropolitan and provincial offices of education, analyzing the preceding research on school meals, and identifying the actual conditions at school foodservice sites. To verify the validity of the school foodservice survey questionnaire, 1,031 schools were sampled from a total of 10,251 schools and the pilot test of ‘2017 School Foodservice Survey’ was conducted. The final model of「The Survey on School Foodservice Programã€consisted of 12 survey sections, 29 survey categories, and 433 survey items, and the survey cycle was set for one year and three years for each survey item. CONCLUSIONS Based on the objective statistical data through「The Survey on School Foodservice Programã€, it is possible to develop the school foodservice policy, which will help establish the reliability of the school meals.
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OBJECTIVES We investigated the operation needs of school meal support centers (SMSC) in Chungnam-do based on analysis of nutrition teachers' perception of them. METHODS The Chungnam government established the first SMSC in 2012. Thirteen SMSCs are currently being operated in Chungnam-do. To analyze the results quantitatively, we investigated nutrition teachers opinions regarding the necessity for SMSCs as a dependent variable and derived the independent variables based on the causal relationships with dependent variables using the ordered logit model. Those independent variables included region, school type, number of students, attitude regarding free meal policy, satisfaction with school meal policy, and preference for local food. RESULTS Briefly, teachers in the region in which the SMSC was located more strongly supported the SMSC. In addition, teachers in public schools with a smaller number of students believed that having a SMSC is more beneficial, and that other variables also affected the necessity for SMSCs. Moreover, nutrition teachers preferred local foods rather than organic foods because of the unstable supply of organic foods. CONCLUSIONS Based on the results of this study, it was recommended that the local government implement the policy consistently. Moreover, it was recommended that the government operate the SMSC more efficiently, enhance the roles of the SMSC as the local organization responsible for student nutritional planing and expand the coverage of agricultural products.
OBJECTIVES Based on individual and environmental characteristics of low-income children, we developed a nutrition education program for school-aged children from low-income families according to effective use in social welfare centers. METHODS We conducted in-depth group interviews to assess program needs in 28 participants, 10 low-income school-aged children and 9 of their care givers, 9 social workers and 9 care-givers. Theoretical backgrounds of our program were heath belief model and social cognitive theory considering motivation, action and environment characteristics. RESULTS Based on the findings of this qualitative study, we developed major program themes and contents. Five selected key themes were 'balanced diet', 'processed food', 'food hygiene and safety', 'Korean healthy traditional diet', and 'family cooking' to induce changes in dietary behaviors. Main findings of in-depth group interviews included 'child's active participation', 'simple and easy to understand messages', and 'environmental constraints' such as a lack of child care at home, limited budget of social welfare centers, and less qualified educators for nutrition and health. Each lesson was constructed as a 1-hour program particularly emphasizing activity-based programs, including cooking and teamwork exercises. Program contents in each session consisted of activities that could induce outcome and value expectations, self-efficacy, perceived benefits, and barriers and cues to actions regarding diet behavior. CONCLUSIONS We developed a nutrition education programthat is rarely available for low-income children in Korea, considering theoretical bases. Further studies are needed to validate our program.
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This study compared levels of health beliefs and health behavior practices according to lifestyle pattern among adults in Seoul. A self-administered survey questionnaire was collected from a total of 1,004 Seoul residents aged 30-59 years. The levels of perceived benefit, perceived barrier, and self-efficacy from health belief model and health behavior practices were measured across multiple health behavior areas including dietary behavior, drinking, smoking, exercise, functional food consumption, and weight control behavior. Factor analysis and subsequent cluster analysis based on 28 lifestyle questions divided the subjects into four lifestyles of society-, economy-, trend-, and health-oriented lifestyle. Some general characteristics were significantly different by lifestyles. The society-oriented lifestyle was significantly higher in proportions of men and overweight. The trend-oriented lifestyle was significantly younger and spent more monthly allowance. Health-oriented lifestyle was older. The levels of health belief variables and health behavior practices significantly differed by lifestyles. Overall the health-oriented lifestyle showed more desirable levels of health belief variables and health behavior practice in various health behavior areas compared to the other lifestyles, whereas the society-oriented lifestyle was found the other way. Health belief model variables including perceived benefit, perceived barrier, and self-efficacy were generally significant in predicting the levels of various health behavior practice, with somewhat differences by lifestyle pattern and health behavior type. The study findings suggest it may be useful to segment target subjects according to lifestyle pattern in planning and administering health education programs.
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For the correct dietary habit and balanced dietary intake of aged people, the nutrition management that fits to the dietary behavior change stage has to be accomplished. In order to do so, in this paper, we chose 175 women that are aged more than 65 years old who are rural long life community residents and surveyed the dietary intake for 2 days including a twice depth interview and the 24 hour recall method. Also, for the sake of our aim, using the transtheoretical model, the dietary behavior change stage group was divided into the contemplation stage group, the preparation stage group, the action stage group and the maintenance stage group. The results are as follows: In the intake amount of protein (p < 0.01), vitamin B1 (p < 0.05) and vitamin B6 (p < 0.05), the intake amount of these nutrients in the action stage group and the maintenance stage group were significantly larger than the intake amount in the contemplation stage group and the preparation stage group. The nutrition evaluation according to the dietary behavior change stage, the ratio of subjects who took insufficient amount of energy, protein, vitamin A, and vitamin C were low as the dietary behavior change stage was upgraded. The subjects of maintenance stage group were most likely to consume vegetables more than once a day, and consume fruits and milk and milk products more than 5 times/week. MAR [13], MAR [10] and MAR [4] of subjects in the action stage group and the maintenance stage roup were significantly higher than MAR [13], MAR [10] and MAR [4] of subjects in the contemplation stage group and the preparation stage group (p < 0.001). From the above results, there were differences of nutrient intakes according to the dietary behavior change stage. Therefore, it is considered that the intervention for the dietary behavior motivation induction has to be advanced before accomplishing the individually fitting intervention at the time of nutrient management intervention.
It was well received that well grounded behavioral theories were important in the development of effective nutrition education programs, but there are only a few programs available for Korean women. The objective of this study was to develop nutrition education programs for childbearing-aged women in Korea. Based on the findings of the needs assessment for the program and theoretical backgrounds, we developed behaviorally oriented tailored nutrition education program including motivation (MT), modifying (MD) and maintenance (MA) stages. The key concepts of the stages were motivation promotion for MT, increasing behavioral capabilities for MD, and strengthening self-management and building favorable environmental condition for MA. The education program was intended to be need in individual nutrition counseling, but it could be well used for group education by developing materials using the relevant contents. The primary users of the program were nutrition educators, however it could be also used by clients as needed. The introductory chapter provided dietary assessment tools and nutrition education tips. MT chapter included subjects such as nutritional status screening, costs of inappropriate nutrition and weight management, benefits of eating right, and activities for motivation promotion. MD stage chapter dealt with topics of healthy weight, knowledges and skills for better eating habits and physical activity status, and activities related to setting tailored behavioral objectives. MA stage focused on facilitating self management skills and building helping relationships. Each stage underlined activities using various educational tools in order to promote active participation of the client (s). For better use of this program, it was recommended to conduct program validation study.
The purpose of this study was to assess how the changes in the food services environment on patients satisfaction with the hospital food service. Statistical data analyses were completed using the SPSS 11.0 program. The results can be summarized as follows: The flow line and environment of the food services in the hospital were improved through remodeling, which included the replacement of all cooking utensils, ventilation facilities and material storages, the purchase of a combi steamer, and the change of meal carts and trays. After the remodeling, the hospital food service was improved so that it provided spoons at each meal, diversified the menu utilizing the combi steamer, served event meals three times a week as well as water boiled with burned rice in the morning twice a week. In addition, various types of tableware were used in the table settings to produce attractive visual effects. Among the 10 items included on the patient satisfaction questionnaire, "satisfaction with offered menus" (p<0.01) showed significantly higher scores before the remodeling. "cooking/seasoning of food", "amount of meals" and "taste of meals" were not statistically significant, but showed increased satisfaction after the remodeling. However "temperature of food", "cleanliness of clothes and features" and "satisfaction with meal times" were not statistically significant, but showed decreased satisfaction after the remodeling.
The purpose of the study was to find the sociopsychological factors predicting the intention of compliance with the dietary regimen in diabetes with a questionnaire. Data were collected from 282 adult noninsulin-dependent diabetics in Seoul, Kyoggida, and Kyongsangbukdo in Korea. Stepwise multiple regression analysis was conducted with predictor variables from theories of the Health Belief Model, Social Cognitive Model, The Theory of Reasoned Action, and Social Support. The behavioral intention of compliance with the prescribed diet was the independent variable. Subjects norm self-efficacy knowledge about diet therapy, outcome expectation, relationship with medical team, threat of deterioration of disease, and social support were the independent variables, The mean score of behavior intention was high ie 35.3 out to 42. Subjective norm and self-efficacy were the significant variables to predict the intention of dietary compliance. These variables comprised 39% of the common variance. To increase dietary compliance by influence of the referents and improve self-efficacy significant referents must be included and concrete and practical methods to follow the dietary regimen must be provided in nutrition education.
Although many people initially enroll in health education programs, there are many instances of erratic participation and dropouts. Inconsistent participation in intervention programs minimizes their impact on health promotion. Therefore, a theoretical understanding of factors influencing participation in these programs can potentially enhance the effectiveness of its educational strategy. This study used the Pender's Health Promotion Model to examine specific factors influencing incentives to participate in an elderly nutrition education program. The Elderly Nutrition Counseling and Education Program was conducted with 147 volunteers (76 males, 71 females), aged 60 to 87, at 5 separate community elderly centers, by public health dietitians from February to April 1997. Some participants dropped out during the program. Overall, 61 people(18 males, 43 females) finished all 7 steps over 2 months. Pre-intervention data were collected by trained dietitians. This data included individual cognitive-perceptual factors(perceived benefits of nutrition improvement, importance of health, perceived control over health by multidimensional health locus of control, self esteem, perceived health status, concern about health, depression scale and social health scale), which were known to influence the likelihood of health behavior, and modifying factors(socioeconomic variables, biological characteristics, behavioral factors, such as smoking, alcohol drinking and exercise). Male finalists had a significantly lower chance for health locus of control, and better social health status with their children and grandchildren, compared to males who dropped out. Female finalists had a significantly higher locus of control regarding food behavior, higher self-esteem, better recognized nutritional status, worse self-recognized health status and lower concern about health than those who dropped out. There was no significant difference between the attendees and dropouts in age, BMI( kg/m2), Nutritional Risk Index, depression scale and daily nutrient intake. These results suggest that elderly nutrition intervention plans should focus on the individual cognitive and perceptual factors, with interpersonal influences, to increase participation in nutrition in nutrition improvement programs.
Community nutritionists draw upon theories from the social sciences to improve their work in health promotion and disease prevention. Social science theories are sets of concepts that provide systematic explanations that can predict events or situations, and are classified into several paradigms and worldviews. these theories interact with research and practice around the subject matter of community nutrition. Use of these theories provides benefits in community nutrition by helping to organize thinking about nutrition topics in ways that are useful for assessing, understanding, intervening, and evaluation community nutrition issues. Community nutrition researchers and practitioners can be choose from many available social science theories by evaluating assumptions, scope, applicability, complexity, effectiveness, and other aspects of the theories. Awareness and use of social science theories should enhance the development of community nutrition.