Objective: To describe low-income parents’ and caregivers’ perceptions of the Cooking Matters Mobile Application (CM App) meal planning and preparation features. Design: Explanatory mixed-methods design where data were gathered via online surveys based on the Theory of Planned Behaviour and the Theory of Reasoned Action, followed by telephone interviews. Setting: CM App, a mobile phone-based resource geared towards low-income parents and caregivers of young children (pregnancy/infant to age 5 years) for meal planning and preparation, with features based on skills taught in the Cooking Matters course: recipes, shopping list and meal planning. Participants: Low-income parents and caregivers (survey participants, n 461; interview participants, n 20) who had downloaded the CM App to their smartphone and agreed to participate in the current evaluation. Results: Attitudes and self-efficacy related to CM App’s subject matter and functions (meal planning; recipe use; creating and using a shopping list) were measured via surveys and interviews. Mean (sd) responses were positive towards ‘meal planning’ and ‘shopping and cooking’ (4·17 (0·63) and 3·49 (0·86) on a 5-point Likert scale, respectively). Interviewees described meal planning and preparation behaviours as intrinsic, based on habit, and influenced by family preference and food costs. Early adopters of the CM App may already be engaged in and/or are motivated to engage in the targeted health behaviours. Conclusions: Users may benefit most from incorporating into their routines new ways to prepare easy, cost-efficient, healthy meals at home that their families will enjoy.
Purpose and Objectives Embedding healthy eating and physical activity best practices in early care and education settings is important for instilling healthy behaviors early in life. A collaborative partnership between Nemours Children’s Health System and the Centers for Disease Control and Prevention was created to implement the National Early Care and Education Learning Collaboratives Project (ECELC) in childcare settings in 10 states. We measured improvement at the program level by the self-reported number of best practices implemented related to healthy eating and physical activity. Intervention Approach The ECELC implemented a collaborative model with state-level partners (eg, child care resource and referral networks) and early care and education programs. Intervention components received by program directors and lead teachers included 1) self-assessment, 2) in-person learning and training sessions, 3) action planning and implementation, 4) technical assistance, and 5) post-reassessment. Evaluation Methods A pre–post design assessed self-reported policies and practices related to breastfeeding and infant feeding, child nutrition, infant and child physical activity, screen time, and outdoor play and learning as measured by the validated Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) best practices instrument. The sample included 1,173 early care and education programs. Results The number of best practices met for each of the 5 NAP SACC areas increased from pre-assessment to post-assessment approximately 6 months later and ranged from 1.5 to 4.7 best practices ( P < .001). Almost all increases occurred regardless of participation in the Child and Adult Care Food Program, Quality Rating Improvement System, Head Start/Early Head Start, and/or accreditation status. Implications for Public Health The innovative and collaborative partnerships led to broad implementation of healthy eating and physical activity–based practices in early care and education settings. Development, implementation, and evaluation of policy and practice-based partnerships to promote healthy eating and physical activity among children attending early care and education programs may contribute to obesity prevention in the United States.
The purpose of this study was to qualitatively explore the per- and poly-fluoroalkyl substances (PFAS) exposure experience and associated stressors, to inform public health efforts to support psychosocial health and resilience in affected communities. Semi-structured interviews (n = 9) were conducted from July–September 2019 with community members and state public health department representatives from areas with PFAS-contaminated drinking water. Thematic analysis was completed and themes were described and summarized. Reported stressors included health concerns and uncertainty, institutional delegitimization and associated distrust, and financial burdens. Interviewees provided several strategies to reduce stress and promote stress coping capacity and resilience, including showing empathy and validating the normalcy of experiencing stress; building trust through visible action and sustained community engagement; providing information and actionable guidance; discussing stress carefully; fostering stress coping capacity and resilience with opportunities to build social capital and restore agency; and building capacity among government agencies and health care providers to address psychosocial stress. While communities affected by PFAS contamination will face unavoidable stressors, positive interactions with government responders and health care providers may help reduce negative stress. More research on how best to integrate community psychosocial health and stress coping and resilience concepts into the public health response to environmental contamination could be helpful in addressing these stressors.
Purpose and ObjectivesThe National Early Care and Education Learning Collaboratives Project (ECELC) aims to improve best practices in early care and education (ECE) programs in topic areas of the Nutrition and Physical Activity Self-Assessment in Child Care (NAP SACC). Technical assistance is a component of the ECELC, yet its effect on outcomes is unclear. Beyond dose and duration of technical assistance, limited research exists on characteristics of technical assistance that contribute to outcomes. The objective of this study was to identify and describe technical assistance characteristics and explore associations with NAP SACC outcomes.Intervention ApproachWe collected data from 10 collaboratives comprising 84 ECE programs in 2 states in 2015–2016. The objective of technical assistance was to support programs in improving best practices. Technical assistance was provided to programs via on-site, telephone, or email and was tailored to program needs.Evaluation MethodsWe used a mixed-methods design to examine associations between technical assistance and NAP SACC outcomes. We used multiple regression analysis to assess quantitative data and qualitative comparative analysis to determine necessary and sufficient technical assistance conditions supporting NAP SACC outcomes. We also conducted a document review to describe technical assistance that referred conditions identified by the qualitative comparative analysis.ResultsRegression analyses detected an inverse relationship between changes in NAP SACC scores and hours of technical assistance. No clear pattern emerged in the qualitative comparative analysis, leaving no necessary and sufficient conditions. However, the qualitative comparative analysis identified feedback as a potentially important component of technical assistance, whereas resource sharing and frequent email were characteristics that seemed to reduce the likelihood of improved outcomes. Email and resource sharing were considered primarily general information rather than tailored technical assistance.Implications for Public HealthTechnical assistance may be used in programs and made adaptable to program needs. The inclusion and evaluation of technical assistance, especially tailored approaches, is warranted for environmental interventions, including ECE settings.
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