Food Security, Dietary Diversity and Glycemic Control Among Adults Diagnosed with Type 2 Diabetes in Malawi

Abstract

Background (Background, Rationale, Prior Research, and/or Theory): Descriptions of college students' perception of the healthfulness of their campus can inform the development of tailored nutrition education programs. Objective: To develop an assessment tool, Behavior Environment Perception Survey (BEPS), measuring college students' perception of the healthfulness of different domains of environmental influencers of health. Study Design, Setting, Participants, Intervention: A sequential process of measurement development included item generation by experts at seven universities using a pool of existing items and item sorting based on domain/ construct. Then, college students participated in cognitive interviews and a pilot survey administration. Finally, survey field testing data were used for confirmatory factor analysis and reliability testing to construct the final questionnaire. Analyses used SPSS and EQS. Outcome Measures and Analysis: Item generation from experts at seven universities resulted in 100 items, reduced to 93 items based on sorting. Items were eliminated based on content analysis of cognitive interviews (n = 120); identification of misinterpreted items and exploratory factor analysis of pilot survey data (n = 724 at 6 universities; elimination of cross-loading [ > .30] or weak loading [ < .40] items). The field test (n = 2,724 at 6 universities) included the refined 31-item measure which underwent confirmatory factor analysis and structural equation modeling. Results: A 23-item, 5-factor structure was the best fit for the data (χ = 3,462.15, df = 209; CFI = .841; RMSEA = 0.076). The perceived healthfulness of the environment factors were: physical activity (α = .71; 5 items), healthy eating (α = .85; 5 items), mental health (α = .85; 5 items), barriers to health (α = .70; 4 items), and social influences (α = .73; 3 items). Conclusions and Implications: BEPS is a novel, brief instrument measuring college students' perception of the healthfulness of their environment. Strengths include: strong psychometric properties, breadth of constructs, and comprehensive instrument development process involving a large sample from seven different universities. Future steps include validation studies.

Food Consumption Patterns and Predictors of Dietary Diversity in Pastoral Communities of Ngorongoro District, Tanzania

“…Food insecurity and micronutrient malnutrition are widespread public health problems that can be alleviated in part through increasing dietary diversity (Harris-Fry et al, 2015;Mphwanthe et al, 2018;Larson et al, 2019). Dietary Diversity Score (DDS), a qualitative measure of food consumption, has become a widely used method of determining variety in the diet and by proxy, nutrient adequacy (Labadarios et al, 2011;Arsenault et al, 2013;Martin-Prével et al, 2015).…”