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Amanda Fox Kelly Knopf
Thesis Advisor: Catherine Arnold, MS, EdD, RD, LDN
EFFECT OF A NUTRITION AND
HEALTH FAIR ON THE ELDERLY AND BENEDICTINE
STUDENTS
The elderly are at an increased risk for low fruit and vegetable intake due to: Cost Preparation Mental limitations Poor oral health Multiple chronic diseases
Meta-Analysis Inverse relationship between fruit and vegetable
consumption and risk of CHD and stroke. Fruit and vegetable intake can be used to prevent some
chronic conditions Awareness, education, and intervention is key.
BACKGROUND
Dauchet, Luc & Amouyel, Philippe & Hercberg, Serge & Dallongeville, Jean. (2006). Fruit and vegetable consumption and risk of coronaryheart disease: a meta-analysis of cohort studies. The Journal of nutrition, 136.
To investigate the effect of participation in a health and nutrition fair on the attitudes of undergraduate nutrition students in reference to service learning and volunteerism.
To investigate the relationships between fruit and vegetable servings in relation to self-effi cacy, stage of change, and quality of life at a nutrition education health fair.
PURPOSE
Date: Thursday, April 14, 2011
Location: Villa St. Benedict
Time: 2:30 – 7:30pm 2:30-3:00 students set
up booths 3:00 – 7:00 active
participation in the health fair 7:00 – 7:30 clean up
Educational Booths provided by Benedictine University undergraduate students
Other booths provided by Benedictine University exercise physiology students and other outside vendors
METHODS: HEALTH FAIR
Student booth topics selectedVendors and donors contactedPlanning with Nutrition instructorMeeting with NUTR 280 students, topics
chosenRoom layout designedIndividual meetings with NUTR280
students for grading of educational booth and interactive component
Raffl e prizes acquired
METHODS: HEALTH FAIR PLANNING
Heart Disease (11)Diabetes (4)Weight Management (7)Functional Foods (6)Food Safety
METHODS: STUDENT TOPIC BOOTHS
Advertisement March 2011
Marketing flyers were created and distributed at Villa St. Benedict. Flyers contained information on the date, time, and location of the health fair. It also included information on the complimentary services that would be offered at the fair.
Instrumentation Community Health and Nutrition Fair Questionnaire (CHFQ) Service Learning and Volunteerism Questionnaire (SLVQ)
METHODS: HEALTH FAIR
ElderlyAdministered during
the Health Fair The raffl e was held
every 20 minutes for the “Grand Prize Winner”
Health Fair Subjects Inclusion criteria: 50
years and older, attendance to the health fair.
UndergraduatesAdministered one time,
one week following the fair 4 raffl e tickets were drawn
and those students received prizes
Students in the Spring semester of NUTR280: Community Nutrition Inclusion criteria: all students
enrolled in the class who participated in the health fair and present on the night the survey was administered
SURVEY ADMINISTRATION AND SAMPLING
Amanda Fox
EFFECT OF A NUTRITION AND
HEALTH FAIR ON THE ELDERLY
LITERATURE REVIEW – STAGE OF CHANGE
Greene G,Fey-Yensan N, Padula C,Rossi S,Rossi J,Clark P. Differences in psychosocial variables by stage of change for fruits and vegetables in older adults J Am Diet Assoc 2004;104:1236-1243.
Part of the Social Cognitive Theory
If belief in oneself is achieved, a person feels more motivated to complete the task.
Good for predicting fruit and vegetable intake higher in the action and maintenance phase
LITERATURE REVIEW- SELF-EFFICACY
Bandura, A. (1998). Health promotion from the perspective of social cognitive theory.Psychology and Health, 13, 623-649.
According to the CDC, fruit and vegetable consumption among the elderly is low.
Do the SOC and self-effi cacy theory still apply to the elderly?
Need more research to look at the effects of fruit and vegetable consumption on disease state
NEED FOR THIS RESEARCH
State-Specific Trends in Fruit and Vegetable Consumption Among Adults --- United States, 2010. Centers for Disease Control and Prevention. Web. 07 Nov. 2011. <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5935a1.htm?s_cid=mm5935a1_w>.
METHODS: SAMPLING
Participants who attended the Health Fair
Descriptive Statistics for Health Fair Participants
NMinimu
mMaximu
m MeanStd.
Deviation
age 58 51.00 94.00 79.0345 11.84396
Valid N (listwise)
58
Gender Race
STUDY DEMOGRAPHICS
Chi-square Testx2 (4)= 21.55=p<.001
Null Hypothesis: Rejected
H01: THERE IS NO DIFFERENCE BETWEEN MENTAL AND PHYSICAL HEALTH.
H0 2 ( A ) : THERE IS NO DIFFERENCE IN THE NUMBER OF VEGETABLE SERVINGS BETWEEN PREACTION STAGE OF CHANGE GROUP AND ACTION STAGE OF CHANGE GROUP.
(t(52)= -3.306, p<.01, d= 1.002
Rejected p=.002
Frequency
Valid Percent
Stage of change 2 category
Valid Precontemplation
7 12.5 Preactionn= 35
Contemplation 17 30.4
Preparation 11 19.6
Action 7 12.5 Actionn= 21
Maintenance 14 25.0
Total 56 100.0Missing
999.002
Total 58
Stage of change frequencies Number of vegetable servings per day
Preaction m=2.36
Action m=3.29
H0 2 ( B ) : THERE IS NO DIFFERENCE IN THE NUMBER OF FRUIT SERVINGS BETWEEN PREACTION STAGE OF CHANGE GROUP AND ACTION STAGE OF CHANGE GROUP.
(t(52)= -4.44, p<.01, d= .89
Rejected p<.001
Frequency
Valid Percent
Stage of change 2 category
Valid Precontemplation
8 14.3 Preactionn= 43
Contemplation 17 30.4
Preparation 18 32.1
Action 5 8.9 Actionn= 18
Maintenance 8 14.3
Total 56 100.0
Missing
999.00 2
Total 58
Stage of change frequencies
Number of fruit servings per day
Preaction m=2.12
Action m= 3.38
Diseases that were considered LinkedHigh Blood PressureHigh Blood CholesterolLow HDLHigh TriglyceridesHeart ProblemsOverweight/ObeseCancer
H0 3 ( A ) : THERE IS NO DIFFERENCE IN THE NUMBER OF LINKED DISEASES AND PREACTION STAGE OF CHANGE GROUP BETWEEN ACTION STAGE OF CHANGE GROUP FOR FRUIT.
(t(54)= .072, p=.837)
Accepted p=.837Linked Disease m= 1.78
Diseases that were considered LinkedHigh Blood PressureHigh Blood CholesterolLow HDLHigh TriglyceridesHeart ProblemsOverweight/ObeseCancer
H0 3 ( B ) : THERE IS NO DIFFERENCE IN THE NUMBER OF LINKED DISEASES AND PREACTION STAGE OF CHANGE GROUP BETWEEN ACTION STAGE OF CHANGE GROUP FOR VEGETABLE.
(t(54)= . 072, p= .479). Accepted p= .479). Linked Disease m= 1.78
Predictors of Fruit ServingsStage of change fruit- preaction and action group Number of vegetable servings
Results (F(3,48)= 9.768, p<.001 R2 of .379
Regression Equation1.150(SOC fruit2) + .320 (number of vegetables per day)
Rejected p<.001
H04(A) : THERE ARE NO PREDICTORS FOR NUMBER OF FRUIT SERVINGS.
H04(B) : THERE ARE NO PREDICTORS FOR NUMBER OF VEGETABLE SERVINGS.
Predictors of Vegetables Servings Stage of change vegetable- preaction and
action group Number of fruit servings Gender
Result (F(3,52)= 594291.41, p<.001 R2 of 1.0.
Regression Equation 1(number of fruit per day) + .755 (stage of
change vegetable intake 2)-.921 (Gender)
Distinguished the importance between mental and physical health as separate entities instead of together. Provided insight for the confidence and importance the elderly have for fruit and vegetable intake
The number of fruit and vegetables consumed was significantly diff erent between the stage of change categories.
The number of disease was not connected to ties of motivation.
The number of vegetables predicted with 100% variance.
The number of fruit can be predicted with close to 40%.
CONCLUSION
Kelly Knopf
EFFECT OF A NUTRITION AND HEALTH FAIR ON
BENEDICTINE STUDENTS
Forum for the delivery of health information
Students will have a more positive attitude toward research Interdisciplinary approachPooled resources
LITERATURE REVIEW – HEALTH FAIRS
Levy K, Lehna C. A service-oriented teaching and learning project. Pediatr Nurs. 2002;28(3):219.Mason DJ, Calvacca LR. Health fair: Providing a learning experience through a community service project. J Nurs Educ. 1982;21:39-47Maltby H. Use of health fairs to develop public health nursing competencies. Public Health Nursing. 2006;23(2):183-189
Service Learning defined: any learning experience that occurs by blending learning objectives, preparation, and reflection within a community setting
Service Learning in Dietetics is under represented
Gain experiential knowledge
LITERATURE REVIEW – SERVICE LEARNING
Gilboy MB. Incorporating Service Learning in Community Nutrition. Topics in Clinical Nutrition. 2009;24(1):16-24.Leonard LG. Primary health care and partnerships: Collaboration of a community agency, health department, and university nursing program. J Nurs Educ. 1998;37(3):144-148. Fournier AM, Harea C, Ardalan K, Sobin L. Health fairs as a unique teaching methodology. Teaching & Learning in Medicine. 1999;11(1):48-51
Bandura’s Social Learning Theory
Kolb’s Experiential Learning Cycle
LEARNING THEORIES
Attentional – Memorization of material
Retention – Regurgitation of material
Reproduction - Engage in creating educational materials
Motivational – Become motivated to share the informationFournier AM, Harea C, Ardalan K, Sobin L. Health fairs as a unique teaching methodology. Teaching & Learning in Medicine. 1999;11(1):48-51Kolb D, Boyatzis R, Mainemelis C. Experiential learning theory: Previous research and new directions. Perspectives on thinking, learning, and cognitive styles. Mahwah, NJ US: Lawrence Erlbaum Associates Publishers; 2001:227-247.
Service Learning in Dietetics is under represented
Most outcomes focus on success of the program to meet objectives
Need more research focused on impact to students
NEED FOR THIS RESEARCH
METHODS: SAMPLING
Spring 2011 Nutrition 280: Community Nutrition
26 undergraduate nutrition students
Descriptive Statistics for Undergraduate Student Participants
N Minimum Maximum MeanStd.
Deviation
Age in years 26 20.00 36.00 22.88 3.85
Valid N (listwise) 26
Age: Traditional vs. Non-traditional
Gender: Male vs. Female
STUDY DEMOGRAPHICS
80.8% traditional19.2% non traditional
84.6% female15.4% male
Provided you with personal satisfaction through helping others (m=6.50)
Applied nutrition information/knowledge learned in courses (m=6.42)
Improved your understanding of how nutrition education can be integrated into community activities (m= 6.46)
TOOL: SLVQ: HEALTH FAIR (HF)
4 factorsDeveloping Deeper Understanding and Higher Order Skills (5 variables)
Experiential Learning (4 variables)Self-efficacy and Values (4 variables)Impact on Community (2 variables)
These four factors account for 77% of the variance in the health fair variables
PCA: HEALTH FAIR (HF) QUESTIONS
RELIABILITY FOR HEALTH FAIR (HF) FACTORS
Reliability Statistics for Health Fair Factors
Cronbach's Alpha
N of Items
Level of Internal Reliability
Developing Deeper Understanding and Higher Order Skills
.83 5 Good
Experiential Learning .80 4 Good
Self-efficacy and Values
.76 4 Acceptable
Impact on Community
.67 2 Questionable to Acceptable
Health Fair Variables .89 15 Excellent
H0 5 : THERE IS NO DIFFERENCE IN HEALTH FACTOR MEAN RATING SCORES ACROSS TWO AGE CATEGORIES, TRADITIONAL AND NON-TRADITIONAL UNDERGRADUATE STUDENTS.
Developing deeper understanding and higher order skills
t(24) = .016, p>.05
Experiential t(24) = -.90, p>.05
Self-efficacy and values
t(24) = 1.00, p>.05
Impact on community
t(24) = .69, p>.05
H05 is accepted
I prefer courses in which applied experiences are authentic (m=6.77)
Learning by doing is a necessary component for adequate training in health care professions (m=6.92)
I am committed to making a positive difference (m=6.88)
TOOL: SLVQ: SERVICE LEARNING (SL)
4 factorsContemplation/Preparation phase for Volunteerism (3 variables)
Action Phase and Value Integration (3 variables)
Curricular Requirement (1 variable)Curricular Preference (1 variable).
These four factors account for 79% of the variance.
PCA: SERVICE LEARNING QUESTIONS (SL)
RELIABILITY FOR SERVICE LEARNING (SL) FACTORS
Reliability Statistics for Service Learning Factors
Cronbach's Alpha
N of Items
Level of Internal Reliability
Contemplation/Preparation Stage for
Volunteerism
.63 3 Questionable
Action Phase and Values Integration
.81 3 Good
Service Learning Variables
.69 8 Questionable to Acceptable
H0 6 : THERE IS NO DIFFERENCE IN SERVICE LEARNING FACTOR MEAN RATING SCORES ACROSS TWO AGE CATEGORIES, TRADITIONAL AND NON-TRADITIONAL UNDERGRADUATE STUDENTS.
Contemplation/Preparation Stage of Volunteerism
t(24) = -1.09, p>.05
Action/Value Integration t(24) = -1.07, p>.05
Curricular requirement t(24) = -.70, p>.05
Curricular Preference t(24) = 1.84, p>.05
H06 is accepted
H 0 7 : T H E R E I S N O R E L AT I O N S H I P B E T W E E N AG E A N D M E A N S O F D E V E LO P I N G D E E P E R U N D E R S TA N D I N G A N D H I G H E R O R D E R S K I L L S , E X P E R I E N T I A L L E A R N I N G , S E L F -E F F I C ACY A N D VA LU E S , I M PAC T O N C O M M U N I T Y , C O N T E M P L AT I O N / P R E PA RAT I O N P H A S E O F VO LU N T E E R I S M , AC T I O N P H A S E A N D VA LU E I N T E G RAT I O N O F VO LU N T E E R I S M , C U R R I C U L A R R E Q U I R E M E N T , A N D C U R R I C U L A R P R E F E R E N C E .
Developing deeper
understanding and higher order
skills Experiential
Self-efficacy
and values
Impact on
community
Contemplation/ preparation phase for volunteerism
Pearson Correlation
.065 .572** -.030 .071
Sig. (2-tailed)
.752 .002 .884 .729
Action phase and values integration
Pearson Correlation
.507** .588** .356 .338
Sig. (2-tailed)
.008 .002 .074 .091
Curricular requirement
Pearson Correlation
-.049 -.121 .173 .009
Sig. (2-tailed)
.812 .557 .398 .964
Curricular preference
Pearson Correlation
-.239 .061 .089 .068
Sig. (2-tailed)
.240 .768 .665 .743
H07 is rejected
Health Fair factorsDeveloping Understanding and Higher Order SkillsF(4,21) = 2.72, p>.05 with R2 of .34
Self-efficacy and ValuesF(4,21) = 1.34, p>.05 with R2 of .20
Impact on CommunityF(4,21) = .74, p>.05 with R2 of .12
H08: SERVICE LEARNING FACTORS WILL NOT PREDICT HEALTH FAIR
FACTORS
Health Fair factorExperiential Learning
FormulaF(4,21) = 5.30, p<.05 with an R2 of .50
EquationExperiential Learning = .06(Contemplation/preparation phase for volunteerism) + .24(Action Phase and Values Integration) and accounts for 50% of the variance
Rejected p <.05
H08: SERVICE LEARNING FACTORS WILL NOT PREDICT HEALTH FAIR
FACTORS
Age does not aff ect the mean rating scores for Health Fair (HF) factors and Service Learning (SL) factors
There is no correlation between age and any of the Health Fair (HF) or Service Learning (SL) factors.
There is a correlation between Experiential Learning and Contemplation/Preparation Phase for Volunteerism, and Action Phase and Values Integration. There is also a correlation between Developing Deeper Understanding and Higher Order Skills and Action Phase and Values Integration.
Contemplation/preparation Phase for Volunteerism and Action Phase and Values Integration, service learning factors, are good predictors of Experiential Learning, a health fair factor.
If future results confi rm the current fi ndings, the survey tool can be pared down to those questions within the Experiential Learning, Contemplation/Preparation Phase for Volunteerism, and Action Phase and Values Integration factors.
CONCLUSIONS
Reliable data collection tools CHFQ and SLVQ
All surveys coded and entered by researchers
Incentive to participate
Participation rate for in-class survey
STRENGTHS
Useful in developing future service learning opportunities to undergraduate students
Useful in designing undergraduate nutrition courses
Mental health and Physical health can be separated in future surveys than as one question.
The number of vegetables predicted with 100% variance could be used in future thesis.
APPLICATIONS
Small sample sizeEvent held during dinner time of the
residentsIncentive given out for filling out
survey toolNo control, no randomizationGeneralizability, limited
High % of femaleHigh % of Caucasian
WEAKNESSES
Shorten the time for the health fair and end the fair when the residents go to dinner.
Larger venue or more tables to create better traffi c flow
It would be interesting to do pre- and post test of the SLVQ to see if there is any change in attitudes as a result of the health fair
Repeat both studies for larger N to increase generalizability
FUTURE RESEARCH
THANK YOU FOR YOUR ATTENTION