ENROLLED IN THE EXPANDED NUTRITION PROGRAM A THESIS

THE EFFECT OF NUTRITION EDUCATION ON NUTRITION

KNOWLEDGE AND FOOD PATTERNS OF LEADERS

ENROLLED IN THE EXPANDED

NUTRITION PROGRAM

by

SHELLEY WILLIAMS FILLIPP, B.S. in H.E.

A THESIS

IN

FOOD AND NUTRITION

Submitted to the Graduate Faculty of Texas Tech University in

Partial Fulfillment of the Requirements for

the Degree of

MASTER OF SCIENCE

IN

HOME ECONOMICS

Approved

Acceoted

May, 1983

l ? » * " j — W F ^ ^ ^ ^ W f W W I p M l g liral I jl.1 III I j W W É I M — M f c " ^

ACKNOWLEDGMENTS

Sincere appreciation is extended to Dr. Merrilyn Cummings for

her professional direction and encouraging support throughout this

study. Appreciation is also extended to Dr. Helen Brittin and Mrs.

Margarette Harden for their direction and interest. I would like

to thank the Lubbock Food Stamp Office, the Lubbock Expanded Nutri-

tion Program Staff, and Tina Vanpelt for their assistance with this

study. In addition, I wish to thank my husband, Steve for his sup-

port and understanding in this endeavor.

n

TABLE OF CONTENTS

ACKNOWLEDGMENTS ii

LIST OF TABLES v

Chapter

I. INTRODUCTION 1

Statement of the Problem 4 Hypotheses 4 Scope and Limitations 7 Definitions of Terms 9

II. REVIEW OF LITERATURE 13

Overview of the Expanded Food and Nutrition Education Program (EFNEP) 13

Factors Influencing Nutritional Status 15 Income Level 15 Educational Level 17 Attitudes 18 Culture 19

Development of Food Patterns 22 Strategies for Nutrition Education 25

Methods and Approaches 26 Utilization of Paraprofessionals 28

Summary 30

III. METHODS AND PROCEDURES 31

Overview of Nutrition Lessons and Training 31 Design and Development of Instruments 32

Development of Original Version of the Demographic Data Information Sheet 32

Development of Original Version of Food Behavior Questionnaire 33

Original Version of Nutrition Knowledge Test . . . . 33 Input on Original Instruments and Revisions Made . . 34 Pretesting of the Revised Instruments 34 Development of Final Instruments 35 Development of Food Model Flip Chart 36

Selection and Description of Sample 37 Expanded Nutrition Program (ENP) Leaders 37 Control Group Participants 40

iii

Collection of Data 41 Expanded Nutrition Program (ENP) Leâdêrs . . . . . 41 Control Group Participants 42

Treatment of the Data 42

IV. ANALYSIS AND INTERPRETATION OF THE DATA 43

Statistical Analysis of Hypotheses 43 Hypothesis 1 44 Hypothesis 2 44 Hypothesis 3 45 Hypothesis 4 45 Hypothesis 5 46 Hypothesis 6 49 Hypothesis 7 49 Hypothesis 8 52 Hypothesis 9 53 Hypothesis 10 53 Hypothesis 11 55 Hypothesis 12 55 Hypothesis 13 57 Hypothesis 14 57 Hypothesis 15 59 Hypothesis 16 71 Hypothesis 17 74 Hypothesis 18 81

Summary 83 V. SUMMARY AND CONCLUSIONS 89

Summary of the Study 89 Findings of the Study 90 Conclusions and Implications of the Study 96 Recommendations for Further Research 105

LIST OF REFERENCES 106

APPENDICES

A. STANDARDIZATION TRAINING LESSON PLANS 111 B. DEMOGRAPHIC DATA INFORMATION SHEET 130 C. FOOD BEHAVIOR QUESTIONNAIRE 133 D. NUTRITION KNOWLEDGE TEST 138

IV

'. I m 1 1 1 1 ', "I _ . . _ ^ j j — — — i f c ^ ? - l

LIST OF TABLES

Table Page

1. Demographic Data for ENP Leaders and Control Group Participants 38

2. Analysis of Differences Between Mean Preassessment and Postassessment Nutrition Knowledge Test Scores for ENP Leaders and Control Group Participants. . . . 44

3. Analysis of Differences Between ENP Leaders and Control Group Participants Mean Preassessment and Postassessment Nutrition Knowledge Test Scores. . . . 45

4. Analysis of Differences Between Mean Preassessment and Postassessment Daily Food Consumption Scores for ENP Leaders and Control Group Participants 47

5. Analysis of Differences Between ENP Leaders and Control Group Participants Mean Daily Food Consump-tion Scores on the Preassessment and Postassessment . 50

6. Analysis of Differences Between Mean Preassessment and Postassessment of Weekly Food Patterns for ENP Leaders and Control Group Participants 54

7. Analysis of Differences Between Mean Weekly Food Pattern Scores of ENP Leaders and Control Group Participants on Preassessment and Postassessment. . . 56

8. Analysis of Differences Between Mean Nutrition Knowledge Preassessment Test Scores and Post-assessment Test Scores of ENP Leaders When Clas-sified on Various Demographic Variables 58

9. Analysis of Differences Between Mean Daily Food Consumption Scores of ENP Leaders When Classified by Race for Preassessment and Postassessment 60

10. Analysis of Differences Between Mean Daily Food Consumption Scores of ENP Leaders Classified by Age for Preassessment and Postassessment 62

iMaiÊiummmmnn

Table Page

11. Analysis of Differences Between Mean Daily Food Consumption Scores of ENP Leaders Classified by Educational Level for Preassessment and Post-assessment 64

12. Analysis of Differences Between Mean Daily Food Consumption Scores of ENP Leaders Classified by Income Level For Preassessment and Post-assessment 66

13. Analysis of Differences Between Mean Daily Food Consumption Scores of ENP Leaders Classified by Number of People Living in Household for Preassessment and Postassessment 68

14. Analysis of Differences Between Mean Weekly Food Pattern Scores of ENP Leaders When Classified by Race for Preassessment and Postassessment 75

15. Analysis of Differences Between Mean Weekly Food Pattern Scores of ENP Leaders When Classified by Age for Preassessment and Postassessment 76

16. Analysis of Differences Between Mean Weekly Food Pattern Scores of ENP Leaders When Classified by Educational Level for Preassessment and Post-assessment 77

17. Analysis of Differences Between Mean Weekly Food Pattern Scores of ENP Leaders When Classified by Income Level for Preassessment and Postassessment . . 78

18. Analysis of Differences Between Mean Weekly Food Pattern Scores of ENP Leaders When Classified by Number of People Living in Household for Pre-assessment and Postassessment 79

VI

p W W i' , íiwii ••i>n'N&«»#)Maiiîi7i '

CHAPTER I

INTRODUCTION

A need exists for effective nutrition education for all

populations around the world. According to Fusillo and Beloian (18),

consumers with limited nutrition knowledge have less education and

income than individuals with more nutrition knowledge. Other re-

searchers (1, 24, 31, 37) have concurred with Fusillo and Beloian (18).

Economic factors play an important role in determining a family's

food selections as noted by Abdel-Ghany and Schrimper (1), Craig (12),

Koh and Caples (23), and Mills (28).

According to 1980 statistics from the United States Department

of Commerce and the Bureau of the Census (42) 29,272 people were

below the poverty level and 29.3 million people were classified as

poor. Researchers (1, 23, 24, 28, 37) have indicated that the low-

income population is much more susceptible to poor eating habits and

buying practices than other income groups. A need exists to help

this group through nutrition education.

The Expanded Food and Nutrition Education Program (EFNEP) was

established in 1968 by the United States government and is administered

by the Cooperative Extension Service within each state. The purpose

of EFNEP as set forth in the Revised Policy Guidelines and Suqqes-

tions for Conducting the Extension Expanded Food and Nutrition

1

•if- • .„^ '•.,• • • , t u ^ j , ^ — . - . ^ . , ^.i>

Education Program (25) is to help low-income families learn more

about nutrition, sanitation, meal planning, and food preparation.

Within Texas, the program title was shortened to the Expanded

Nutrition Program (ENP). Paraprofessionals, titled Program Assistants

and Program Aides, are utilized to teach nutrition lessons to in-

dividuals in low-income areas.

There are two phases of the ENP, the adult and youth aspects.

In the adult phase, Program Assistants and Program Aides work with

homemakers for as long as a two-year period. The Program Assistants

and Program Aides select lessons based upon the homemakers' needs.

Generally the homemaker was taught on an individual basis for the

first few months and then moved to a group of homemakers who re-

ceived ENP nutrition lessons.

In the youth phase of the ENP, Program Assistants work with

leaders and youth for approximately four months or the time needed

to complete a nine-lesson nutrition series. Leaders can be home-

makers, teenagers, community center workers, or university students.

The nine-lesson series is composed of nine different lesson plans

dealing with various aspects of nutrition, sanitation, food buying,

and food preparation. The Program Assistant will teach a nutrition

lesson and present a foods demonstration for the leader on each of

the nine lessons. Each leader then teaches a group of youth each of

the nine lessons. In Lubbock, where this research was conducted,

the ENP unit consisted of the youth phase only.

Research data related to the ENP have indicated varying degrees

of improvement in food patterns. In 1972 Feaster (16) found that

after 6 months of enrollment in the ENP 11 percent of the families

reported adequate diets as compared to an earlier 4 percent. In 1975

Leidenfrost (25) reported that after one year of participation in

the ENP, 19 percent of the families in the program were meeting

recommended dietary allowances.

In 1976 Boone and White (5) evaluated different nutrition

education environments and found that youth participating in an

informal environment through the ENP exhibited greater positive food

pattern changes than youth taught nutrition education in elementary

classroom settings. Home-based education for each stage of the

family life cycle has been advocated by Kolasa et al. (24).

After the results of a 1976 study by Feaster and Perkins (17)

it was concluded that the length of participation in the ENP was a

significant determinant of food consumption levels. Most of the

improvements in diet patterns were made in the first 18 months of

participation with the ENP. The most dramatic changes in the diet

were seen during the first six months that the homemakers participated

in the ENP. After this period of time, the changes in diet patterns

occurred much slower in those homemakers continuing to participate

in the ENP for another year. Since in the youth program, leaders

are involved from three to five months, the youth phase may benefit

the leader just as much as the adult phase where homemakers are

enrolled for a longer period.

Statement of the Problem

While several studies involving the ENP homemakers in the adult

program and youth participants in the youth program have been con-

ducted, studies have not been found that focused on leaders involved

in the youth phase of the ENP and changes in their nutrition knowledge

and food patterns as a result of being ENP leaders. This study was

designed for the following purposes:

1. To determine if changes in the ENP leaders' nutrition

knowledge and food patterns resulted after they received nutrition

information from an ENP Program Assistant and then taught that

nutrition information to a group of youth

2. To determine if significant differences in nutrition

knowledge and food patterns existed when the ENP leaders were clas-

sified according to various demographic variables

Hypotheses

Eighteen hypotheses were tested in this study. They included

the foUowing:

1. There is no significant difference between the mean pre-

assessment and postassessment nutrition knowledge test scores of

leaders enrolled in the ENP.


assessment and postassessment nutrition knowledge test scores of

the control group participants.


assessment nutrition knowledge test scores of the ENP leaders and


4. There is no significant difference between the mean post-

assessment nutrition knowledge test scores of the ENP leaders and


5. There is no significant difference between the mean daily

food consumption scores of the ENP leaders on the preassessment and

postassessment of the Food Behavior Questionnaire for each of 13 food

categories.


food consumption scores of the control group participants on the pre-

assessment and postassessment of the Food Behavior Questionnaire for

each of 13 food categories.


food consumption scores of the ENP leaders and the control group

participants on the preassessment of the Food Behavior Questionnaire

for each of 13 food categories.



participants on the postassessment of the Food Behavior Question-

naire for each of 13 food categories.

9. There is no significant difference between the mean weekly

food pattern scores of the ENP leaders on the preassessment and post-

assessment of the Food Behavior Questionnaire for each of five food

patterns.


food pattern scores of the control group participants on the pre-

assessment and postassessment of the Food Behavior Questionnaire for

each of five food patterns.


food pattern scores of the ENP leaders and the control group par-

ticipants on the preassessment of the Food Behavior Questionnaire

for each of five food patterns.


food pattern scores of the ENP leaders and the control group par-

ticipants on the postassessment of the Food Behavior Questionnaire

for eachof five food patterns.


assessment nutrition knowledge test scores of the ENP leaders when

they are classified on each of five demographic variables.


assessment nutrition knowledge test scores of the ENP leaders when

they are classified on each of five demographic variables.


assessment daily food consumption scores for each of 13 food categories

when the ENP leaders are classified on each of 5 demographic

variables.


assessment daily food consumption scores for each of 13 food categories

when the ENP leaders are classified on each of 5 demographic

variables.


assessment weekly food pattern scores for each of five food patterns

when the ENP leaders are classified on each of five demographic

variables.


assessment weekly food pattern scores for each of five food patterns

when the ENP leaders are classified on each of five demographic

variables.

Scope and Limitations

This study was conducted between June and December of 1981.

Available leaders enrolled in the ENP in Lubbock, Texas, were tested

for nutrition knowledge and food patterns before and after receiving

nutrition lessons from an ENP Program Assistant. The length of time

from the preassessment to the postassessment varied from leader to

leader. The postassessment was conducted from 9 to 12 weeks after

beginning the nutrition lessons. There were nine lessons, and

generally a Program Assistant saw a leader once a week. Since

leaders sometimes missed their weekly appointments, a 12-week limit

was set for the postassessment. To be postassessed the leader must

have completed at least six lessons, since that is the minimum

number of lessons that can be completed in order to graduate from the

program. Forty-four leaders were involved in the preassessment,

but only 31 of these leaders completed the postassessment. This

loss can be attributed to leaders moving and leaving no address or

8

not completing a minimum of six lessons so that they could be post-

assessed. The actual number of lessons completed may have influenced

a leader's score on the instruments.

The four Program Assistants received special training on the

nutrition lessons to standardize information taught to the leaders.

Each Program Assistant however, may have presented the material in a

slightly different way allowing variations to be introduced into the

lessons. In addition, the teaching skills of the Program Assistants

may have varied according to individual capabilities.

The instruments were administered orally by the researcher to

all leaders. Even though the researcher read the questions, varying

educational and language levels may have affected interpretations of

the questions.

Due to time limitations, the control group data were collected

by an individual trained by the researcher. While the person col-

lecting the data on the control group participants had previously

worked as a Program Assistant for the ENP there may have been some

variations in the way the data were collected. In addition, the

control group participants were selected from a comparable but dif-

ferent population group due to time limitations and availability of

individuals. The control group participants differed from the ENP

leaders in several different ways. The control group was composed

of more Anglo participants, more people in the 30 years and older

age group, more individuals with income levels of S5,000 or more, and

a smaller number of persons in their households than the ENP leaders.

" ' " ^ " • • --'- ~ , ^ .v

8

not completing a minimum of six lessons so that they could be post-

assessed. The actual number of lessons completed may have influenced

a leader's score on the instruments.

The four Program Assistants received special training on the

nutrition lessons to standardize information taught to the leaders.

Each Program Assistant however, may have presented the material in a

slightly different way allowing variations to be introduced into the

lessons. In addition, the teaching skills of the Program Assistants

may have varied according to individual capabilities.

The instruments were administered orally by the researcher to

all leaders. Even though the researcher read the questions, varying

educational and language levels may have affected interpretations of

the questions.

Due to time limitations, the control group data were collected

by an individual trained by the researcher. While the person col-

lecting the data on the control group participants had previously

worked as a Program Assistant for the ENP there may have been some

variations in the way the data were collected. In addition, the

control group participants were selected from a comparable but dif-

ferent population group due to time limitations and availability of

individuals. The control group participants differed from the ENP

leaders in several different ways. The control group was composed

of more Anglo participants, more people in the 30 years and older

age group, more individuals with income levels of $5,000 or more, and

a smaller number of persons in their households than the ENP leaders.

No significant difference was found between the control group

participants and the ENP leaders' scores on the preassessment of the

Nutrition Knowledge Test, and only three significant differences

were found between scores of the two groups on the preassessment

of the Food Behavior Questionnaire. The two groups were comparable

based on the mean scores on these two instruments.

Definitions of Terms

The following terms were defined according to their use in

the study:

1. Control Group - thirty-one people who were administered

the Demographic Data Information Sheet, the Nutrition Knowledge Test,

and the Food Behavior Questionnaire with a maximum of a 12-week

interval between the preassessments and the postassessments. This

group received no nutrition information from Program Assistants in

the ENP during this 12-week interval.

2. Daily Food Consumption Scores - scores representing the

number of servings consumed on a daily basis by a person for each

of 13 food categories on the Food Behavior Questionnaire. Possible

scores ranged from zero to seven for each food category indicating

number of servings consumed daily.

3. Demographic Data Information Sheet - a series of eight

closed-ended questions used to gather the following information:

name, sex, race, age, educational level , income level, number of

people living in household, and previous enrollment in the ENP.

-V-'-Hi

No significant difference was found between the control group

participants and the ENP leaders' scores on the preassessment of the

Nutrition Knowledge Test, and only three significant differences

were found between scores of the two groups on the preassessment

of the Food Behavior Questionnaire. The two groups were comparable

based on the mean scores on these two instruments.

Definitions of Terms

The following terms were defined according to their use in

the study:

1. Control Group - thirty-one people who were administered

the Demographic Data Information Sheet, the Nutrition Knowledge Test,

and the Food Behavior Questionnaire with a maximum of a 12-week

interval between the preassessments and the postassessments. This

group received no nutrition information from Program Assistants in

the ENP during this 12-week interval.

2. Daily Food Consumption Scores - scores representing the

number of servings consumed on a daily basis by a person for each

of 13 food categories on the Food Behavior Questionnaire. Possible

scores ranged from zero to seven for each food category indicating

number of servings consumed daily.

3. Demographic Data Information Sheet - a series of eight

closed-ended questions used to gather the following information:

name, sex, race, age, educational level, income level, number of

people living in household, and previous enrollment in the ENP.

10

4. Expanded Nutrition Program (ENP) - the Texas title designa-

tion for a federally funded program to help low-income families at-

tain nutrition information. ENP is administered in each state by the

Cooperative Extension Service. Paraprofessionals are employed to

work with low-income families under the supervision of an Extension

Agent. At the time of this study Lubbock, Texas, had the youth phase

in which leaders were recruited to teach nutrition information to

youth.

5. Extension Agent - a person employed by the Cooperative

Extension Service to teach the public in the areas of home economics

or agriculture. In this study, the Extension Agent was in charge of

the ENP and had a Bachelor of Science degree in Home Economics.

6. Food Behavior Questionnaire - a two-part instrument con-

sisting of a total of 18 items developed by the researcher to deter-

mine the food patterns of leaders in the ENP. Items in part one

dealt with daily and/or weekly food patterns, while items in part

two dealt with food patterns that were likely to occur on a weekly

ba s i s.

7. Food Model Flip Chart - a flip chart shown to each ENP

leader and control group participant during the administration of

the Food Behavior Questionnaire. The flip chart consisted of pictures

of examples of several foods for each food category and the standard

serving sizes to aid the ENP leaders and control group participants

in answering questions in the Food Behavior Questionnaire.

11

8. Home Visit - the method through which most ENP leaders

received their nutrition lessons. Generally the Program Assistants

visited the homes of the leaders once a week to instruct them on one

of nine nutrition lessons.

9. ENP Leader - a person who volunteered to receive nutrition

information lessons from an ENP Program Assistant and then taught

this information to a group of low-income youth. An ENP leader was

a homemaker, teenager, community center worker, college student, or

anyone willing to volunteer. There were 31 ENP leaders in the

study.

10. Nine-Lesson Nutrition Series - the group of standardized

nutrition lessons taught to the ENP leader by the Program Assistant

during the nutrition training. Each lesson dealt with aspects of

nutrition, sanitation, food buying, and food preparation.

11. Nutrition Knowledge Test - the instrument consisting of 8

true-false questions and 12 multiple-choice questions based on the

content of the nine-lesson nutrition series. The instrument was

developed by the researcher to assess nutrition knowledge of the

ENP leaders.

12. Nutrition Knowledge Test Scores - scores that were based

upon answers given on the Nutrition Knowledge Test. The possible

range of scores was 0 to 20.

13. Program Aide and Program Assistant - a paraprofessional

employee of the ENP. This person taught the ENP leaders nutrition,

sanitation, food buying, and food preparation after receiving

12

training from the Extension Agent in charge of the ENP. The Program

Aide works only in the adult phase of ENP. A Program Assistant can

work either in the adult or youth phase of ENP.

14. Youth - low-income youth between the ages of 9 and 19 who

are eligible to participate in the youth phase of the ENP.

15. Weekly Food Pattern Scores - scores representing number

of times five different food patterns were followed on a weekly

basis by a person as indicated on the Food Behavior Questionnaire.

Possible scores ranged from zero to seven for each food pattern

indicating number of times per week the pattern was followed.

CHAPTER II

REVIEW OF LITERATURE

The review of literature consisted of four sections. The first

section provides an overview of the Expanded Food and Nutrition Educa-

tion Program (EFNEP). The second section deals with factors in-

fluencing nutritional status. The third section is concerned with

the development of food patterns. The fourth section highlights

strategies for nutrition education.

Overview of the Expanded Food and Nutrition Education Program (EFNEP)

The author of EFNEP...Accomplishments and Future Needs (25)

has outlined the development of the Expanded Food and Nutrition

Education Program (EFNEP) which is aimed at helping low-income

families improve their nutritional status. Since its beginning, the

Cooperative Extension Service has worked with rural disadvantaged

families; however, in the 1960's a decision was made to use more

structured programs to reach these families. Pilot projects funded

by the Extension Service were conducted in five states to determine

how to reach low-income families. The results of the pilot studies

and a nationwide concern about the nutritional status of low-income

families resulted in the establishment of the EFNEP in 1968. The

Cooperative Extension Service was selected to administer the EFNEP.

13

14

The primary method selected to reach the low-income families was the

use of paraprofessional aides trained by Extension Agents.

In the 1976 Policy Guidelines and Suggestions for Conducting

the Extension EFNEP the following was stated:

EFNEP is an integral part of the Cooperative Extension Service Home Economics and 4-H Youth Programs. The EFNEP Program is designed to reach low-income audiences to help them improve their dietary level through nutrition educa-tion and to help them become more efficient and effective users of available resources.

The adult phase of EFNEP is charged with providing a food and nutrition educational program to enhance the quality of the families' nutrition. The progression of families from EFNEP to other home economics programs enables the families to participate in educational programs in family-living areas in addition to nutrition. Extension has a challenge and responsibility to develop additional educa-tional experiences with this particular audience.

The 4-H phase of EFNEP is charged specifically with pro-viding educational programs to youth from low-income families primarily in urban areas. While meeting this need, the goal of Extension is to encourage participating youth to pursue other opportunities through involvement in additional 4-H programs for meeting the 4-H mission of developing responsible youth citizenship.

The three distinguishing features of EFNEP are (1) inten-sive education on an individual and/or small group basis, (2) conducted by Extension paraprofessionals and/or volunteers trained and supervised by Extension profes-sionals, (3) with low-income families and youth. (35:1)

In 1980, Cross (13) reported that nationwide the EFNEP employed

approximately 5,673 paraprofessional aides per year to work with

low-income families. As of 1980, 1.7 million families had been

enrolled by the EFNEP aides, affecting an estimated 6 million in-

dividual family members. The state ENP office (38) reported that as

of 1981, 237,128 adults had participated in the ENP since the program

14

The primary method selected to reach the low-income families was the

use of paraprofessional aides trained by Extension Agents.

In the 1976 Policy Guidelines and Sugqestions for Conducting

the Extension EFNEP the following was stated:

EFNEP is an integral part of the Cooperative Extension Service Home Economics and 4-H Youth Programs. The EFNEP Program is designed to reach low-income audiences to help them improve their dietary level through nutrition educa-tion and to help them become more efficient and effective users of available resources.

The adult phase of EFNEP is charged with providing a food and nutrition educational program to enhance the quality of the families' nutrition. The progression of families from EFNEP to other home economics programs enables the families to participate in educational programs in family-living areas in addition to nutrition. Extension has a challenge and responsibility to develop additional educa-tional experiences with this particular audience.

The 4-H phase of EFNEP is charged specifically with pro-viding educational programs to youth from low-income families primarily in urban areas. While meeting this need, the goal of Extension is to encourage participating youth to pursue other opportunities through involvement in additional 4-H programs for meeting the 4-H mission of developing responsible youth citizenship.

The three distinguishing features of EFNEP are (1) inten-sive education on an individual and/or small group basis, (2) conducted by Extension paraprofessionals and/or volunteers trained and supervised by Extension profes-sionals, (3) with low-income families and youth. (35:1)

In 1980, Cross (13) reported that nationwide the EFNEP employed

approximately 5,673 paraprofessional aides per year to work with

low-income families. As of 1980, 1.7 million families had been

enrolled by the EFNEP aides, affecting an estimated 6 million in-

dividual family members. The state ENP office (38) reported that as

of 1981, 237,128 adults had participated in the ENP since the program

15

began in Texas in 1970. In the youth phase in Texas, 233,431 youth

and 25,516 leaders have been enrolled since the program was started.

Factors Influencing Nutritional Status

Income Level

All socioeconomic groups are faced with varying levels of

malnutrition due to factors such as income, educational level,

attitudes, and culture which influence nutritional status. Several

studies (1, 20, 23, 27, 30, 43) have shown that poorer nutritional

status is associated with lower income. The sample for the Ten-

State Nutrition Survey, 1968-1970, (43) was selected from low-income

districts. While most of the families sampled were living below or

slightly above the poverty 1evel, there were some families with middle-

and upper-income levels living within the low-income districts that

were tested. Twenty-four thousand families were evaluated. The

results of the survey indicated increasing evidence of malnutrition

as the income level decreased. Some of the nutrients found to be

consumed in inadequate amounts in general were Vitamin A, iron, and

riboflavin. Malnutrition in different segments of the population

varied in severity and with regard to the specific nutrients involved.

In 1965 Hendel et al. (20) evaluated dietary survey records and

family and home study sheets of 302 Ohio children, 9 to 11 years old.

Vitamin A and C intakes were found to be positively correlated with

the income level of the families. About half of the children studied

had diets supplying recommended amounts of Vitamins A and C. In

16

general, the higher income children consumed diets adequate in Vitamins

A and C and ate slightly larger quantities of foods high in these

vitamins.

Mayer et al. (27) have addressed determinants of nutritional

status in Food and Nutrition Policy in a Changing World by stating

that obligatory expenses such as rent, utilities, car payments, and

upkeep are paid first, with the remaining money going to other ex-

penses including food. Therefore the amount of money available for

food is strictly limited.

In 1976 Myres and Kroetsch (30) surveyed 12,000 Canadians.

They found a consistent trend of increased consumption of Vitamin C

and folate with income level increases. A larger intake of fruits

and vegetables was also seen with an increasing income.

Abdel-Ghany and Schrimper (1) analyzed data reported in the

1965-66 United States Department of Agriculture Household Food Con-

sumption Survey to determine the effect of income on food selection.

The study involved 6,734 households of varying income levels. The

consumption of 22 different foods was analyzed. The researchers

found that income level could have a significant effect on the com-

position of food expenditures. Overall, the smaller the family in-

come, the less often these families consumed the 22 foods in question.

With a lower income level, a decreased consumption seen in some of

the 22 foods included milk products; meat, poultry, and fish;

vegetables; fruits; and butter. Lower income families had less money

to spend on food; however, a higher proportion of their income was

spent on food than those with higher incomes.

16

general, the higher income children consumed diets adequate in Vitamins

A and C and ate slightly larger quantities of foods high in these

vitamins.

Mayer et al. (27) have addressed determinants of nutritional

status in Food and Nutrition Policy in a Changing World by stating

that obligatory expenses such as rent, utilities, car payments, and

upkeep are paid first, with the remaining money going to other ex-

penses including food. Therefore the amount of money available for

food is strictly limited.

In 1976 Myres and Kroetsch (30) surveyed 12,000 Canadians.

They found a consistent trend of increased consumption of Vitamin C

and folate with income level increases. A larger intake of fruits

and vegetables was also seen with an increasing income.

Abdel-Ghany and Schrimper (1) analyzed data reported in the

1965-66 United States Department of Agriculture Household Food Con-

sumption Survey to determine the effect of income on food selection.

The study involved 6,734 households of varying income levels. The

consumption of 22 different foods was analyzed. The researchers

found that income level could have a significant effect on the com-

position of food expenditures. Overall, the smaller the family in-

come, the less often these families consumed the 22 foods in question.

With a lower income level, a decreased consumption seen in some of

the 22 foods included milk products; meat, poultry, and fish;

vegetables; fruits; and butter. Lower income families had less money

to spend on food; however, a higher proportion of their income was

spent on food than those with higher incomes.

17

In 1973 Koh and Caples (23) studied the impact of income and

educational level on food frequency and food resources for 1,000

households of low-income Black families in Mississippi. For all food

groups, the households with higher incomes and more education had

better food consumption patterns than those with lower incomes and

less education. In this study, income had a greater negative effect

than education on nutrient intake.

Educational Level

The educational level of individuals has been correlated with

nutritional intake. In 1975, Fusillo and Beloian (18) administered

a survey questionnaire dealing with food and nutrition knowledge to

1,664 United States adults who did at least one half of the food

shopping for their households. The findings indicated the partici-

pants had wery little knowledge about the functions of iron, thiamin,

riboflavin, Vitamin A, or Vitamin D and were not aware of good sources

of these nutrients. The consumers with low nutrition knowledge tended

to have less education, lower income, and less prestigious occupations

Low educational level had a stronger relationship than income with

low nutrition knowledge.

Koh and Caples (23) evaluated the food resources, shopping

practices, expenditures, skills of the homemaker in food preparation

and selection, and frequency of food consumption of certain food

groups of 1000 households in Mississippi in 1973. The researchers

found that educational level had the second greatest effect on food

consumption patterns while income had the greatest influence.

18

In 1965 Hendel et al. (20) found that the education of mothers

was positively related to the Vitamin A and C intakes of their

children. The study was of 302 Ohio children, ages 9 to 11 years.

To determine the effect of educational level on the selection

of different food products, Abdel-Ghany and Schrimper (1) analyzed

data reported in the 1965-66 United States Department of Agriculture

Food Consumption Survey. There were 6,734 households with varying

educational levels involved in the study. Of the nine major food

groups, four were significantly affected by the level of education.

These 4 groups, meat, dairy products, fruits, and vegetables

accounted for more than 66 percent of the total food consumption.

Lower consumption of these foods by persons with lower educational

levels indicates a potentially important effect on the composition

of diets of people with lower educational levels.

Attitudes

A 1979 study of 100 women in Sacramento, California, led re-

searchers Baird and Schutz (3) to conclude that life styles, at-

titudes, and behaviors can greatly influence the nutritional status

of people. Some of the interrelationships among individual food

attitudes, behaviors, and nutritional status were sorted into these

patterns:

(a) Depressed, anxious, immature attitudes and behavior which have an overall negative relationship to nutritional status.

(b) Rational attitudes and behavior which are positively related to dietary intake of many nutrients but which are not related to elevated serum nutrient levels or to the heart disease- and obesity-related measures.

19

(c) Picky, careless, self-indulgent attitudes and be-havior which are negatively related to dietary intake of many nutrients but which are not related to lower serum nutrient levels or to the heart disease- and obesity-related measures.

(d) Positive attitudes and behavior suggestive of physical, social, emotional, intellectual, and economic whole-ness-in other words, an entire life style-which have a positive relationship to both dietary intake and serum nutrient levels and a negative relationship to

the heart disease- and obesity-related measures. (3:233)

While the above patterns are only generalizations from the data ob-

tained from the sample surveyed, the results merit further investiga-

tion. The researchers noted that understanding food attitudes and

what influences these attitudes could be very helpful in planning

nutrition education activities.

In 1976, Carruth et al. (8) administered an attitude question-

naire, personality questionnaire, and a nutrition knowledge test of

weight modification concepts to nine paraprofessionals employed with

the Expanded Food and Nutrition Education Program in Missouri. The

paraprofessionals completed the instruments before and after receiving

training dealing with weight modification concepts. Age and attitude

scores accounted for the largest variances in nutrition-related

behavior scores. The attitude questionnaire used in the study

measured an individual's adaptability toward changing nutritional

practices. The results indicated that flexible attitudes were better

predictors of nutrition-related behaviors than nutritional knowledge.

Culture

Several researchers have found culture to be a factor in food

selection and nutritional status. At a University of California

20

Extension Symposium in 1968, Niehoff (32) stated that to success-

fully change food habits we must know something about food traditions

in different cultures.

The Ten-State Nutrition Survey (43), conducted from 1968-1970

involving 24,000 families primarily with low-income background,

showed various nutritional problems in different cultures and popula-

tions. For example, Mexican-Americans from states classified as

low-income-ratio states (below poverty level) had low Vitamin A

consumption, while Puerto Ricans in high-income-ratio states (above

poverty level) did not have low Vitamin A consumption. The study

found that characteristics of malnutrition were unique to local

situations and specific groups or cultures. Also in this study, the

riboflavin status was poor among Blacks and young people of all

ethnic groups. One of the conclusions of the Ten-State Nutrition

Survey (43) was that different types of nutrition problems will be

encountered among different segments of the population having varying

social, cultural, and economic characteristics.

Day and Lentner (14) interviewed 40 Spanish adults in 1978

living in New Mexico to determine factors affecting food acceptance.

They concluded that encouraging nutritious food habits because they

will improve their health is not enough incentive for food selection.

The researchers felt that teaching improved food selection that re-

lates to everyday practical matters of food preparation, cost, and

availability within the context of culturally defined preferences of

how food should look, smell, and taste would be most likely to succeed

21

In Food and Nutrition Policy in a Changing World Mayer et al .

(27) have stated that local food customs often limit the consumption

of readily available, cheap, and nutritious foods. Such customs

and attitudes may be extremely resistant to change.

Yetley et al. (47) have discussed two types of variables that

can be used to evaluate the cultural dimensions of role structures.

These variables include the division of labor in the home and role

sanctions or expectations. These variables can affect food patterns

by influencing family participation in household tasks including food

preparation and the roles the family members are expected to follow.

Hochbaum (21) has stated that psychosocial, cultural, and

certain situational factors determine food buying, food preparation,

and consumption more than physiological factors. In the United States

a wide variation in food preferences can be found. There are food

preferences that are resistant to changes despite wide availability

of a variety of foods. Cultural influences play a major factor in

this resistance to change.

A study of food habits led by Lewin (26) was conducted in 1942

at the Child Welfare Research Station of the State University of

lowa. The following five population groups were utilized: Caucasian

Americans of three income levels, Czechoslavakians, and Blacks.

Housewives were interviewed to determine factors influencing family

food behavior. Results indicated that in all of these groups a

"gatekeeper" controlled the foods that reached the table. The

"gatekeepers'" ideas about foods and values determined what foods

the family received.

22

Jelliffe (22) working in a rural welfare clinic in West Bengal

in 1947, emphasized several important principles of health education

related to culture. One of these principles was that people accepted

new knowledge about nutrition and health only to the extent that it

could be incorporated into their existing patterns of customs and

beliefs.

Development of Food Patterns

Many different factors have been cited as having an influence

on the development of food patterns. Among these are parents,

spouses, cost of food, personal concern for health, and peer influence.

Several studies (7, 29, 36) have indicated that parents play a

wery important role in the determination of meals served and the

development of food habits of their children. Morse et al. (29)

assessed 238 mothers in Vermont in 1966. The results of this study

indicated the mother's strong role in meal planning. This group of

mothers scored poorly on some areas of nutrition knowledge; therefore,

it was suggested that nutrition education for these mothers would be

of great benefit in planning family meals. The researchers also

indicated that, because many girls drop out of school at the secondary

level, courses in nutrition should be taught at the elementary level.

In 1977 Schafer (36) interviewed 116 couples from 2 Mid-

western cities on food behavior and diet. Their responses indicated

that the immediate family had the greatest influence on foods eaten

by a family. Influences outside the home, except for cost, had less

influence on the food consumption patterns. The husbands and wives

23

were asked to rank reasons for making decisions about food choices.

The four main reasons included were taste, nutrition, cost, and health.

While the wife indicated the husband exerted some influence on the

food eaten, the results indicated that the wife exerted more influence

in determining the nutritional adequacy of the family's diet.

Schafer and Keith (37) in 1980 conducted research involving

336 couples in lowa to determine the effects of the family life cycle

on various factors that influence food decisions. The following four

life cycle stages were used: young families with young children;

maturing families with children in school; middle-age, empty-nest

families; and retirement families. The data indicated that over the

life cycle the cost of food and personal concern for health and weight

were the most important considerations in food decisions. Another

important influence that was constant over time was family members

and their food preferences. Casual information sources such as food

articles and advertisements were only moderately important in af-

fecting food decisions.

In 1977 Burt and Hertzler (7) surveyed 46 families living in

Missouri to determine parental influence on the child's food preferences

Their results indicated that each parent influenced a child's food

preferences approximately equally. The father had an indirect in-

fluence because his food preferences affected the meal planning done

by the mother.

Responses to a questionnaire administered by Cosper and Wake-

field (11) to 591 women in Kansas in 1973 indicated that women

24

purchased and prepared the meals in 9 out of 10 households. The

husband was found to exert the strongest influence on most of the

women to try a new food. The majority of the women were motivated to

eat a particular food because of a personal or family preference.

In 1978 Yperman and Vermeersch (48) surveyed 307 Californian

children in the first through third grades. The childrens' parents

completed a questionnaire to determine factors associated with food

preferences and dietary complexity. The most important predictors

of a child's food preferences and dietary complexity were parental

attitudes and peer influence.

A nutrition knowledge survey of mothers and children living

in New York conducted by Emmons and Hayes (15) in 1970-71 indicated a

significant number of mothers could name nutritionally important

foods, but few could provide valid nutrition-related reasons for the

importance of the foods. Their nutrition practices seemed much

better than their nutrition knowledge. Therefore feeding practices

in the home were not based on nutrition knowledge. Instead, food

patterns were being instilled based on habit and custom.

The family role structure and food-related roles in Mexican-

American families living in South Texas were studied by Yetley et al.

(47) in 1980. The results suggested that husbands in many families

in this sample were involved in food-related decisions and sometimes

were the predominant figure in these decisions. In this sample,

men were most likely to be involved in decisions controlling re-

sources such as purchasing and budgeting; however, they were not

25

necessarily involved in all food-related tasks. The researcher sug-

gested that nutrition education be directed towards both parents.

Strateqies for Nutrition Education

Mills (28), Suter and Barbour (41), and Nelson et al. (31)

have noted that when planning nutrition education it is important to

determine the background of the population to be taught. Character-

istics of a population will greatly influence what is taught and how

it wil 1 be taught.

Nutrition educators are faced with the challenge of how to

bring about changes in food patterns. Hochbaum (21) has stressed

that knowledge alone is not sufficient to change eating habits.

Nelson et al. (31) have stated that problems will be encountered

regarding how to motivate a person to eat enough of the foods needed

for good health. Education can encourage change; however, education

needs to be interesting enough to encourage participation.

It is important to understand the stages in the learning

process. Bohlen and Beal (4) have outlined a series of stages in

learning that can guide the educator in determining the level of

progress that has been made. These stages include gaining the at-

tention of the student, cultivating student interest in the lesson,

instilling in the student confidence in his ability to learn,

developing a desire to change or learn in the student, promoting

action on the part of the student in relation to the new knowledge,

and increasing satisfaction of the student with the new knowledge.

26

Retention and learning are directly related to involvement and active

participation in the lesson. Guthrie (19) has stressed the importance

of motivating people to act on the received information and to make

intelligent, informed, purposeful food choices.

In 1975 Suter and Barbour (41) asked 42 mothers of low-income

families in Oklahoma to rank the following 6 food related values:

family life, work efficiency, health, economy, friendship, and educa-

tion. Each of these values was viewed in terms of its relationship

to food. For example, education was defined as purposeful self-

improvement involving some form of food and nutrition learning for

self and family. Education was ranked last by these mothers. Be-

cause education was ranked low in value by these mothers, more effort

will have to be made to encourage enrollment of these mothers in

nutrition education programs. Nutrition educators are challenged to

use creativity in developing materials which are acceptable, meaning-

ful, and effective.

Methods and Approaches

Many methods are available to use in teaching nutrition.

Williams (46) has outlined the use of individual counseling, small

discussion groups, structured classes, libraries, exhibits, and self-

teaching devices to reach people in community settings. The nutri-

tion clinic staff at the University of Virginia Hospitals in

Charlottesville (33) experimented with many different methods to

effectively teach nutrition principles to their clients who had

minimal schooling. Some of their ideas included a poster campaign,

27

handouts, simplified written diet instructions, and a film series.

Based on feedback from the patients, the simplified diet instruction

and film series were the most effective methods with the patients at

the hospital.

Some debate exists as to the most effective methods in teaching

nutrition. Cerqueira et al. (9) conducted a pilot study in Mexico

to test the effectiveness of mass media techniques as compared to

direct methods of education in teaching the basic concepts of hygiene^

health, and an adequate diet. There were 1083 participants in the

direct education group, 959 participants in the mass media group,

and 976 participants in a control group. Nutrition information

taught by the use of mass media including radio, posters, and

pamphlets was learned equally well as that taught by the direct

person-to-person contact. The researchers did not indicate if these

results would influence future nutritional strategies.

Christopher et al. (10) in 1978 compared knowledge scores of

college students at the University of Pennsylvania receiving nutri-

tion information through a multimedia course including videotapes

and a traditional lecture-discussion mode of instruction. A total

of 124 students participated. Knowledge gain of students receiving

multimedia instruction was at least as good as those students in the

lecture-discussion instruction. The researchers concluded that the

multimedia approach could be used in presenting basic nutrition in-

formation, thus freeing time of instructors for other activities.

Boren et al. (6) reported similar results for Texas Tech University

28

students receiving multi-mode nutrition instruction in 1979 and

1980.

Lewin (26) in his 1942 study of Czechoslavakian, Black, and three

income levels of Caucasian American housewives compared responses to

lectures and to group discussions on nutrition. He found that changes

in food habits come about more readily as a result of group discussions

than lectures.

Angove (2) has noted that informal teaching is more successful

with the public and possibly with all groups, especially if changes

in food patterns are desired as opposed to nutrition knowledge only.

She has stated that continuous evaluation is needed to provide feed-

back on the effectiveness of nutrition education.

Utilization of Paraprofessionals

Kolasa et al. (24) have indicated that programs should be

designed for home-based nutrition education, including nutrition

education for each stage of the family life cycle. One approach

that has been used for home-based nutrition education has been the

use of paraprofessionals.

Pritchard and Hall (34), Spindler (39), Sullivan et al. (40)

and Wang (44) have evaluated the use of paraprofessionals as educators.

Paraprofessionals have been identified as one strategy for helping

people change behavior. In 1967 Spindler (39) noted that contribu-

tions can be made to the health of the poor by using paraprofessionals

to influence low-income homemakers to improve the diets of their

families. A paraprofessional has been defined in Webster's

29

Dictionary as "a trained aide who assists a professional person"

(45:832).

In 1969 Pritchard and Hall (34) tested the attitudes of 76

homemakers and 14 paraprofessionals, titled Program Aides in the

Expanded Nutrition Program (ENP). The work-oriented attitudes of

the aides and the attitudes of the homemakers toward the aides were

tested. The attitude among the aides that was most predominant was

that liking their job was not based upon the money they earned, but

upon the satisfaction of feeling helpful to the client. The attitudes

of the homemakers toward the aides were generally positive. The

clients looked up to the aides. The researchers found that both

cognitive and affective learning of the clients occurred with the use

of paraprofessionals indigenous to an area.

Wang (44) used data collected from 1969-1975 on paraprofes-

sional aides employed with the Expanded Food and Nutrition Educa-

tion Program (EFNEP) and the Family Aid Program (FAP) in Maryland.

The effectiveness of the educator was evaluated through the use of

24-hour recalls administered to the clients. The results indicated

that the paraprofessional aides could be effective agents in changing

dietary parctices of homemakers.

Sullivan et al. (40) developed an instructional program to be

used by professional nutrition educators and paraprofessionals to

teach nutrition to homemakers. After training, three nutritionists

and five paraprofessionals conducted one workshop each for a group

of homemakers. The mean posttest score was 86% for the workshop

30

participants taught by the nutritionists and 81% for those taught by

the paraprofessionals. This indicated that the paraprofessional

instruction led to results comparable to the instruction of the

professional nutritionists.

Pritchard and Hall (34), Spindler (39), and Wang (44) have

noted that in addition to providing nutrition education, many para-

professionals provide emotional support for their clients. Between

63-70% of the clients interviewed by Pritchard and Hall (34) in-

dicated the paraprofessionals employed with the ENP listened to their

problems, understood their problems, and knew how to help. Wang (44)

found the paraprofessionals played an important part as friends and

confidants to the homemakers by providing emotional support.

Summary

The Expanded Food and Nutrition Education Program (EFNEP), a

part of the Cooperative Extension Service, was established in 1968.

The main purpose of EFNEP is to help low-income families learn about

nutrition and good eating habits.

Several factors found to influence nutrition status include

the income level, educational level, attitudes, and culture of the

individual. Many people have been shown to have an influence on

the development of an individual's food patterns with parents,

spouses, and peers having the greatest influences. Many strategies

are available for use in teaching nutrition, and evaluating the

audience is yery important in selecting an appropriate strategy.

CHAPTER III

METHODS AND PROCEDURES

The major purpose of this study was to determine nutrition

knowledge and food patterns of Expanded Nutrition Program (ENP)

leaders before and after receiving nutrition lessons from Program

Assistants and teaching the nutrition lessons to a group of youth.

The control group received no nutrition instruction and was tested

for comparison of nutrition knowledge and food patterns. In addition,

race, age, educational level, income level, and number of people in

household were analyzed for determination of influences on nutrition

knowledge and food patterns of the ENP leaders.

Overview of Nutrition Lessons and Traininq

The Expanded Nutrition Program (ENP) Program Assistants utilized

a nine-lesson nutrition series when teaching the ENP leaders. These

lessons were developed by the State ENP Office, and each lesson dealt

with various aspects of nutrition, sanitation, food buying, and food

preparation. The major area covered in each of the nine lessons

is as follows: (1) Four Food Groups, (2) milk, (3) vegetables,

(4) fruits, (5) meats, (6) breads and cereals, (7) breakfast, (8)

casseroles, and (9) snacks. Each Program Assistant usually met with

the leader once a week to teach the leader a nutrition lesson. The

31

32

leader then taught this nutrition lesson to a group of youth during

the week before the next visit by the Program Assistant.

Since the majority of the home visits made by the Program

Assistants were unsupervised, lesson standardization training was

provided by the researcher to the Program Assistants in the study in

May 1981. The purpose of the training was to provide consistency in

the material presented to and by the Program Assistants. The content

of the nine-lesson nutrition series was reviewed. One lesson per day

was covered. It took approximately 30-45 minutes for each lesson.

The standardization training plans developed by the researcher are

in Appendix A. One Program Assistant who was employed after the

initial standardization training received the material during intital

training.

Desiqn and Development of Instruments

Development of Original Version of the Demoqraphic Data Informa-tion Sheet

The original version of the Demographic Data Information Sheet

was developed by the researcher. There were seven closed-ended

questions that dealt with sex, race, age group, educational level,

income level, number of people living in household, and previous

enrollment in the ENP. Space was also provided for the leaders'

name.

33

Development of Original Version of Food Behavior Questionnaire

The original Food Behavior Questionnaire developed by the

researcher was composed of eight items dealing with daily food con-

sumption patterns related to milk; milk products; fruits, vegetables;

breads; cereals; meats, poultry, and fish; and meat substitutes.

Twelve items dealt with the weekly food patterns of eating breakfast

or a morning meal, eating lunch or a noon meal, eating dinner or an

evening meal, using the Four Food Groups in meal planning, using

meat substitutes, using vegetables high in Vitamin A, using fruits

and vegetables high in Vitamin C, using casseroles, using nonfat dry

milk in food preparation and cooking, using nonfat dry milk for

drinking, introducing new foods to family, and consuming nutritious

snacks. The items were based on information presented and food

patterns encouraged in the nine-lesson nutrition series taught by

the Program Assistants to the leaders. Next to each item on the

questionnaire the numbers zero through seven and an over seven

category were included to record the participant's response indicating

the number of times items were consumed on either a daily or weekly

basis.

Oriqinal Version of Nutrition Knowledqe Test

The original version of the Nutrition Knowledge Test was

developed by the researcher. Al1 questions for the Nutrition Knowledge

Test were based on content presented in the nine-lesson nutrition

series taught by the Program Assistants to the leaders. A Table

34

of Specifications was used to insure content validity of the Nutri-

tion Knowledge Test.

There were approximately two questions per lesson. The nutri-

tion lesson number on which each question was based is listed in

parenthesis at the end of each question. Eight true-false questions

and 12 multiple-choice questions composed the original Nutrition

Knowledge Test.

Input on Original Instruments and Revisions Made

The researcher's thesis committee members reviewed the original

instruments and made several recommendations for revisions. These

revisions included adding 5 more items to the daily food patterns

section of the original Food Behavior Questionnaire resulting in a

total of 13 items and allowing space for weekly responses within

this section. The 12 items in the weekly response section of the

Food Behavior Questionnaire were shortened to 5 items. Two items

in the weekly response section were deleted, and the other five were

moved to the daily response section.

A revision was made on the multiple-choice question in the

Nutrition Knowledge Test that dealt with the fruit and vegetable

group. No revisions were made at this point on the original version

of the Demographic Data Information Sheet.

Pretestinq of the Revised Instruments

The revised instruments were administered to ten ENP leaders

in Lubbock, Texas, who were selected as a result of convenience.

35

The instruments were administered orally by the researcher. The

pretesting was done to determine clarity of the questions, ability

of the leaders to respond to the oral format, and the amount of time

needed to administer the instruments. The ten leaders selected

had completed varying numbers of the nine-lesson nutrition series.

This was done to provide feedback on the ability of the leaders

with varying backgrounds in nutrition knowledge to answer the ques-

tions. The pretesting took approximately 30 minutes to complete with

each leader. The leaders seemed to respond better when the Food

Behavior Questionnaire was administered first, the Nutrition Knowledge

Test second, and the Demographic Information Sheet third. This gave

the leaders time to relax with the researcher before having to answer

nutrition knowledge questions and personal demographic information.

The leaders had difficulty answering two of the multiple-choice

questions which were later revised.

Development of Final Instruments

The following revisions were made on the Demographic Data

Information Sheet, the Food Behavior Questionnaire, and Nutrition

Knowledge Test after input from the pretesting of the ten leaders

and additional input from committee members:

1. Places for the address of the leader, an identification

number for leader, Program Assistant's name, and the date

of testing were added to the Demographic Data Information

Sheet.

36

2. A closed-ended question in the daily food patterns section

of the Food Behavior Questionnaire which asked how often

various nutritious snacks were served was deleted. An

open-ended question dealing with snack consumption was

substituted.

3. A true-false question in the Nutrition Knowledge Test

which read, "What we eat is used mainly to build our

bones" was revised to read "What we eat is used mainly for

energy."

4. A revision was made on the multiple-choice question in

the Nutrition Knowledge Test dealing with breads and

cereals.

Final versions of the Demographic Data Information Sheet, Food

Behavior Questionnaire, and Nutrition Knowledge Test are found in

Appendix B, C, and D, respectively. The final Demographic Data

Information Sheet consisted of 12 questions, the final Food Behavior

Questionnaire consisted of 13 questions in the daily section and 5

questions in the weekly section, and the final Nutrition Knowledge

Test had 8 true-false questions and 12 multiple-choice questions.

Development of Food Model Flip Chart

A flip chart was developed by the researcher to be shown to

each leader during the administration of the Food Behavior Question-

naire. The flip chart was used in the pretesting of the instruments

and for the preassessments and postassessments of the ENP leaders

37

and the control group participants. Pictures of examples of several

foods for each food category and the standard serving sizes were

included to be shown during the administration of the Food Behavior

Questionnaire to help the ENP leaders and control group participants

provide accurate answers regarding the number of servings eaten

daily or weekly.

Selection and Description of Sample

Expanded Nutrition Program (ENP) Leaders

The experimental group consisted of leaders enrolled in the ENP

in Lubbock, Texas. Available leaders were preassessed by the re-

searcher in an oral interview as they were enrolled in the ENP. The

preassessments and postassessments of these leaders took place over

a six-month period. Forty-four leaders were preassessed but only 31

leaders completed the postassessment. Losses resulted from not

completing the nine-lesson nutrition series due to lack of interest,

conflicts, or moving to unknown addresses. The demographic data

for the ENP leaders are found in Table 1. There were 30 (96.77%)

females and 1 (3.23%) male. When analyzed by racial group there were

15 (48.39%) Blacks, 12 (38.71%) Hispanics, and 4 (12.90^.) Anglos.

The largest numbers of leaders fell in two age categories. There

were 11 (35.48%) under 20 years of age and 9 (29.03%) between the

ages of 30 and 39. The 2 educational categories having the largest

number of leaders were 11 to 12 years of school with 14 (45.16%)

38

TABLE 1

DEMOGRAPHIC DATA FOR ENP LEADERS AND CONTROL GROUP PARTICIPANTS

Variables

Sex Male Female

Race Hispanic Black Anglo

Age Under 20 years 20-29 years 30-39 years 40-49 years 50-59 years Over 60 years

Years of School Less than 9 years 9-10 years 11-12 years Over 12 years

Income Less than $5,000 $5,001-9,000 $9,001-13,000 $13,001-17,000 Over $17,000

Number of people in 1 2 3 4 5 6 7 8 9 10 Over 10

ENP

N

1 30

12 15 4

11 7 9 1 2 1

10 6

14 1

18 5 6 2 0

household 0 1 6 4 6 9 1 2 1 0 1

Leaders 01 /3

3.23 96.77

38.71 48.39 12.90

35.48 22.58 29.03 3.23 6.45 3.23

32.26 19.35 45.16

3.23

58.06 16.13 19.36 6.45 0.00

0.00 3.23

19.35 12.90 19.35 29.03

3.23 6.45 3.23 0.00 3.23

Control

N

1 30

4 9

18

1 9 7 4 6 4

13 10 7 1

6 8 6 8 3

1 8 4 9 5 2 2 0 0 0 0

Group

%

3.23 96.77

12.90 29.03 58.07

3.23 29.03 22.58 12.90 19.36 12.90

41.93 32.26 22.58 3.23

19.36 25.80 19.36 25.80 9.68

3.23 25.81 12.90 29.03 16.13

6.45 6.45 0.00 0.00 0.00 0.00

39

TABLE l--Continued

Variables

Previous Enrollment in ENP Yes No

ENP

N

7 24

Leaders

%

22.58 77.42

Con

N

5 26

trol Group

%

16.13 83.87

40

leaders, and less than 9 years of school with 10 (32.26%) leaders.

The largest numbers of leaders fell in one income category. Eighteen

(58.06%) leaders earned less than $5,000 per year. The largest

household size was 6 as represented by 9 (29.03%) of the leaders.

Seven (22.58%) of the leaders had been enrolled previously in the

ENP, while 24 (77.42%) had never been enrolled in the ENP.

Control Group Participants

The control group participants were interviewed by a former

ENP Program Assistant hired by the researcher. Thirty-one people

were preassessed and postassessed. Personnel at the Lubbock, Texas,

Food Stamp Office provided the names of several people who agreed

to be tested for the control group. In addition, the interviewer

selected people with whom she had previously worked during her employ-

ment with the ENP. People were also recruited for testing by door

knocking in low-income areas of Lubbock, Texas. The demographic

data on this group are found in Table 1. There were 30 (96.77%)

females and 1 (3.25%) male. In the race category there were 18

(58.07%) Anglos, 9 (29,03%) Blacks, and 4 (12.90%) Hispanics. The

largest numbers of persons fell in two age categories. There were

9 (29.03%) between the ages of 20-29 and 7 (22.58%) between the ages

of 30 and 39. The 2 educational categories having the largest number

of people were less than 9 years of school with 13 (41.93%) control

group pariticpants and 9 to 10 years of school with 10 (32.26'0

control group participants. The two largest income categories were

$5,001-9,000 and $13,001-17,000 with 8 people in each category. The

41

largest househole size was 4 as represented by 9 (29.03%) of

the control group participants. The next largest group of 8 (25.81%)

fell in the household size of 2. Five (16.13%) of the participants

had been enrolled previously in the ENP, while 26 (83.87%) had never

been enrolled in the ENP.

Collection of Data

Expanded Nutrition Program (ENP) Leaders

Preassessment of the ENP leaders began in June 1981. Thirty-

minute oral interviews were conducted by the researcher to administer

the Demographic Data Information Sheet, the Food Behavior Ouestion-

naire, and the Nutrition Knowledge Test. The researcher administered

postassessments no later than 12 weeks from the preassessment date.

While there were 9 nutrition lessons and the Program Assistant usually

meets with the leader once a week, 12 weeks was set as the maximum

time limit because leaders were sometimes unable to keep all their

weekly appointments. Since a leader could be graduated if he/she

completed six lessons, the six lesson mark was set as the minimum

number of lessons to be completed to qualify for postassessment.

In each case it was hoped that all nine lessons would be completed.

Forty-four leaders were preassessed, but only 31 completed the post-

assessment. Of those leaders completing the postassessment, 8

completed 9 lessons, 8 completed 8 lessons, 4 completed 7 lessons,

and 11 completed 6 lessons. The preassessments continued through

October, and the postassessments were completed in November and

December of 19S1.

42

Control Group Participants

Before beginning the preassessment of the control sample, the

interviewer hired by the researcher observed the researcher interview

two leaders, and the researcher then observed the interviewer ad-

minister two interviews to insure full understanding of how to ad-

minister the Demographic Data Information Sheet, the Food Behavior

Questionnaire, and the Nutrition Knowledge Test.

Preassessment of the control sample began in October 1981.

The final postassessments were conducted in December 1981. The

elapsed time between the preassessments and the postassessments was

approximately nine to ten weeks. This was a shorter time span than

that for the ENP leaders; however, it was decided to finish inter-

viewing this group before the Christmas season.

Treatment of the Data

Data were obtained from 31 ENP leaders forming the experimental

group and 31 volunteers composing the control group. Data obtained

were keypunched on data cards and processed at the Texas Tech

University Computer Center. Differences were judged to be significant

at the .05 level or beyond. All data in this study were subjected

to jt-tests to determine if significant differences existed between

means being compared in each hypothesis.

CHAPTER IV

ANALYSIS AND INTERPRETATION

OF THE DATA

The major purpose of the study was to determine nutrition

knowledge and food patterns of leaders before and after receiving

nutrition lessons from Program Assistants with the Expanded Nutrition

Program (ENP) and then teaching these nutrition lessons to a group of

youth. A control group receiving no nutrition education from the ENP

Program Assistants was also tested for comparison of nutrition knowledge

and food patterns. In addition, race, age, educational level, income

level, and number of people living in each household were analyzed to

determine their influence on the nutrition knowledge and food patterns

of the leaders. In this chapter, the statistical data related to the

hypotheses tested in the study are presented.

Statistical Analysis of Hypotheses

Of the 18 hypotheses analyzed in this study, 4 dealt

with nutrition knowledge, 8 dealt with the participants' food

patterns, and 6 were concerned with the effect of selected demo-

graphic variables on nutrition knowledge and food behaviors of the

ENP leaders. The demographic variables utilized in this study were

race, age, educational level, income level, and number of people

living in the household. A _t-test was used to determine if

43

44

significant differences existed for each hypothesis tested.

Hypothesis 1

Data were analyzed for Hypothesis 1 which stated:

There is no significant difference between the mean preassessment and postassessment nutrition knowledge test scores of leaders enrolled in the ENP.

The data pertaining to Hypothesis 1 are presented in Table 2.

A significant difference did not exist between the mean preassessment

and postassessment nutrition knowledge test scores of the 31 ENP

leaders. Therefore, Hypothesis 1 was accepted.

TABLE 2

ANALYSIS OF DIFFERENCES BETWEEN MEAN PREASSESSMENT AND POSTASSESSMENT NUTRITION KNOWLEDGE TEST SCORES

FOR ENP LEADERS AND CONTROL GROUP PARTICIPANTS

Mean Test Scores

Groups N Pre Post t_-values*

ENP leaders 31 12.90 13.90 -1.43

Control 31 13.68 13.93 -0.46

t-values were not significant at the .05 level or beyond

Hypothesis 2


There is no significant difference between the mean preassessment and postassessment nutrition knowledge test scores of the control group participants.

The data pertaining to Hypothesis 2 are presented in Table 2. A

significant difference did not exist between the mean preassessment

45

and postassessment nutrition knowledge test scores of the 31 control

group participants. Therefore, Hypothesis 2 was accepted.

Hypothesis 3


There is no significant difference between the mean preassessment nutrition knowledge test scores of the ENP leaders and the control group participants.

The data pertaining to Hypothesis 3 are presented in Table 3. No

significant difference was found between the mean preassessment

nutrition knowledge test scores of the ENP leaders and the control


TABLE 3

ANALYSIS OF DIFFERENCES BETWEEN ENP LEADERS AND CONTROL GROUP PARTICIPANTS MEAN PREASSESSMENT AND POSTASSESSMENT

NUTRITION KNOWLEDGE TEST SCORES

Mean Test Scores

Assessments Control Participants ENP Leaders ^-values*

Pre 13.68 12.90 1.30

Post 13.93 13.90 0.04

t-values were not significant at the .05 level or beyond

Hvpothesis 4


There is no significant difference between the mean postassessment nutrition knowledge test scores of the ENP leaders and the control group participants.

46


significant difference was found to exist between the mean post-

assessment nutrition knowledge test scores of the ENP leaders and the

control group participants. Therefore, Hypothesis 4 was accepted.

Hypothesis 5


There is no significant difference between the mean daily food consumption scores of the ENP leaders on the preassessment and postassessment of the Food Behavior Questionnaire for each of 13 food categories.


significant differences existed between the mean preassessment and

postassessment daily food consumption scores of the ENP leaders for

9 of the 13 food categories on the Food Behavior Questionnaire.

Significant differences were found for the following four food

categories: fruits; fruits and vegetables high in Vitamin C; meat,

poultry, and fish; and low nutrient, high calorie foods. The fruit

consumption difference was significant at the .01 level. The other

differences were significant at the .05 level. The mean postassessment

score was higher than the mean preassessment score for fruits and

for fruits and vegetables high in Vitamin C. The mean preassessment

scores were higher for the consumption of meat, poultry, and fish and

low nutrient, high calorie foods. Therefore, Hypothesis 5 was ac-

cepted for nine of the food categories and rejected for four of the

food categories.

47

Q O O

to (V 3

( 0

> i|

o o

• o

o o

• o

o •

o

LO 0 0

• o

cr> cn

1

p ^ L n

o 1

t ^ ^

1

CT> 0 0

o 1

r-. o

^

LO

o

•—I o o < : h -Q ^

< : 1— o . ^ H-( U J o ^ 1—1 OO 1— OO CJi U J c í OO Q_ OO <: o. f - o c>o o O û ^ Q_ t D

Q _ l

2: o < : Q :

1—

1— z : z o LLJ O

s: OO Q C/5 Z u j «íi:

•^ oo C/î o o

u j < : Q : —1 U J U J o a Q i Q < : Q - c t h- LLJ

Z _ l < L U Q_

s: zr U J

2 : u j Q : : LU 0 3 u -(— LJU 0 0 Cû U J

Q : 0 0 0 U J 0 0 0 0

04 o s-

C 3

O Í -

4-> C o o

o

to OJ s-o CJ

LO

o Q .

o oo u_ > í o

tn Q . Q E

3 £= 00

O) o 2 : o

O) s-

Q .

CO rv .

0 0 L n co ro

f— cn c\j r^

co r^

cy> vo

ro

r^ C\J L n

cy> ro co

0 0 C>sJ LO

ro c o

O CT>

r^ co

LO LD CX)

00 OJ 3

1 —

(T5

> 1

• ^ l

0 CO

. 0

1

Q : O

u. o. Q Q

00 u- 2 : 0 0

o 0 0 1—1 0 0 >-_ J < «3;

LO s-O)

-o 03

to OJ s-

-o o o o O W)

>, o I - 4-> íC Q . Q E

Z3 C co <n c QJ O ^ o

+-> LO o

Q .

co

• • ^ CO

• CNJ

co l ^ • 0

1

•íc

r^

CNJ

ro <.o

O O L n

• O ro

CXD

O I

o ,— C\J I

co o o

LO

o VO ro cu

o o o

<T) CT> CT>

cu s-

cr>

00 OJ

s-o cn 

u 3 • 0 0 S-Q .

.^ 1 —

•^ ^

LO <X>

00 4->

• I —

3 S-

U -

0

1.9



LO

tab

les

in

C

.6

cu E CT> 03 CU 4 J > - r -

> o 3

C LO -r—

-!-> • r - J Z 3 C7) S- • ! -

Li_ . C

L n

tab

les

in

A

.3

 •!->

o 3

c 00 T -+ J • r - J Z 3 c n S- • ! -

U_ J Z

0

4.3

00

-o 03 , S-

+ J ,_ 3 0 0 .

A

+-> 03 dJ

c:^

tes

.9

3 • M

+ J 00 n 3 00

+-> 03 CU ^

48

to 

a 3 O S-

cs r—

o S-

+-> c o o

to í o r— T -• 1 - +-) 03 Q .

Q E 3

C 00 03 C OJ O

s: o

- M 00 o

Q .

 c o

o

I

Cû

<:

to 

to s-> o ^ " ' r -

n D

ai

sum

pt

03 C <U o

2 : o

+ j 00 o

Q .

<u s-

Q .

oo (U

S -o CJ) <u

• * - )

03 O

-o o o

on C sJ

o I

VO ^

• C\l 1

r— CM

• o

co o CvJ

co ro

co LO CO

o ro

•K C3^

c\i I

ro C^J

ro c o

c\j ro

ro O

ro

00 LO

r co Ln

CsJ

Cvl Ln

O l •r— J =

« to +-) -a c o 03 03

,— to M-

.:> c - o

• 1 - OJ s- c

- O 

+J 03

+J

c 03 o •r—

4 -•^ c cn

• r -

oo

 +-) 03

-t-> C 03 O

•r— 4 -•^ C O)

•r—

oo • •

49

Hypothesis 6


There is no significant difference between the mean daily food consumption scores of the control group participants on the preassessment and postassessment of the Food Behavior Questionnaire for each of 13 food categories.


significant differences existed between mean preassessment and post-

assessment daily food consumption scores of control group participants

for 12 of 13 food categories on the Food Behavior Questionnaire.

The one food category where a significant difference was found was

soft drinks and sweetened flavored drinks. This was a difference

significant at the .05 level. The mean postassessment score was

lower for this food category. Therefore, Hypothesis 6 was accepted

for 12 of the food categories and rejected for 1 of the food categories

Hypothesis 7


There is no significant difference between the mean daily food consumption scores of the ENP leaders and the control group participants on the preassessment of the Food Behavior Questionnaire for each of the 13 food categories.

The data pertaining to Hypothesis 7 are presented in Table 5. There

were no significant differences between the mean preassessment daily


participants for 11 of 13 food categories on the Food Behavior

Questionnaire. Significant differences were found for the following

two food categories: breads and meat, poultry, and fish at the .001

50

<: Q

OO

Ln

LU _ j

co <c h -

<=C LU Q . 2 : •—• </î 0 0 0 1—( L L J

1— 0 0 ct: 0 0 < : < : a. \—

0 0 Q . 0 ZD Q . 0 Q i Q 0 2 :

< __l 0 h-Q i 2 : 1— UJ ^ ^ 0 00 0 <yO

LU Q OO 2 : 0 0 < : < :

LU ut cxl ce: Q. LU Q LU <: :n

Q. O 2 : LU 0 0

LU

LU o LU O 3 0 0

Cû O H—(

0 0 H -LU Q-o 2 : Z 3> LU 0 0

cc 2: LU O U - O u . t—t Q Q O

O U_ U-o 00 1 — 4

0 0 >-

to I

-Ml

to (U S-o o

c/>

<: <:

3

c o o -o o o

03 Q

c 03 *

• c>o o « ^ Ln

o r^ o r

• ro ';3-<sO ^

r o t— LO ^

•K

• K •>{

•»c -K • •K r- r^ r - . I—

CT) O Ln t o

o o I I I I

r— C O I I

C\l I— I I

o I

r o I

o o I I

Ln Lo I I

r— O I

r^ vo r^ r^

CvJ co Ln ^

CT) Ln r o ^

co ^ CNJ r—

c>o ,— Ln cn

cn o 00 CM

O <T) <D r>-.

r-. LO co r^

to S- c (U E 00 00 c o

Lo r o CO r -

Ln <D r o c\i

c o r o

o o

co o L n <T>

< r «^

t/1 

(U 00 S- O

Q- Ci.

00

+J 0 3

- 0 0 S-Q .

J ^ r— • f —

2 :

00

+-> • r "

3 S-

U_

to (U

1 —

JD 03 +J (U Oî (U

>

00 (U

r— 0 JO 03 C

• ! -> T -

CU E cn 03 > •<-

> oC

C 00 •!— -U) • r - ^ 3 O í s- •>-

u_ x :

00 (U

-— < : J 3 03 C -1-) - r -(U E D1 03 OJ -M > •»-

> oS

c tO - r --t-> •r- . C 3 U) s - • > -

U_ JZ

(/) - 0 03 

{/) (U s-o u

oo

-o (U 3 c

o o

I I

Ln

Cû

<

• ( - >

OLJ

E 3 to c o

o

XJ o o

03 Q

c 03 CU

O S-

+-> c o

o

00 s-(U

-o m Qi

to +-) c sJ

C\J o r o ^ 0 0 C\J

• • •

CsJ CVJ <T> C O

I r o o o

I I r o

I

CT> o

co o • •

o o I I

on cr> Ln <o

• i- r o co <T>

o vo co i ^

Ln o t o oo c j r o

r— r o t o CT>

o ^ <T> CT>

í ^ CM r* r o

co r o Ln o

c\j 00 Ln Ln

CNJ r— Csj r o

 03

o

-o o o

to *r— M-

OÍ5

A

>> S-+-> — 3 O CL.

9\

+-> 03 d)

to (U

+-> 3

+-> +J to

J 3 3 to

03 - o c o - <+-s--l-> M-O

00

-o (U

vor

03 1 —

M-

• o (U c (U +-> (U (U

s

oo Jx: c

• r—

s-00 - o

to .i^ u 03 c

oo

. r— (U > (U —

tn o

•

 03

+->

c 03 O

•r— <4-'f—

C O)

• ^ oo

. r—

 

-(-) 03

+-)

c 03 O

• ^ H-• r -C

oo • ^ oo •

•

r—

cu > 

c 03 O

• ^ " -• r* C CD

• ^ co •

• •

(U > 

-t-> 03

+J c 03 o

" ^ M--r— C cn

• ^ 0 0

* • • •

52

level. The mean preassessment scores were higher for the ENP leaders

in both food categories. Therefore, Hypothesis 7 was accepted for

11 of the food categories and rejected for 2 food categories.

Hypothesis 8


There is no significant difference between the mean daily food consumption scores of the ENP leaders and the control group participants on the postassessment of the Food Behavior Questionnaire for each of 13 food categories.


were no significant differences between the mean postassessment daily


participants for 8 of 13 food categories on the Food Behavior Question-

naire. Significant differences between the mean postassessment daily


participants were found on the following five categories: fruits;

fruits and vegetables high in Vitamin C; breads; meat, poultry, and

fish; and soft drinks and sweetened flavored drinks. The mean post-

assessment scores were higher for the ENP leaders in all of these

food categories. Differences on the consumption of fruits and fruits

and vegetables high in Vitamin C were found to be significant at the

.05 level. The difference on the consumption of breads was found to

be significant at the .0001 level. A significant difference of .01

was found on the consumption of meat, poultry, and fish and a

significant difference of .001 was found on the consumption of soft

drinks and sweetened flavored drinks. Therefore, the Hypothesis 8

53

was accepted for eight of the food categories and rejected for five

of the food categories.

Hypothesis 9


There is no significant difference between the mean weekly food pattern scores of the ENP leaders on the preassessment and postassessment of the Food Behavior Questionnaire for each of five food patterns.


were no significant differences between mean preassessment and post-

assessment scores on four of five weekly food patterns for the ENP

leaders. A difference significant at the .05 level was found between

the mean preassessment and postassessment scores on the weekly food

pattern dealing with the introduction of new foods to the family.

The mean postassessment score was higher. Therefore, Hypothesis 9

was accepted for four of the food patterns and rejected for one food

pattern.

Hypothesis 10


There is no significant difference between the mean weekly food pattern scores of the control group participants on the preassessment and postassessment of the Food Behavior Questionnaire for each of five food patterns.


There were no significant differences between preassessment and post-

assessment scores on any of the weekly food patterns for the control


54

Q O O

>-_ J

C/

vo LU _ l CQ < 1—

oo < : l/^ Q . LU 1—1 oo o 0 0 1—1 < h-h - QL OO < O Q-Q .

O L Q r 3 Z O < Q ;

o 1— 2 : _ j LU O 2 : û i oo 1— 0 0 z LU O oo o oo < : Q LU Z Q: < Q_

oo z cr: < LU LU Q 2 : <

LU Q .

LU CQ

OO L U

Q i o U .

o oo "Z. •z. LU C£. a: L U u_

LU 1— 1—

u . < H H Q

u_ o Ul t—1

oo >-_ J < "Z. <

O L

to I

Q . 3 O s-o 1 —

o s--t-) c o

o

-o o O 00

u_ > o >— o Jí^ o o (U 

oo co o

<T> O

O O

CO C\J

ro on ro

co

LO

t n

ro

<£> 0 0

ro

ro

r-. <X)

t o

o 00

<^ o

CT> ro

00

O I

o •

C>0

00 s-^ o — o

J í C/í -!-> 03

Q-



ro LO

<JD O

< ^

Ln ro

ro

00

ro O

00 Ln

ro

CM

<J3

00

on

c\i

co <^

oo c s. -u> 03

Q -

-o O O

u.

-1-)

oo fO

<+-j * : 1 — 03 03 03 S-

LU O

S-

o

x : o c 3

r—

M -O

1 —

03 03

LU

c o o c

S-(U c c

•r—

-o

<+-o

cn c

• 1 —

-(-) 03

LU

f— 03 > O 1—

• t— C E O 03

• - - M -+ J O O 3 +->

-o O tO s- -o

4-> O c o

H-l C ( -

(U > <u

t n o

(U

.c

-i-j

03 C 03 O

c O)

00

55

Hypothesis 11


There is no significant difference between the mean weekly food pattern scores of the ENP leaders and the control group participants on the preassessment of the Food Behavior Questionnaire for each of five food patterns.


There were no significant differences between the mean weekly food

pattern preassessment scores of the ENP leaders and the control group

participants on four of five food patterns. The one food pattern

where there was a difference significant at the .05 level dealt with

the use of the Four Food Groups in meal planning. The mean pre-

assessment score for this food pattern was higher for the control

group participants than the ENP leaders. Therefore, Hypothesis 11


pattern.

Hypothesis 12


There is no significant difference between the mean weekly food pattern scores of the ENP leaders and the control group participants on the postassessment of the Food Behavior Questionnaire for each of five food patterns.


There were no significant differences between mean postassessment

weekly food pattern scores of the ENP leaders and the control group

participants on any of the weekly food patterns. Therefore, Hypothesis

12 was accepted.

56

Q 2 : < C/1

cc LU Q <

Q- Z

r^ LU .u C < H -

00 U_ </î 0 UJ

0 0 0 0 C/î LU < CSL \— 0 00 0 0 00 Q-

Z Q cel 2 : LU cC H -1— 1— < Z Q_ LU

^ Q 0 0 0 0 0 0 UJ u . 0 0

0 0 > - < _ J UJ ^ Q : LU Q-LU 3 Z

0 z^ < 0 0 UJ t— ^ Z.

< 2 : C^

00 I

LU O

LU cel Cû <

Q . 0 0 LU CL. O ZD •21 O LU CC Csl CJ

U . O i-H Q : Q f—

u_ o o o 0 0 H—t

0 0 >-

to c o

o

00 S-CU -o 03 c (U E 00 00 CD

t n < ^ r— Ln

o* crj

• 00 CVJ ^ r o

cû o

r>. Ln r^ CT>

o .—

rooo r ^ r - <x>r— o t n ^ < ^ I— c\j o o ^ 1— ro I— Ln æ c o

ro ro "vf Ln co <^ • ^ r o

ro o O O

0 0 cr> Ln 0 0

^ Ln

r o C>sJ o tO LO

00 LO

t n r o

c\j r o

00 00 <^ "NJ-

-l-> +-> 03

CL.

- 0 0 0

U-

+-> 00 03

M-. ^ 1 —

fO 03 (U d) S- E

XJ cn

<+- c 0 •r-

c CD S-c 0

•<- E +-> 03 S-

LU 0

S-0

. c 0 c 3

r—

H -0

1 —

03 (U

cn E c

• r -+J 03

LU

C 0 0 c

^ 0

s- (U 03 >

LU CU

- 0 0 0

Ll_

s-3 0

U_

M-0

CU 00

Q

C 03

^— Q .

r— 03 (U E c

• r—

LO Q . 3 0 S-

0

3 (U c

^ >> 0 r—

• r -C E 0 03

• - - M-+J 0 0 3 -M

- 0 0 to s- -o +-> 0 c 0

HH M -

cu > cu

t n o

cu JZ +->

+-> 03

c 03 o

c cn

00

57

Hypothesis 13


There is no significant difference between the mean nutrition knowledge preassessment test scores of the ENP leaders when they are classified on each of five demographic variables.


There were no significant differences between the mean preassessment

nutrition knowledge test scores of the ENP leaders when they were

classified on four of five demographic variables. There was a

difference significant at the .05 level between preassessment nutri-

tion knowledge test scores of the ENP leaders when they were

classified according to income level. The mean preassessment nutri-

tion knowledge test score was higher for the ENP leaders with a family

income of $5,000 or more. Therefore, Hypothesis 13 was accepted for

four of the demographic variables and rejected for one demographic

variable.

Hypothesis 14


There is no significant difference between the mean nutrition knowledge postassessment test scores of the ENP leaders when they are classified on each of five demographic variables.


No significant differences were found between the mean postassessment

nutrition knowledge scores of the ENP leaders when they were clas-

sified on the various demographic variables. Therefore, Hypothesis

14 was accepted.

58

Q

< oo LU Cd O o OO t /1 I — o <y) i-H Lu Q ; I — <

LU O 2 : 00 Q 0 0 LU LU I—( t / í U_ 0 0 •—• < 0 0 UJ t / í c s : < Q I

o LU O ^ Q LU

to cu 3

03 > I

+^l

0 0

O 0 0 CÛ Z ^ < ^ LU I—I

Q cn 00 ^r < <

o u j > LU I—I _ i

—I h- o C û t-H Q . I-H

< cc^ zn h - h— LU Q-

=) <

z u_ cc: o o

2: o < 00 2 : LU UJ LU 2 : Û Í : Q

o 2 : 0 Lu m \— 00 LU LU CÛ I—

0 0 I— Lu ; z O LU Z 2 : UJ 0 0 Q : 0 0 LU LU LL. 00 u_ 00 ' - ' < Q I—

00

u_o O C L LO I—I t / >-

c 03 4!>|

< <

c 03 I

cr>

0 0 < ^

ro

OsJ L n

ro

LO

ro

cr> 0

^

<X)

ro

ro

^

ro co

ro

0 0 0

<:!-

C\J

^

C\J C^sJ

ro

rv. LO

t o r^

o I

.07

* CvJ

1

t o 0 0

0

LO C>J

ro

r^ 10

CNJ

«cr 0

ro

0 L n

ro

ro 0

ro

r>.

CO

0 L n

C\J

CTi

ro

L n

ro

cr> 0 0

C\J

o j Ln 00 ro vo Ln co ro

o c 03 Q . to

to s-03 í > >

to s-03 ^

to s-03 í

<T> C\J

V |

o ro

O r—

O O O O O O

t n t n i3^ -(sO-

A | V A |

to 

(U 0 03

Cd



<

1 03 0 - 0 3 (U

-0 c 0 -t-)

03 n— 0 

(U E 0 0 c

l -H

Ln Ln

V I A

(U

CL o 03

03 O

C CJ»

0 0

59

Hypothesis 15


There is no significant difference between the mean preassessment daily food consumption scores for each of 13 food categories when the ENP leaders are clas-sified on each of five demographic variables.

The data pertaining to Hypothesis 15 are presented in Tables 9-13,

with a different demographic variable in each table.

From the data presented in Table 9, it can be seen that no

significant differences existed between the mean preassessment daily

food consumption scores of the ENP leaders when they were classified

by race for 9 of 13 food categories. Due to the low number of Anglos,

data were analyzed by just two racial groups. The four food categories

for which significant differences were found included vegetables;

meat, poultry, and fish; low nutrient, high calorie foods; and snacks.

Differences on the consumption of vegetables; meat, poultry, and

fish; and low nutrient, high calorie foods were found to be sig-

nificant at the .05 level. The consumption of snacks was found to be

significant at the .01 level. In all four of the categories Blacks

consumed more of the foods than the Hispanics. Therefore, Hypothesis

15 was accepted for nine of the food categories and rejected for

four food categories when the ENP leaders were classified by race.

As shown in Table 10, no significant differences existed

between the mean preassessment daily food consumption scores of the

ENP leaders when they were classified by age for 8 of 13 food

categories. Significant differences were found for the following

60

oo Q: L U Q

<

o -z.

oo 2 : LU t / í cc 00 0 UJ 0 00 c/î 00

< z 1— 0 00 t-H 0 t— Q-Qu 2 : Q => 2 : 00 < 2 : 0 h-0 2 :

LU Q 2 :

CT> 0 00 0 </1

LU U_ UJ _ I 0 0 Cû > - 0 0 < - J < 1— t—1 LU

< Û i Q ûu

Z CSi < 0 LU U_ ^

LU Z 0 LU < LU CXL 2S h- >-LU CÛ Cû

Q 0 0 UJ L U 1—1 0 U_ •z. •—< LU 0 0 Q^ 0 0 LU — 1

0 0 >-_ l < 2 : <

to (U 3

03 > I

+-) C C 00 tO U_ Q . O)

C , 3 O 03 O 00 Q O O

Q .

to 

+J c c to

c 00 LL. C L (U 03 , 3 O

^ 00 I— 00 O 03 • r - C 0 0 03

o

o r-

c\i r-* r^

o ro o

I

on cr> ^ r -

Ln Ln

ro r>

0 0 ro

Ln i n

r o r— <X> CT>

0 0

ro O o Ln

r— O

ro r ^

0 0 0 0

• 0 0

C\J I

o

o I

<o r-

Ln CNJ

r^ 0 0

o t n

o o

o Ln o

0 0

0 0 o

r->. 00 Ln ro

r- O O

ro r-.

1— C\J

c\j Ln c si Ln c\i Ln c\ j L n C\J LO CM L n

o c 03 CL tO

o 03

o c 03 .^ Q . O tO 03

3 1 Cû

O

03 . ^ Q . O t / l 03

n: cû

o

03 . ^ Q . O to to

o c 03 Q . to

Cû

o 03

O

c 03 CL 00

j)t:

o 03

CQ

00 +J 0 3

- 0 0 S-CL

.^ r— • 1 —

V.'

00 -M • r -3 S-

U_

to (U

>

1 <D

cn c CU T ->

.c - 0 CJ) C T - 0 03 . C

c tO tO T -+-> (U E • 1 - r— fO 3 . Q +J S- (B •r-

U . +J >

1 (U cn c (U •r->

.c -0 cn C •!- < 03 . c

c 00 tO •!— +-) CU E • r - ^ fO 3 J 3 +-> S- 03 • - -

U_ -)-) >

61

c c to tO U . £2. ) 3 O CU tO 1— tO O

2 : 03 T - C OO -M 03 O OO Q O O

Q .

OO 1

•^-»1

Ln «^

. r—

r—

ro .

r— 1

• Ln ro

• C\l

1

<x>

• ' ^ 1 —

. C\l 1

00 r>.

. 1

• • CXI CVI

• ro 1

- o 

-M C C CU "O o E O • . -oo o +-) t/0

C 00 u_ c x , 3 O

2 1 oo I— 00 o 03 •>- C OO (U OS o S- Q O

Q_

o o cr> <x)

r o r-

t n c>j

(T> O

on Ln Ln r^

Ln r o •— •— C\i t—

o o

I

CT> CT>

•K CT> O

C\l I

cn r o

r^ < ^

r o 0 0

oo Ln

Ln r-» o

00

OsJ «îí-

r o r-»

-— r o I—

to cu o 03

cel

03 Q . to

*r—

i n

j i ^

o 03

r— Cû

csj Ln

o

CM Ln

o

c\j Ln csj Ln

c 03 a. to

o

03

CO

O

c 03 O. 00

O 03

CQ

O

c 03 Q . tO

O 03

oo (U

•r—

s-o cn cu

-(-> 03

o

OO "O 03 > S-+-) r—

3 o Q .

. C X to

+-) T -03 M-(U 2 : oa

oo 03 (U

21

on cTi

«5^ r—

C\l

•

cn C\l

I

r^ <^

o o

r o

Osj Ln

o

c ro . ^ CL O OO fO

n: 5

•»-> 

c\j r o

on CM

O I

Ln r^

o o c\j r o

c\j Ln

o

c 03 - ^ CL O tO 03

3 1 Cû

-o 03 03

t O t 4 _

c -o •.- . ^

+-> cu c < 4 - ( U • ! -O 2 s-

00 oo - o

co

CM

• • 00

r o I

• •

(U > (U

o (U

03

o

c CTí

oo

LO r>..

r-~ o C\J

c\j on

o

c 03 Q . 00

O 03

Cû

 (U

on o



•t-> 03

03 O

c

C7)

OO 00

o 03 c

oo

62

to Q:

á

co <

O h -

C/1 LU LU 2 : Qi: 0 0 o 0 0 O LU 0 0 0 0

0 0 2 : < O I— • — I < / 1 I— o û - Q -

Q Q 0 0 2 : ^ < o O h-Q LU o 2: o 00 U_ (/í

LU > - 00 _ l 00 h - i < : < L U Q CC

Q -

< ûc: LU O

LU CD LU <

I— •>-L U CQ Cû

Q 0 0 L U L U H-( O U_ Z •—• LU t / î Q : 0 0 LU -

c c (U - o o E O • . - 00 to O +-) <D tn U- Q . S-

C CU E O 03 00 > , 3 O 03 O 00 Q O O

Q -

1/1 

+^1

•<-) c c 

C OO U_ C2. 03 , 3 2 1 to 1 — to

ro • r - C CU 03 0 S- Q 0

Q -

to (U S-0 0

0 0

<

<

00 (U C7Í

<

00 cu

•r— s-o cn 03

o -o o o

to

 ^l

• -on r** CNJ

• • •=^ L n

• ro

ro 0 0

• 0

C\l 0 0

0

-r>. ro

• C\J

^ ro

^

C\l O J

ro CNJ

CT> 0 0

cr> co

00 ro

(/) s-03 CU >

cr> C\J

v l

to s-03 í

o ro

I— t n <o r—

C\l LO cvj 0 0

0 0 0 0 r> « r o

O c>j Ln <^

•

o 0 0

« C^J

<o C\J

c> I

r^ c\ j

C\J

C J f—

co ro 00 ro 00 ro 00 ro

to s-03 , > , > , > ,

(/1 s-03 CU

00 s-03 (U

> ^ > í

00 s-03 (U

00 S-03 cu

> > > í

cr> c\ j

o ro

CT> C>0

O ro

<T> C\l

o ro cu o

ro vj v | V I V I A| V | A | V | A|

O O Ln o

o

ro C J

1 —

to <T> <X)

CM C>sJ

<X> •îí-

ro 0 0

0 0 ro

0 L n

L n

00 ro

to s-03 ^ >^

CT> C\J

O

ro V | A |

to

+-> 0 3

- 0 0 S-Q .

. 1 ^

^

to

+-> •'— 3 S-

to O )

• r - C J o S ^

c tO tO • r -

- M (U E • í - . — 03 •^ .CX -^ S- 03 - 1 -

1 C cu •.-<J) (U . C > 0 1

•r- < : oe .c

c to tO -1— +-> S- 03 • . -

63

to 

CT> 00

•K

r-»

C sJ

<X) 00

t n Ln

• • CT> 00

CNJ

• • 00

ro

• •

r^

c\i

c c OJ " O o E O - ^ oo o +-> 00 oo LL . Q . 0)

C , 3 o O) tO .— tO O

2 1 fO • r - C OO •*-> ra o tO Q O O

Q .

• o 00

U . CL CU E S^

>» 3 O

r - Ln <X5 r—

CsJ C J

<J3 <:3-

«cí- r o r—

oo 1 ,

•^^1

• ro OsJ

. C J

tO I— to o • I - c oo 03 O

S- Q O Q-

03 03

o •o o o U -

to -o 03

> >»

cr> CsJ

o ro

V | A

ro r-

<x> <^ t û « ^

0 0 r o

00 to s- s-03 03 > >>

<T> OJ

O ro

«^ ro r>. C M r -

to

03 d) S-(U o

• • C^J

ro «

ro

r ^ t n t o .—

00 r o

to s-03 i

CT> C M

to s-03 (U > í

O ro

CNJ <x>

C\l .— r -

00 Ln

O o r^

r o r— ,—

00 r o

tO lO s- s-<0 fO

> >>

(T) CsJ

O ro

V j A | V | A |

r\

>> S-+-> r—

3 o Q .

x: « (/)

+-> •r -03 ^ - .,— -(-> to

J 3 3 to

-(-> 03 (U

C>sJ

CsJ

o o

•

<n <x) CM

C\J r^ C M

t o

00 r o

to to s- s-03 03 (U >» CT> CsJ

V |

o ro

Al

-M í >>

CT> C\J

V |

O ro

A I

-o (U s-

-o o c > 03 ro

tO <4-

C "O • r - d) s- c

-O J>£

+-> 

-M 03

+-> C 03 O

CT)

oo

<T> 0 0

O O

0 0 r o

to s-03 î > ^

CTi C\l

O ro A |

 

-l->

03

+-> c 03 O

c C7)

O O to

Ja£ O 03 C

oo

64

00 cel LU Q

<

Q . UJ Z 2 : LU 0 0

0 0 U . LU o 0 0

0 0 0 0 < UJ I— ai 00 o o O Q-00

Q 2 : Z o <

</) tyO Z 0 0 O UJ o 0 0

0 0 Q < O LU

<— o Q: .— U_ Q .

ÛQ H-( < < h- Q

Q; o

< LU

2 : < LU 2 : LU 0 3 1—

1—H

1— LU < CQ 0

:D LO Q LU 0 ^ LU Q :

LU

>-CQ

UJ Q u. Ll_ 1—1

Q

LU .—1 U_ 1—1 t/7

u_ 0 0 o <

_ l 00 0 H - l

0 0 >-_ J <

<

00 ^ l

c c 00 00 Ll_ C2. , 3 O O) 00 .— 00 O

2 : 03 • . - C t O -!-> 03 O (/) Q O O

a.

00 cu

03

> ^ l

c c 00

C 00 Ll- Q . O) 03 > 3 O

2 1 to I— to U 03 • . - C t / î o r>N I — on to co

r^ «d-

<o ro O LO

o o

• < ^ o

• C\l

I

r>.

o

<^ co

Osl co

o I

(T> 00

o I

03 c O to

+-> o 03

O

• o o o

cr> ro (T>

00 r o r o r—

on r^ ro

Ln 00 ro r»» o

Ln O 00

<y) r o .— Ln

.— CM

t o t n <sO Ln <.0 LO <X) Ln <.o Ln <X) t n

00 s-03 >

to s-03 >

00 s-03 CU

00 s-03 (U

>) >^

to s-05 >

00 s-03 >

to s-03 >

to S-03 (U >>

to s-03 (U >>

00 s_ 03 >

00 s-03 > > , o .—

V I Aj V I A | V I A | V I Aj V I A i Vl Aj

00 -!-> 0 3

- 0 0 í. Q .

.^ r— •r—

2 :

to +-> •f—

3 S-

U .

to (U O) 

 cn

• . - 0 oS . C

c tO 00 T -+-> S- rO ' r -

U_ +J >

(U •r-cn (U .c > CD

• . - e t oa . C

c to to •.— +-> S- ro • . -

U_ +-> >

65

to 1

^ 1

Ln <x)

• o

c c to tO U - Q . ) 3 O I

+-> c c (O

C 00 LU Q. CU 03 CU E S-CU OO >, 3 O S tO 1— tO O

03 •.- C OO O CU 3 _ l

-o

o

o o C sJ CsJ

o C^sl

I

Ln CsJ

ro r.. ro

CD r^ 00

t o LT)

ro ro

t n CM

ro r^

o Ln

r— Osl r -

ro Ln

O I

• o •

C\J

-Ln o

• C^J

I

ro ro 1— LD

0 0 00

r-v Csl

CT> (J3

o <x»

.— r o

( ^ Ln D Ln <0 LD

to s-03 cu >>

to s -03 CU >>

to S-03 >

to S -03 >

to s -03 r- 00

t O LO

to s -03 cu

to s -03 cu

>> > , >> >, O r -

A

A

>> S-+J r— 3 O Q .

. C « oo

+-> •.-03 ^ -CU

21 oej

to (U -M 3 +-> • ^ +J to

J 2 3 to

-(-> 03 CU

2 :

o C\J OJ

•

C\l

t n r^ r>.

0 0

Csl

<0 LO

to s -03 (U > í

v |

to s -03 (U >>

o CM

l ^ Ln

o o Ln <.o

c sj r o

cNj r ^ t— o

r— CM

r-*

I

LO CsJ CT>

t O LO

to s -03 (U

to s -fO > >> O r—

•— r o r o r ^

c\ i c\ j ,— .—

<J3 Ln

LO s -03 í

to s -03 (U >)

O r -

V| A|

rs

+-> (U c •.-(U S-

.- o S - r— • M 03 3 O C

.c 2 O) O - r -- j x :

to -o o o

M-

-o c fO

to J^

c • I —

S-• o

+-> <+-o oo

X3 03

.— <+--o 

+-> 03

c 03 O

O)

oo

66

oo Q ; LU Q

<

O oo oo

W) LU UJ OO Q : OO o < O I— OO l / )

o ^ Q-

o l-H Q I— 2 : a . < 0 0

CsJ 1 —

LU _ l CQ < 1—

0 S 0 0 0

0 0 Q LU 0 00 0 0 0

u- < LU

> - ûc: _J O-1—1

< Q : Q 0

< _ J

LU LU

to ^ l

c c 00 00 U_ £3. , 3 O 03 O to Q O O Q.

CsJ

o' I

r o <T> 00

CM

•

o I

<T> O

O I

co C^sJ

CM C\l r-s. CT>

0 0 C>sl c\i t o

r o 00 co r o

t o O) on vo

. — Ln r o r o r o c^j

to

cu 3

r—

03 >

^l

Ln 0

. r—

Ln r o

00 o t o

o

Ln Ln

r o « ^

o I

\— 0 LU Cû

0 0 LU 0 d!^_

0 "Z. I - H

>-CQ

LU Q

cc LU U -U -1—1

LU t—1

U_ t—1

0 0 Q 0 0

U . < _ l

0 0

0 0 • - H

0 0

> -_ 1 < •z. < :

c c tn

C tO U - Q . , 3 O

2 1 </) 1— to o fO • • - c 0 0 ^

O Ln t n co CTi

Ln 00

c\i ^ r^ Ln

00 CM

<^

0 0 < ^ 00 r o 00 r o co r o 00 r o 00 r o

 c 03

O

-o O O

o o o o o o o o o o o o

o o o o o o

o o o o o o o o o o o o

o o o o o o t n Ln

•faO- ^ T O -

V A |

Ln Ln

V A |

t n Ln •faO- <30-

V A |

Ln Ln -fae- -fao-

V A |

Ln Ln

V A l

Ln Ln fac>- -faO-

V A|

to

o 3

T3 O S-Q . to

3 S-

to O)

• I —

03 JC

to to -(-> (U T— r— 3 . Û S- 03

0

C T —

= 03

+-> • r -

1 c

 C7)

•r- < oS JH

c tO (/) •.—

+J (U E • r - . — fO

3 J3 +J S- 03 •r-

67

ues

03 > 1

+^l

.76

• "

•

.02

C sJ

.33

o 1

• • -00 00

ro

ro O

O

o OsJ

o

+-> c c oo OO U_ Q . QJ

C , 3 O 

ro C\l

OsJ OsJ

to ^

ro co

00 o

CTl ro

^ ro

ro ro ro r—

Osl CT>

ro ro 0 0 Osj

ro .— .— OsJ .— ' — .— r o Osj I— I—

" O

 C O o

I I

O J

CQ

<

03 > I

+-> c c , 3 O

2 : oo .— oo o ro - 1 - C OO 

OsJ

o I

OsJ 0 0

c\i o

on ro

cvj 0 0 I— ro

0 0 0 0 r>v cn

< ^ o

cr> to

CM r>.

L n 0 0

Osi C\J r—

 C d)

00 ro

o o o o o o

LO o n -fa^ -t/î-

00 ro

O O O O O O

Ln Ln "(sO- -tjO-

V A V A |

00 ro

o o O O O O

L n LT) •09- faO-

V A I

00 ro

O O O O O O

Ln tn fa<»- -fa«^

V A I

oo •> s-+-> n— 3 O Q .

. C r, 00

-l-> • r -03 <4- 3

- M • r— - M OO

JQ 3 00

-(-) fO (U

2 :

00 ro

O O o o o o

L n L n faO- -faO-

V AJ

2 O

oo " - O

(U O • r - O S- M -o

r— +-> 03 C O CU

. C S-C7>-t->

• r - 3 ^ C

o ro on

<J3 L n

CM to

•— 0 0 <^ ro

00 ro

O O O

O o o

LO L n -faO- âO-

V A |

"O (U s-

-o o c > ro 03

oo 4 -

c -o • r - CU S- c

" O <D 00 - M J í

+-> (U c ^- <v •<-O 2 S-

OO to - O

00 ro

o o o o o o

Ln on -faO- -faí)"

A |

to

o 03 c

oo

cu > (U

cu .c -t->

-M 03

-(-> C 03

o • r— (^-T —

c C7)

oo

. .—

 



 03

-(->

c 03 O

•^-M-•r—

c C7)

• 1 —

oo

03

C 03 O

c CJ)

oo

68

oo Cd LU Q <

O

oo LU a: o o t/í

cc: o

Q _ J o

o =o oo ZD O I—

00

o o Q

ro o .— o

CQ _ l < '-' \— <

Q

I—1 t / î OO

O LU ^ OO l-H 00

< I— oo O

LU Q-_ l Q . Q O Z LU <

a. O LU

2 1 a: oo LU oo Cû LU 2 : 00 0 0 0 ^ <

LU > - Q i CQ Q .

L U

I— LU CQ

0 0 LU O

LU 0 0 Q : 0 0 LU -< <

to 1

^ ro

• 1

 00 00 U - CL , 3 O 03 O 00 Q O O

00 

ro ro

• 1 —

•t-i c c tn

c 00 U_ Q. , 3 O 2: 00 .— 00 o

03 •r- c t/) o Ln L n

ro 0 0

<X) ro OsJ

r«* o

00 00

ro (T> CM

CT> Csj

r— .— Osl

t n <X) CM

CTi Ln

r-. ro

« o

I

<o to

• o

I

Ln (T> t o OJ

r> . r-> ^ o r- LO

00 LO o

<T) t— Lo r^ OsJ

o Ln

c^j

Ln Ln

V I A

Ln Ln

V I A

Ln Ln

V I A

Ln Ln

V I A

Ln Ln

V I A

Ln LO

V I A

00 -l-> 0 3

- 0 0 S-CL

.i^ r—

•^ 2 :

to •4-) • t —

3 S-

U_

00 (U

.— J 3 03 -(-> (U O ) (U

>

1 c CD

•r- 0 o?5 JC

c 00 tO -r-+-> (U E •r- , fO 3 J 2 -(-> s_ 03 • . -

U_ -(-> >

1 c cn

•r- < oQ JC

'!~ to t/) •.— +-) (U E •r- .— 03 3 X I -(-> S- 03 •r-

U . +J >

69

to 1

tn <^

. o 1

c c 00 tO U_ Q . OJ E S-c , 3 O 03 O OO Q O O

Q -

00 

0 0

ro CNJ

I

0 0 <T>

O I

o o o

0 0

o I

• o OsJ

• OsJ

I

o •

o I

t o cr> f ^ OsJ

ro c\i

r>» ro ^ «^

CD t n

LO

ro o r^

O r -O r^

00 r^ .— o

r>. .—

r— r - OsJ r— •— C\l ^ r - r—

C > 3 O

to .— to o 03 T - C OO CU 03 O

Q O

oo 00 05

O

• o O o

r<» «!í-

on Ln

V I A

Ln Ln

V I A

to -o 03 í S-

+-> 3 O CL

. C " to

+J • . -03 H -

+-> to

JD 3 t o

-l-> 03 (U

o

 03 03 tO t4_

c -o •p- (U

t n o

<u sz -(-)

03

c 03 O

c

O )

OO oo

o 03 c

0 0

70

five food categories: milk products; breads; meat, poultry, and fish;

low nutrient, high calorie foods; and snacks. Differences on the

consumption of milk products and meat, poultry, and fish were found

to be significant at the .01 level. Differences on the consumption

of breads; low nutrient, high calorie foods; and snacks were found

to be significant at the .05 level. The ENP leaders 29 years of age

or younger consumed larger amounts of foods in each of these

categories. Therefore, Hypothesis 15 was accepted for eight of the

food categories and rejected for five food categories when the ENP

leaders were classified by age.

From the data presented in Table 11, it can be seen that

there were no significant differences between the mean preassessment

daily food consumption scores of the ENP leaders when classified by

educational level on 9 of 13 food categories. Differences sig-

nificant at the .05 level were found for the following four categories:

milk products; cereals; meat, poultry, and fish; and low nutrient,

high calorie foods. For the milk products; meat, poultry, and fish;

and low nutrient, high calorie foods leaders with 11 or more years

of education consumed larger amounts. For the cereal category, the

group with ten or less years of education consumed larger amounts.

Therefore, Hypothesis 15 was accepted for nine of the food categories

and rejected for four food categories when the ENP leaders were clas-

sified by educational level.

As reflected in Table 12 no significant differences existed

between the mean preassessment daily food consumption scores of the

71

ENP leaders when they were classified by income level for 12 of 13

food categories. A difference significant at the .01 level was found

for the breads category. The ENP leaders with an income of less

than $5,000 consumed more breads. Therefore, Hypothesis 15 was

accepted for 12 of the food categories and rejected for 1 food

category when the ENP leaders were classified by income level.

From the data presented in Table 13, it can be seen that there

were no significant differences between the mean preassessment daily


by the number of people living in the household for 12 of 13 food

categories. A difference significant at the .01 level was found for

the soft drinks and sweetened flavored drinks category. The ENP

leaders with more than five people in their families consumed more

of these beverages. Therefore, Hypothesis 15 was accepted for 12 of

the food categories and rejected for 1 food category when the ENP

leaders were classified by number of people living in household.

Hypothesis 16


There is no significant difference between the mean postassessment daily food consumption scores for each of 13 food categories when the ENP leaders are clas-sified on each of five demographic variables.




were no significant differences between the mean postassessment

daily food consumption scores of the ENP leaders when they were

72

classified by race for 10 of 13 food categories. Significant dif-

ferences between the mean daily food consumption postassessment scores

of the ENP leaders were found for the following three food categories:

meat, poultry, and fish; low nutrient, high calorie foods; and snacks.

Differences on the consumption of meat, poultry, and fish and low

nutrient, high calorie foods were found to be significant at the .05

level. A difference significant at the .01 level was found on the

consumption of snacks. Blacks consumed more foods in each of these

categories daily than Hispanics. Therefore, Hypothesis 16 was ac-

cepted for ten of the food categories and rejected for three food

categories when the ENP leaders were classified by race.

As shown in Table 10, no significant differences existed be-

tween the mean postassessment daily food consumption scores of the

ENP leaders when classified by age for 6 of 13 food categories.

Significant differences were found for the following seven food

categories: milk; milk products; fruits and vegetables high in

Vitamin C; cereals; low nutrient, high calorie foods; soft drinks

and sweetened flavored drinks; and snacks. Differences on the con-

sumption of milk; milk products; low nutrient, high calorie foods;

soft drinks and sweetened flavored drinks; and snacks were sig-

nificant at the .01 level. Differences on the consumption of fruits

and vegetables high in Vitamin C and cereals were significant at the

.05 level. The ENP leaders 29 years of age and younger consumed

larger amounts of foods in all categories. Therefore, Hypothesis 16

was accepted for six of the food categories and rejected for seven

73

food categories when the ENP leaders were classified by age.


were no significant differences between the mean postassessment daily


by educational level for any of the daily food categories. Therefore,

the Hypothesis 16 was accepted for all 13 food categories when the

ENP leaders were classified by educational level.

As reflected in Table 12, no significant differences existed

between the mean postassessment daily food consumption scores on

the ENP leaders when they were classified by income level for 11 of

13 food categories. Significant differences were found for the

cereal category and meat substitutes category at the .05 and .001

levels, respectively. The ENP leaders with an income of less than

$5,000 consumed more foods in these two categories than leaders with

higher incomes. Therefore, Hypothesis 16 was accepted for 11 of the

food categories and rejected for 2 food categories when the ENP

leaders were classified by income level.



daily food consumption scores for 11 of 13 food categories when ENP

leaders were classified by the number of people living in the house-

hold. Differences significant at the .05 level were found for the

cereals and soft drinks and sweetened flavored drink categories.

For both of these categories, the ENP leaders with more than five

people in their families consumed more of these foods. Therefore,

74

Hypothesis 16 was accepted for 11 of the food categories and rejected

for 2 food categories when the ENP leaders were classified by the

number of people living in the household.

Hypothesis 17


There is no significant difference between the mean preassessment weekly food pattern scores for each of five food patterns when the ENP leaders are classified on each of five demographic variables.




were no significant differences between the mean preassessment weekly

food pattern scores of the ENP leaders when they were classified by

race for four of five food patterns. Due to the low number of Anglos,

data were analyzed by just two racial groups. A difference signifi-

cant at the .05 level was found on the pattern dealing with the use

of the Four Food Groups in meal planning. Blacks reported using the

Four Food Groups more often in their meal planning than Hispanics.

Therefore, Hypothesis 17 was accepted for four of the food patterns

and rejected for one food pattern when the ENP leaders were clas-

sified by race.

As can be seen in Table 15, no significant differences existed

between the mean preassessment weekly food pattern scores of the ENP

leaders when they were classified by age for four of five food

patterns. A difference significant at the .05 level was found on

the food pattern dealing with eating breakfast or a morning meal.

75

oo ai LU Q

<

oo I

+ J |

0 0 ro L n

CD 0 0

• O

I

•

Csj

OsJ

ro

o 2: oo

oo oo LU LU ai (j-> o </) o < OO h -

oo 2 : o cc a. L U \— Q \— 2 : < < a.

\— Q 2 : O L U o 2 : u_ 00

t/^ ^ > - LU t— _ l 0 0

i ^ 0 0 LU L U < CQ

< 3 Q::

< CC LU O

Z LU LU O LU < 3 Q ; I— LU > -CQ CQ

t / ) Q L U L U O t—•

Q : 0 0 LU t/7 U_ 

+-> 00 C " O (U (U 0 s-E 0 0 to U- u 00 0 0

C ) 03 00 r— C 0

t—

CD

r -

< 2 : < :

- M c -o , CU 00 I— c s: to js s-

03 (U (U S- 3 - M

C^ (O Q -

00 (U O 03

Q :

r . r>. ro

CD on

• o

t

• r-s.

C\J I

Osl

o I

r^ t o

i ^ 0 0

ro

L n OsJ

r- OJ

Osl (D

r^ c^j

ro Ln L n t o

ro ro ro .—

r— ro

r^ t o

ro r^

CNj t n

o •r— c 03 .^ Q . O i/) 03

Osj L n

o

CM L n

o

c 03 Q . 00

-^ 0 03

C 03 Q . 00

.^ 0 03

CQ CQ CQ

c\i on

o c 03 .^ o. o 00 fO

31 S

c\i on

o c 03 .^ Q . O 00 ro

00

c S-OJ

-(-> -»-> 03

Q -

- 0 0 0

U_

1 c

1 s-^ 0

2 ^ -(-> 00 03 03

LU t ) _

r— 03 03 S_

LU 0

CD C

• 1 —

+-> 03

S-0

s- > 0 <+- 1 — S- T -••-> 2 E C (U 03

•—' C M -

(U > (U

on o

cu

03

c fO

o

c CD

00

76

oo ce: LU Q <

LO L L .

CQ < \—

o 2 : 0 0

<r> u~> U J LU Q : 0 0 o </o o < 0 0 I—

0 0 ^ o Q : Û -LU h- Q I— 2 : < < Q .

f— Q 2 : O LU O "^

t / ) 0 0

> - LU _ l 0 0 ^ 0 0 LU < C LU LU 3 Q:

a. •21 < Q : LU O

LU O U J <

I— >-LU CQ CQ

Q 0 0 LU LU I—) O U . "Z, I—H LU 0 0 Q : 0 0 LU 0 I—t t / l > -

00

cu 3

<— 03

> 1

to r-v

• 0

• • r>. •—;

ro 1

ro 0

• 0

1

^ ro

0 1

0 0 C\l

0

< <

-(-> 00 c -o cu (U o s-E O O 00 U - o

C 00 t / ) fO , (U tO r— C

S tO Ji^ S-fO S- 3 +-)

Q- ro Q-

to C s -cu

03 Q .

-o O O

+-> 00 c -0 0

c , 03 00 .— C (U +-) 00 3 -t-> 0 03

Q - Q .

CD ro

<:i-

CÔ LO

ro

• * «;d-

«^

<D to

<X>

t o 0

<x>

0 0 0

<X)

<UD «^

CM

to

Csj

to on

.—

0 0

ro .—

00

 * l

•K to ro

• C J

CD

ro O

I

CD r^

OsJ

0 0 OsJ

o o

on

ro ro

0 0

o to t o

00 ro

00

cu O )

<

t/) S-03 CU >^

( D Osl

vj

00 s-03 (U > 5

0 ro

A|

00 ro

00 to s - s -03 03 > > í

00 ro

CD OsJ

o ro

to s -03 >

<D Osl

to s -03 >

o ro

V | A| V | A |

+ J 03 tO 

•r- <V T—

•M 03 03 S- o O

00 ro

to s-03 > > í

cr> C sl

o ro

s - 00 3 Q . o 3 c

Ll - O 03 S- r—

4 - CJ3 Q . O

- O 1 — , > i

<D C\l

o ro

V | A | V | A |

4 -O

C O O •»-)

+-> 00

o -o 3 O

- o O > í O ^ r -S- • r -

c 35 03 - i c <+-

 fO

+-> c 03 0

T —

<+-•r—

c CD

•^ 0 0

 (U

'— ,_ 0

• (U

sz +-> +-> 03

+-> c 03 0

'r— M -

•^ C CD

• r " 0 0

• ¥

77

oo ai LU Q <

Q - LU ^ 2 : LU W)

00 U_ LU o 00

00 00 < LU I— ai 00 0 0 O Q -0 0

Q ceL<c

< L U a. 2 :

00 Q 0 0 O U J o 00 u_ 00

< > - L U

t O _ t Q:: r— Í Í Í : Q -

c to o

Q .

to I

to , c:

.— s-

. ^ (U 

3 03 Q -

to (U

03

>

CQ

<

LU Ctí 3 0

< . u

3 < I— 2 : LU O CQ t-H

I— 0 0 < LU O O I D 2 : Q L U LU ce: LU > -U_ CQ L L . HH Q Q LU

0 » - H 0 0

0 0 t o — ' < 0 0 _ l >- o _ l < <

-•-> 00 C - Q , CU 00 r— C

2 : </) Jí^ S-fO cu S- 3 + J

Q - fO Q -

t o L n 0 0

CD • t o t n

C J I

t n r^

ro

O L n r>.

o o

CD t o

r- •53-

LO L n L n t o

ro

c \ i

«^ o o

o o

.— c o

t o «!:í-

O i

<XÍ CD

• O

I

0 0

o o

I

t o C\l

t— r«* 00 Osl

ro rs. f— O

t n OsJ

o Osl

< D to

rv.

ro LO t o t o c^j c \ i

CO CO

o I

to LO

o CO

z

1 —

fO c 00 0 1 —

• r - ro 5

0

V

1 j x : 03 (U S-

JQ

O )

- c

+-> fO LU

LO

t/) S.-03 í

•—

A |

1 C s. 0 E 03

t or

mea

l

00 CD rO C

- ( - T -

t o

00 S-03 (U

>> 0

S-0

. c 0 c 3

CD C

+-) 03 LU

03 (U

E c 0 0 c 03

LO

00

s-03 CU >^

A |

t o

00 s-03 )

0

s-0

s-(U c c

- 0

cn c

+-> 03

L U

L n

00 S-03 (U >>

r -

A |

, _ 03 í

0

- 0 0 0

U -

3 0

U -

C(-0

>

.—

A |

f —

03 . > .

0 .—

V | A |

(+-0

c 0 0 + J

+ J to 0 - 0 •D 0

- 0 0 > > 0 4 - r -S- •.—

•^J S E C (U 03

1—1 C t t_

lev

el.

t n 0

(U . c +-)

ica

nt

at

(+-

c V - ^ '

0 0 •

78

• to I .

OO

a: LU Q <

Q. S 2 : 00 LU OO

LU U- </) O OO

< 00 I— UJ OO a: o o Q-o t / Î Q

a:

< 2 : Q - t / )

0 0 Q L U

r-s o o o .— o oo

u - < LU LU _i >- a: ÛQ _ I Q . ^ \— mce:

LU O

< LU

3 0 I — O LU Z ÛQ •—•

0 0 > -L U OQ o 2 : Q LU L U a: t-H

U_ 00 t—i <r> Q <

_ l U- o o

oo I—1

OO > -_ J < •z. <

c 03 c -o , 00 1 — to Js^ 03 (U

+-> cu 00 3 O

Q .

oo (U s-o o

0 0

c s- -t-> 03

Q_

to 

+-) 00 C "O , S_ 3 +-)

Q - 03 Q .

 o-

0 0 0

LO •bO-

0 0 0 Ln

•fc.0-

0 0 0

Ln •faív

0 0 0

Ln •faO-

0 0 0

Ln v^

0 0 0

Ln •fc.0-

0 0 0

Ln •fc»0-

Ln

C5 I

r o 00 r o

00 r o

r o

O Ln

co r o

r o

00 r o

cr> L n

C3 I

CD O

O C^J

L n

o I

r ^ CD r— t o

L n L n

00 r^

t o

Ln t o

cr> 00 Osl

o o Ln

CD L n o

o

co «:3-

cn O O

I

r o 00

r o C>sJ

C\J C>sJ

o r o

t o O

o r o

r-s <D to to

to to c>sj r o

00 r o 00 r o 00 r o 00 r o

A | V A | A I A

00 c S-

cu +-) +-> rO

Q -

- 0 0 0

U -

+-) 00 03

<+-. i ^ CD 03 C 03 S-

LU 0

r— 03 (U

E

S-0

. c 0 r— C 03 3 

LU 

-t-> to 0 - 0 3 0

- 0 0 >> 0 "+- r— s- •.--M S E C (U 03

1—. C t j _

- o c o >> 03

c 03 O

c cn

to

+-> o c

 I

79

0 0

oo cc \— LU S Q LU

< 2 : L U </ ) _ J t / ^

L U Q - 0 0 2 : t/O L U <

L U u_ Q: O Q -

t o Q ; LU O a: u . o o Q 0 0 _ i

o a: u j L U 0 0 \- :=) h - O < n : h -a. 2 :

Z LU Q I—• 2 : o 0 0 o o 00

¥ to 

• M 00 C -o , ro to I— c (U to . i ^ S-

2 : 03 CU O 03

Q - Û -

to I ,

O t n

t o o OsJ

o' I

00 «:í-

to

<D CD Osj r ^

• • - ^ ro Ln

<J3

ro

Ln

o - ^ O r—

• • to <o

r>*

C^sl

r^ o

r^ r«v

to 00

<d- r— t—

*—* </) LU > - > 0 0 _ J _ l •—. <

5 LU 00 fZ LU LU O

3 _ l O. Q -

^ O Q < LU Z LU Q . ca:

2 : 0 LU Lu a: 3 LU I— ca U J 2 : CQ Z3

•z. 0 0 LU > -O C û

LU Q Q : U J

I—I t / í Q 0 0

 -

r^ 0 0

• o

Osl cr>

ro to

00 f O r^

o I

< •z. <

c -o

o s- . c (U 03

Q -

-o O O

LO

V I

+-> 00 03

<+-.!<: 03 C fO

LU fo

Ln Ln

V I A

s-o

S- 

L U , O 14- r -S- - r -+J 5 E c 33 03

•—I C <+-

• o c o > , 03

+-> c 03 O

c CD

t/)

+-> O c

 I

80

ENP leaders 29 years of age and younger ate breakfast more often.



sified by age.


were no significant differences between the mean preassessment weekly

food pattern scores of ENP leaders when they were classified by

educational level attained for any of the weekly food patterns.

Therefore, Hypothesis 17 was accepted for all five food patterns

when the ENP leaders were classified by educational level.

As reflected in Table 17, there were no significant differences

between the mean preassessment weekly food pattern scores of the ENP

leaders when they were classified by income level for any of the

weekly food patterns. Therefore, Hypothesis 17 was accepted for all

five food patterns when the ENP leaders were classified by income

level.


were no significant differences between the mean preassessment

weekly food patterns scores of the ENP leaders when they were clas-

sified by the number of people living in the household for any of

the weekly food patterns. Therefore, Hypothesis 17 was accepted for

all five food patterns when the leaders were classified by the num-

ber of people living in the household.

81

Hypothesis 18


There is no significant difference between the mean postassessment weekly food patterns scores for each of five food patterns when the ENP leaders are clas-sified on each of five demographic variables.





weekly food pattern scores of the ENP leaders when they were clas-

sified by race for four of five food patterns. A difference sig-

nificant at the .05 level was found on the pattern dealing with the

use of the Four Food Groups in meal planning. Blacks reported using

the Four Food Groups more often in their meal planning than Hispanics.



sified by race.

As reflected in Table 15, no significant differences existed

between the mean postassessment weekly food pattern scores of the

ENP leaders when they were classified by age for four of five food

patterns. A difference significant at the .01 level was found for

the food pattern dealing with eating lunch or a noon meal. The ENP

leaders 30 years of age and older ate lunch more often. Therefore,

Hypothesis 18 was accepted for four of the food patterns and re-

jected for one food pattern when the ENP leaders were classified by

age.

82




sified by educational level for four of five food patterns. A dif-

ference significant at the .05 level was found for the food pattern

dealing with the use of the Four Food Groups in meal planning. The

ENP leaders with 11 years or more of education used the Four Food

Groups more often in their meal planning. Therefore, Hypothesis 18


pattern when the ENP leaders were classified by education attained.

It can be seen in Table 17, that no significant differences

existed between the mean postassessment weekly food pattern scores

of the ENP leaders when they were classified by income level for any

of the weekly food patterns. Therefore, Hypothesis 18 was accepted

for all five of the food patterns when the ENP leaders were clas-

sified by income level.




sified by the number of people living in the household for any of

the weekly food patterns. Therefore, Hypothesis 18 was accepted for

all five of the food patterns when the ENP leaders were classified

by the number of people living in the household.

83

Summary

1. When comparisons were made between the mean preassessment and

postassessment nutrition knowledge test scores for both the ENP

leaders and the control group participants, no significant differences

were found for either group. When both the mean preassessment and

postassessment nutrition knowledge test scores of the ENP leaders

and the control group participants were compared, no significant

differences were found.

2. When various comparisons of mean preassessment and postassessment

daily food consumption scores for the ENP leaders and the control

group participants were made, the following significant findings

resulted:

A. There were significant differences between the mean pre-

assessment and postassessment daily food consumption scores of the

ENP leaders on the following four food categories: fruits; fruits

and vegetables high in Vitamin C; meat, poultry, and fish; and low

nutrient, high calorie foods. The mean postassessment scores on the

consumption of fruits and fruits and vegetables high in Vitamin C

were higher than the preassessment scores. The mean preassessment

daily food consumption scores were higher for meat, poultry, and

fish and low nutrient, high calorie foods than the mean postassess-

ment scores.

B. There was a significant difference between the mean pre-


control group participants on the following food category: soft

84

drinks and sweetened flavored drinks. The mean postassessment score

on this food category was lower than the preassessment score.

C. There were significant differences between the mean pre-

assessment daily food consumption scores of the ENP leaders and the

control group participants for the following two food categories:

breads and meat, poultry, and fish. The mean preassessment scores

of the ENP leaders were higher for both of these food categories.

D. There were significant differences between the mean post-


control group participants for the following five food categories:

fruits, fruits and vegetables high in Vitamin C; breads; meat,

poultry, and fish; and soft drinks and sweetened flavored drinks.

The mean postassessment scores were higher for the ENP leaders than

the control group participants for all these food categories.

3. When various comparisons of preassessment and postassessment

weekly food patterns were made for the ENP leaders and the control

group participants, the following significant findings resulted:

A. There was a significant difference between the mean pre-

assessment and postassessment weekly food pattern scores of the ENP

leaders on the following food pattern: introducing new foods to

the family. The mean postassessment score was higher for this food

pattern.


assessment weekly food pattern scores of the ENP leaders and the

control group participants on the following food pattern: use of

85

the Four Food Groups in meal planning. The mean preassessment score

for this food pattern was higher for the control group participants

than for the ENP leaders.

4. When the ENP leaders in the study were classified on various

demographic variables a significant difference was found between

their mean preassessment nutrition knowledge test scores when they

were classified by income level. The ENP leaders with a family

income of $5,000 or more scored higher on the preassessment than

leaders with a lower income.

5. When the ENP leaders in the study were classified according to

various demographic variables, the following significant differences

were found in their daily food consumption scores:


assessment daily food consumption scores of the ENP leaders when

they were classified by race for the following four food categories:

vegetables; meat, poultry, and fish; low nutrient, high calorie

foods; and snacks. In all four of these food categories Blacks

consumed more of these foods daily than the Hispanics.

B. There were significant differences between the mean pre-


they were classified by age for the following five food categories:

milk products; breads; meat, poultry, and fish; low nutrient, high

calorie foods; and snacks. The ENP leaders 29 years of age or

younger consumed larger amounts of foods in each of these categories

86



they were classified by educational level for the following four

food categories: milk products; cereals; meat, poultry, and fish;

and low nutrient, high calorie foods. For the milk products; meat,

poultry, and fish; and low nutrient, high calorie foods, those ENP

leaders with 11 or more years of education consumed larger amounts.

For the cereal category, the ENP leaders with ten or less years of

education consumed larger amounts.

D. There was a significant difference between the mean pre-


they were classified by income level for the following food category:

breads. The ENP leaders with an income of less than $5,000 consumed

more breads than those with higher incomes.

E. There was a significant difference between the mean pre-


classified by number of people living in household for the following

food category: soft drinks and sweetened flavored drinks. The

ENP leaders with more than five people in their households consumed

more of these beverages.

F. There were significant differences between the mean post-


they were classified by race for the following three food categories:

meat, poultry, and fish; low nutrient, high calorie foods; and snacks

Blacks consumed more foods in each of these food categories daily

than did Hispanics.

87

G. There were significant differences between the mean post-

assessment daily food consumption scores of the ENP leaders when they

wereclassifiedby age for the following seven food categories: milk;

milk products; fruits and vegetables high in Vitamin C; cereals;

low nutrient, high calorie foods; soft drinks and sweetened flavored

drinks; and snacks. The ENP leaders 29 years of age and younger con-

sumed larger amounts of foods in each of these categories.

H. There were significant differences between the mean post-


classified by income level for the following two food categories:

cereals and meat substitutes. The ENP leaders with an income of less

than $5,000 consumed more foods in these two categories than ENP

leaders with higher incomes.

I. There were significant differences between the mean post-



two food categories: cereals and soft drinks and sweetened flavored

drinks. For both of these categories, the ENP leaders with more

than five people in their households consumed more of these foods

than ENP leaders with less individuals in their households.



were found in their weekly food pattern scores:


assessment weekly food pattern scores of the ENP leaders when

88

classified by race for the following food pattern: using the Four

Food Groups in meal planning. Black ENP leaders utilized the Four

Food Groups in meal planning more often than did Hispanic ENP leaders


assessment weekly food pattern score of the ENP leaders when clas-

sified by age for the following food pattern: eating of breakfast

or a morning meal. The ENP leaders 29 years of age and younger ate

breakfast or a morning meal more often.

C. There was a significant difference between the mean post-

assessment weekly food pattern scores of the ENP leaders when clas-

sified by race for the following food pattern: using the Four Food

Groups in meal planning. Black ENP leaders utilized the Four Food

Groups in meal planning more often than did Hispanic ENP leaders.

D. There was a significant difference between the mean post-


sified by age for the following food pattern: eating lunch or a noon

meal. The ENP leaders 30 years of age and older ate lunch or a noon

meal more often.

E. There was a significant difference between the mean post-


sified by educational level for the following food pattern: using

the Four Food Groups in meal planning. The ENP leaders with 11 years

or more of education used the Four Food Groups more often in their

meal planning than those with less education.

CHAPTER V

SUMMARY AND CONCLUSIONS

The chapter is divided into four sections. The summary con-

sists of an overview of the study. The findings are based on results

obtained through the analyses of data pertaining to the study. The

conclusions and implications are drawn from the findings, and recom-

mendations are given for further investigation in areas related to

the study.

Summary of the Study

The major purpose of this study was to determine nutrition

knowledge and food patterns of Expanded Nutrition Program (ENP)

leaders before receiving nutrition lessons from Program Assistants

with ENP and after receiving lessons and then teaching these nutri-

tion lessons to a group of youth. The control group received no

nutrition lessons and was tested for comparability of nutrition

knowledge and food behavior patterns. In addition, race, age,

educational level, income level, and number of people living in

household were analyzed to determine their influence on nutrition

knowledge and food patterns of the ENP leaders.

Three instruments were developed by the researcher for col-

lection of data in this study. These instruments were the Demographic

89

90

Data Information Sheet, the Food Behavior Questionnaire, and the

Nutrition Knowledge Test.

These three instruments were administered by the researcher

to 31 leaders participating in the ENP in Lubbock, Texas, through an

oral interview format. The major purpose of these interviews was

to determine nutrition knowledge and food patterns before and after

receiving nutrition lessons from an ENP Program Assistant and then

teaching the lessons to youth. The testing of these leaders was

conducted between June and December of 1981. A preassessment and

postassessment pattern of administration was utilized.

A control group composed of 31 people was interviewed by a

former ENP Program Assistant hired by the researcher. She administered

the three instruments in a preassessment and postassessment pattern

between October and December of 1981. The elapsed time between the

preassessment and postassessment was approximately nine to ten weeks,

and during that time this group received no nutrition information from

the ENP office.

Findinqs of the Study

1. When comparisons were made between the mean preassessment and

postassessment nutrition knowledge test scores for both the ENP

leaders and the control group participants, no significant dif-

ferences were found for either group. When both the mean pre-

assessment and postassessment nutrition knowledge test scores of the

ENP leaders and the control group participants were compared, no

significant differences were found.

91

2. When various comparisons of mean preassessment and postassessment

daily food consumption scores for the ENP leaders and the control

group participants were made, the following significant findings

resulted:



ENP leaders on the following four food categories: fruits; fruits

and vegetables high in Vitamin C; meat, poultry, and fish; and low

nutrient, high calorie foods. The mean postassessment scores on the


were higher than the preassessment scores. The mean preassessment

daily food consumption scores were higher for meat, poultry, and fish

and low nutrient, high calorie foods than the mean postassessment

scores.



control group participants on the following food category: soft

drinks and sweetened flavored drinks. The mean postassessment score

on this food category was lower than the preassessment score.



control group participants for the following two food categories:

breads and meat, poultry, and fish. The mean preassessment scores

of the ENP leaders were higher for both of these food categories.

92

D. There were significant differences between the mean post-


control group participants for the following five food categories:

fruits; fruits and vegetables high in Vitamin C; breads; meat,

poultry, and fish; and soft drinks and sweetened flavored drinks.

The mean postassessment scores were higher for the ENP leaders than

the control group for all these food categories.

3. When various comparisons of preassessment and postassessment

weekly food patterns were made for the ENP leaders and the control

group participants, the following significant findings resulted:


assessment and postassessment weekly food pattern scores of the ENP

leaders on the following food pattern: introducing new foods to the

family. The mean postassessment score was higher for this food

pattern.


assessment weekly food pattern scores of the ENP leaders and the

control group participants on the following food pattern: use of the

Four Food Groups in meal planning. The mean preassessment score for

this food pattern was higher for the control group participants than

for the ENP leaders.

4. When the ENP leaders in the study were classified on various

demographic variables a significant difference was found between

their mean preassessment nutrition knowledge test scores when they

were classified by income level. The ENP leaders with a family

93

income of $5,000 or more scored higher on the preassessment than

leaders with a lower income.



were found in their daily food consumption scores:



they were classified by race for the following four food categories:

vegetables; meat, poultry, and fish; low nutrient, high calorie foods;

and snacks. In all four of these food categories Blacks consumed

more of these foods daily than the Hispanics.

B. There were significant differences between the mean pre-


they were classified by age for the following five food categories:

milk products; breads; meat, poultry, and fish; low nutrient, high

calorie foods; and snacks. The ENP leaders 29 years of age or

younger consumed larger amounts of foods in each of these categories.



were classified by educational level for the following four food

categories: milk products; cereals; meat, poultry, and fish; and

low nutrient, high calorie foods. For the milk products; meat,

poultry, and fish; and low nutrient, high calorie foods, those ENP

leaders with 11 or more years of education consumed larger amounts.

For the cereal category, the ENP leaders with ten or less years of

education consumed larger amounts.

94

D. There was a significant difference between the mean pre-


theywereclassified by income level for the following food category:

breads. The ENP leaders with an income of less than $5,000 consumed

more breads then those with higher incomes.

E. There was a significant difference between the mean pre-



food category: soft drinks and sweetened flavored drinks. The ENP

leaders with more than five people in their households consumed more

of these beverages.

F. There were significant differences between the mean post-


they were classified by race for the following three food categories:

meat, poultry, and fish; low nutrient, high calorie foods; and snacks

Blacks consumed more foods in each of these food categories daily

than did Hispanics.

G. There were significant differences between the mean post-


are classified by age for the following seven food categories: milk;

milk products; fruits and vegetables high in Vitamin C; cereals;

low nutrient, high calorie foods; soft drinks and sweetened flavored

drinks; and snacks. The ENP leaders 29 years of age and younger

consumed larger amounts of foods in each of these categories.

95

H. There were significant differences between the mean post-


classified by income level for the following two food categories:

cereals and meat substitutes. The ENP leaders with an income of less

than $5,000 consumed more foods in these two categories than ENP

leaders with higher incomes.

I. There were significant differences between the mean post-



two food categories: cereals and soft drinks and sweetened flavored

drinks. For both of these categories, the ENP leaders with more

than five people in their households consumed more foods than ENP

leaders with less invididuals in their households.



were found in their weekly food pattern scores:







assessment weekly food pattern score of the ENP leaders when clas-

sified by age for the following food pattern: eating of breakfast

96

or a morning meal. The ENP leaders 29 years of age and younger

ate breakfast or a morning meal more often.

C. There was a significant difference between the mean post-





D. There was a significant difference between the mean post-


sified by age for the following food pattern: eating lunch or a noon

meal. The ENP leaders 30 years of age and older ate lunch or a noon

meal more often.

E. There was a significant difference between the mean post-


sified by educational level attained for the following food pattern:

using the Four Food Groups in meal planning. The ENP leaders with

11 years or more of education used the Four Food Groups more often

in their meal planning than those with less education.

Conclusions and Implications of the Study

The following conclusions and implications are based on the

analyses and interpretations of the data and findings of the study:

1. While there was an increase in the mean postassessment

nutrition knowledge test score when compared to the preassessment

score for the ENP leaders, this increase was not significant.

97

Therefore it is suggested that the nine-lesson nutrition series given

by the Program Assistants needs to be evaluated to determine content

being presented and the teaching methods being used in the training.

It seems that the basic nutrition concepts are not being presented

effectively for this type of audience. The level of education at-

tained by the ENP leaders and language barriers may also have af-

fected the leader's ability to complete an oral nutrition knowledge

test. It is possible that new nutrition knowledge presented to the

leaders may have been difficult to retain if the information was not

used on a frequent basis.

2. The lack of a significant difference between the mean

nutrition knowledge preassessment and postassessment test scores for

the control group participants was expected, since this group re-

ceived no nutrition lessons from the ENP.

3. Since no significant difference between the mean nutrition

knowledge preassessment test scores of the control group participants

and the ENP leaders was found, it would appear that two comparable

groups were being assessed, and that any increase in nutrition

knowledge for the ENP leaders could have been attributed to the ENP

nine-lesson nutrition series.

4. It was hoped there would have been a significant difference

between the mean postassessment nutrition knowledge test scores of

control group participants and the ENP leaders with the ENP leaders

scoring higher than the control group participants. The lack of a

significant difference would indicate that either the ENP leaders

98

were not receiving and/or retaining adequate nutrition information

in their training or were unable to relay acquired nutrition knowledge

through an oral nutrition test.

5. The significant differences found for four food categories

between the mean preassessment and postassessment daily food con-

sumption scores of the ENP leaders indicated that nutrition informa-

tion presented in the ENP lessons seemed to be influencing the leaders

to change some of their eating habits. Desirable increases in the


were seen. Although there was a decreased consumption of meat,

poultry, and fish, foods in this category were still consumed at

adequate levels. Perhaps the information presented in the lessons

regarding food budgeting influenced the leaders to decrease consump-

tion of foods in this category to save money. It should be noted

that the leaders were possibly also overestimating their meat,

poultry, and fish intakes in the preassessment since it was a higher

value than would be expected for low-income families. Information

about the high cost and low nutritive value of low nutrient, high

calorie foods may have caused a decreased consumption of these foods

by the leaders. The leaders may have substituted fruits and fruits

and vegetables high in Vitamin C for the low nutrient, high calorie

foods since there was increased consumption of these two groups.

6. The decreased daily food consumption scores of the control

group participants on the postassessment for soft drinks and sweetened

flavored beverages may be due to weather changes. The preassessments

99

took place in October during warmer weather, while the postassess-

ments were completed in December in much colder weather which could

limit the consumption of cold drinks.

7. Only two daily food consumption patterns were significantly

different for the ENP leaders and the control group participants in

the preassessment indicating that these were fairly comparable groups

in terms of daily food consumption. The ENP leaders consumed larger

amounts of breads and meat, poultry, and fish which may be due to the

fact that there were more ENP leaders who were 29 years of age or

younger who may have higher activity and calorie levels. These

younger leaders may also have had a higher income level accounting

for a higher consumption of meat, poultry, and fish.

8. In the postassessment the ENP leaders consumed significantly

larger amounts of foods from five food categories than did the control

group participants. Since larger consumptions of fruits; fruits and

vegetables high in Vitamin C; breads; and meat, poultry, and fish

indicate more nutritious food consumption patterns, it would appear

that information from the ENP may have attributed to these dif-

ferences. Since on the preassessment the ENP leaders were already

consuming more breads and meat, poultry, and fish, it appears that

the most significant impacts of the lessons were on the increased

consumption of fruits and fruits and vegetables high in Vitamin C.

It is difficult to draw a conclusion for the increased consumption

on the postassessment of soft drinks and sweetened flavored drinks

by the ENP leaders.

100

9. The ENP leaders were introducing new foods to their

families significantly more often in the postassessment than they

did in the preassessment. Since the preparation of a variety of

foods is emphasized in the ENP lessons, this may have prompted the

ENP leaders to try more new foods with their families.

10. The control group participants experienced no significant

changes in weekly food patterns between the preassessment and the

postassessment. This was expected since they received no ENP

nutrition lessons.

11. The Four Food Groups system was used significantly more

often in meal planning by the control group participants than the

ENP leaders in the preassessment. Perhaps the control group par-

ticipants had had previous exposure to the use of the Four Food

Groups.

12. No significant differences were seen between the weekly

food pattern scores for the ENP leaders and the control group

participants in the postassessment. It was hoped that there would

be some significant differences for the ENP leaders. While the ENP

leaders did significantly increase the number of times they introduced

new foods to their families in the postassessment when compared to

the preassessment, the postassessment score was not significantly

different from the control group's postassessment score. Therefore,

while the control group introduced new foods to their families more

often in the preassessment than the ENP leaders the lessons from the

ENP apparently helped increase the number of times the ENP leaders

introduced new foods to their families on a weekly basis.

101

13. The ENP leaders with an income of $5,000 or more scored

significantly higher on the nutrition knowledge preassessment test

scores. A logical reason for the higher score by leaders with a

higher income is that this group might have a higher educational

level; however, since there were no significant differences seen

on the nutrition knowledge test scores when the leaders were clas-

sified by educational level it may be that the leaders with a higher

income have more access to informal sources of education and nutri-

tion information.

14. The various demographic variables do not seem to be a

factor in determining the nutrition knowledge postassessment test

scores of the ENP leaders since no significant differences were found.

It would appear that the significant difference found on the pre-

assessment when the leaders were classified by income was offset by

receiving ENP lessons.

15. Significant differences were found in 4 of 13 food

categories between the mean preassessment daily food consumption

scores of the ENP leaders when classified by race. The data would

suggest that Blacks consume more vegetables; meat, poultry, and

fish; low nutrient, high calorie foods; and snacks than do Hispanics.

A higher consumption of low nutrient, high calorie foods by Blacks

may be due to the fact that Blacks also consumed more snacks on a

daily basis than Hispanics.

16. A significantly higher consumption of five food categories

on the preassessment of daily food consumption scores for the ENP

102

leaders 29 years of age or younger may be because this younger group

may be more physically active and needs more calories. In addition,

some of these leaders were still teenagers and would need extra

calories for growth.

17. The ENP leaders with 11 or more years of education con-

sumed significantly larger amounts of milk products; meat, poultry,

and fish; and low nutrient, high calorie foods on the preassessment

of daily food consumption. Those leaders with a higher educational

level may have received more information on nutrition in school ac-

counting for the higher consumption of more nutritious foods. Leaders

with ten or less years of education consumed significantly larger

amounts of cereals. Those leaders with less education may also be in

lower paying jobs and the use of cereals is one way to stretch the

food budget.

18. When ENP leaders were classified by income level, those

leaders with an income of less than $5,000 consumed significantly

more breads on the daily food consumption preassessment. Using more

breads would be one way for families with limited incomes to stretch

their food budgets.

19. In only 1 of 13 daily food consumption categories was a

significant difference found on the preassessment of ENP leaders

when classified by number of persons living in household. A higher

consumption of soft drinks and sweetened flavored drinks was seen in

households with more than five people. The ease in preparing these

beverages for a large family may be one reason for a higher usage

103

by larger families. Larger families are also probably less able to

afford milk and fruit juices.

20. On the daily food consumption postassessment, Blacks

still consumed significantly larger amounts of meat, poultry, and

fish; low nutrient, high calorie foods; and snacks than Hispanics.

The ENP lessons apparently did not influence the consumption of these

foods.

21. The ENP leaders 29 years of age and younger consumed

significantly larger amounts of milk; milk products; fruits and

vegetables high in Vitamin C; cereals; low nutrient, high calorie

foods; soft drinks and sweetened flavored drinks; and snacks on the

daily food consumption postassessment than older individuals. The

increases seen for this age group from the preassessment for milk,

milk products, fruits and vegetables high in Vitamin C, and cereals

are desirable food behavior changes. It would appear that the ENP

lessons may have influenced these changes but were unable to reduce

the consumption of low nutrient, high calorie foods and soft drinks

and sweetened flavored drinks.

22. The ENP leaders with an income of less than $5,000

consumed meat substitutes and breads significantly more often than

leaders with higher incomes in the daily food consumption post-

assessment. The use of these foods would be an excellent way

for this group to stretch their food budget.

23. One out of five weekly food patterns was found to be

significant in the preassesement and in the postassessment when ENP

104

leaders were classified by race. Since Blacks reported using the

Four Food Groups in meal planning more often than Hispanics they may

be having more nutritionally balanced meals. Perhaps previous ex-

posure to the Four Food Groups or home training may account for

this difference between the two groups.

24. One out of five weekly food patterns was found to be

significant in the preassessment when ENP leaders were classified

by age. Since ENP leaders 29 years of age and younger ate breakfast

or a morning meal more often then their older counterparts, a higher

activity level or calorie level may account for this higher con-

sumption. This difference was seen only on the preassessment, how-

ever.

25. Educational level, income level, and number of people in

the household do not appear to affect weekly food pattern preassess-

ment scores of the ENP leaders prior to any instruction in nutri-

tion education.

26. ENP leaders 30 years of age and older ate lunch or a noon

meal significantly more often in the postassessment than the younger

leaders. The ENP lessons may have been responsible for this improved

weekly food pattern.

27. The increased use of the Four Food Groups in meal planning

in the postassessment by ENP leaders with 11 years or more of educa-

tion may indicate that leaders with a higher educational level were

better able to grasp and utilize the Four Food Groups in meal plan-

ning.

105

28. Income and the number of people in the household do not

appear to affect weekly food pattern postassessment scores of the

ENP leaders even after receiving nutrition information and teaching

nutrition lessons.

Recommendations for Further Research

The findings, conclusions, and implications of the study sug-

gest that the following investigations would be appropriate:

1. Conduct the same study with an increased sample size in

ENP units with youth phases to determine significant changes occurring

in nutrition knowledge and food patterns in other units.

2. Conduct a study using the instruments on newly hired

Program Assistants for the youth program throughout the state and

then again after three months of employment to assess nutrition

knowledge and food patterns of the Program Assistants.

3. Conduct a study on ENP leaders receiving group training

and ENP leaders receiving individual training to determine if the

type of training significantly affects nutrition knowledge and food

behaviors.

4. Conduct a study on ENP leaders who would receive and use

nutrition information repeatedly in several different situations to

determine if repeated use of nutrition information would affect

nutrition knowledge and food patterns.

LIST OF REFERENCES

1. Abdel-Ghany, Mohamed, and Schrimper, Ronald A. "Food Consumption Expenditures and Education of the Homemaker." Home Economics Research Journal, 6 (June 1978): 233-292.

2. Angove, Ruth. "Nutrition Education for Change." Journal of Human Nutrition 33 (January 1979): 65-69.

3. Baird, Pamela C , and Schutz, Howard C. "Life Style Correlates of Dietary and Biochemical Measures of Nutrition." Journal of the American Dietetic Association 76 (March 1980): 228-235. ~ ~

4. Bohlen, J. M., and Beal, G. M. "How Farm People Accept New Ideas." Agricultural Extension Service Special Report No. 15. Ames, lowa: North Central Regional Publishers, 1955.

5. Boone, E. J., and White, E. E. The Effect of Extension Service's Youth Youth Teach( of a 1

Nutrition Util 2rs:

izing Lesson Series on 1 Behav Different Educational

An Evaluative Study o -esson Ser' ies Developed by

f the

nori al Chanqe Environments Use

Extension

in EFNEP and

and Effectiveness Service, USDA for

EFNEP Youth. Raleigh, North Carolina: USDA, Extension Service, 1976.

6. Boren,Angela R.; Dixon, Paul N.; and Harden, Margarette L. "Innovations in Nutrition Education." Journal of the American Dietetic Association 80 (February 1982): 148-153.

7. Burt, Jill V., and Hertzler, Ann A. "Parental Influence on the Child's Food Preference." Journal of Nutrition Education 10 (July-September 1978): 127-128.

8. Carruth, Betty R.; Mangel, Margaret; and Anderson, Helen L. "Assessing Change-Proneness and Nutrition-Related Behaviors. Journal of the American Dietetic Association 70 (January 1977): 47-53.

9. Cerqueira, Maria T.; Casanueva, Esther; Derrer, Ana M.; Fontanot, Grisel; Chavea, Adolfo; and Flores, Roberto. "A Comparison of Mass Media Techniques and a Direct Method for Nutrition Education in Rural Mexico." Journal of Nutrition Education 11 (July-September 1979): 133-137.

106

107

10. Christopher, Carole; Shannon, Barbara; and Sims, Laura S. "A Multimedia Approach to Teaching Nutrition." Journal of Nutrition Education 12 (January-March 1980): 8-13.

11. Cosper, Barbara A., and Wakefield, Lucille M. "Food Choices of Women." Journal of the American Dietetic Association 66 (February 1975): 152-155.

12. Craig, David E. "Guiding the Change Process in People." Journal of the American Dietetic Association 58 (January 1971): 2^-25.

13. Cross, Audrey T. "USDA's Strategies for the 80's: Nutrition Education." Journal of the American Dietetic Association 76 (April 1980): 333-337.

14. Day, M. L.; Lentner, M. and Jaquez, S. "Food Acceptance Patterns of Spanish Speaking New Mexicans." Journal of Nutrition Education 10 (July-September 1978): 121-123.

15. Emmons, Lillian, and Hayes, Marian. "Nutrition Knowledge of Mothers and Children." Journal of Nutrition Education 5 (April-June 1973): 134-138.

16. Feaster, J. G. Impact of the Expanded Food and Nutrition Education Program on Low-Income Families: An Indepth Analysis. Washington, D. C : USDA, Extension Service, 1972.

17. Feaster, J. G., and Perkins, G. B. Progress of Selected Florida and Georqia Families in the Expanded Food and Nutrition Education Proqram. Washington, D. C : USDA, Extension Service, 1976.

18. Fusillo, Alice E., and Beloian, Arletta, M. "Consumer Nutrition Knowledge and Self Reported Food Shopping Behavior." American Journal of Public Health 67 (September 1977): 846-850.

19. Guthrie, H. A. "The Role of Nutrition Education in Dietary Improvement." Food Technology 32 (February, 1978): 89-90.

20. Hendel, Grace M.; Burk, Marguerite C ; and Lund, Lois A. "Socioeconomic Factors Influence Children's Diets." Journal of Home Economics 57 (March 1965): 205-208.

21. Hochbaum, Godfrey M. "Strategies and Their Rationale for Changing People's Eating Habits." Journal of Nutrition Education 13 (Supplement 1981): 59-65.

108

22. Jelliffe, D. B. "Cultural Variations and the Practical Pediatrician." Journalof Pediatrics 49 (December 1956): 661-671.

23. Koh, Eunsook T., and Caples, Virginia. "Frequency of Selection of Food Groups by Low-Income Families in Southwestern Mississippi." Journal of the American Dietetic Association 74 (June 1979): 660-664. ~

24. Kolasa, Kathryn; Wenger, Andrea; Paolucci, Beatrice; and Bobbitt, Norma. "Home-Based Learning--Implications for Nutrition Educators." Journal of Nutrition Education 11 (January-March 1979): 19-21.

25. Leidenfrost, Nancy B. EFNEP...Accomplishments and Future Needs. Washington, D. C : USDA, Extension Service, 1975.

26. Lewin, Kurt. "Forces Behind Food Habits and Motives of Change in the Problem of Changing Food Habits." Washington, D. C : National Academy of Sciences, National Research Council, 1943.

27. Mayer, Jean; Dwyer, Johanna T.; Dowd, Kathryn; and Mayer, Laura. Food and Nutrition Policy in a Changing World. New York: Oxford University Press, 1979.

28. Mills, Elizabeth R. "Psychosocial Aspects of Food Habits." (Journal of Nutrition Education 9 (January-March 1977): 67-68.

29. Morse, Ellen H.; Clayton, Mary M.; and Cosgrove, Lola D. "Mother's Nutrition Knowledge." Journal of Home Economics 59 (October 1967): 667-669.

30. Myres, A. W. and Kroetsch, Daniele. "The Influence of Family Income on Food Consumption Patterns and Nutrient Intake in Canada." Canadian Journal of Public Health 69 (May-June 1978): 208-221.

31. Nelson, Helen Y.; Jacoby, Gertrude P.; and Shannon, Terrie M. "Evaluation of Homemaking and Consumer Education Programs for Low-Income Adults." Home Economics Research Journal 6 (March 1978): 223-241.

32. Niehoff, Arthur. "Changing Food Habits." Journal of Nutrition Education 1 (Summer, 1969): 10-12.

33. "Nutrition Education Geared to Patients Who Have Had Minimal Schooling." Hospitals 51 (Marchl977): 14-15.

109

34. Pritchard, Keith, and Hall, Mary R. "Attitude of Aides and Clients." Jouranl of Home Economics 63 (October 1971): 545-548.

^ - Revised Policy Guidelines and Suggestions for Conducting the Extension Expanded Food and Nutrition Education Program. Washington, D. C : Federal Extension Service, USDA, 1976.

36. Schafer, Robert B. "Factors Affecting Food Behavior and the Quality of Husbands' and Wives' Diets." Journal of the American Dietetic Association 72 (February 1978): 138-143.

37. Schafer, Robert B., and Keith, Pat M. "Influences on Food Decisions Across the Family Life Cycle." Journal of the American Dietetic Association 78 (February 1981): 144-148.

38. Smith, Marjorie. State Expanded Nutrition Program Office, College Station, Texas. Interview, 4 October 1982.

39. Spindler, Evelyn B. "Program Aides for Work with Low-Income Fami1ies." Journal of the American Dietetic Association 50 (June 1967): 478-486.

40. Sullivan, Howard J.; Gere, Margaret; Nowlin, Bettye J.; and Kloehn, Beverly. "Development of a Nutrition Education Program for Homemakers." Journal of Nutrition Education 8 (July-September 1976): 118-121.

41. Suter, Carol B., and Barbour, Helen F. "Identifying Food-Related Values of Low-Income Mothers." Home Economics Research Journal 3 (March 1975): 198-204.

42. U.S. Department of Commerce. Money Income and Poverty States of Families and Persons in the United States: 1980. Series Publication No. 127.

43. U.S. Department of Health, Education, and Welfare. Ten-State Nutrition Survey 1968-1969: Highlights. Pubn. No. 72-8134 (1972).

44. Wang, Virginia L. "Changing Nutritional Behavior by Aides in Two Programs." Journal of Nutrition Education 9 (July-September 1977): 108-113.

45. Webster's New Collegiate Dictionary. Springfield: G and C Merriam Company, 1974.

110

46. Williams, Sue R. Nutrition and Diet Therapv. St. Louis: C.V. Mosby Company, 1977.

47. Yetley, Elizabeth A.; Yetley, Mervin J.; and Aguirie, Benigno. "Family Role Structure and Food-Related Roles in Mexican-American Families." Journal of Nutrition Education 13 (Supplement 1981): 96-101.

48. Yperman, Astrid M., and Vermeersh, Joyce A. "Factors Associated with Children's Food Habits." Journa! of Nutrition Education 11 (April-June 1979): 72-76.

APPENDIX A

STANDARDIZATION TRAINING LESSON PLANS

111

112

oo LU O LU 1—1

Û : LU Q . X LU

o

Q: <

o o

>-a: o I— oo

Q t—. 00

o oo oo

•o s-o s -o X : •.-+-> •.- c S o

-o c s- o 03 • . -o +->

. r -

5 s-

• r - 3

> c

«+-o O ) c

• r -

c 03 •r— S-

-t-> 3 C

> í

-o o

JO

^-o to •

o -l->

c o

't—

+-) 03

(— 3 C

i X (U

s-

to 03

c oo

• r -_ J

 c s- o o •.-Q . + - > E •<-

•t- S --t->

 3 C

-)-> . 3 - 0 O O

O r - ( + -r— 03 C

O ^ r -

-o o o

U -

s-3 O u_ (U

X : -(->

 fO o

o. 3 o s-

o

C J ro

+-> 03 QJ .

+-> O 00 O 3 <4-

M - O > í

 JO o

oo S- to • f - 3 • . -

O c >, c o o

• . - s, •<-+-> o +J • r - . C • . -s- s-

-t-> - o +-> 3 C 3

2 : 03 Z

• .c +-> l ^

03 OJ

X :

to -!-> 0 00 CD C

• r— . c + J

<+-0

- l - >

s-03 CL

03

to 03 

M - S-0 i - •< 03 00 Q . O)

1 —

m 0 (U 00 E 3 0 E 0 Oj •«

J D x : +->

•> (1) 00 

• 00 > c 3 C

> i (U ^

to c

• r -

E 03 + J

> 1

to 1 —

03 S-(U c

• r ™

E 1

c •^ 0 S-

-M 03

Q . 4 -i i

00 (U +-> 03 S-

- 0 >,

sz 0

JD s-03 0 i

to (U

1 —

JO 03

• • - ( - > r -to CL 3 0 S-

0

- 0 0 0 u.

s-3 0 u_

 - 0 • . - 03 3 5

s_ -)-) 1 —

3 0 0.

#« -1-) 03 (U

to

c 03 (U

E . Q i

 >—> \— 0 L U r-D CÛ 0

0 t—. U . 1—( 0 LU Q -0 0

^k^

1 0

C 0

•r—

+-> •r— S-

+ J 3 C



JZ •r-+-> S-

+-> C 3

•.- C 03

I— - o Q . O X O

LU CD

CJ

ro

to +-> c (U

+ J Í Í Í : 3 i c o > > ^ (U

.:^ • -o

 <+-

>, c +-> -o c c í JD

O - M OO C Q .

• . - 3 O

</) S--o O O o -o «+- o

o 

tO 

oo oo O •r -00 J 3

• . - 03 Q J =

o c 03 -t-) s-o Q . E

• f —



to to 3 o to

• r— Q

• CD C

• f —

c 03 (U

t—

o M-O

LD l O

O o

i s- fO 00

+ J 03 03

JZí

-o c •> fO to

 CD • r - C 3 03 S_ S-

LL. O

I s-03 O

>> •> s-

oo (U C r -

. - fO S-

C JD

O. OO E 4-> 3 O Q . S-

OO

03 (U S_ - o 03 fO

- M to -O •O (U c 03 I— <0 (U -o S- o ••«•

. Q O . C c c 00 S- • r -O • « 4 -O - r -

- M •« " • M > >

00 . — C D . — O 03 3 í. O. O

OO Q .

-O •> •> t/) 03 (U +J C oo S_ . i í í - o t-o « CL C

o - E

S - í— 

. Q 03 E c 03 3

o : -(->

 + J O O

 <U S- <U

C O

o - O (/) c

r— 03

O 

S-s- •.-

• 1 - 03 03 . C (/)

. C (U C J=

I — 0 3 -<-> .— S-

o

03 2 O s-CD

C 2 . r -O

03 • r - C s- o -!-> O O fO 03

. Q S-

C 03 O) 03

(U oo 3 03 o (U

J 3

00 -t-) c .— 

- o <v 3 C

+ J C o o

oo

• - D CQ O

O OO O O

o C CJ

•"" to -o o o <+-M-

• to Q . 3 O s-

O O

to (U

r—

-o o o

C ^ U -E 03 X (U



s-3 o

U -

(U

to

O-

oo

o +->

LD

-t-> • . -.- 2

JD 03 CD

. C C • 1 —

oo . ^ 00 S-

. -o o o

l+-

H- CD o c

• f —

 E «+-

• . - 03

O) Q. . C 3 -!->

cn c c

• ^ ' r -03 C ^

r - 03 O Q. (U 1 X r - O

LU O — '

t£)

114

00 s . CU

oo LU O

a. X

o

a: <

oo O Q.

oo oo 3 o t o

•o C 03

2 cu

CO

c o

oo •*->(/){/> c -o j * : ^ .- o C 00 fO O O •> 

03 S-r— "O 3 O ,^

<a o

oo 3 +->

3 ^ o e -o

• r - C S- 03

-o .c

to • o -«-> o c

J C CU +-> S-<u <u E <+-

«4-S - r - . <u - o .^ CL r— O CD^r-S- C E C L ^ . -

s_ o

i <u S -a. - o

<u

-o (U N

to 3 o 00

o

• r - t J

• <u tO <U I— CX Q . <D ( U T - 00 +J u 00 Q . 3 x : O + J S- • ! -O) 2

o o 3 • r -

o

-o 3 c

o o

o oo </)

oo

CQ

o

o L U Q .

oo

• o

c 3

o

oo 

3

0 0

to +-> - o o c 3 03 •

- o tO o c JÍÉ: s- o c C:L-r- T -

+-> s-JSíí • r - X J r - S-•r- +-> +J E 3 « + -

c o 2 00 o c

. C • r - ^

+-> C 

oo j><: c

Q 'Z -o

oQ

C < r -> oo E 03 C

r— ' r - (4_ + J S- • . - • ! - 00 Q. $- > o 1 i I O

• • </)

J ^

c •r— S-

-o +-> <f-

o 00

í ^

-^ c

• r -S-

"O

+-> <+-o 00 1

to

c s- c dJ > > 03 cn í. a.

•r- +J -o , s - c C > o r - • r - S- O •r; E -O 

íO o c 2 O C 3

 ) sl (+-^ o o •r- +-> •»-> 00 0 0

î= E 

o Q: s- o

<+- I CD-

- 0 > - ' o o

<+-

03 a. 3 O S-O )

(U S-03 Q L J I ^ 

•o c S- (U 03 S-O (U

(+-C i+-

o •.-to " O

' ^ E 03 O

OO Q . S-

c (U S-(U

l+-

l+-o

(U Q .

o (U S-

c (U

to •.— r - S-r— + J • I - 00

<— o OO Q -

i I

oo (U o s-3 o (/) - o </) O CJ

 T -3 - 0 0 —> 1 i

115

0 0 LU

o L U I — (

a: LU Q_ X L U

o

Q :

<

OO I— - O • r -O E o

*+- 

(U 03 E .c 03 + J

CL 3 O

s-C D

(/) . ^ +-> r -

• O • r -CL 3 E 3 - O O O -t-> S- i -O (U - o 2 (/) - c

r— . C CL o J^Í: E •+-> r -O 03 • . -

O E E

• oo Q . 3 O s_ C7)



(U 

 í o i i

o o 1—1

o <

o oo oo

o L U Q .

oo

E o s-

to CDI

> s -J

to CD

> S-(U to

ro

to O )

oo Q J S-3 03 O , CD

C>sJ

CD I

oo cn c

•.— > s- fO 1 I

0 0 LU > 1—1

\— o LU •-D CQ o O 1—1

E O ^

M-

oo ^ - ^ • o O O i O O

»+->—' 4 -O •

Q . to 3 (U O

-— s-CX CD E 03 J ^ X r -(U •r-

E (U > OJ

O •!->

OO + J

o 3

-o o S-

(U Q . N . C

• . - + - > js«: tn •r- I—

2 •.-O ) E C of)

•.- -o (+-> s- O S- 03 (U O oo to i

s-03

_E S - •

O E to s- S- E o s-

<+-

CD c

"^ > II

s- S-

 S-

 s-(U to

'

• r -

E

c

00 +J c (U

T —

s--(-) 3 C

>, s-03 E

•r— S-

Q -

C * ~ o S-Q. i

E 3

T —

o 1 —

03 O i

Q

-o C fO

< c

00 > C 03

E ^4-fO O

+J JD •r— •.— > S-1 i

ro

. ^ r ^

tO - r -O) E

c •.- .c S- 4-> ^:^ ^D 03 E S- S_ OO (+-

oo + J c í S-03 • E .^ S - • r -

Q- E

 -o (U c E 3 03 O

2 : (4-

c ro

116

oo LU O

Q-X LU

O

Q: <

LU

O O

E 3

•r—

o r— 03 O

t t -

O

to s-(U +-> to o Q .

2 (U

•r—

>

• i/)

c o

•r—

+J o c 3

M-

c o + j <u <u

.c (/)

Ji£.

s-o 2

(U +J (U

f ^

Q . E O o

• E 3

• f —

O r—

03 O

«4-O

to C o

• f —

+J o c 3

M-

i (U s-a. c

• r -

to cx o 3 tO

0 0

 Q . 3 .C O +-> S - • . -O) 2

t n t o

• o e

• • íO E 3

•r—

o 03 O

*+-O

to c o

. ^ +-> o c 3 u_

00

 oo

-o r— •r— 3

JD 1

JC -t-) (U (U -t->

+-> o

1 —

o o -+J

•o o o —

JD

oo Q .

f —

(U X :

1

LO

- o c o

o

oo

o LU CQ O

O oo oo

o oo c O'—>

•r- O +-> i o o c 3

C E •r- 3 03 •r-

.— O Q . r -X 03

LU O

Q-OO \S)



o a: s- o

M- i Q-

-o --^ o o (+- •

Q . fO 3

O oo s-d) (U

1— oo Q . E ^ 03 .— X •<-

uj s : i i

t / ) (U o s-3 o oo (U

Q :

S-03 O

 O

• 1 — Q-

i

oo c O

• f —

+J o c 3

(4-

E 3

. f —

O r ^

03 O

4 -O

00 S-

o c 3 u_

c -(-> 3 O C , (U S- t/) 03 E S-

•r- O S - <+ -CL

00 14- +-)

o c -a: o

o o

oo L U O Z L U

-1

a: L U Q -X L U

O Z 1—1

2 ^ Q : <

M- • . -O 3

S-OO t (_ 03 X E 

-o c 03

 S- 03

4 - 

• O fO OO O -(-> 03 O 03 O JZl

-o oo C • (U o3 OO

.— (U Q . + - > CD E-.-fO 3 X S-

L U 4 -

S-03

« t j •> 00 > , C •« S-

• I - 00 + j O £3. OO 03 — E ••-' - M C (U

• r - </) CD 2 O ) J = • . -to > - o

s- c to (U 03 i - </) 4 - • r -00 O 3 O S-Q . S- 4 -

(U

2 .Q E C 4 -

• CL 3 O s-C7>

-o CU

-o E tn s- 03

d) 4-> S- 00 • , - +-> 4 -00 O 4 -O o a. s-

, 2 J 2 r - * c -o

C\J

(U r— JZl

-o s-

-o c 03

+ J •r— 3 S-

4 -



E O

s-4 -

• . Q . 3

o S-0 1

</) CD

c • ^ > s-cu to

^ i

l - H

>

LU _ l CQ < f— L U O L U >

L U ~:~ h-

• • L U L U cx: I C 1—

2 : 0 0 0 0 0 LU _ J

t / î LU > 1—1

1— 0 LU •-D Cû 0

0 l - H

U_ 1—1

0 L U Q . 0 0

E 0 S-

4 -CU

OO 1 — • 0 J 2 0 03 0 -(-^

4 - 

00 - 0 <v c ^ - .

r— 03 0 C^ i E i/) 0 03 •(-> — ' X • . -(U 3

S- • (U 4 - CL +-> 3 03 CD

• r—

C J

+ - > ' — . •.- ^ 3 i

to s- o CD<4 C

• r - . C • S- +-> Q . <V 3 00 E

o 4 - S-O 4 -

,<— <V •— JZi

J S •.— 03 E 03 +-) 3 -O •*-> - o 03 

c •f—

E 03

+ J • ^ >

4 -0

00 c 0

• ,— 4-> 0 c 3

^-

03

-o O O • 0 ) <

c o

 -t->

- O 03 • r -O J = > O 4->

4 - 4 -+ J O

> , S- i —

•r— 03

- 0

>^ 03

" O

S-



-(-> 0

> i S-

 

<+-0

U1 c 0

•r— -(-) 0

c 3

U_

J C -(-> 2 0

s-CD i

c •.— .^ 00

.c 4-> 0 0 E U) i

J ^

s_ 03

- 0



4 -0

to <V 0 S-3 0 to

- 0 0 0

0

00 -(-> 0 S-

s-03 0 1

00 0 +-> >> 03 4 _

+-> 03 0 -t- <V

C Q . - — r— • . - 0 Jx: 4-) (_) c Q . s-(U 00

4 -0

s-(U

J 2 E 3 C

^ 1

0

>)<C t—

• 1—

03 - 0

- 0 - 0 03 +-> 0 0

(U



c •f—

to c o

o c 3

O C i

•.- o

X •

LU <

- 0 c 03

to + J • 1 —

3 S-

4 -

4 -0

00 

•f—

0

- 0 0 0 CD



to 

0 1

0

• <

c LUJ

03 + J • r -

>

4 -0

to J ro LO

118

o o

- o t o (U

CD s- £2. O S- • S- O LO Q . 4 - +J

.,— </) 00 3 oo - o S-3 O 4 -O sz (/) +J "O

• . - s - • OO <

03 00 C OO C D T -

3 C E O • r - fO t/) S- 4->

• r - fO •.— Q C i . >

C

o 00 oo 

-o 

4 -O oo

t û

• • t/) +J •r— 3 S-

4 -

4 -O

to

-o O

't—

S- 03

4-> OO

. f—

o Ul-



f —

o o o i

CU

-o c 03

(/) CD (U 03 r— S - JZi O +J 00

s-d) a. o s-

03 +J 

s-o

C L 4 -

C •r— 03

n—

to "O o sz

£ ^ + J X

LU <v

: > < ^ 1

o

. to

+J •f—

3 S-

E <+-

 o S - •

o < +-> c 3 S- 03

03 >



• o

c 03

00

-o O O

4 -•.- < 3 S- C

4 -

4 -O

TD <V -o (U S -

 > (/) O 4 -a. o

i

00 (U o s-3 o oo <V

a:

•t- <v E Q. 03 - r -+-) O • r - (U > S-

CD-O c > O

4 - C </) s-

 C '



-o c 03

3 s-4 - •

O L E 3

o o 5- S-4 - CD

-o E 00 S- 03



4-> 4 -00 o 4 -O O Q . S-

(U > , 2 - Q .— c -o

0

C 4 -C D * r - 0 £= E

•.— fO 00 2 +J c 0 • r - 0

- C > • r -tO + J

4 - 0 to 0 C <V 3

- 0 LO t4_ •.— C .— 0 to 00 T - tO

4-> 3 2 0 0 4 - Q

• 0

c •.— E 03

4-> • f —

>

- 0 0 0 C D O

fO 

- 0 03 •!— 0 .c > 0 +->

4 - 4 _ +-) 0

> > tO 0 C Jiíí S-—' 2 00

1 t ^ -• r ™

- 0

4 -0

to (U — CL E 03 X (U

2 (U

• . —

>

to 4-> • f —

3 S-

4 -

4 - • 0 00

(U 00 1— E J 3 s - 03 0 +->

4 - (U CD

+-) 0 ro LO

O o

0 0 Q O O

• • CC

O </ ) 0 0

0 0 LU

CQ O

O L U Q -0 0

- 0 s- 

o25

+-J • f —

3 S-

4 -



E 0 S-

4 -

> í 03

-o 00 O )

c

> S-

CLÍ<V 3 O s-CDI

00

I

00 CD C

• r - S -

<v 00

s-<v

JD

E 3 C

(U 4-> 03 4-> 00

• M Q . 3

E O o s-S- CD

4 - ^ r -r - X 3 • r - fO fO +->

- o 

-o s-cu 00

4 -0

s-> • f —

03 T 3

CVJ

• • 0

c '<— E fO

+ J

"^ >

> í

s- 5 03

c -0 i

S- 4 -0

00

c 0

• r -+ J 0 c 3

u_

+-> t— 0

- 0 > ^ 0

• 0 0 0 r—

JD JZl

-0 a. t— <v 0 <v

. c . ^ 1 1

• ro c

> í 00 Sl

- 0 + J

c .— 3 03 0 to

CL Q . <— <V <v 

> 4 -0

</) <V 0 S-3 0 00

- 0 0 0

0

00 + J • r -3 i -

4 -

00 3 S-

+ J • -0 i

«^

to (U

s-s- to

'

00

 s->cJ •r— 03

-o • 0 (U

• 0



c •r—

03

C\l

</) c o

o c 3

4 - -—« O

C i • r - O 03

Q . X

LU t_)

ro

I >^ s- • 03 o

00 > 4-> C • f - C D ^ . -3 C E S- • . - 03

4 - > 4-) 03 • ! -

4 - . C > O

to (+-tO E +-) c 03 O) 3 X CD O (U 03 ' - ^ -o cn I •.- c c o

O 03 • . - >—'

- 0 c 03

to + J •r— 3 S-

^-. C 0

•r—

2

c •.— 00

E S-0 u_

+-) x : cn 3 0

JD

<V j Q

C 03 0

to 

s: to 

•^ 0

to 0

•- _ • 0 c 03 •

4-> 00 JZ 4-> CD • r - 3 3 0 S- X )

4- C O

o

a: o

o oo oo

t / 1 L U O •z. LU 1—(

Q : LU Q -X L U

O "Z. 1—1

2 : C Í ;

< LU _ l

1— Z L U 1— •2:

O o

L U

> 1—( 1—

o LU "-3 CQ O O 1—1 U -1—1

o L U û -oo

c 1

 S- • 00 o

03 00 C OO C D ^ . -

3 c E O • . - 03 OO S- 4->

• . - 03 • r -

(U c CL O

• r - OO O 00 (U OJ S- t—

- O OO (U o •.-

+ j x : O C 4-) (/) 4-> • r -

•.- 2 fO >

" O 

Q c ^ > Q . j i : 3

• t o

 O 

s- • o o

4-) C •.— •! 3 E S- 03

4 - + J

•.— 03 >



>

-o C

t an

d vegetable

grou

p ai

food

s it

s and veg

etab

les

• . - O 3 3 S-S- O C 4 -

4 - - r - <L) C E 4 - Q .

tf— 'r- fO O • r -

need

ed o

of Vitam

fyin

g Vit

nt fo

rms

ecte

d rec

00 OO • r - + J " O 4 - S-S- O • . - • . - O C

O -o J«: E s-00 T - S- fO CD O r - O X C

Q- <r) 3 LU 1—1 1 1 i i 1

, , 00 tO fO

- o (U 03

CD c o 

4-> OO 03

- o cu O E o

• 4 - O E S- 03 C C D 2 : • . -

CLl 3 O S-

<yi

+-> 03

) oo s- .—

+ J T -4 - - i ^ .— x : 4-> +-> 3

JZi

<v . Q

+ J 3

OO C CD 03

O O • . - 

, ^ o

1

o —

• Q . 3 O S-O )

4-) 03 <D E +-> (U S- 03

• . - 00 E

C\l

-o S-

 03 (V E E O s_

(+->>

r— • r -fO

-o

00 CD c > s-

• . - fO S- + J 00 C 3 O • . - 4-> Q . • . -

- O 4-> 2 c oo 4 - (/)

ro

o 3

oo 4-) 03 c (U

s-+ J 3

ro

00 (U

4-) 3

4->

+ J tn

JZl 3

oo

+-> 03 <V

<V +-> C 0 o s- s-CL't-1 i

-o 00 c -r-tO 4-> O O Q . C

3 2 4 -(U

• . - C > O

• c

•.— 

o S-

4 -O

to c o

4-)

o c 3

4 -

OO

oo 3

o to

• r ™

C L Q

• c •^ • . -00 +-> o o a. c

3 2 <+- o

. c

T -



o s-Q .

4 -O

OO • C C O • r -

• r - 

o s-C4 í -o o

to

s-03 CL

• o c 03

oo (/) +-> S- 03 - o 03 <v oo c

» • — s .

:: i

o >-^

. Q . 3

o s-O )

c . • r - 00

cu - o +-> C 3 3 + J O - 1 -

4 - + J to

(/) JZi +-> 3 C 00 <V

't- + J S- 03

+-> í c :

4 - o3 •^ 4-> OO ' ^ C + J i i í í 1 s: +-> 03 c o o

oo

CQ o

 to

s- 03 tO

oo to 3 O t/)

•.— Q

 O O S- 00 03 3

(U cx

o (U s-CL 3 O s-CD

• c o oo 00 <v

(/) •r— .c +-> J C + J .,_ 2

t û

 03 0 0

to

to +-> O 03 O S- S- 4 -OO 2 T -

S- -r-O 03 fO 00 (U C > , C d) 03 C r—

-O 03 O •>

t . >) <V (V í.

CVJ S- 4-> 4-> O +-> C

C +J 3 03 •r- OO . Q £:L

i

ro i

 oo S_ X . '

. £:L 3 O s_ cn

Q . + J 03 

E o s-

4 -

(/) -o O o

4 -

4 -O

(/) s-

c •r—

<v 4-> O s-Q .

oa

c o S-

• r -

<U 4 -(/) Q . 3 O S-

o OO c o

• .— C D + J

+ J 03 (U E

<+-O

S-(U

+ J

(/) o a. 1

o c 3

4 -

C o to s- o c 3

4 -

C o oo <V

-o • f —

f ^

0 0 1

4-> CL • 1 —

c u •.- ^ -3 C OO

+-) 4 - C O (U

• r -

s- -o (U S-to CD O C

Q . >-i i 1

123

0 0 LU O

Q -X

o

ai <

oo _ J < LU

a: L U

o o S

oo Q < LU a: ca

o o

oo < : _ i C û

X 1—1

oo

o oo oo

oo

r-D CQ o

-o 03

00 (U fO

03

CL lO 3 - O O O S- O C D 4 -

.— S-03 (U (U X : S- +J <u o o

<u •O E C fO 03 2 :

-o c 03

• o fO d) s .

JZi

 E O S-

4 -

00 • o o o

L L .

• • Q . 3 O s-cr

— 03 O 3

• o o S- 00 Q . C

s-o

.— «3 ro r - S- I CD

i 03 > > Q .

• O oo 03 <D - O S- C

03 S-

o - o ^ ^

Q . 3

i <V O

> .c s-S- +-> C7) "O -O OO T - JD

C>J

03

-o -o CU -o

O s-

 s- S-(U oo

i

C\l

-o 03 Í : C I

• . - (U o > . c >— S- +J (U 00 E

o 4 - S-O 4 -

Q -OO

£^ 3 O s-

S- > , O) <v <—

JZl 'T- t— E 03 03 3 - O O

+ J S-00 C O ) O • . -CL r—

T 3 (O 2 C 4 -

ro

- O 03 OO

C • o C 4 -03 O

to to S- C (U O

+ J • . -oo + J O O

c^ c 3

2 4- o

• 00 <v

4-> 03 S-

-o >>

J C o

JD

s-03 O

-o c 03

#\ c o s-

• r -

Cû

4 -O

t/) c o

•.— + J

o c 3

4 -

00

(/) 3 O (/)

'r— Q

-o c 03

*s

c o s-

• f —

M

oo c

•.— E 03

+ J • r -

>

• 00 1

sz o

JZl S-03 O

OO c

•r— (/) E • . — T —

<— > oo

Cû • o C 4 -03 O

to oo S- C <V O

4-> •<-OO 4-> O O CL C

3 2 4 - o

• t/) OJ

4-) 03 s-

• o >>

J C o

J D s-03 O

• o c fO

# t

c o S-

•.—

Cû

4 -O

00

c o

•r—

+-) O c 3

4 -

00 00 3 o oo

•r— Q

-o c 03

n

c o S-

• r—

•« to c

• r— E 03

+ J •r—

>

• (/) <v

4-) 03 i -

-o > ,

J C

o JD S-03 O

Lf)

 - O , S- • r - C .— . C : LO

"O o o

o s-

4 -TD

> , O t - 4 -QJ C +-) (U 00

 O c 3

U_

s-

>> .c + J t —

03 (U

sz

oo -o r— •t—

3 JD

1

oo r— r ^ (U o

c • f—

X J c 3 o

4 -

OO +-> c 3 C

• CL 3 O s-O )

1 —

03 <V s- í 03

4 -• f —

4-> C —

co

oo C ' ^ o o

• . — I

+J o O — ' c 3

4 - • oo

c c Z i

r - fO Q.+-> X r-

( ^

LD

C

o S-

4 -O

00 c o

o c 3

03 -—^ r— O C L I X o

LU > —

LD

124

oo LU O •^ LU t — 1

Q : LU o. •X LU

CU 2 1 • — •

"Z^ a: <c LU

-o </) C •

tO 00 00 c OJ E 03 +-> <o S-(/)+-> -o O -r - > , Q . > JC

O 2 QQ . a OJ s .

•r- C (13 > o u

•

Cû

4 -o -o to c O

• r -

+-> o c 3

M-

to tn 3 O 00 •^ o

c 03

«% c • o oo s- i . (/) "O S= >>

•r- x : E O 03 . Q +-> $-• f - 03

> o

• Q . S- S_ - O CD^r-

J=> t—

•f- - O 3 U 03 - O O) O (U i - .— S- N C2. O CD .— r— T - O tO O) íO 03 "O ••-> tO

to 

•

LU

O O

"O CU 3

+-> C o o

X I—<

oo

O OO

oo

0 0

o LU '-:> Cû

o

o LU O -oo

(^

to fO S-

• o

O J 3 s. <o o

oo c o

•r— +-> o c

V£3

o S-

to

c

03 +->

CQ

OO

Q - O

> í O ) S-(U

c (U (U

T 3 •r-> O s-CL I

4 - O O

to c O

•^ 4-> o c 3

*+-c

•r— 03 — C^ X

LU

1 o

• tn 03 s-

• o > í f—

o J 3 s-03 O

(U • . c C:L 4-> 3

O E s-O CD s-

4 - .— rtJ

- o (U O S-O OJ

4 - O

03 - O c

 s- o CD C

3 .— 4 -03 Q) •« S- CL X) O ) c C •r-o

.— - o tO

CD OO C -o •.-o > o S-

14_ (U to

^-

to .c o

r— S- J 3 O . (U E -M 03 tn X o

S-

to 03 &. -o a. >> 3

sz o o s-

. Û CD s-(O r -O 03

d) oa s-

(U •» t j

c O "O S- c

•f- 03

•>-o 00 fO C (U

•f- S-E -Q 03 +J c • ^ T—

> •o

 o c

•f- (U +J • . -o s-C +J 3 3

4 - C

. c C

o o tn s-(U (U

03 • O +-> O

LU O- oS 1 i

• • oo (U o S-3 o oo c 4 - 4 -

Jl^ " O OO 03 C + J 3 C

03

(U 00 O Q .

E O o

• 4->

(/) 03

4 -.:)^ 03 CU S-

J D

c o -o 

o to

i 03 E 4 -O - i ^ O 03

<V - o S-.— JZi 3 O to 2 3

O + J '<-03 +->

. C • . -4-> S-

4-> 4-) 3 OO OO + J 03 í (U 00 4 -•r— + J

c (U -o 1—1

4 - 3 «+-• r - 00 - O 3

C c <v

•.- E

s-o

4 -

OJ 1 1—

<V JD S_ 03 Q . 4 - )

•^ C 3 r- OO

00 <U C^ C^ 03 (/) 03

4 -Ji^ 03 > 03

ro

to -o o o

to 03

4 -

03 

E O s-

4_ to Q .

00 3 - o O O S-O O 4 -

-o to O 

to + J

c (U

•^ s-

+ J 3 C

> i 4 - ^ • ^

4-> C

<v -o l - H

+ J to 03

4 -.i^ 03 <V S-

ja

E O s-

4 -

• o <V

c • r -03 +-> ja

o , • r - . C fO

4 -

to

c 't—

E 03 + J

•.— > i

00 r— 03 S-OJ

c 't—

E 1

4 -O •

4-> o3 S- (U O S-C L . Q E

•<- - o o

0>J

o I

 o to

03 - O 4 -I — . ^

03 (U

s-JZi

cn

c 03 O

+ J fO

3 O sz to

c z 4 - ^ 4 -

to •.— + J " O • c <v

to

<v o CJ)

03

03

O-OO

• r - CD 03 C ^ - N

. — • r - O C Í . + J i X 03 O

LU J

3 C

C

 4 -> , . Q . ^

r - O 03 03 <V C (+-

-o o o

4 -

03

J : 03 

S- C O (U

4 - • . -

+ j to 03

S- 4 -00 4->

- O 3

o c o

.^ 03 <V S-

4 - CDJQ C

0^>'t— 4 -

c >, o • r - 4 -+ J • . -o +-> 

•^ r— <U <+-<u - o (/) 'r—

C C

o o + J + J 0) <u <U (U

. C J Z to to

J ^ . i ^ s- s-o o

(U

c <u

. Q

c o 00

s-<u

4-) to

o 3 3 D-

1 i i

to

 -

o

l / î

C.3

O OO oo

'-0 CQ O

O

oo

03

0 0 L U O "Z. L U t - H

o:: L U O -X L U

t D Z T » — 1

:z o:: < : L U

OO OJ oo o O-E o o

+- i <o

x: • 2 OJ

lO o t o i -3 (U o to t n t o

• r - <0 Q O

•

oo

-o O O

(U S -(U

M -<+-

-o

c 03 £ : L

s-o

to

• o

03

(U

o S-(U oo to 03

o

o • o

o +->

fO tO T -i . • . - (U cu in E

•>) to oo fO 03 (U . C i I

(U S -<o

(U s-Q . I

03

oo (U oo o Q . O E i O O o

+ J 03

sz 2 (U c

•f—

M -(U

Q

• OJ

r—

o S-(U oo oo fO

o

tn (U

'o S-(U to tn (O

o ^

2 O O E

(U oo > tO fO 3 lO O OO C

•r— (O Q O

CNJ

>\ (U c o E CU > íO

to

to (U o s- o

+-> < 4 -

 +-> tO fO O (U o E I

2 -c 0 o

r— +-> CU

(U s-to +-> 3 tO 1 I

c 03 O

OO (U

r—

O ^ (U 00 t o 03 O

2 O

sz

c •T—

03 ^— CL X

L U

<.—V

o i o

.

> > (U

c O E (U > Oî OO

-o C 00 3 (U o .—

4 - O s .

oo (U +J

c oo OO (/)

 • r - O +-> JC 3 C tO C (U - ^

$- S->> o <u OO 00

03 t o <u oo O ) t . 3 C 03 O • r - Q . oo S- <u

• r - 03 S-Q C ^ Q .

• oo • £n.4-> CO OO

C CD CL 2 (U C C 3 (U S- ro • . - O

• f - « • - O . 3 O

• o c 3 o

4 -

to

T - 3 C

(U

-o

ro

LO

-o o o

3 O

u_ (U

oo (U 4-> fO & -

• o c: >>

•r- . C (U O +-> J 3

to to c .— f - fO E S-03 +-> S- fO 03 •r-Q. O <+- > E i i I I I

 CD C

•r— t o 3

to r ^

fO (U E

c fO

r— O -

. . to

o. zs O

s-o

r— 03 (U

s-

• o c fO

+-> •r— 3 S-

4 -i

+ J J i^ 03 <— (U - r -

E E i i

LT)

c • " -

00 + J c (U

• ^ S-

+-> 3 C

 c (U S - ^ (U 2 :

 (U

<+- i •.- c_)

Q • o - —

. f—

oo • f—

-o (U

r—

o s-(U to to 03 O

03

-+-> oo

1 C D O C * — '

• r-to 3 •

t o OO Q .

r— 3 03 O <U S-E O

c -o 03 O

r— O CX. U -

C\J ro LO

127

oo LU O LU t—I

a: LU Q . X LU

o

cc <

CJ)

c OO OO 3 03

00 tO 03 CL C >. o

+-> -c 

c CU 4- -O 4-•r— •o

C o to S- .i«: to o

s-o Q- 2

1 i

to c <u T -

-o <u s-O) c l-H

128

oo U J

o "Z. L U l—H ûc: L U Q -X L U

O "Z. *—\ Z

a: <

to o

• r —

+ J 00

•^ s- x : •.- 3 4-> + J C •r— •r—

2 S- 2 + J O

00 3 .— S- C (U -o

+-> 4 - C OO O 03 O CL OO l/)

t: 2 . — O 03 00

• oo

J í O 03 c oo

oo • o s-03 O +->

c c <v O S-oo to

4-o to 

• f —

+ J T -

s_ 4-> 3 C

• to -o o o

4 -

.^ O 03 c to

• o o o cr| 03

to o 4-) (/)

•r— s- o 03 s-03

. C o

to 3 00 O 3

• r - O 4-) • r -

. . r— ; - O j : o 03

c 00

s- •.-03 4-> r— E 3 3

2 O

c o

s-4-) 3 C

O )

 •.—



00

O 03 C oo

c O

oo +J fO 3 C OO

4-) 4-) J C • . - • . -O ) 3 3 r- S- S-C 4 - 4 -i

C 03 CU C L OO

S-r^ OJ

<v .^ 00 o S-E (U 03 4-> (U +-> S- 3 O X i

 o >, 03 "O C C tO 03

O c o -

• r - tO 4-> .^ '1- c s- •.-+J s-3 -O C OO

+ J Q . 2 4 - • . -O O . C

r - 00 O I

C\J

O-OO

4 -O

oo O

T— + J ' - ^

oo o •r— i

S- o ( U v - '

+ J o 03 • S - . ^ 03 O

SZ 03 o c

oo c

• r - - 0 03 O

r— O Q . CD X

LU 03

oo J ^

o r—

o -o 03 C 00

4 -O

to (U

r— CL E 03 X <v

<v >

•^ o

c 03

c o o

• f—

+ J • f—

s-+-> 3 C

C

••" . C

1 o

• c o

•r— 4-> •r— S-

CD4-> 't— . C

3 C

to (U 3

.— 03 > (U >

'<— +J •r—

s-+-) 3 C

to to 3 O to

to -o o o

4 -

j :

o 03 c to 4-) c <v s-<v

4 -4 -•f—

-o

Q O

ro

4-> c • r—

s-+ J 3 C

4-)

c 03

. C + J

to j x :

o 03 c to

to +J c 03 S-

• o >)

 i i

to -o -o c o 3 O O 4 -

4 -J I Í :

to o + J 03 c c (U to

•r— S- 4-)

4-> C 3 (U C S-

<v . - r -

t— " O 03 c c

< -r-

Z

-c oo 03 i

r— O Q_

CM ro

129

<

0 0 L U O sz LU l - H

a: LU Q -X L U

O Z l - H

Z

• .^ i (U o

(U CL 03 S- - r - C CX o to

 OO O O Q . fO <U <U C r -

+-) 00 <U 00 OO

03 OO <U OO CD S-3 C 03 O • r - Q . 00 S- <U

• r - 03 S-Q C 2 . Q -

• (U Q .

• r— o <v s-

m

o o

- o O • r - 4 -s-+-i . i^ 3 O C 03

C 2 (n O

r— 4 -o

o S to

-c -o C7) S-

• r - <0 - C O

4 - C O O

to 00 • . -s - s - o • r - 3 - O C O) o c c <u <u <u •<-

sz -o to <U

+ J CLJx í S-00 E O O

Q . O 1 i

• • oo <u o S-3 o (/) <v

ce:

S- CD o c:

3 f-H 1 i

APPENDIX B

DEMOGRAPHIC DATA INFORMATION SHEET

130

131

DEMOGRAPHIC DATA INFORMATION SHEET

Address

Name:

Sex:

Race:

Age Group:

Famale

Hispanic

under 20

20-29 years

30-39 years

40-49 years

50-59 years

over 60

Program Assistant:

Date Tested:

I.D. No.

Male

Black Anglo Other (please specify)

How many years did you go to school?

less than 9

9-10

11-12

over 12 (specify)

Income: less than $5,000

$5,001-9,000

$9,001-13,000

$13,001-17,000

Over $17,000

132

How many people live in your household?

2 7

3 8

5 10

6 over 10 (specify)

Have you ever been enrolled in the Expanded Nutrition Program

before? yes no

If yes, when? Adult Youth

APPENDIX C

FOOD BEHAVIOR QUESTIONNAIRE

133

mM^m

134

FOOD PATTERN QUESTIONNAIRE - PART I

Instructions:

You wiU be asked questions about different foods that you eat, Select the number that indicates the number of times each day or number of days each week that you eat the foods mentioned.

1. How many times a day do you drink milk? 0 1 2 3 4 5 6 7 over 7

*la. How many days each week do you drink milk? 0 1 2 3 4 5 6 7

2. How many times a day do you eat milk products such as puddings, ice cream, cheese, and/or yogurt? 0 1 2 3 4 5 6 7 over 7

*2a. How many days each week do you eat milk products such as puddings, ice cream, cheese, and/or yogurt? 0 1 2 3 4 5 6 7

3. How many times a day do you eat fruit? 0 1 2 3 4 5 6 7 over 7

*3a. How many days each week do you eat fruit? 0 1 2 3 4 5 6 7

4. How many times a day do you eat vegetables? 0 1 2 3 4 5 6 7 over 7

*4a. How many days each week do you eat vegetables? 0 1 2 3 4 5 6 7

5. How many times a day do you eat fruits or vegetables such as oranges, orange juice, grapefruit, tomatoes, and/or raw cabbage? 0 1 2 3 4 5 6 7 over 7

*5a. How many days each week do you eat fruits or vegetables such as oranges, orange juice, grapefruit, tomatoes, and/or raw cabbage? 0 1 2 3 4 5 6 7

135

6. How many times a day do you eat dark green or deep yellow vegetables such as broccoli, greens, carrots, and/or sweet potatoes? 0 1 2 3 4 5 6 7 over 7

*6a. How many days each week do you eat dark green or deep yellow vegetables such as broccoli, greens, carrots, and/or sweet potatoes? 0 1 2 3 4 5 6 7

7. How many times a day do you eat breads such as rolls, corn-bread, sliced bread, and/or pancakes? 0 1 2 3 4 5 6 7 over 7

*7a. How many days each week do you eat breads such as rolls, cornbread, sliced bread, and/or pancakes? 0 1 2 3 4 5 6 7

8. How many times a day do you eat cereals and cereal products such as rice, oats, spaghetti, macaroni, noodles, and/or breakfast cereals? 0 1 2 3 4 5 6 7 over 7

*8a. How many days each week do you eat cereals and cereal products such as rice, oats, spaghetti, macaroni, noodles, and/or breakfast cereals? 0 1 2 3 4 5 6 7

9. How many times a day do you eat meat, poultry, and/or fish? 0 1 2 3 4 5 6 7 over 7

*9a. How many days each week do you eat meat, poultry, and/or fish? 0 1 2 3 4 5 6 7

136

10. How many times a day do you eat eggs, peanut butter, and/ or dried beans? 0 1 2 3 4 5 6 7 over 7

*10a. How many days each week do you eat eggs, peanut butter, and/or dried beans? 0 1 2 3 4 5 6 7

11. How many times a day do you eat foods such as potato chips, corn chips, cake and/or candy? 0 1 2 3 4 5 6 7 over 7

*lla. How many days each week do you eat foods such as potato chips, corn chips, cake, and/or candy? 0 1 2 3 4 5 6 7

12. How many times a day do you drink soft drinks and/or sweetened flavored drinks? 0 1 2 3 4 5 6 7 over 7

*12a. How many days each week do you drink soft drinks and/or sweetned flavored drinks? 0 1 2 3 4 5 6 7

13. How many times a day do you eat a snack between meals? 0 1 2 3 4 5 6. 7 over 7

*13a. How many days each week do you eat a snack between meals? 0 1 2 3 4 5 6 7

*13b. What do you usually have for your snacks?

137

FOOD PATTERN QUESTIONNAIRE - PART II

Instructions:

You will be asked questions about different foods that you eat. Select the number that indicates the number of days each week that you eat the foods mentioned.

1. How many days each week do you eat breakfast or a morning meal? 0 1 2 3 4 5 6 7

2. How many days each week do you eat lunch or a noon meal? 0 1 2 3 4 5 6 7

3. How many days each week do you eat dinner or an evening meal? 0 1 2 3 4 5 6 7

4. How many days each week do you use the Basic Four Food Groups in meal planning? 0 1 2 3 4 5 6 7

5. How many days each week do you try new foods? 0 1 2 3 4 5 6 7

Ask these questions only if answer to previous question is 0,

• • Translate times eaten per day or week into serving sizes -record this only if amount differs from number of times given

APPENDIX D

NUTRITION KNOWLEDGE TEST

138

139

NUTRITION KNOWLEDGE TEST

True-False Section:

Answer the foUowing questions by selecting a True or False card.

1- T F Vitamins and minerals are examples of nutrients. (1)

2^ T F What we eat is used mainly to give our bodies energy. (1)

3. T F Breakfast is less important than lunch and dinner. (7)

4. T F Breakfast can help give you energy in the morning. (7)

5. T F When planning a mean you should include foods from the Basic 4 Food Groups. (8)

6. T F A casserole or "Do Your Thing Meal" supplies very few nutrients. (8)

7. T F A soft drink would be a good choice for a nutritious snack. (9)

8. T F A snack or "mini meal" should be a food from one of the Basic 4 Food Groups. (9)

Multiple Choice Section:

You will be asked questions and will be given four different answers for each question. You are to select the answer that you feel is correct by selecting the appropriate card.

1. Which one of the following foods is the best source of calcium? (2)

A. Hamburger B. Corn C. Milk D. Bread

2. Which of the following is the major reason why calcium is so important in our bodies? (2)

A. Builds strong bones and teeth B. Helps one see better C. Builds body muscles D. Helps one digest foods

140

3. Which one of the following foods supplies the most Vitamin A? (3)

A. Pears B. Carrots C. Celery D. Macaroni

4. How many servings are recommended each day from the fruit and vegetable group? (3)

A. One serving B. Two servings C. Three servings D. Four servings

5. How often should you eat fruits and vegetables that contain Vitamin C? (4)

A. Once a day B. Three times a day C. Once a week D. Twice a week

6. What is the most important reason why we need Vitamin C? (4)

A. Helps eyesight B. Keeps gums healthy C. Builds bones and teeth D. Provides energy

7. Which one of the following foods is a good source of Vitamin C? (4)

A. Tuna B. Crackers C. Orange D. Milk

8. Which nutrient helps build and repair your body? (5)

A. Fat B. Protein C. Minerals D. Carbohydrates

141

9. Which one of the following foods can be used as a meat sub-stitute? (5)

A. Potatoes B. Rice C. Tomatoes D. Dry beans

10. Which one of the following foods supplies the most iron? (5)

A. Milk B. Carrots C. Liver D. Rice

11. How many servings do you need each day from the Bread and Cereal Group? (6)

A. B. C. D.

Wh-

A. B. C. D.

One serving Two servings Three servings Four servings

ich Food Group suppli

Fruit and Vegetable Bread and Cereal Meat Milk

12. Which Food Group supplies the most B vitamins? (6)

Date post:	07-Jan-2022
Category:	Documents
Upload:	others
View:	1 times
Download:	0 times

ENROLLED IN THE EXPANDED NUTRITION PROGRAM A THESIS

Documents