Mountain Scholar
Mountain Scholar is an open access repository service that collects, preserves, and provides access to digitized library collections and other scholarly and creative works from Colorado State University and the University Press of Colorado. It also serves as a dark archive for the Open Textbook Library.
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Recent Submissions
Assessment of nutrition education strategies to reduce cardiovascular disease in U.S. Army hospitals
(Colorado State University. Libraries, 2007) Bukhari, Asma Sultana, author; Jennifer Anderson, advisor; Kaminski, Karen, committee member; Gould, Susan, committee member
Cardiovascular disease (CVD) continues to be the leading cause of death in the United States with an estimated 79,400,000 adults diagnosed with this disease in 2004 and costs of $431.8 billion projected this year. As a result there is an increased emphasis on early detection and treatment of risk factors. Military personnel are vulnerable to this killer disease due to indulgence in unhealthy behaviors such as cigarette smoking, physical inactivity, poor nutrition, and increased stress. These behaviors can have a profound impact on the military readiness and mission accomplishment. The purpose of this study was to identify strategies to enhance nutrition education provided to the military personnel at US Anny hospitals to manage CVD. The results will be used to identify weaknesses and gaps in an existing program and facilitate improvement of CVD nutrition education. It was hypothesized that nutrition education can be enhanced by aligning the existing CVD management programs with evidenced based guidelines that will provide program consistency. The target audience for this study was Registered Dietitians in clinical leadership positions at U.S Anny hospitals and outpatient clinics. The study was approved by the Colorado State University Human Research Committee and the U.S Anny Medical Research and Material Command Human Research Protection Office. Survey validity was established by obtaining information from a review of literature and feedback from expert Army dietitians and CSU faculty. Survey reliability was established by a test and re-test during a pilot test on a subset of Army dietitians. The responses were analyzed using computer software and reported as mean, standard deviations and frequencies. The survey response rate was 70% (n=21). The primary educators of CVD risk reduction were dietitian. Sixty-two percent of the hospitals provided nutrition education based on current guidelines. The current program was rated either "very good" or "good" by 67% of the dietitians. Eighty-one percent of dietitians experienced variation in the program at their hospitals. Only 24% of the dietitians indicated a mechanism to reach deployed soldiers with hypercholesterolemia. A web-based resource center was selected by 43% of the dietitians followed by 23% who suggested development of a self-paced web-based education program for deployed or remotely located soldiers. Caution is advised while interpreting the results because the findings are based on dietitians' knowledge and opinions and may not have captured all the services offered to the patients. The survey provided insight into current program and suggestions for future program improvements. Cost effectiveness and improved patient satisfaction of medical nutrition therapy by Registered Dietitians is already established. Army dietitians need to take the lead in designing and implementing programs to reduce the CVD risks among military personnel. Such interventions will improve the quality of life of soldiers by providing long term health benefits; and that, in tum, will save resources from reduction in mortality and morbidity associated with CVD events. It is important to explore various communication media for information dissemination.
Development and evaluation of Food friends get movin' with mighty movesâ„¢ : a physical activity program to prevent obesity in low-income preschoolers
(Colorado State University. Libraries, 2007) Bellows, Laura Leigh, author; Jennifer Anderson, advisor; Auld, Garry, committee member; Kennedy, Catherine, committee member; Davies, Patricia, committee member
The prevalence of overweight among preschool-aged children in the United States is increasing at an alarming rate. The preschool years provide an opportunity to establish healthful eating and physical activity behaviors which can lessen the growth of obesity. Unfortunately, preschoolers have been largely ignored when it comes to obesity prevention efforts. The overall objective of this project was to design, develop, and evaluate a physical activity program to compliment the Food Friends ® nutrition program in an effort to prevent overweight in young children. Food Friends Get Movin' with Mighty Moves™ is an 18 week program focusing on gross motor development, physical fitness, and physical activity in the classroom environment. This project utilized the steps of social marketing to develop the Mighty Moves™ program. Further, to enhance the likelihood that behavior change would occur, the Social Learning Theory was embedded within the social marketing framework. The Food Friends Get Movin' with Mighty Moves™ study was a randomized controlled trial of 3- to 5-year old children (n=201) enrolled in 8 Head Start centers in Colorado. On-site measures included height, weight, physical fitness (sit-ups, sit-n-reach, shuttle run, 3-minute run), and gross motor skill (Peabody Developmental Motor Scales) assessments. BMI, BMI z-score and BMI percentiles were calculated. Additionally, physical activity was assessed by pedometers over a 6-day timeframe (4 weekdays and 2 weekend days), and daily step counts were recorded by parents. Characteristics of the study population indicated a high prevalence of overweight, low physical activity levels, and average to below-average motor skills. The intervention did not have an effect on weight status but did improve gross motor skills and fitness levels. Lastly, no difference was found for physical activity by treatment. The success of Mighty Moves™ at increasing gross motor skills and physical fitness in preschoolers, in concert with the Food Friends® program's demonstrated ability to increase children's willingness to try new foods, has contributed to the establishment of healthful behaviors for proper growth and development in the early years. These behaviors serve as foundations to building healthy lifestyles, which may decrease the risk of overweight later in life.
Effectiveness of a Web-based nutrition education program to reduce cardiovascular disease risk among U.S. Army personnel and their families ("Defend your heart" study)
(Colorado State University. Libraries, 2009) Bukhari, Asma Sultana, author; Jennifer Anderson, advisor; Kaminski, Karen, committee member; Harris, Mary, committee member; Gould, Susa Martin, committee member
Cardiovascular disease (CVD) continues to be the leading cause of mortality and morbidity in the United States. Military personnel are also vulnerable to this killer disease due to indulgence in unhealthy behaviors such as cigarette smoking, physical inactivity, poor nutrition, and high stress. Formative assessment identified a need for web-based resources for the Army registered dietitians (RDs) and for deployed or remotely located military beneficiaries. The purpose of the current study was to create and assess the effectiveness of a web-site "Defend Your Heart". This web-site was targeted to two audiences: RDs and a self care program for the military beneficiaries. This self care program was created using the framework of Rosenstock's Expanded Health Belief Model (EHBM). The effectiveness of a web-based self care program was evaluated using a randomized 4-month study with participants either in the web-based group (n=17) or the usual care (n=13) at a U.S. Army hospital. Data were collected at baseline, two months and four months. Variables measured were anthropometric, blood pressure, lipid profile, fasting glucose, C-reactive protein, nutrient intake, physical activity, and EHBM constructs. Data were analyzed using analysis of covariance and using baseline means to adjust the two and four month data. Results indicated a significant reduction of total blood cholesterol, LDL-cholesterol, predicted body fat percent, and estimated body mass index (P<0.05) in the web-based group. The usual group demonstrated a significant increase in self-efficacy score at month four (p<0.05). Significant within group changes for both groups were demonstrated for the reduction in waist circumference and serum triglycerides (p<0.05). Due to a smaller sample size caution is required while interpreting the results. The results of the web-site usability showed that a majority of the RDs (n=34) and web-based participants (n=8) were satisfied with the content and ease of navigation. RDs and web-based groups suggested enhancing web-site eye appeal, interactivity, and printing capability. Web-based programs may serve as an effective alternate mechanism of delivering CVD risk reduction education. The U.S Army needs to invest in further research to launch an effective web-based program for military beneficiaries to reduce CVD risk factors.
Developing and evaluating a website on infant feeding, specifically breastfeeding, for child care providers
(Colorado State University. Libraries, 2006) Clark, Alena Michelle, author; Jennifer Anderson, advisor; Adams, Elizabeth, committee member; Baker, Susan, committee member; Barrett, Karen, committee member
Research studies have shown that breastfeeding provides a multitude of benefits to infants, mothers and communities. Yet, many women cease breastfeeding before the recommended times. A common reason women cease breastfeeding is because of returning to work or school. Because child care providers often provide care to these infants, further research on the role of child care providers on infant feeding practices, specifically breastfeeding, is warranted. This research project occurred in three phases. First, a needs assessment survey was conducted to determine the knowledge, attitudes, behaviors and training needs of child care providers on infant feeding, specifically breastfeeding, in child care centers. The most appropriate medium to integrate best practice information and provide educational tools to child care providers was also examined. Based on the first phase of this project, a website for child care providers on infant feeding, specifically breastfeeding, was determined to be the desired medium for child care providers. Because no other infant feeding website for child care providers was available, InfaNET Nutrition for Child Care Providers website was developed during the second phase of this project based upon the needs assessment results and facilitated group discussions' feedback. The Social Learning Theory was used as the theoretical framework for the development of the content information on the website. A process evaluation with infant feeding experts, child care providers and web design experts deemed the website ready to be tested. Thirdly, a quasi-experimental research design with a control and intervention group was completed. The target population viewed the website as a well-liked and effective means to provide infant feeding information. Results also showed that between the pre- and post-test intervention, the intervention group had more statistically significant positive changes in attitude and behaviors than the control group. Child care providers already possessed a desirable level of knowledge in regards to storing, preparing and feeding infants' breastmilk and formula, but not in distinguishing hunger cues or introducing solid foods. The behavior and attitude changes were not sustained at follow-up, but results showed there was a non-significant positive trend in knowledge for the intervention group.
The effectiveness of an Internet-based nutrition and fitness education program for senior military officers
(Colorado State University. Libraries, 2004) Sigrist, Lori D., author; Jennifer Anderson, advisor; DeVoe, Dale, committee member; Kennedy, Cathy, committee member; Auld, Garry, committee member
A six-month Internet-based nutrition and fitness education program, entitled Taking Command of Your Health, to improve diet and fitness behaviors and physiological measures in a group of senior military officers enrolled in the Distance Education course at the U.S. Army War College. The intervention was based on the Transtheoretical Model (TTM) for behavior change and was delivered via the Internet. A needs assessment survey assessed senior military officers' health concerns, educational preferences for nutrition and health topics, eating habits, and motivators and barriers for eating healthfully and exercising regularly. Survey results determined the content of the intervention. Participants were randomly assigned to either a control group that did not have access to the website intervention or to the treatment group that had access to the program. The program was designed in a monthly newsletter format which combined nutrition and fitness information. Staging algorithm surveys determined stage of change for diet and exercise for participants each month. Participants were provided with stage-matched education based on the diet algorithm and all participants received identical fitness information regardless of stage for exercise. To evaluate the program, treatment participants completed exit surveys at the end of the intervention. Results of the study indicate that an intervention based on the TTM did not result in statistically significant improvement in behavioral and physiological measures between treatment and control groups. The program was effective in significantly progressing treatment participants through the stages for diet behavior, but not for exercise behavior. Unfortunately, dietary behavior change was not maintained as participants regressed to earlier stages after the intervention. In the exit survey, participants reported that they liked receiving health information over the Internet and they would recommend a similar program to others in the military. Future research on the implementation of a theory-based intervention should focus on an individual's cognitive and behavioral processes that determine one's success and failure with behavior change, factors that determine participation and regular usage of a website program, and the impact of program duration and content on other military populations.