Thesis Presentation

Amanda Fox Kelly Knopf

Thesis Advisor: Catherine Arnold, MS, EdD, RD, LDN

EFFECT OF A NUTRITION AND

HEALTH FAIR ON THE ELDERLY AND BENEDICTINE

STUDENTS

The elderly are at an increased risk for low fruit and vegetable intake due to: Cost Preparation Mental limitations Poor oral health Multiple chronic diseases

Meta-Analysis Inverse relationship between fruit and vegetable

consumption and risk of CHD and stroke. Fruit and vegetable intake can be used to prevent some

chronic conditions Awareness, education, and intervention is key.

BACKGROUND

Dauchet, Luc & Amouyel, Philippe & Hercberg, Serge & Dallongeville, Jean. (2006). Fruit and vegetable consumption and risk of coronaryheart disease: a meta-analysis of cohort studies. The Journal of nutrition, 136.

To investigate the effect of participation in a health and nutrition fair on the attitudes of undergraduate nutrition students in reference to service learning and volunteerism.

To investigate the relationships between fruit and vegetable servings in relation to self-effi cacy, stage of change, and quality of life at a nutrition education health fair.

PURPOSE

Date: Thursday, April 14, 2011

Location: Villa St. Benedict

Time: 2:30 – 7:30pm 2:30-3:00 students set

up booths 3:00 – 7:00 active

participation in the health fair 7:00 – 7:30 clean up

Educational Booths provided by Benedictine University undergraduate students

Other booths provided by Benedictine University exercise physiology students and other outside vendors

METHODS: HEALTH FAIR

Student booth topics selectedVendors and donors contactedPlanning with Nutrition instructorMeeting with NUTR 280 students, topics

chosenRoom layout designedIndividual meetings with NUTR280

students for grading of educational booth and interactive component

Raffl e prizes acquired

METHODS: HEALTH FAIR PLANNING

Heart Disease (11)Diabetes (4)Weight Management (7)Functional Foods (6)Food Safety

METHODS: STUDENT TOPIC BOOTHS

Advertisement March 2011

Marketing flyers were created and distributed at Villa St. Benedict. Flyers contained information on the date, time, and location of the health fair. It also included information on the complimentary services that would be offered at the fair.

Instrumentation Community Health and Nutrition Fair Questionnaire (CHFQ) Service Learning and Volunteerism Questionnaire (SLVQ)

METHODS: HEALTH FAIR

ElderlyAdministered during

the Health Fair The raffl e was held

every 20 minutes for the “Grand Prize Winner”

Health Fair Subjects Inclusion criteria: 50

years and older, attendance to the health fair.

UndergraduatesAdministered one time,

one week following the fair 4 raffl e tickets were drawn

and those students received prizes

Students in the Spring semester of NUTR280: Community Nutrition Inclusion criteria: all students

enrolled in the class who participated in the health fair and present on the night the survey was administered

SURVEY ADMINISTRATION AND SAMPLING

Amanda Fox

EFFECT OF A NUTRITION AND

HEALTH FAIR ON THE ELDERLY

LITERATURE REVIEW – STAGE OF CHANGE

Greene G,Fey-Yensan N, Padula C,Rossi S,Rossi J,Clark P. Differences in psychosocial variables by stage of change for fruits and vegetables in older adults J Am Diet Assoc 2004;104:1236-1243.

Part of the Social Cognitive Theory

If belief in oneself is achieved, a person feels more motivated to complete the task.

Good for predicting fruit and vegetable intake higher in the action and maintenance phase

LITERATURE REVIEW- SELF-EFFICACY

Bandura, A. (1998). Health promotion from the perspective of social cognitive theory.Psychology and Health, 13, 623-649.

According to the CDC, fruit and vegetable consumption among the elderly is low.

Do the SOC and self-effi cacy theory still apply to the elderly?

Need more research to look at the effects of fruit and vegetable consumption on disease state

NEED FOR THIS RESEARCH

State-Specific Trends in Fruit and Vegetable Consumption Among Adults --- United States, 2010. Centers for Disease Control and Prevention. Web. 07 Nov. 2011. <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5935a1.htm?s_cid=mm5935a1_w>.

METHODS: SAMPLING

Participants who attended the Health Fair

Descriptive Statistics for Health Fair Participants

NMinimu

mMaximu

m MeanStd.

Deviation

age 58 51.00 94.00 79.0345 11.84396

Valid N (listwise)

58

Gender Race

STUDY DEMOGRAPHICS

Chi-square Testx2 (4)= 21.55=p<.001

Null Hypothesis: Rejected

H01: THERE IS NO DIFFERENCE BETWEEN MENTAL AND PHYSICAL HEALTH.

H0 2 ( A ) : THERE IS NO DIFFERENCE IN THE NUMBER OF VEGETABLE SERVINGS BETWEEN PREACTION STAGE OF CHANGE GROUP AND ACTION STAGE OF CHANGE GROUP.

(t(52)= -3.306, p<.01, d= 1.002

Rejected p=.002

Frequency

Valid Percent

Stage of change 2 category

Valid Precontemplation

7 12.5 Preactionn= 35

Contemplation 17 30.4

Preparation 11 19.6

Action 7 12.5 Actionn= 21

Maintenance 14 25.0

Total 56 100.0Missing

999.002

Total 58

Stage of change frequencies Number of vegetable servings per day

Preaction m=2.36

Action m=3.29

H0 2 ( B ) : THERE IS NO DIFFERENCE IN THE NUMBER OF FRUIT SERVINGS BETWEEN PREACTION STAGE OF CHANGE GROUP AND ACTION STAGE OF CHANGE GROUP.

(t(52)= -4.44, p<.01, d= .89

Rejected p<.001

Frequency

Valid Percent

Stage of change 2 category

Valid Precontemplation

8 14.3 Preactionn= 43

Contemplation 17 30.4

Preparation 18 32.1

Action 5 8.9 Actionn= 18

Maintenance 8 14.3

Total 56 100.0

Missing

999.00 2

Total 58

Stage of change frequencies

Number of fruit servings per day

Preaction m=2.12

Action m= 3.38

Diseases that were considered LinkedHigh Blood PressureHigh Blood CholesterolLow HDLHigh TriglyceridesHeart ProblemsOverweight/ObeseCancer

H0 3 ( A ) : THERE IS NO DIFFERENCE IN THE NUMBER OF LINKED DISEASES AND PREACTION STAGE OF CHANGE GROUP BETWEEN ACTION STAGE OF CHANGE GROUP FOR FRUIT.

(t(54)= .072, p=.837)

Accepted p=.837Linked Disease m= 1.78

Diseases that were considered LinkedHigh Blood PressureHigh Blood CholesterolLow HDLHigh TriglyceridesHeart ProblemsOverweight/ObeseCancer

H0 3 ( B ) : THERE IS NO DIFFERENCE IN THE NUMBER OF LINKED DISEASES AND PREACTION STAGE OF CHANGE GROUP BETWEEN ACTION STAGE OF CHANGE GROUP FOR VEGETABLE.

(t(54)= . 072, p= .479). Accepted p= .479). Linked Disease m= 1.78

Predictors of Fruit ServingsStage of change fruit- preaction and action group Number of vegetable servings

Results (F(3,48)= 9.768, p<.001 R2 of .379

Regression Equation1.150(SOC fruit2) + .320 (number of vegetables per day)

Rejected p<.001

H04(A) : THERE ARE NO PREDICTORS FOR NUMBER OF FRUIT SERVINGS.

H04(B) : THERE ARE NO PREDICTORS FOR NUMBER OF VEGETABLE SERVINGS.

Predictors of Vegetables Servings Stage of change vegetable- preaction and

action group Number of fruit servings Gender

Result (F(3,52)= 594291.41, p<.001 R2 of 1.0.

Regression Equation 1(number of fruit per day) + .755 (stage of

change vegetable intake 2)-.921 (Gender)

Distinguished the importance between mental and physical health as separate entities instead of together. Provided insight for the confidence and importance the elderly have for fruit and vegetable intake

The number of fruit and vegetables consumed was significantly diff erent between the stage of change categories.

The number of disease was not connected to ties of motivation.

The number of vegetables predicted with 100% variance.

The number of fruit can be predicted with close to 40%.

CONCLUSION

Kelly Knopf

EFFECT OF A NUTRITION AND HEALTH FAIR ON

BENEDICTINE STUDENTS

Forum for the delivery of health information

Students will have a more positive attitude toward research Interdisciplinary approachPooled resources

LITERATURE REVIEW – HEALTH FAIRS

Levy K, Lehna C. A service-oriented teaching and learning project. Pediatr Nurs. 2002;28(3):219.Mason DJ, Calvacca LR. Health fair: Providing a learning experience through a community service project. J Nurs Educ. 1982;21:39-47Maltby H. Use of health fairs to develop public health nursing competencies. Public Health Nursing. 2006;23(2):183-189

Service Learning defined: any learning experience that occurs by blending learning objectives, preparation, and reflection within a community setting

Service Learning in Dietetics is under represented

Gain experiential knowledge

LITERATURE REVIEW – SERVICE LEARNING

Gilboy MB. Incorporating Service Learning in Community Nutrition. Topics in Clinical Nutrition. 2009;24(1):16-24.Leonard LG. Primary health care and partnerships: Collaboration of a community agency, health department, and university nursing program. J Nurs Educ. 1998;37(3):144-148. Fournier AM, Harea C, Ardalan K, Sobin L. Health fairs as a unique teaching methodology. Teaching & Learning in Medicine. 1999;11(1):48-51

Bandura’s Social Learning Theory

Kolb’s Experiential Learning Cycle

LEARNING THEORIES

Attentional – Memorization of material

Retention – Regurgitation of material

Reproduction - Engage in creating educational materials

Motivational – Become motivated to share the informationFournier AM, Harea C, Ardalan K, Sobin L. Health fairs as a unique teaching methodology. Teaching & Learning in Medicine. 1999;11(1):48-51Kolb D, Boyatzis R, Mainemelis C. Experiential learning theory: Previous research and new directions. Perspectives on thinking, learning, and cognitive styles. Mahwah, NJ US: Lawrence Erlbaum Associates Publishers; 2001:227-247.

Service Learning in Dietetics is under represented

Most outcomes focus on success of the program to meet objectives

Need more research focused on impact to students

NEED FOR THIS RESEARCH

METHODS: SAMPLING

Spring 2011 Nutrition 280: Community Nutrition

26 undergraduate nutrition students

Descriptive Statistics for Undergraduate Student Participants

  N Minimum Maximum MeanStd.

Deviation

Age in years 26 20.00 36.00 22.88 3.85

Valid N (listwise) 26        

Age: Traditional vs. Non-traditional

Gender: Male vs. Female

STUDY DEMOGRAPHICS

80.8% traditional19.2% non traditional

84.6% female15.4% male

Provided you with personal satisfaction through helping others (m=6.50)

Applied nutrition information/knowledge learned in courses (m=6.42)

Improved your understanding of how nutrition education can be integrated into community activities (m= 6.46)

TOOL: SLVQ: HEALTH FAIR (HF)

4 factorsDeveloping Deeper Understanding and Higher Order Skills (5 variables)

Experiential Learning (4 variables)Self-efficacy and Values (4 variables)Impact on Community (2 variables)

These four factors account for 77% of the variance in the health fair variables

PCA: HEALTH FAIR (HF) QUESTIONS

RELIABILITY FOR HEALTH FAIR (HF) FACTORS

Reliability Statistics for Health Fair Factors

  Cronbach's Alpha

N of Items

Level of Internal Reliability

Developing Deeper Understanding and Higher Order Skills

.83 5 Good

Experiential Learning .80 4 Good

Self-efficacy and Values

.76 4 Acceptable

Impact on Community

.67 2 Questionable to Acceptable

Health Fair Variables .89 15 Excellent

H0 5 : THERE IS NO DIFFERENCE IN HEALTH FACTOR MEAN RATING SCORES ACROSS TWO AGE CATEGORIES, TRADITIONAL AND NON-TRADITIONAL UNDERGRADUATE STUDENTS.

Developing deeper understanding and higher order skills

t(24) = .016, p>.05

Experiential t(24) = -.90, p>.05

Self-efficacy and values

t(24) = 1.00, p>.05

Impact on community

t(24) = .69, p>.05

H05 is accepted

I prefer courses in which applied experiences are authentic (m=6.77)

Learning by doing is a necessary component for adequate training in health care professions (m=6.92)

I am committed to making a positive difference (m=6.88)

TOOL: SLVQ: SERVICE LEARNING (SL)

4 factorsContemplation/Preparation phase for Volunteerism (3 variables)

Action Phase and Value Integration (3 variables)

Curricular Requirement (1 variable)Curricular Preference (1 variable).

These four factors account for 79% of the variance.

PCA: SERVICE LEARNING QUESTIONS (SL)

RELIABILITY FOR SERVICE LEARNING (SL) FACTORS

Reliability Statistics for Service Learning Factors

  Cronbach's Alpha

N of Items

Level of Internal Reliability

Contemplation/Preparation Stage for

Volunteerism

.63 3 Questionable

Action Phase and Values Integration

.81 3 Good

Service Learning Variables

.69 8 Questionable to Acceptable

H0 6 : THERE IS NO DIFFERENCE IN SERVICE LEARNING FACTOR MEAN RATING SCORES ACROSS TWO AGE CATEGORIES, TRADITIONAL AND NON-TRADITIONAL UNDERGRADUATE STUDENTS.

Contemplation/Preparation Stage of Volunteerism

t(24) = -1.09, p>.05

Action/Value Integration t(24) = -1.07, p>.05

Curricular requirement t(24) = -.70, p>.05

Curricular Preference t(24) = 1.84, p>.05

H06 is accepted

H 0 7 : T H E R E I S N O R E L AT I O N S H I P B E T W E E N AG E A N D M E A N S O F D E V E LO P I N G D E E P E R U N D E R S TA N D I N G A N D H I G H E R O R D E R S K I L L S , E X P E R I E N T I A L L E A R N I N G , S E L F -E F F I C ACY A N D VA LU E S , I M PAC T O N C O M M U N I T Y , C O N T E M P L AT I O N / P R E PA RAT I O N P H A S E O F VO LU N T E E R I S M , AC T I O N P H A S E A N D VA LU E I N T E G RAT I O N O F VO LU N T E E R I S M , C U R R I C U L A R R E Q U I R E M E N T , A N D C U R R I C U L A R P R E F E R E N C E .

Developing deeper

understanding and higher order

skills Experiential

Self-efficacy

and values

Impact on

community

Contemplation/ preparation phase for volunteerism

Pearson Correlation

.065 .572** -.030 .071

Sig. (2-tailed)

.752 .002 .884 .729

Action phase and values integration

Pearson Correlation

.507** .588** .356 .338

Sig. (2-tailed)

.008 .002 .074 .091

Curricular requirement

Pearson Correlation

-.049 -.121 .173 .009

Sig. (2-tailed)

.812 .557 .398 .964

Curricular preference

Pearson Correlation

-.239 .061 .089 .068

Sig. (2-tailed)

.240 .768 .665 .743

H07 is rejected

Health Fair factorsDeveloping Understanding and Higher Order SkillsF(4,21) = 2.72, p>.05 with R2 of .34

Self-efficacy and ValuesF(4,21) = 1.34, p>.05 with R2 of .20

Impact on CommunityF(4,21) = .74, p>.05 with R2 of .12

H08: SERVICE LEARNING FACTORS WILL NOT PREDICT HEALTH FAIR

FACTORS

Health Fair factorExperiential Learning

FormulaF(4,21) = 5.30, p<.05 with an R2 of .50

EquationExperiential Learning = .06(Contemplation/preparation phase for volunteerism) + .24(Action Phase and Values Integration) and accounts for 50% of the variance

Rejected p <.05

H08: SERVICE LEARNING FACTORS WILL NOT PREDICT HEALTH FAIR

FACTORS

Age does not aff ect the mean rating scores for Health Fair (HF) factors and Service Learning (SL) factors

There is no correlation between age and any of the Health Fair (HF) or Service Learning (SL) factors.

There is a correlation between Experiential Learning and Contemplation/Preparation Phase for Volunteerism, and Action Phase and Values Integration. There is also a correlation between Developing Deeper Understanding and Higher Order Skills and Action Phase and Values Integration.

Contemplation/preparation Phase for Volunteerism and Action Phase and Values Integration, service learning factors, are good predictors of Experiential Learning, a health fair factor.

If future results confi rm the current fi ndings, the survey tool can be pared down to those questions within the Experiential Learning, Contemplation/Preparation Phase for Volunteerism, and Action Phase and Values Integration factors.

CONCLUSIONS

Reliable data collection tools CHFQ and SLVQ

All surveys coded and entered by researchers

Incentive to participate

Participation rate for in-class survey

STRENGTHS

Useful in developing future service learning opportunities to undergraduate students

Useful in designing undergraduate nutrition courses

Mental health and Physical health can be separated in future surveys than as one question.

The number of vegetables predicted with 100% variance could be used in future thesis.

APPLICATIONS

Small sample sizeEvent held during dinner time of the

residentsIncentive given out for filling out

survey toolNo control, no randomizationGeneralizability, limited

High % of femaleHigh % of Caucasian

WEAKNESSES

Shorten the time for the health fair and end the fair when the residents go to dinner.

Larger venue or more tables to create better traffi c flow

It would be interesting to do pre- and post test of the SLVQ to see if there is any change in attitudes as a result of the health fair

Repeat both studies for larger N to increase generalizability

FUTURE RESEARCH

THANK YOU FOR YOUR ATTENTION