Applied Learning and Reflection: Improving Food Choice Behavior 2012-2013
Abstract. The nation and the world are facing an increasing trend of burdensome healthcare costs. Many measures are proposed to check the growth of healthcare costs. But none are as economically effective and scientifically sound as nutrition-care. Importantly, there is a direct linear relationship between healthcare costs and nutrition-care issues. These are linked to the leading causes of death including heart disease, certain cancers, stroke and associated conditions.
This QEP, experiential, applied learning experience with continuous reflection is designed to provide university students with professional experiences assisting selected patients, clients, or attendees that have nutritionally preventable or mitigating conditions including overweight-obesity (oo), diabetes (nidd), and/or hyperlipidemia (hyl). These practicum experiences are integrated into Introduction to Therapeutic Nutrition, a junior-level course for nursing students, exercise science students and public health education students. Students have the opportunity to observe nutrition-care programs, and then develop and implement a personalized intervention, service or activity using the Activated Health Education model.
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Reflection data will be used to evaluate this applied learning experience. Data will be collected each week during the practicum. Both individual and group data from recorded WebEx sessions will be summarized. Pre-practicum data will be compared with post practicum data. Scatter-grams and histograms will be used to trace the sequencing of critical reflection data. These data will provide dynamic enhancements to modify objectives for current students in the observation/implementation phases, improve the practicum for future students, and provide prompts for researchers to develop empirical critical reflection evaluations. The developed applied learning experience will utilize WebEx with breakout rooms including, SLOs, content outline, field study options, assessments, rubrics and critical reflection artifacts to provide the basis for future studies.
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Development of a Virtual, Interactive, Energy Balance Module 2011
Darwin Dennison, EdD, Certified Nutrition Specialist, Deborah Deal, Graduate Student.
- Abstract This project focused upon an innovative approach to teaching. A two-class 100-minute Virtual Interactive Energy Balance Module was designed to be integrated into any online course or in any face-to-face class in a Smart Classroom to assist students with the understanding and application of energy balance. The National Cancer Institute, the Institute of Medicine and the National Institutes of Health indicate that “energy balance” is paramount to the development and progression of quality of life (Ad Hoc Committee on Health Literacy for Council on Scientific Affairs).
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Standard to Evaluate Food Choice Behavior -
DINE Healthy: Index of Healthy Eating 2003 - 2010
Darwin Dennison, EdD, Certified Nutrition Specialist
Abstract. There is a plethora of scientific instruments, processes, tests and procedures to determine standards in health and medical sciences. Systems have been designed to quantify measures related to blood pressure, body mass index, cholesterol level, prostate-specific antigen test, glucose test, and blood cell counts and cholesterol levels to name a few.
The project developed an instrument to evaluate food choices to determine ‘how well or how poorly’ individuals are eating. The DINE Healthy software is a valid and reliable, interactive, computer-based method to evaluate diets to determine a positional value of the nutrient composition of diets and whether or not the diet adhered to the United States Department of Agriculture and Institute of Medicine standards.
DINE Healthy software provides an Evolution of Eating. that requires four (4) procedures. First, to ensure Accuracy and Precision during the procedures certain criteria must be achieved. Second, a Personal Profile including the selection of a base diet for comparison purposes must be completed. The DINE Diet adheres to U.S. Dietary Guidelines and Institute of Medicine standards. DASH standards are from the National Heart Lung and Blood Institute. Third, Food Entry must be precisely entered and must be completed for a minimum of three (3) days and include one (1) weekend day. Fourth, new foods must be added to the database to keep the database reflective of foods currently available in the marketplace. New foods are continuously introduced into the worldwide market; and foods are continuously being reformulated in response to marketing data.
Research-Tested Intervention Program: National Cancer Institute 2008
Darwin Dennison, EdD and Kathryn F. Dennison, EdD
Abstract. The administration of the National Cancer Institute and independent NIH consultants have approved the DINE Healthy: Diet Improvement Software (and related materials including the Eating and Fitness Excellence text, the Curriculum Guide and peripherals) for inclusion on the Research-Tested Intervention Programs (RTIPs) Web site.
The RTIP Web site represents an effort by the National Cancer Institute to provide easy and immediate access to interventions tested in a research studies. To be listed on RTIPs, programs must have been developed and tested through a peer-reviewed research grant, have outcomes of the intervention published in a peer-reviewed research journal, and have intervention components that can be implemented in other community or clinical settings.
The DINE Healthy: Diet Improvement Software was scored at the highest level for dissemination capability and five (5) peer-reviewed research publications were cited as evidence for research integrity and intervention impact.
Weight Management Course, Tablet Initiative 2008
Darwin Dennison, EdD
Abstract. A proposed trial course in the Department of Health and Applied Human Sciences, was designed to improve the food choices and eating behaviors of incoming freshman students. The course featured a tablet-based electronic food and activity log designed to capture the student’s food choices and related eating behaviors. Upon completion of their daily log, the students “click to send” these data to the instructor for analysis. The analyses included PDF and TIF files that graphically indicate their energy balance and adherence to United States Department of Agriculture and Institute of Medicine standards.
According to an American Medical Association study, obesity among college age students has increased from seven percent in 1991 to 12 percent in 2003 (Manson et al, 2004). College students, some for the first time away from home for an extended period, tend to eat exclusively in fast food restaurants (Dennison, 2005).
The dreaded “freshman 15” refers to the amount of weight many students gain during their first year of college. Some weight gain is often related to stress, a sedentary lifestyle, and changes in food intake and diet patterns. Meals are often skipped by college students, especially during exams and finals. Class and work schedules change daily, as well as every semester. Lifestyle changes, peer pressure, limited finances, and access to food also contribute to erratic eating patterns.
The focus of this course will be on the actual food choices of the students. The objectives for the students include: 1) record their food choices and eating behaviors using an electronic system, 2) analyze these behaviors via nutrient analysis software, 3) compare these behaviors with established United States Department of Agriculture dietary standards to identify salient strengths and weaknesses, and 4) develop a nutrition lifestyle management program. The strategy will be to use the students’ own food choices and eating behaviors as a basis to learn about and improve their nutrition and health. With the exception of the small group sessions, the process will be electronic and virtual.
A 2003-2004 National Health and Nutrition Examination Survey reported that about two-thirds of adults in the United States were overweight and almost one-third obese. College freshmen are greatly influenced by society and peers which generally result in selecting foods that are high in empty calories (fat, trans fat, sodium, refined sugar) and low in vital nutrients and fiber. The collected descriptive data from this initiative will be analyzed to assess baseline and follow-up eating behavior of selected college freshmen. These data will be used to determine equivalence, feasibility, and to generate power estimates for future experimental-based research on college freshmen, our future leaders.
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American Cancer Society Project, Cancer Prevention Nutrition Intervention 2003
Darwin Dennison, PI; Mike Perko, Co I; John Bennett, Inv
Abstract. The purpose of this million dollar 5-year study was to develop a nutrition and physical activity intervention for students in rural middle schools in North Carolina to promote and sustain protective nutritional lifestyle behaviors. During this one-year development phase, protocol focused on the prevention of nutrition-related cancers through the improvement of food choice behavior and increased physical activity of middle school students. The developed intervention modified the American Cancer Society's "Changing the Course" intermediate curriculum, and integrated Pyramid Challenge: The CD ROM Healthy Eating Guide. The Activated Health Education (AHE) model was used to provide the theoretical framework for the intervention. Major objectives were to 1) increase the consumption of fruits, juice, and vegetables (FJV) and 2) reduce the consumption of fat, sodium, and sugar (FSS) of the students. The final completed intervention was submitted and approved by the American Cancer Society (2004) and utilized in their support materials. The final phases of the project were not completed, primarily due to support attrition and non-availability of qualified assistance and support..
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Charles L. Cahill Project 2001
Darwin Dennison, EdD
Abstract: The purpose of this project was to 1) obtain additional pilot data from middle school students and their parents/caregivers in Pender, Columbus, and Brunswick Counties, and 2) collect supportive information from selected middle school personnel in the same counties to improve the review score of an application submitted March 1, 2000, to the American Cancer Society (ACS). This project will increase the probability of funding of the ACS grant by attending to each and every suggestion cited by the reviewers. The project will focus upon an enhanced, more competitive application including an updated review of the literature and a new intervention feature to increase physical activity.
Objectives of the Project: The revised objectives of this project include the following: 1) identify an equivalent sample of underserved, rural, middle school students and their parents and caregivers, 2) secure administrative, health teacher, physical education teacher, food service personnel and parent cooperation and support to conduct a long-term study, 3) collect additional baseline data from to determine feasibility and generate power estimates for sample size, and 4) organize a multidisciplinary research team to conduct the multi-year field study.
Results of the student/parent/caregiver data were as follows:
Samplel(n) |
Mean Age (years |
FJV (mean servings) |
Fat (% of total calories) |
Sugar(% of total calories) |
Sodium (milligrams) |
Dietary Fiber(grams) |
Students(20) |
12.5 |
1.50 |
35 |
17 |
3443 |
11.7 |
Parents(16) |
42.5 |
1.33 |
32 |
15 |
3284 |
12.5 |
Recommended |
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5 or more servings |
<30% |
<10% |
500-2400mg |
20-35 g |
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Charles L. Cahill Project 2000
Darwin Dennison, EdD
Abstract: The purpose of this study was to 1) measure the food choices of eighth grade students in three underserved, rural school districts in southeastern North Carolina, 2) review policy regarding the school lunch and food vending machine program, and 3) organize a comprehensive, school-based intervention to improve nutritional status. The selected schools reported an average poverty index of 30 percent, with free or reduced price lunches served to an average of 65 percent of the students. This presentation will focus on the students’ food choice behavior. Project staff trained health education and homeroom teachers to instruct the students to record their food intake for 3 days. Food record sheets, and oral and written instructions were given to each child. Breakfast and lunch meals were recorded at school and dinner/snack foods were recorded as homework assignments for three days. On the fourth day, a project staff member returned to individually review/interview students to clarify foods consumed and amounts eaten using food models. Food record data from 86 eighth grade students were analyzed to determine 1) the number of servings of fruits, fruit juice, and vegetables (FJV) per day and 2) the fat, sugar, and sodium (FSS) content of the foods. The records were coded for servings of FJV eaten at breakfast, lunch, dinner, and snacks. The average number of servings of FJV consumed by the students over the three-day period was 1.5 servings. Over the three-day period analyzed, the students consumed an average of 36 percent of calories from fat, 20 percent from added sugar, and 2719 milligrams of sodium. Each of these values exceeded recommended dietary standards. Formative data regarding school nutrition policy and the development of an intervention to improve the food choice behavior will also be presented.
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Public Broadcasting Service Project 2000
Darwin Dennison, Mike Perko, Carl Stockton
Abstract: The purpose of this project was to develop a Health Knowledge Base that will be connected to educational resources and education standards’ databases. The Health Knowledge Base was designed to enable health educators to comprehensively review, develop, and evaluate curricula in health education based upon health education standards. Additionally, health educators will be able to review and select educational resources that focus on the statements in the Health Knowledge Base to ensure inclusion and logical sequence. The project called upon ten nationally recognized content experts to submit the depth and breathe of concepts and facts in the following areas: Environmental Health, Human Growth and Development, Injury Prevention and Safety, Consumer Health, Nutrition, Fitness and Health, Alcohol, Tobacco and Other Drugs, Mental and Emotional Health, Human Diseases, and Personal Health. Each expert developed statements, including conceptual understandings, processes and facts that were submitted to a university-based central depository. The statements were then edited and placed in a sequential K-2, 3-5, 6-8, 9-12 format. The project used a continuous information distillation method via email with the experts to develop the database. The Knowledge Base serves as a “connecting table” through which the three other elements (educational resource references, educational standards data, and curricula) were interrelated. These three elements were independently “correlated” to the Knowledge Base and were matched to one another as the result of connections to common Knowledge Base Statements.
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