S68 Poster Abstracts
P58 (continued)
discussion, was implemented with a group of 25 Head Start
Center supervisors and staff in San Luis Obispo County,
CA.
Outcome Measures and Analysis: The program was eval-
uated using a self-efficacy pre- and post-test of the training
participants. Paired t-tests were used to measure change in
self-efficacy, skills and outcome expectancies from pre- to
post-test.
Results: Major results showed a significant (p 0.005)
increase in self-efficacy to: 1) communicate nutrition con-
cepts effectively; 2) influence changes in nutrition related
attitudes; and 3) find resources to answer questions.
Conclusions and Implications: These results suggest that
facilitated group discussion, led by a skilled facilitator, can
be effective in increasing the self-efficacy of paraprofession-
als working as nutrition educators.
P59 Fall and Fracture Preventive Behaviors
Increased Following a Community-Based
Intervention in Older Adults in Georgia
Senior Centers
Jennifer Teems, BS, University of Georgia, 871 Meigs
Street, Athens, GA 30606, JET0802@uga.edu;
Tiffany Lommel, MS, RD, LD, University of Georgia,
tsellers@uga.edu; Joan G. Fischer, PhD, RD, LD,
University of Georgia, jfischer@fcs.uga.edu;
Jung Sun Lee, PhD, RD, LD, University of Georgia,
leejs@fcs.uga.edu; Sudha Reddy, MS, RD, LD, Georgia
Department of Human Resources, Division of Aging
Services, sureddy@dhr.state.ga.us;
Mary Ann Johnson, PhD, University of Georgia,
mjohnson@fcs.uga.edu
Objective: The purpose of this study was to evaluate a
community-based intervention to reduce risk factors related
to falls and fractures in older adults.
Design, Setting and Participants: The intervention took
place in Georgia senior centers and participants were a
convenience sample (N 849; mean age 74; 83%
female; 55% white, 44% black, 1% other).
Intervention: The 4-month intervention consisted of 16
sessions, eight of which focused on prevention of falls and
fractures, and incorporated components of the Health Be-
lief Model. All 16 sessions included physical activity.
Outcome Measures and Analysis: Pre- and post-tests were
interviewer-administered and evaluated fall preventive
home safety behaviors, intakes of calcium- and vitamin
D-containing foods and supplements, and 6 modifiable
osteoporosis-related risk (MORR) factors (low intake of
calcium-rich food, non-use of a calcium supplement, non-
use of a vitamin D-containing supplement, low physical
activity, high risk of falling, and current tobacco use).
Results: There were significant (P 0.01) increases in the
intake of calcium- and vitamin D-rich foods (increased by
4 weekly servings), the use of calcium- or vitamin
D-containing supplements (8 to 9 percentage-point in-
creases), and following 7 to 8 of the 8 fall preventive
behaviors (pre: 35% vs. post: 51%), and decreases in overall
MORR ( 5-6 risk factors: pre: 19% vs. post: 9%).
Conclusions and Implications: This evaluation provides
evidence that this intervention improves several preventive
behaviors that are important for decreasing the risk of falls
and fractures in older adults. This project was funded by the
Georgia Division of Aging Services, the Northeast Georgia
Area Agency on Aging, and the University of Georgia.
P60 Focus Groups to Inform the
Development of Online Theory Based
Education in Breastfeeding Initiation Best
Practices
Jennifer Weddig, PhDc, RD, CLC, Metropolitan State
College of Denver, CB 33, Denver, CO 80217;
Susan Baker, EdD, Department of Food Science and
Human Nutrition, 214E Gifford Building, Colorado State
University, Fort Collins, CO 80523,
sbaker@cahs.colostate.edu; Garry Auld, PhD, RD,
Department of Food Science and Human Nutrition, 229
Gifford Building, Colorado State University, Fort Collins,
CO 80523, auld@cahs.colostate.edu
Objective: To determine what factors affect a registered
nurses ability to support their patient in breastfeeding
initiation, if registered nurses have access to computers and
the computer skills necessary to complete an online course,
and what hospital policies and procedures, if any, impede a
nurses ability to put their breastfeeding knowledge into
practice with their patients.
Design, Setting and Participants: Focus groups were con-
ducted at 8 Colorado hospitals with over 40 nurses from
Labor/Delivery, NICU, Postpartum, and Pediatrics.
Outcome Measures and Analysis: The focus group tran-
scripts were analyzed by hand and the main themes of the
focus groups were extracted.
Results: Most nurses report that: 1. They do not have
official protocols for feeding. 2. They are supportive of
breastfeeding but lacked the hands on skills necessary to
assist dyads. 3. The infant is not given uninterrupted skin to
skin contact during the first 2 hours after birth. 4. They did
not observe a dyad breastfeeding every shift and often never
observed an actual feeding during a shift. 5. They are
interested in additional education that would allow them to
assess a dyad and provide help for common problems 6.
They would benefit from an online course with a skills lab
and that they would have access to high speed internet to
allow for the course to include streaming video and other
Continued on page S69
 Journal of Nutrition Education and Behavior Volume 40, Number 4, July/August 2008 Supplement
P60 (continued)
interactive tools 7. That getting CEUs for completion of
the course would be valuable and a motivator for partici-
pation.
Conclusions and Implications: The focus groups informed
the development of an online course teaching breastfeeding
initiation best practices and policies that was conducted
during November 2007.
P61 Segmentation of Midlife Women by
Attitude and Eating Occasion Need State and
Relationship to Obesity Indicators, Food
Group and Nutrient Intake
Noriko Sudo, PhD, RD, University of Minnesota,
Department of Food Science and Nutrition, 1334 Eckles
Avenue, 225 FScN, St. Paul, MN 55108,
sudox008@umn.edu; Dennis Degeneffe, MBA, University
of Minnesota, Department of Applied Economics, 317
Classroom Office Building, 1994 Buford Avenue, St.
Paul, MN 55108-6040, ddegenef@umn.edu;
Houa Vue, MS, RD, University of Minnesota,
Department of Food Science and Nutrition, 1334 Eckles
Avenue, 225 FScN, St. Paul, MN 55108,
vuex0067@umn.edu; Marla Reicks, PhD, RD, University
of Minnesota, Department of Food Science and
Nutrition, 1334 Eckles Avenue, 225 FScN, St. Paul, MN
55108, mreicks@umn.edu
Objective: To segment women by attitude and eating oc-
casion need state and to determine the relationship be-
tween these segments and obesity indicators, food group
and nutrient intake.
Design, Setting and Participants: Cross-sectional study
with 200 midlife women (46 1 6 years).
Outcome Measures and Analysis: Women completed an
Attitude/Control Belief Questionnaire once and an Eating
Occasion Questionnaire for 3 eating occasions during
3-days when diet records were collected. Cluster analyses
segmented women based on attitudes toward food and
eating occasions based on motivations underlying food
choices.
Results: Five attitude segments and six eating occasion
need state segments were identified. Estimated marginal
means of body mass index, waist circumference, and per-
cent body fat were highest in attitude segments defined as
impulsive eaters. Busy cooking avoiders had a higher
energy intake compared to women in other attitude seg-
ments. Energy, total fat, and cholesterol consumption per
occasion were highest in routine family meal occasions of
which more than 60% were dinner and eaten at home with
children. The percentage of eating occasions in which
fruits/vegetables were eaten was also highest in routine
family meal followed by healthy regimen occasions. More
than half of indulgent escape occasions occurred away from
S69
home and about one-third were experienced as a snack.
Saturated fat and sweets intakes were highest in indulgent
escape occasions.
Conclusions and Implications: Attitude and eating occa-
sion need state affect eating behaviors and should be con-
sidered when developing tailored interventions to improve
intake and control weight. This project was funded by NIH.
P62 Improving the Accuracy of a Self-
Administered Mailed 24-Hour Food Record
Noriko Sudo, PhD, RD, University of Minnesota,
Department of Food Science and Nutrition, 1334 Eckles
Avenue, 225 FScN, St. Paul, MN 55108,
sudox008@umn.edu; Courtney Perry, MS, RD, University
of Minnesota, Department of Food Science and
Nutrition, perry244@umn.edu; Marla Reicks, PhD, RD,
University of Minnesota, Department of Food Science
and Nutrition, mreicks@umn.edu
Objective: To determine the accuracy of a self-administered
mailed 24-hour food record (FR) by comparing the uncor-
rected FR (as received) to the FR corrected by telephone
interview.
Design, Setting and Participants: Forty midlife women (49
1 5 years) were recruited from flyers on a university campus.
Women were mailed a FR booklet and a 16-page actual-size
2D food model booklet. The FR booklet instructed women
to describe foods consumed and preparation methods/
recipes. Women returned the completed uncorrected FR
form by mail and were interviewed by phone to review
missing detail and clarify amounts and omissions (corrected
FR).
Outcome Measures and Analysis: Pearsons correlation
coefficients and mean differences were calculated for intake
of energy and nutrients between the uncorrected and cor-
rected FR.
Results: All intakes based on the uncorrected and cor-
rected FR were significantly correlated. Mean difference (1
SE) was the highest for energy (154 1 62 kcal) and the
lowest for vitamin E (0.57 1 0.40 mg). For all nutrients and
energy, the uncorrected FR overestimated intakes. The
most frequent missing data in the uncorrected FR was
inadequate description of foods and inadequate descrip-
tion of serving sizes. The median number of food items (25
and 75 percentiles) per FR with these types of missing data
was 3.5 (2.0, 5.8) and 1.0 (0.0, 1.0), respectively. Education
level may have contributed to more frequent missing data
in the uncorrected FR.
Conclusions and Implications: Even with use of well-
designed booklets, accuracy of mailed FR could be im-
proved via telephone interviews.