ass ssociat ociated ed wi with th health althy me meal l pre - - PowerPoint PPT Presentation

Self lf-efficacy efficacy & ho & home me fo food

• d avai

ailabi labilit lity y is s ass ssociat

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ed wi with th health althy me meal l pre repa paratio ration n pra ractices ctices in Kua uala la Lum umpur pur child ldren ren

Presented by,

• Asst. Prof. Dr. Satvinder Kaur

In Introduction

Healthy Meal Preparation in Children

Increased in fruits & vegetables preference and intake Increased food group intake: grains & milk Willingness to taste novel foods

Chu et. al. 2013, Chu et. al. 2014, Van der Horst et. al. 2014, Allirot et al. 2016, Cunningham-Sabo and Lohse 2013.

Conceptual Framework

Knowledge, Attitude & Self-efficacy

towards healthy meal preparation

Home Food Availability

Fruits, vegetables, ready-to-eat (healthful & less healthful)

Practices of Healthy Meal Preparation

Objectives

To identify factors associated with good practices of healthy meal preparation among children To determine children’s knowledge, attitude, practice and self- efficacy towards healthy meal preparation To determine home food availability of children aged 9 to 11 in Kuala Lumpur

Cross-Sectional Study

‘Sekolah Kebangsaan’ in Kuala Lumpur Stratified Random Sampling:

• Bangsar-Pudu
• Keramat
• Sentul

Simple Random Sampling to select schools from each zones Convenienc e Sampling to recruit eligible children in schools

Jabatan Pendidikan Wilayah Persekutuan Kuala Lumpur 2011.

In Inclusion & Exclusion Criteria

6

Inclusion Exclusion  Malaysian children aged 9-11  Able to read, write understand English/Malay language  Children that expressed interest to participate  Physically & mentally disabled children  Children with any co-morbidities  Without parent’s consent

Data Collection

7

Anthropometry assessment

• Height: Portable stadiometer Seca 213
• Weight Tanita body composition analyzer SC-330

Children were guided to complete the questionnaire Parents received & submitted the home food environment questionnaire via their child Healthy meal preparation questionnaire was distributed to children

Medical Research & Ethics Committee Ministry of Education Malaysia Kuala Lumpur Education Department Approval from Principal

• f Primary

Schools Information Sheet & Consent Form for Parents Assent from Eligible Students

Eth thic ics

Results & Discussions

Characteristics n (%) Age 9 (Standard 3) 10 (Standard 4) 11 (Standard 5) 113 (56.5) 58 (29.0) 29 (14.5) Gender Boy Girl 85 (42.5) 115 (57.5) Monthly Household Income ≤ RM 2500 RM2501-RM5500 > RM5500 62 (31.0) 73 (36.5) 65 (32.5)

Children Characteristics (n (n=200)

[VALUE].0 49.5 33.5 14.0 10 20 30 40 50 60 Thinness Normal Overweight Obese Percentage %

*According to BMI z-score

Children Weight Status (n (n=200)

Parent’s concern of child becoming overweight

47.5% of parents

were concerned of their child becomes overweight

21.5% of parents

were very concerned of their child becomes overweight

62.78 78.97 75.93 60.97 Knowledge Attitude Self-efficacy Practice Percentage %

Chil ildren Psychosocial Scores* (n (n=200)

*Score=

𝑵𝒇𝒃𝒐 𝑵𝒃𝒔𝒍𝒕 𝑼𝒑𝒖𝒃𝒎 𝑵𝒃𝒔𝒍𝒕 x 100%

30.56 50.81 44.44 50.18 Fruits at Home Vegetables at Home Ready-to-eat Food (Healthful) Ready-to-eat Food (Less Healthful) Percentage %

Home Food Avail ilabili lity Score*

*Score=

𝑵𝒇𝒃𝒐 𝑵𝒃𝒔𝒍𝒕 𝑼𝒑𝒖𝒃𝒎 𝑵𝒃𝒔𝒍𝒕 x 100%

n=200, p significant at <0.05 Variables Pearson correlatio n p-value Knowledge 0.133 0.061 Attitude 0.344 <0.001* Self-efficacy 0.501 <0.001* Fruits at Home 0.304 <0.001* Vegetables at Home 0.248 <0.001* Ready-to-eat (Healthful) 0.227 0.001* Ready-to-eat (Less Healthful)

• 0.017

0.811

Factors Correlated wit ith Healt lthy Meal l Preparation Practic ices

Social Cognitive Theory

Individual Factors (Attitude, Self- efficacy) Environment (Home Food Availability) Behaviour (Practice)

Bandura 1999.

Factors Associated with Healthy Meal Preparation Practices

Variables β 95% Cl p-value Knowledge

• 0.04
• 0.38-0.18

0.497 Attitude 0.06

• 0.12-0.28

0.416 Self-efficacy 0.43 0.24-0.49 <0.001* Fruits at Home 0.21 0.11-0.68 0.007* Vegetables at Home 0.89

• 0.09-0.34

0.251 Ready-to-eat Food (Healthful) 0.03

• 0.23-0.41

0.662 Ready-to-eat Food (Less Healthful)

• 0.36
• 0.64-(-0.07)

0.015*

𝑆2=.325, dependant variable= healthy meal preparation practices, p significant at <0.05

Discussions

• Children’s confidence & belief that they can accomplish healthy

meal preparation tasks may be a driving force that lead to the behaviour

• Children with higher self-efficacy may also be healthier eaters who

are more interested in food-related activities (meal preparation)

In this study, higher self-efficacy was associated with increased frequency

• f healthy meal preparation (β=0.43)

A study conducted among Canadian children showed that preparing meals at home daily is achieved through high self-efficacy (β=2.88)

Chu et at. 2013, Woodruff and Kirby 2013, Bandura 1999.

Dis iscussions

Osei-Assibey et. al. 2013, Jin and Jones-Smith 2015, Savage et. al. 2007, Rosenkranz and Dzewaltowski 2008, Swinburn 2011 et. al. 2011.

There are limited studies that explored home food availability as a factor for healthy meal preparation practices among children Studies demonstrated that home food availability can influence the development of nutrition-related behaviors in children Less availability of obesity-protective food predict lower consumption

• levels. Higher availability of obesity risk-factor food predict higher

consumption. Modifying the ‘obesogenic’ environment could produce a more lasting effect on behaviour change – consumption & practice of healthy meal preparation

Conclusion

Children’s knowledge, attitude & self-efficacy score towards healthy meal preparation were moderate Parents reported a variety of fruits & vegetables available in their home, however, they also had various unhealthy snack & drink options The practice of healthy meal preparation among children was lacking Self-efficacy & home food availability should be improved to encourage the practices of healthy meal preparation in children

References

1. Chu, Y.L., Farmer, A., Fung, C., Kuhle, S., Storey, K.E. and Veugelers, P.J., 2013. Involvement in home meal preparation is associated with food preference and self-efficacy among Canadian children. Public Health Nutrition, 16(01), 108-112. 2. Chu, Y.L., Storey, K.E. and Veugelers, P.J., 2014. Involvement in meal preparation at home is associated with better diet quality among Canadian children. Journal of nutrition education and behavior, 46(4), 304-308 3. Van der Horst, K., Ferrage, A. and Rytz, A., 2014. Involving children in meal preparation. Effects on food intake. Appetite, 79(1), 18-24. 4. Allirot, X., da Quinta, N., Chokupermal, K. and Urdaneta, E., 2016. Involving children in cooking activities: A potential strategy for directing food choices toward novel foods containing vegetables. Appetite, 103(1), 275-285. 5. Cunningham-Sabo, L. and Lohse, B., 2013. Cooking with kids positively affects fourth graders' vegetable preferences and attitudes and self- efficacy for food and cooking. Childhood Obesity, 9(6), 549-556. 6. Jabatan Pendidikan Wilayah Persekutuan Kuala Lumpur 2011. Sekolah-Sekolah Wilayah Persekutuan Kuala Lumpur. [online] Jpwpkl.moe.gov.my. Available at: http://jpwpkl.moe.gov.my/index.php/sekolah [Accessed 1 Jan. 2018]. 7. Bandura, A., 1999. Social cognitive theory: An agentic perspective. Asian Journal of Social Psychology, 2(1), 21-41. 8. Woodruff, S.J. and Kirby, A.R., 2013. The associations among family meal frequency, food preparation frequency, self-efficacy for cooking, and food preparation techniques in children and adolescents. Journal of nutrition education and behavior, 45(4), 296-303. 9. Osei-Assibey, G., Dick, S., Macdiarmid, J., Semple, S., Reilly, J.J., Ellaway, A., Cowie, H. and McNeill, G., 2012. The influence of the food environment on overweight and obesity in young children: a systematic review. BMJ open, 2(6), e001538.

• 10. Swinburn, B.A., Sacks, G., Hall, K.D., McPherson, K., Finegood, D.T., Moodie, M.L. and Gortmaker, S.L., 2011. The global obesity pandemic:

Shaped by global drivers and local environments. The Lancet, 378(9793), 804-814.

• 11. Jin, Y. and Jones-Smith, J., 2015. Associations between family income and children’s physical fitness and obesity in California, 2010–2012.

Preventing Chronic Disease, 12(1), 1-9.

• 12. Savage, J.S., Fisher, J.O. and Birch, L.L., 2007. Parental influence on eating behavior: conception to adolescence. The Journal of Law, Medicine

& Ethics, 35(1), 22-34.

• 13. Rosenkranz, R.R. and Dzewaltowski, D.A., 2008. Model of the home food environment pertaining to childhood obesity. Nutrition

reviews, 66(3), 123-140.

Sample Size Determination

Where n is the sample size,

Z = Statistic corresponding to level of confidence of 95%, Z value is 1.96. P = Expected prevalence 0.148, National prevalence of childhood obesity in Malaysia (aged 5 to 9) is 14.8% [1] d = Precision of 5%, thus 0.05 Hence: n = 1.962 0.148 (1-0.148) 0.052 n = 193.7642 ≈ 194 To avoid of non-compliance & non-response, sample size is increased (±20%) to

233 n =

𝑎2𝑄 1−𝑄 𝑒2

[34]

Questionnaires

22

Children- Psychosocial factors towards Healthy Meal Preparation

• Knowledge (9 items, 1-point for every correct answer)
• Attitude (7 items, 5-point Likert scale)
• Self-efficacy (9 items, 5-point Likert scale)
• Practices (7 items, 5-point Likert scale)

Parents- Home Food Environment

• Sociodemographic factors
• Concern about child becoming overweight
• Food availability: Vegetables (16), Fruits (16), Healthful Ready-to-

eat Food (9), Less Healthful Ready-to-eat Food (11)

• Self-reported weight & height

Did you have th these fr fruits in in your home during th the past week?

68.5 % 65.5 % 27.5 % 13.0 % 40.5 % 10.0 % 15.5 % 48.5 % 52.0 %

Did you have th these fr fruits in in your home during th the past week?

23.0 % 8.0% 26.5 % 28.0 % 35.5 % 11.5 % 16.0 %

Did you have these vegetables in your home during the past week?

37.0 % 36.0 % 81.5 % 53.5 % 53.0 % 71.0 % 46.5 % 17.5 % 73.0 %

Did you have these vegetables in your home during the past week?

62.5 % 74.5 % 18.0 % 36.0 % 19.0 % 79.0 % 55.0 %

Did id you have these foods/drinks in in your home during the past week?

Juice Zero Sugar Low Fat Sports Drinks

56.5 % 71.0 % 68.0 % 47.0 % 24.5 % 11.5 % 36.5 % 48.5 % 68.0 % 60.5 % 59.5 %

Did you have these foods/drinks in your home during the past week?

Full Cream Low Fat

Culture d milk

Yogurt

Unsweetene d Cereal

64.5 % 45.5 % 56.0 % 58.0 % 15.0 % 34.5 % 38.5 % 49.0 % 38.5 %