Lora Beth Brown EdD, RD, Brigham Young University
201: Society, Nutrition & Chronic Disease 2 credits; Nutr 100 prerequisite Course emphasizes behavioral & social sciences, not physiology or biochemistry Students Exercise Science, Health Science, and Nutrition majors Future health professionals Enrollment varies from 50-150/semester The Nutrition Course
To increase awareness of environmental barriers to & opportunities for a healthy nutrition environment in the United States. To recommend ways to reduce barriers & expand opportunities. To evaluate the recommendations: Are they realistic? Assignments Purposes
Students photographed what they saw as nutrition- related barriers & opportunities in the environment. They posted photos on a web platform & described how each was a barrier or opportunity & recommended a way to reduce the barrier or expand the opportunity. They viewed & evaluated barriers & opportunities posted by students in their online discussion group. The Assignment
Cook your own meals! Its hard for students to find time but its much healthier. You can control portion sizes and ingredients and limit the processed foods. It brings back memories of family dinners, making meals both physically and emotionally fortifying.
Dinner Calendar on the Fridge. I make a 2-week dinner calendar to know what to buy and I don't have to think about what to make for dinner every day. I have a nutritious dinner every day and I save money. Expand this opportunity by involving roommates and friends in planning meals together
The Great Wall of China, and Tupperware, and utensils, and pots… With fast food, you throw away a paper bag. Cook a healthy meal and you're left with... this. When time is limited, cookings no fun because of cleaning up afterward! Solutions? Put as many different food groups into one dish as possible. Get different roommates.
Baby Annie Eating Fruits and Vegetables. Feeding babies and young kids lots of fruits and veggies helps them develop a taste for healthy foods at a young age.
Poor Example. This photo represents a common barrier of parents feeding their children vegetables but being a bad example. This barrier can be reduced by teaching the parents the importance of eating as healthy as they want their children to eat
On campus vending. Students in a hurry can grab something really quick and nutritious. The apples are almost sold out too -- a good sign that students want to eat healthy – they just need opportunities to do so when on the run.
Overly Accessible Junk. The glass window and bright packages are visually appealing and attract unsuspecting students. Machines in high traffic areas give students an excuse to not pack healthy a healthy lunch. "I'll just grab something on campus. Solution? Tuck vending machines in out of the way places.
Vending Machine Prices. Big price differences between unhealthy soda (60 cents) and healthy juice ($1.60). You don't want to spend a lot of money at the vending machine so often you settle a cheaper but less nutritious drink or food. Solution? Reduce the price of healthy things or raise the price of unhealthy things so that the price difference is eliminated.
Healthy Food On Sale. People usually buy more of things when they're on sale. If we could have more healthy foods on sale and make them cheaper, we'd have more people eating healthy and not buying as much junk food.
Buy One Get One Free. This just doubles the calories and fat theyre consuming. Instead they should offer something healthier instead of another burger. Chances are one person will eat both of the burgers if given one free. Offering something like a fruit cup or a small bag of carrots would be so much healthier.
Waiting In Line, The Candy Aisle. Everywhere we wait – the store, the carwash -- candy and drinks surround us and are calling to us. It might affect sales but it would help our health to move these candies and drinks to the places they belong in their respective aisles.
Supermarket Fruit. This fruit was at the store entrance -- one of the first things you see. This is an opportunity: Move the healthy foods to the front, so you dont have to pass the unhealthy stuff before getting to the healthy section. This course of action represents opportunity.
Community Co-Op. This is a "standard share" at a local co-op: 5 different types of fruits and vegetables, 2 pounds of chicken/ground beef/bacon and a loaf of stone-ground bread (for only $27.81 after tax) -- affordable, healthy foods. The co-op could advertise better. If more people knew about it I think more people would take advantage of the opportunity.
Refrigerators in Cheap Apartments. Not enough fridge space for 6 girls to store good foods like fruits and vegetables. We cant buy healthy foods because theres not enough room to store them. Campus Housing should mandate refrigerator shelf space for each person in the apartment. The landlord will have to do something: install bigger fridges or an extra one.
All day and all night too. We are bombarded with opportunities to eat poorly. With 24 hour availability its convenient, especially if you have to work late -- probably not choosing the healthier option. Consumers need to choose the more nutritious foods.
Taco Tuesday. I went to Del Taco with a bunch of friends and we got 100 tacos for only $33.00 dollars. Thats an incredible price for poor students but its not nutritious.
Drinks Available At The Gym. Monster energy drinks that we sell at our gym is completely contradictory to our purpose: promoting healthy & fitness. Reduce the barrier by providing only beneficial, needed drinks like water and Gatorade.
Obligated to eat it. Almost every weekend my mother-in-law visits and brings snacks like this. Every time were hungry we instinctively reach for the sugary and salty snacks. We feel bad just throwing away things she has graciously given us …
Home Health Donation. How often are gifts from companies or friends just junk food? Instead of candies for gifts, we should advise people to send fruit baskets.
Clean the Sink. We paid to eat an outrageous amount of ice cream out of a "kitchen sink." Americans are obsessed about eating large amounts of food in one sitting, just to say we did it. This encourages overeating for social recognition. Americans will gradually learn portion control as food service establishments stop providing such large portion sizes with catchy names to entice consumers.
Over 350 pounds eat free. This Las Vegas restaurant is called the Heart Attack Grill – it almost idolizes an unhealthy diet by inviting people over 350 pounds to eat for free. A way to reduce this barrier is to create healthier all-you- can-eat buffet options.
Happiness is Junk Food. This gas station on State Street is promoting unhealthy food and telling everybody unhealthy food will make you happy. Reduce the barrier by removing the sign (obviously), but also to talk to the gas station owners about how unhealthy food harms people and try to get them to promote healthy food instead.
Favorable responses to Likert-scaled questions (1= negative, 5 = positive) Ease 3.8 ± 0.7 Usefulness 3.7 ± 0.9 Enjoyable 3.8 ± 0.8 Made them think 3.8 ± 0.8 Open-ended question: What did this assignment contribute to your learning in this course? Students evaluation of the assignment (1 st semester)
More aware of barriers & opportunities 62% Personal or professional applications 26% Not much 12% It helped me to really look at the barriers but also see the good things that help us eat better. …there are all sorts of positive & negative influences surrounding me. I just need to recognize the effect they might be having on me. …I can identify potential areas of change in the way Americans currently think about & eat food. As a health professional I can help change these things for the better. Contributions to learning
Retrospective pretest Now that the semester is over, how aware are you of the barriers to and opportunities for good nutrition for the US population? Based on what you know now, how aware would you have been of the barriers to and opportunities for good nutrition for the US population before doing this assignment? Very aware70%10% Somewhat aware26%61% Not very aware1%23% Not at all aware1%3% Awareness improved
Nearly all focused on teaching individuals to change their behavior or were unrealistically simple suggestions. This provided an introduction to the Social Ecological Model, to consider how complex it is to improve the nutrition environment. Quality of students recommendations
Dietary Guidelines for Americans, 2010 Chapter Six (p 55)
In future semesters… Discuss the Social Ecological Model before they do the assignment. Add questions to the assignment, to improve the quality and depth of their recommendations What specific changes are needed in at least 2 additional factors or levels of the Model? How realistic is your recommendation? Be more discriminating in grading the assignment.
More creative, less academic A way for quiet students to participate more actively Made use of interactive, out-of-classroom learning Capitalized on students media-savvy skills Assignments advantages
The best learning often comes through discovery. Did I tell them, or did they tell me? It takes several iterations to develop an effective assignment. My Reflections…
I welcome your suggestions and questions. Have fun developing innovative assignments using cell-phone photo capabilities! Lora Beth Brown, EdD, RD Lorabeth_brown@byu.edu