Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, 209 Chenoweth Laboratory, 100 Holdsworth Way, Amherst, MA 01003, USA.
Matern Child Health J. 2010 Jul;14(4):535-47. doi: 10.1007/s10995-009-0507-9. Epub 2009 Aug 5.
The purpose was to develop, implement and evaluate a peer-led nutrition curriculum Healthy Eating and Harambee that addresses established objectives of maternal and infant health and to shift the stage for African American women of childbearing age in Genesee County toward healthier dietary patterns using a socio-cultural and biomedical orientation. The PEN-3 model, which frames culture in the context of health promotion interventions, was integrated with the Transtheoretical Model to guide this 13-week pre-test/post-test curriculum. Materials developed included soul food plate visuals, a micronutrient availability worksheet, a fruit stand, and gardening kits. Learning activities included affirmations, stories, case-scenarios, point-of-purchase product recognition, church health teams, and community health fairs. We investigated health-promoting dietary behaviors (consumption of more fruits and vegetables (F&V), serving more F&V to their families, and moderating dietary sodium and fat intakes), and biomedical behaviors (self-monitoring blood pressure and exercising) across five stages of change. Session attendance and program satisfaction were assessed. N = 102 women participated (mean age = 27.5 years). A majority (77%) reported adopting at least one healthy eating behavior (moderating sodium, serving more F&V to their families), 23% adopted at least two such behaviors (reading food labels for sodium; using culinary herbs/spices; serving more F&V to their families), and 45% adopted both dietary (moderating sodium; eating more fruits) and biomedical behaviors. Participants and facilitators favorably evaluated the curriculum and suggested improvements. A multi-conceptual approach coupled with cultural and biomedical tailoring has potential to promote young African American women's movement to more advanced stages of change and improve self-efficacy for fruit and vegetable intake, dietary sodium moderation, and self-monitoring blood pressure and physical activity.
本研究旨在开发、实施和评估一项同伴主导的营养课程——“健康饮食与哈拉姆比”（Healthy Eating and Harambee），以满足母婴健康的既定目标，并通过社会文化和生物医学导向，推动生育年龄段的非裔美国妇女朝着更健康的饮食模式转变。本课程将 PEN-3 模式（将文化纳入健康促进干预的框架）与跨理论模型（Transtheoretical Model）相结合，指导这一为期 13 周的预测试/后测试课程。本课程开发的材料包括灵魂食物餐盘视觉效果、微量营养素可获得性工作表、水果摊和园艺工具包。学习活动包括肯定、故事、案例情景、购买点产品识别、教堂健康团队和社区健康博览会。我们调查了促进健康的饮食行为（食用更多水果和蔬菜、向家人提供更多水果和蔬菜、以及适度控制饮食中的钠和脂肪摄入量）和生物医学行为（自我监测血压和锻炼），涵盖了五个变化阶段。评估了课程出席率和对课程的满意度。共有 102 名女性参与了研究（平均年龄为 27.5 岁）。大多数（77%）报告至少采用了一种健康饮食行为（控制钠摄入、向家人提供更多水果和蔬菜），23%报告至少采用了两种此类行为（阅读食物标签上的钠含量、使用烹饪香草/香料、向家人提供更多水果和蔬菜），45%同时采用了饮食行为（控制钠摄入、多吃水果）和生物医学行为（自我监测血压和进行体育锻炼）。参与者和培训师对课程给予了积极评价，并提出了改进建议。多概念方法结合文化和生物医学调整，有可能促进年轻非裔美国妇女向更高级的变化阶段迈进，并提高她们对水果和蔬菜摄入、饮食中钠的适度控制以及自我监测血压和体育锻炼的自我效能感。
