Publications by authors named "Noereem Z Mena"

12 Publications

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Quality Nutrition Education Materials for Pregnant or Lactating Women and Children Ages 0-24 Months Old.

J Nutr Educ Behav 2021 05;53(5):369

Bradley University, SNEB Nutrition Education for Children Division, Chair-Elect.

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May 2021

College Students' Views on Functional, Interactive and Critical Nutrition Literacy: A Qualitative Study.

Int J Environ Res Public Health 2021 01 27;18(3). Epub 2021 Jan 27.

School of Food and Agriculture, University of Maine Orono, Orono, ME 04469, USA.

This research aimed to uncover how the nutrition literacy domains (functional, interactive, critical) influence the dietary decisions of young adults in college. For this qualitative study, undergraduate college students aged 18-24 years old ( = 24) were recruited to participate in focus groups. The focus group transcripts were independently coded for primary and secondary themes using a grounded theory approach and a basic thematic analysis. Four focus groups with 5-7 participants per group were conducted. The three domains of nutrition literacy emerged in the focus groups with two themes per domain. Themes within functional nutrition literacy included 'food enhances or inhibits good health' and 'components of a healthy diet'; themes within interactive nutrition literacy included 'navigating the college food environment' and 'awareness of food marketing on dietary behavior'; themes within critical nutrition literacy included 'critical appraisal of nutrition information' and 'awareness of societal barriers to good health'. Understanding how the different nutrition literacy domains relate to college students' food choices can inform future researchers on how to appropriately assess nutrition literacy and design programs aimed at improving dietary behaviors of college students.
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January 2021

Dietary Contributors to Food Group Intake in Preschool Children Attending Family Childcare Homes: Differences between Latino and Non-Latino Providers.

Nutrients 2020 Nov 29;12(12). Epub 2020 Nov 29.

Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA.

While there are several factors that contribute to the diet quality of children in childcare, one contributing factor in Family Childcare Homes (FCCHs) is the provider's ethnicity. However, research examining the food items provided in this setting is limited; in particular, with regards to differences between FCCHs of Latino and non-Latino providers. The aim of this study was to identify and describe the food items that contribute to food group intake in preschool-aged children attending FCCHs, and to examine differences by provider ethnicity. This secondary data analysis used baseline data from Healthy Start/Comienzos Sanos: a cluster-randomized trial. Children's dietary intake was collected using the Dietary Observation in Child Care method and entered into Nutrition Data System for Research software. Food groups were based on the Nutrition Coordinating Center classification. Contribution of food items to their respective food group was calculated as a proportion, using ratio of means and presented as a percentage. Ethnic differences were tested with ANCOVA ( < 0.05) with Bonferroni adjustments for multiple comparisons. All providers ( = 120) were female and 67.5% were Latino. Most fruit consumed by children was in the form of juice (85%), three-fourths of the grains consumed were refined (75%), and half of the sweets consumed were syrup/honey/jelly (50%). Most of the vegetables consumed were non-starchy (61%), nearly three-fourths of dairy consumed was low-fat (71%), and vegetable oils contributed the most to the fats group (89%). Food items differed by provider's ethnicity, with children cared for by non-Latino providers consuming a higher proportion of fruit juice, animal fats and a lower proportion of legumes ( < 0.001 for all). Children with Latino providers consumed a lower proportion of non-starchy vegetables, low-fat dairy, and nuts/seeds ( < 0.001 for all). FCCH providers could offer more whole fruits and grains and a greater variety of vegetables. Differences by ethnicity suggest providers could benefit from culturally tailored recommendations.
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November 2020

Food Photography as a Tool to Assess Type, Quantity, and Quality of Foods in Parent-Packed Lunches for Preschoolers.

J Nutr Educ Behav 2021 02 12;53(2):164-173. Epub 2020 Nov 12.

Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO. Electronic address:

Objective: Explore using food photography to assess packed lunches in a university-based Early Childhood Center and contextualize these photographs through parent interviews.

Methods: An explanatory sequential design was used. Packed lunches were photographed to assess the type and quantity of foods offered and consumed by Child and Adult Food Care Program components (fruit, vegetable, grain, and protein) and quality of foods offered using the Healthy Meal Index. Parent interviews aimed to understand motivations and behaviors related to packing lunch.

Results: Data were collected on 401 lunches. Only 16.2% of lunches met all Child and Adult Food Care Program requirements. Most lunches included fruit (84%) and grains (82%), whereas fewer included vegetables (44%). Portion sizes were large, especially for grains (2.7 ± 1.5 servings). In interviews (n = 24), parents expressed tension between offering healthful items and foods they knew their child would eat, as well as concern about children going hungry.

Conclusions And Implications: Food photography is a feasible methodology to capture parent-packed lunches for preschoolers and may have utility in nutrition education, particularly related to age-appropriate portion sizes.
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February 2021

Farm to Early Care and Education Programming: A Descriptive Study of Challenges and Opportunities to Promote Healthful Foods to Young Children.

Int J Environ Res Public Health 2020 09 19;17(18). Epub 2020 Sep 19.

Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO 80532, USA.

Interest in farm to early care and education (ECE) programming, which consists of gardening, nutrition education, and local food procurement, has been growing in the United States, as it may be a promising technique for promoting healthful foods to young children. However, there is limited information about current farm to ECE efforts in specific states, including Colorado, to support funding and resource needs. An online survey was distributed to licensed Colorado ECE providers in two phases to understand current participation in the farm to ECE as well as provider perspectives on benefits and barriers to programming. A total of 250 surveys were completed. Approximately 60% of ECE facilities participated in gardening and nutrition education with providers almost unanimously agreeing on the child-centric benefits of programming. Fewer facilities (37%) participated in local food procurement likely due to significant time, cost, and knowledge barriers. To increase participation in farm to ECE as a technique for promoting healthful foods to young children, future efforts should focus on innovative solutions to reduce ECE-specific barriers.
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September 2020

Exploring Parenting Contexts of Latinx 2-to-5-Year Old Children's Sleep: Qualitative Evidence Informing Intervention Development.

J Pediatr Nurs 2020 Sep - Oct;54:93-100. Epub 2020 Aug 12.

Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA; Department of Epidemiology, Brown School of Public Health, Providence, RI, USA.

Purpose: Poor sleep quality is associated with childhood obesity, and Latinx children have the highest prevalence of obesity in the United States. Parents are key agents to ensuring good sleep quality among children, but limited research has examined sleep parenting among Latinx working parents who may have added responsibilities.

Design And Methods: Working Latinx parents of 2-to-5-year old children participated in in-depth interviews exploring parenting and familial contexts of child sleep. Main topics in the interview guide included sleep-related parenting practices, social support, cultural influences, and intervention service delivery and content preferences. Thematic analysis was used to analyze data.

Results: Twenty parents completed the interview. The following themes emerged: Sleep parenting, sleep knowledge, impact of familial structures, family commitments, child temperament, and broader contextual factors on sleep, and intervention content and design ideas. Across participants, employment was reported to be a barrier to effective sleep parenting. Parents also reported engaging in practices that may interfere with sleep quality such as using screen time as a distraction and reducing naptime during the weekends to increase the amount of family time. Family-level factors such as co-parenting and spousal support were reported to facilitate sleep parenting. Participants also indicated the need for more sleep parenting knowledge and a preference for mobile platforms and social media to deliver information.

Conclusions: Results not only fill critical gaps in the literature, but also highlight the variability in parents' approaches to sleep parenting and an urgent need for intervention/programming efforts to target Latinx parent's sleep knowledge and parenting.
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April 2021

Communication With Family Child Care Providers and Feeding Preschool-Aged Children: Parental Perspectives.

J Nutr Educ Behav 2020 01;52(1):10-20

Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI.

Objective: To describe parent communication about child nutrition-related topics with family child care providers (FCCPs).

Design: Five focus groups conducted from December, 2016 to July, 2017.

Participants: Parents (n = 25) of 2- to 5-year-old children attending family child care homes in Rhode Island.

Phenomenon Of Interest: How and what parents communicate about with FCCPs related to feeding young children.

Analysis: Recordings were transcribed verbatim. Two independent coders employed content analysis to analyze transcripts. Reflections, emerging themes, and final themes were discussed.

Results: Participants were recruited through FCCPs and were mostly Hispanic and female. Parents mainly communicated with FCCPs in person. Communication with FCCPs related to how and what children were fed did not occur frequently, and parents usually inquired about how much children ate.

Conclusions And Implications: Parents did not engage in frequent child nutrition-related communication with their FCCP. However, parents trusted FCCPs to provide healthy and sufficient food to children. More research is needed to identify effective strategies that facilitate child nutrition communication between parents and FCCPs.
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January 2020

Knowledge, attitudes, beliefs, and health behaviors of bone health among Caribbean Hispanic/Latino adults.

Arch Osteoporos 2019 02 4;14(1):14. Epub 2019 Feb 4.

Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, 3 Solomont Way, Suite 4, Lowell, MA, 01854, USA.

Few studies have examined knowledge and perceptions of osteoporosis among Caribbean Latino adults. Confusion regarding the term osteoporosis was noted. Doctors were viewed as trusted sources of health information, although descriptions of a paradoxical relationship emerged. This study can be used to inform culturally tailored interventions for osteoporosis prevention.

Purpose: The overall goal of this study was to assess knowledge, attitudes, and beliefs of bone health and osteoporosis among Caribbean Latino adults aged > 50 years.

Methods: This triangulated mixed methods study included completion of a quantitative questionnaire and participation in one of four focus groups to obtain information on (1) general health, (2) knowledge about bone health and osteoporosis, (3) sources of information about bone health, and (4) prevention knowledge and personal responsibility. Quantitative data were analyzed using SAS, and qualitative data were analyzed using descriptive and structural coding by two independent research members.

Results: The majority of participants were female (73%), Dominican (84%), and low income (82% < $20,000) with a mean age of 68.4 (± 8.5) years. Most participants had heard of osteoporosis (90%); however, the majority were not able to accurately describe this chronic condition. Health care providers were viewed as most trusted sources of health information, despite feelings of being rushed during their visits, with limited communication about preventative care. Most participants felt that nutrition and exercise were important for overall health.

Conclusions: Caribbean Hispanic adults in this study reported knowledge of osteoporosis and nutritional factors associated with prevention of this chronic condition. However, qualitatively, there was confusion between osteoporosis and other bone and joint conditions. Culturally specific interventions to promote prevention of osteoporosis are urgently needed for this underserved, high-risk population.
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February 2019

Nutrition-Related Practices of Family Child Care Providers and Differences by Ethnicity.

Child Obes 2019 04 1;15(3):167-184. Epub 2019 Feb 1.

3 Center for Health Equity Research, Brown University School of Public Health , Providence, RI.

Background: Child care settings play an important role in shaping children's eating behaviors; yet few studies have included family child care homes (FCCHs). We examined provider-reported nutrition-related practices in FCCHs and observed adherence to nutrition guidelines from the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC), exploring differences by provider ethnicity.

Methods: We assessed baseline data from a cluster-randomized trial, including surveys with FCCH providers and observational data collected at the FCCH. We examined provider-reported nutrition-related practices and if providers met NAP SACC guidelines using observational data. Differences by ethnicity were assessed using chi-square and multivariate log-linear analysis adjusting for education.

Results: Providers completed a telephone survey (n = 166, 100% female and 72% Hispanic) and participated in 2 full-day observations (n = 119). Many providers reported engaging in positive nutrition-related practices. Significant differences by ethnicity included the following: Hispanic providers less likely to report feeding practices that were responsive to children's self-regulation, but also less likely to report eating and drinking unhealthy foods/beverages in front of children and having screens on during meals and more likely to report seeking nutrition trainings. Using observational data, only 10 of 26 NAP SACC practices were met by >60% of providers. Few ethnic differences in meeting guidelines were found (7 of 26 practices).

Conclusions: While providers engage in some positive nutrition practices, improvement is needed to ensure that all providers actually meet evidence-based guidelines. Ethnic differences in certain practices underscore the need for culturally relevant trainings.

Trial Registration Number: NCT02452645.
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April 2019

Community-based childhood obesity prevention intervention for parents improves health behaviors and food parenting practices among Hispanic, low-income parents.

BMC Obes 2018 27;5:11. Epub 2018 Mar 27.

1Department of Nutrition and Food Sciences, University of Rhode Island, Fogarty Hall, 41 Lower College Rd, Kingston, RI 02881 USA.

Background: Given the current prevalence of childhood obesity among Hispanic populations, and the importance of parental feeding behaviors, we aimed to assess the impact of the evidence-based Healthy Children, Healthy Families (HCHF) intervention on responsive food parenting practices (FPPs) in a low-income Hispanic population.

Methods: This community-based pilot study used a non-experimental pre/post within-subjects design. Parents ( = 94) of children aged 3-11 years old were recruited to participate in an 8-week, weekly group-based intervention. The intervention was delivered to nine groups of parents by trained paraprofessional educators over a two-year period. Children participated in a separate curriculum that covered topics similar to those covered in the parent intervention. Parents completed self-administered pre/post surveys, which included demographic questions, seven subscales from the Comprehensive Feeding Practices Questionnaire, and the 16-item HCHF Behavior Checklist. Descriptive statistics and paired samples t-tests were used to analyze data from parents that completed the intervention.

Results: Fifty-two, primarily Hispanic (93%) parents completed the intervention (39% attrition rate). For parents who completed the intervention, there was a significant increase in one of the feeding practice subscales: encouragement of balance and variety ( = 0.01). There were significant improvements in several parent and child diet and activity outcomes ( ≤ 0.01).

Conclusions: Although attrition rates were high, parents completing the study reported enjoying and being satisfied with the intervention. For parents who completed the intervention, reported 'encouragement of balance and variety', in addition to several health behaviors significantly improved. Larger studies utilizing an experimental design, should further explore the impact of the HCHF curriculum on improving certain FPPs and health behaviors that contribute to obesity.
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March 2018

Nutrition and Physical Activity Environments of Home-Based Child Care: What Hispanic Providers Have to Say.

Child Obes 2015 Oct 2;11(5):521-9. Epub 2015 Sep 2.

3 Department of Human Development and Family Studies and Center for Health Interventions and Prevention, University of Connecticut , Storrs, CT.

Background: It is important to understand the perceptions and beliefs of family child care providers (FCCPs) regarding which factors influence children's physical activity (PA), screen-time (ST), and dietary behaviors in order to develop and implement appropriate obesity prevention interventions. The aim of this qualitative study was to explore the aforementioned perceptions and beliefs of FCCPs in Rhode Island.

Methods: Four focus groups (n = 30) were held with FCCPs. Providers were female, Hispanic, and Spanish speaking. Providers were asked about different aspects of feeding, PA, and ST behaviors. Themes were coded using NVivo10 (QSR International Pty Ltd, Doncaster, Victoria, Australia). Content analysis was used to analyze final themes.

Results: Providers understood the importance of providing opportunities for healthy eating and PA for the children they cared for, but there was room for improvement, especially with regard to certain feeding and ST practices. Several barriers were evident, including the lack of physical infrastructure for PA, cultural beliefs and practices related to child feeding, and difficulties working with parents to provide consistent messages across environments.

Conclusions: Given that FCCPs are aware of the importance of healthy eating and PA, there is a need to address the specific barriers they face, and operationalize some of their knowledge into practical everyday actions. This formative work will inform the development of a culturally relevant, multicomponent intervention for ethnically diverse FCCPs to improve the food and PA environments of their homes, which should, in turn, improve the dietary, PA, and ST behaviors of the 2- to 5-year-old children they care for.
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October 2015

Contextual and Cultural Influences on Parental Feeding Practices and Involvement in Child Care Centers among Hispanic Parents.

Child Obes 2015 Aug 7;11(4):347-54. Epub 2015 May 7.

1 Department of Nutrition and Food Sciences, University of Rhode Island , Kingston, RI.

Background: Parental feeding practices shape children's dietary preferences and behaviors, which can influence a child's weight status. Limited research exists on the precursors and contextual influences of feeding, particularly among Hispanic parents. Therefore, this study explored two areas potentially important for obesity prevention in young children: (1) precursors and contextual influences on parental feeding and (2) parental perceptions and knowledge of the child care food environment.

Methods: Four focus groups (n=36) were held with Hispanic parents, predominantly mothers, of preschool children at two child care centers. Parents were asked about influences on what and how they feed their children, awareness of the child care center feeding environment, and current involvement in the child care center. Themes were coded using NVivo10 software (QSR International, Melbourne, Australia).

Results: Participants' childhood experiences influenced how they feed their children. Parents stated that both husbands and grandparents often indulged their children with unhealthy foods and thought this interfered with their efforts to maintain a healthy home environment. Participants reported that what their children ate while in child care sometimes influenced the home feeding environment.

Conclusions: Cultural and environmental factors influence parental feeding and involvement in the child care setting. Consistent with socioecological system theory, exploring interactions between the environment and culture using a family focus framework, such as the Family Ecological Model, could provide a better understanding of these influences among Hispanic parents. Future obesity prevention interventions with Hispanic families should be culturally relevant and target the different environments where children spend their time.
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August 2015