Self-efficacy & home food availability is associated with healthy meal preparation practices in Kuala Lumpur children

Transcription

1 Self-efficacy & home food availability is associated with healthy meal preparation practices in Kuala Lumpur children Presented by, Asst. Prof. Dr. Satvinder Kaur

2 Introduction Increased in fruits & vegetables preference and intake Increased food group intake: grains & milk Healthy Meal Preparation in Children 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.

3 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

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

5 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.

6 Inclusion & Exclusion Criteria Inclusion Malaysian children aged 9-11 Able to read, write understand English/Malay language Exclusion Physically & mentally disabled children Children with any co-morbidities Children that expressed interest to Without parent s consent participate 6

7 Data Collection Healthy meal preparation questionnaire was distributed to children Children were guided to complete the questionnaire Anthropometry assessment Height: Portable stadiometer Seca 213 Weight Tanita body composition analyzer SC-330 Parents received & submitted the home food environment questionnaire via their child 7

8 Medical Research & Ethics Committee Approval from Principal of Primary Schools Ethics Ministry of Education Malaysia Information Sheet & Consent Form for Parents Kuala Lumpur Education Department Assent from Eligible Students

9 Results & Discussions

10 Children Characteristics (n=200) Age 9 (Standard 3) 10 (Standard 4) 11 (Standard 5) Gender Boy Girl Characteristics n () Monthly Household Income RM 2500 RM2501-RM5500 > RM (56.5) 58 (29.0) 29 (14.5) 85 (42.5) 115 (57.5) 62 (31.0) 73 (36.5) 65 (32.5)

11 Percentage Children Weight Status (n=200) Parent s concern of child becoming overweight [VALUE].0 Thinness Normal Overweight Obese 47.5 of parents were concerned of their child becomes overweight 21.5 of parents were very concerned of their child becomes overweight *According to BMI z-score

12 Percentage Children Psychosocial Scores* (n=200) *Score= Mean Marks Total Marks x Knowledge Attitude Self-efficacy Practice

13 Percentage Home Food Availability Score* *Score= Mean Marks Total Marks x Fruits at Home Vegetables at Home Ready-to-eat Food (Healthful) Ready-to-eat Food (Less Healthful)

14 Factors Correlated with Healthy Meal Preparation Practices Variables Pearson correlatio n p-value Knowledge Attitude <0.001* Social Cognitive Theory Individual Factors (Attitude, Selfefficacy) Self-efficacy <0.001* Fruits at Home <0.001* Vegetables at Home <0.001* Ready-to-eat (Healthful) * Ready-to-eat (Less Healthful) Behaviour (Practice) Environment (Home Food Availability) n=200, p significant at <0.05 Bandura 1999.

15 Factors Associated with Healthy Meal Preparation Practices Variables β 95 Cl p-value Knowledge Attitude Self-efficacy <0.001* Fruits at Home * Vegetables at Home Ready-to-eat Food (Healthful) Ready-to-eat Food (Less Healthful) (-0.07) 0.015* R 2 =.325, dependant variable= healthy meal preparation practices, p significant at <0.05

16 Discussions In this study, higher self-efficacy was associated with increased frequency of 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) 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) Chu et at. 2013, Woodruff and Kirby 2013, Bandura 1999.

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

18 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

19 References 1. Chu, Y.L., Farmer, A., Fung, C., Kuhle, S., Storey, K.E. and Veugelers, P.J., Involvement in home meal preparation is associated with food preference and self-efficacy among Canadian children. Public Health Nutrition, 16(01), Chu, Y.L., Storey, K.E. and Veugelers, P.J., Involvement in meal preparation at home is associated with better diet quality among Canadian children. Journal of nutrition education and behavior, 46(4), Van der Horst, K., Ferrage, A. and Rytz, A., Involving children in meal preparation. Effects on food intake. Appetite, 79(1), Allirot, X., da Quinta, N., Chokupermal, K. and Urdaneta, E., Involving children in cooking activities: A potential strategy for directing food choices toward novel foods containing vegetables. Appetite, 103(1), Cunningham-Sabo, L. and Lohse, B., Cooking with kids positively affects fourth graders' vegetable preferences and attitudes and selfefficacy for food and cooking. Childhood Obesity, 9(6), Jabatan Pendidikan Wilayah Persekutuan Kuala Lumpur Sekolah-Sekolah Wilayah Persekutuan Kuala Lumpur. [online] Jpwpkl.moe.gov.my. Available at: [Accessed 1 Jan. 2018]. 7. Bandura, A., Social cognitive theory: An agentic perspective. Asian Journal of Social Psychology, 2(1), Woodruff, S.J. and Kirby, A.R., 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), Osei-Assibey, G., Dick, S., Macdiarmid, J., Semple, S., Reilly, J.J., Ellaway, A., Cowie, H. and McNeill, G., The influence of the food environment on overweight and obesity in young children: a systematic review. BMJ open, 2(6), e Swinburn, B.A., Sacks, G., Hall, K.D., McPherson, K., Finegood, D.T., Moodie, M.L. and Gortmaker, S.L., The global obesity pandemic: Shaped by global drivers and local environments. The Lancet, 378(9793), Jin, Y. and Jones-Smith, J., Associations between family income and children s physical fitness and obesity in California, Preventing Chronic Disease, 12(1), Savage, J.S., Fisher, J.O. and Birch, L.L., Parental influence on eating behavior: conception to adolescence. The Journal of Law, Medicine & Ethics, 35(1), Rosenkranz, R.R. and Dzewaltowski, D.A., Model of the home food environment pertaining to childhood obesity. Nutrition reviews, 66(3),

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21 Sample Size Determination n = Z2 P 1 P d 2 [34] Where n is the sample size, Z = Statistic corresponding to level of confidence of 95, Z value is 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 = ( ) n = To avoid of non-compliance & non-response, sample size is increased (±20) to 233

22 Questionnaires 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-toeat Food (9), Less Healthful Ready-to-eat Food (11) Self-reported weight & height 22

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

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

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

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

27 Low Fat Did you have these foods/drinks in your home during the past week? Zero Sugar Juice Sports Drinks

28 Did you have these foods/drinks in your home during the past week? Full Cream Yogurt 38.5 Low Fat 45.5 Unsweetene d Cereal Culture d milk