May / June 2020



AJHE: American Journal of Health Education

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  May/June 2020 (Volume 51, Issue 3)

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Table of Contents

Free Access Article
/Food Craving Intensity and Gender Differences
 – Iva Klimesova, Milan Elfmark, and Jiri Stelzer

Background: Food cravings typically influence individuals’ diets and ultimately their health. However, the differences in food cravings between genders with normal BMI values are unclear.
Purpose: The purpose of this study was to investigate differences in food craving intensity between genders with normal BMI values.
Methods: The research group consisted of 1,394 participants (67% females, 33% males) between 15 and 92 years of age with normal BMI values. The self-reported General Food-Craving Questionnaire-Trait (G-FCQ-T) was used to determine individuals’ food craving intensity on four subscales: preoccupation with food, loss of self-control-once eating, positive outcome expectations, and emotional craving.
Results: The result suggested that there is no difference between males and females in the intensity of food cravings evaluated by the G-FCQ-T total score; however, gender differences were confirmed in two subscale scores. Positive outcome expectations subscale score was higher for males than for females, and an emotional craving subscale score was higher for females than for males.
Discussion: Data indicated that the males’ and females’ food cravings are affected by different mechanisms.
Translation to Health Education Practice: Findings confirmed the importance of creating gender-specific norms in dietary interventions.

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Research Articles

Peer Recognition of Disordered Eating Behaviors: Implications for Improving Awareness through Health Education
Sarah R. Blackstone, Celeste Sangiorgio, and Aimee K. Johnson
Background: Eating disorders (ED) are a concern on college campuses, yet comprehensive education and awareness is low. Few studies have investigated knowledge of disordered eating not fitting prototypical depictions or recognition of disordered eating in males.
Purpose: To assess college students’ ability to identify behavioral symptoms of ED in men and women.
Methods: We explored problem identification ability after reading vignettes depicting either males or females displaying ED behaviors aligned with anorexia, bulimia, and binge eating disorder, and a healthy control vignette. Ordinal logistic was used to examine the effect of vignette target gender, participant gender, and disorder depicted on identification.
Results: Approximately half of the sampled students correctly categorized vignettes as EDs. Participants were most likely to correctly identify the bulimia scenario as an ED, followed by anorexia, and binge-eating, and were more likely to identify ED if the vignette target was a woman.
Discussion: The findings suggest awareness of behavioral presentations of ED, particularly in males, is low. This may stem from prototypical depictions of ED in the media and existing education material.
Translation to Health Education Practice: Health education can focus on observable, behavioral symptoms of ED to improve identification in college students.

Disordered Eating in Men and Women: Internalization of Sociocultural Body Image Norms and Emotion Dysregulation
Erica N. Hutchison, Sara C. Haden, Benjamin A. Saunders, Nicole M. Cain, and Alexandra B. Grundleger
Background: Emotion dysregulation and the internalization of sociocultural body image norms have been individually associated with eating pathology, but most studies utilized samples that were female, not ethnically diverse, or experiencing only diagnosable levels of eating pathology.
Purpose: This study sought to better explain the relationship between emotion dysregulation and disordered eating in an ethnically diverse sample of men and women. Internalization of sociocultural body image norms was examined as a potential moderating variable.
Methods: Participants were 178 undergraduate students (121 women, 30% immigrants, over 40% identified as African/African-Caribbean ethnic backgrounds). Participants completed self-report measures including: DERS; EDI-2, SATAQ-3, and MBAS.
Results: There were no significant differences between sexes on emotion dysregulation, internalization, or disordered eating. Internalization was found to moderate the relationship between emotion dysregulation and eating pathology.
Discussion: High emotion dysregulation only predicted disordered eating when internalization was also high, while low internalization appears to buffer the impact of emotion dysregulation on disordered eating. These findings suggest that low internalization could protect against the development of disordered eating.
Translation to Health Education Practice: Findings provide guidance for developing effective prevention and intervention strategies for disordered eating in at-risk populations.

Motivators of and Barriers to Drinking Healthy Beverages among a Sample of Diverse Adults in Bronx, NY
Guillermo M. Wippold, Carolyn M. Tucker, Maggie L. Hogan, and Pearis L. Bellamy
Background: Consuming sugar-sweetened beverages is associated with several chronic health conditions. In the United States, government regulations and behavioral health interventions to reduce the consumption of sugar-sweetened beverages and increase the consumption of healthy beverages have shown limited effectiveness. Differences in motivation to engage in health promoting behaviors (e.g., drinking water and other healthy beverages) in association with key demographic variables exist.
Purpose: To identify statistically significant differences in the levels of endorsement of these motivators and barriers in association with gender and race/ethnicity.
Methods: A culturally diverse sample of adults (N = 639) from Bronx, New York were recruited.
Results: The top motivator for females and males was preferences, for non-Hispanic Blacks and Hispanics was medical and health issues, and for non-Hispanic Whites was preferences. The top barrier for females, males, non-Hispanic Blacks, Hispanics, and non-Hispanic Whites was availability. Statistically significant differences in the level of endorsement of these motivators/barriers exist.
Discussion: Findings suggest that gender and race-specific differences to engaging in drinking water and other healthy beverages exist.
Translation to Health Education Practice: Interventions seeking to decrease the consumption of unhealthy beverages among culturally diverse adults may consider gender and race-specific motivators and barriers associated with this behavior.

Impact of a Health Empowerment-focused Program on Adult Employee’s Motivators of and Barriers to Engaging in Healthy Behaviors
Jaime Williams, Carolyn M. Tucker, Guillermo Wippold, Julia Roncoroni, Maria E. Moutinho, Susan Lee, Frederic Desmond, and Wafaa Ateyah
Background: Health initiatives have been established in many workplaces to promote healthy behaviors among employees. Health Self-Empowerment Theory (HSET) suggests that personal, modifiable factors, such as motivation to engage in healthy behaviors, are pathways to increasing such behaviors.
Purpose: The present study examined the effects of the Health-Smart Behavior ProgramTM (Health-Smart), which is informed by HSET, on levels of perceived motivators of and barriers to engaging in healthy eating and physical activity among a sample of employees at a large health insurance company.
Methods: Participants were 97 culturally diverse employees at this company who were divided into intervention and control groups.
Results: From pre-intervention to post-intervention, the intervention group experienced significantly greater increases in motivators to engage in healthy eating and physical activity and significantly greater decreases in barriers to engaging in these behaviors.
Discussion: Health-Smart may be effective in increasing motivation to engage in healthy behaviors among workplace employees.
Translation to Health Education Practice: This study suggests that health educators who develop workplace health promotion programs use a theoretical framework (e.g., HSET) to inform these programs, implement a first-step program to increase motivators of and reduce barriers to these behaviors, and empirically evaluate these programs.

Using Community-Based Participatory Research to Explore Food Insecurity in African American Adults
Angelia M. Paschal, Jermaine B. Mitchell, Wanda M. Burton, Jen Nickelson, Pillar Z. Murphy, and Frances Ford
Background: Food insecurity is an ongoing national problem and is linked to chronic diseases and other poor health outcomes. Concerning are the rates in racial and ethnic minorities. Food insecurity is significantly high in African Americans older adults.
Purpose: The purpose of this study was to use a Community-Based Participatory Research approach to assess the extent of food insecurity and associated factors in a sample of African American adults.
Methods: A cross-sectional study design with purposive, convenience sampling was used. The survey included the 10-item USDA Food Security Module, fruit and vegetable intake questions, and sociodemographic items.
Results: Results indicated that food insecurity was very high and was associated with being ≥65 years old, not having a spouse/partner, living alone, and residing in an urban location.
Discussion: The CBPR approach resulted in changes to the survey, engaged community partners, access to a vulnerable population, and plans to build on the findings to address food insecurity in the community. Further research is needed to examine the associated factors.
Translation to Health Education Practice: Given the complex nature of food insecurity and the findings from this study, research that engage the community and focus on multilevel interventions are recommended.