Qamar, Zubaida (2016-12). Development, Implementation and Evaluation of an Online Nutrition Education Program for South Asians in the U.S.. Doctoral Dissertation.
Thesis
South Asians have an increased risk of diabetes and cardiovascular diseases in comparison to other ethnic populations in the U.S. To prevent and mitigate the consequences of these conditions, culturally appropriate, theory-based programs are needed which have a focus on nutrition education, health promotion and disease prevention. The objective of this study was to develop, implement and evaluate an online nutrition education program for South Asian adults in the U.S. and to determine any post-intervention changes in the behavior and its mediators. Needs assessment was conducted to determine the nutrition and health related concerns in this population and to inform the outline of the program. This program followed the DESIGN procedure and was guided by the Theory of Planned Behavior (TPB). The focus was on disease prevention aspects e.g. consumption of fruits and vegetables, label reading, weight management and physical activity. The surveys measured the demographics, dietary and health behaviors, and TPB constructs (attitudes, social norms and perceived behavioral control) related to the behaviors. South Asian participants (n=166) completed the pre-test survey, out of which 66 enrolled in the program. Statistical analysis included descriptive statistics, and independent t-tests that determined the differences between pre- and post-test factors. Additionally, linear regression was conducted to determine the relationships among behavioral elements, TPB constructs, and sociodemographic factors. Results show the mean age of participants was 27.4+-7.4 years. Significant (p<0.05) post-test differences were improved healthy eating strategies score, reduced fast food consumption, and increased confidence towards fruit and vegetable intake after the program. The participants (92%) agreed or strongly agreed that the program was overall helpful and facilitated in increasing their awareness about healthy eating, physical activity and weight management. Regarding the mediators of behavior change, only intention to consume fruits and vegetables was significantly associated with increased fruit intake. However, no significant association was found with vegetable intake. In conclusion, results from this study suggest that a theory-based, online program improved some factors associated with healthy dietary behaviors in South Asians in the U.S. Future large scale studies are needed to determine the effect of such interventions on the South Asian population.
