Promoting the advantages of sustainable and healthy eating using food demonstration kiosks and webpage interventions Claire Chartrand School of Dietetics and Human Nutrition McGill University Montreal, Quebec Submitted May 2013 A project report submitted to McGill University in partial fulfillment of the requirements of the degree of M.Sc. (Applied) Nutrition. © Claire Chartrand 2013 1 Table of Contents Preamble ......................................................................................................................................... 4 Abstract ........................................................................................................................................... 6 Introduction ..................................................................................................................................... 7 Methods......................................................................................................................................... 10 Behavior Change Theory .......................................................................................................... 10 Intervention ............................................................................................................................... 11 Data Collection ......................................................................................................................... 12 Measures ................................................................................................................................... 12 Data Analysis ............................................................................................................................ 14 Results ........................................................................................................................................... 15 Description of Participants ........................................................................................................ 15 Fruit and vegetable intake ......................................................................................................... 15 Eating Locally ........................................................................................................................... 15 Cooking at Home ...................................................................................................................... 16 Meatless Meals .......................................................................................................................... 16 Discussion ..................................................................................................................................... 17 Conclusion .................................................................................................................................... 22 References ..................................................................................................................................... 23 Tables ............................................................................................................................................ 26 Table 1: Descriptive data of basic demographic characteristics of participants ....................... 26 Table 2: Differences in vegetable and fruit intake between time 1 and time 2 ........................ 27 Table 3: Differences in ATT, SN, PBC, and intention scores between time 1 and time 2 ....... 28 Table 4: Differences in specific attitude components for sustainable behaviors between time 1 and time 2 (n=49) ...................................................................................................................... 30 2 Table 5: Correlations of ATT, SN, and PBC scores with behavioral intentions scores for time 1 and time 2 ............................................................................................................................... 31 Appendices .................................................................................................................................... 32 Appendix 1: Sustainable Eating Survey ................................................................................... 32 Appendix 2: Author Guidelines – Environmental Health Perspectives .................................... 36 Appendix 3: Abstract for project presentation .......................................................................... 47 Appendix 4: Slides from project presentation .......................................................................... 48 Appendix 5: Project Presentation – Questions and Answers .................................................... 57 Appendix 6: Literature Review for NUTR 651 ........................................................................ 62 Appendix 7: Research Ethics Board Approval ....................................................................... 119 3 Preamble The main goal of my Masters (Applied) Research Project was to educate McGill students about the environmental and health benefits of sustainable eating in order to increase their participation in sustainable eating behaviors such as eating local, cooking at home, and eating meatless meals. My role in this project was to work in collaboration with Fit@McGill and with dietetic stagieres to prepare intervention materials consisting of a webpage, videos, printed materials and posters, recipe cards, and food demonstrations. I used the Theory of Planned Behavior to design the intervention content and evaluate behavior change. The intervention materials were intended to improve students’ attitudes and knowledge concerning sustainable eating, improve their perceived behavioral control (self efficacy) to take part in sustainable eating behaviors, and provide social influences that encourage them to eat sustainably. McGill students could access these materials on the Fit@McGill Webpage, and weekly McGill Farmers’ Market Kiosks during the months of September and October in the Fall 2012 semester. For the evaluation process, my main objective was determine if the intervention was effective in improving students’ behavioral intentions to eat locally, cook at home, and eat meatless meals, and also to determine which intervention (webpage or kiosk) was most efficacious in doing so. A secondary objective was to increase students’ fruit and vegetable intake as a result of eating more sustainable. Before beginning the study, research ethics board approval was obtained by the Faculty of Environmental and Agricultural Sciences. The Mary H. Brown Fund and Sustainable Projects Fund provided funding for the project. Baseline data was collected during September and October from students who visited the sustainable eating website using Limesurvey, or from 4 paper surveys completed by students who visited the kiosk at the McGill Farmers’ Market. Data was analyzed from December through to February using the software SPSS 20. Descriptive statistics were used to analyze the demographic profile of the participants. Wilcoxin signed rank tests were used to analyze the difference in fruit and vegetable intake, attitude (ATT), perceived behavioral control (PBC), social norms (SN), and intention scores. Partial correlations were performed to assess association between intention and ATT, PBC, and SN. The timeline for this project ran from April 2012 until April 2013. Following the final analysis, I prepared a report according to the Environmental Health Perspectives journal guidelines, outlining the background literature, study objectives, methods, results, discussion and conclusion to prepare for eventual submission to the journal. 5 Abstract Background: Previous research has found that university students lack knowledge about the importance of sustainable eating, and frequently rely on processed and packaged non-sustainable foods as a source of nutrition. Nutrition interventions promoting sustainable eating in university students offer an opportunity to improve their dietary quality while providing environmental benefits. Objectives: (1) To increase students intentions to eat local foods, cook at home, and eat meatless meals using two interventions: a webpage, and informational kiosk; (2) To compare the efficacy of each intervention to improve sustainable eating behavioral intentions; (3) To improve fruit and vegetable intake as a secondary outcome to eating more sustainable. Methods: All participants (n=49) completed baseline and follow-up questionnaires assessing their fruit and vegetable intake, attitudes (ATT), perceived behavioral control (PBC), social norms (SN), and behavioral intentions towards sustainable eating. Wilcoxin signed rank tests were performed to determine changes overtime for variables. Partial correlation tests were performed to assess associations between variables. Results: There was a significant increase in ATT scores towards eating more sustainable. However, intention, PBC, and SN scores, and fruit and vegetable intake did not change overtime. Behavioral intentions were correlated with PBC and ATT scores. Conclusion: Educational kiosks and webpage community nutrition interventions can be used to improve university students’ attitudes concerning sustainable eating. However, increasing PBC may be essential to actually improve behavioral intentions to eat sustainably. Key words: Nutrition interventions, sustainable eating, university students, dietary habits, Theory of Planned Behavior, webpage, videos, farmers’ market 6 Introduction Over the past half century, the global population has risen to 6 billion and it