Feast: Influencing Nutrition Self-Efficacy and Food Choice Quality in Mexican American Women

Abstract

Purpose: The purpose of this quality improvement Doctor of Nursing Practice project was to determine how the use of Feast, a mobile health app, as a supplement to a clinic's existing nutrition education curriculum, can impact the nutrition self-efficacy and food choice quality of Mexican American women at a community health clinic. Background Mexican families who immigrate to the US face various structural vulnerabilities. Due to the natural human tendency to realize a sense of belonging, previous food customs evolve to reflect a more “Americanized” diet (i.e., increased intake of mass-produced refined food, larger portion sizes, more frequent meals). Ensuing obesity, combined with a genetic predisposition to decreased insulin sensitivity, makes type 2 diabetes more prevalent in Mexican Americans than any other US ethnic group. While these dietary changes may occur, cultural values persist: Mexican American females remain highly influential in the family’s food selection and preparation. Providing tailored nutrition education to these women uniquely positions them to lead a health-promoting lifestyle and shape family eating habits. Methods One rapid Plan-Do-Study-Act cycle was completed. Change tests included the Rapid Eating Assessment for Participants – Shortened Version and Dieter’s Inventory of Eating Temptations Self-Efficacy scale. Feast app usability was measured with the mHealth App Usability Questionnaire for Standalone mHealth Apps Used by Patients. Feast use and intervention completion rates were used to evaluate the intervention’s feasibility. Paper-based pre- and post-intervention surveys and manual count of Feast posts were used to gather and compile data. The impact of the intervention on outcomes was illustrated through descriptive quantitative analysis of pre-and post-intervention data. Results Increases in nutrition self-efficacy and improved food choice quality were variable. Results demonstrated high Feast usability and intervention feasibility. Conclusions Additional Plan-Do-Study-Act cycles are needed to evaluate the impact of Feast as a component of a nutrition education protocol, to include modifications such as larger sample sizes, extended intervention periods, and project designs that account for the participant change stage. Feast app use in this project validates the health-promoting qualities of mHealth apps to increase nutrition self-efficacy and improve food choice quality for better health outcomes.