Nutrition education: the state of the art review and analysis...

NUTRITION EDUCATION SERIES

ISSUE 7

NUTRIT ION EDUCATION: THE STATE O F THE ART

REVIEW AND ANALYSIS O F THE LITERATURE

by

R o n a l d C . I s r a e l

and

J o a n n e P . N e s t o r T i g h e

D i v i s i o n o f S c i e n c e , T e c h n i c a l and V o c a t i o n a l E d u c a t i o n

U n i t e d N a t i o n s E d u c a t i o n a l , S c i e n t i f i c and C u l t u r a l O r g a n i z a t i o n

P a r i s 1 9 8 4

PREFACE

The a r t a n d s c i e n c e o f n u t r i t i o n e d u c a t i o n h a s b e e n e v o l v i n g r a p i d l y . The m a t e r i a l s i n t h i s s t a t e o f t h e a r t r e v i e w and a n a l y s i s o f t h e l i t e r a t u r e w e r e s e l e c t e d t o r e p r e s e n t r e c e n t t r e n d s a n d p r o g r e s s i n t h e f i e l d . The a u t h o r s o f t h i s b i b l i o g r a p h y a r e a s s o c i a t e d w i t h E d u c a t i o n D e v e l o p m e n t C e n t e r i n Newton , M a s s a c h u s e t t s , U.S.A. The E d u c a t i o n D e v e l o p m e n t C e n t e r i s a n o n - p r o f i t i n s t i t u t i o n t h a t s p e c i a l i z e s i n t h e a p p l i c a t i o n o f e d u c a t i o n , c o m m u n i c a t i o n s , and t r a i n i n g m e t h o d o l o g i e s t o t h e s o l u t i o n o f p u b l i c h e a l t h and n u t r i t i o n p r o b l e m s . R o n a l d C . I s r a e l i s t h e E d u c a t i o n D e v e l o p m e n t C e n t e r S e n i o r A s s o c i a t e f o r D e v e l o p m e n t and D i r e c t o r o f i t s I n t e r n a t i o n a l N u t r i t i o n C o m m u n i c a t i o n S e r v i c e ( INCS) , a p r o j e c t t h a t p r o v i d e s t e c h n i c a l s u p p o r t f o r n u t r i t i o n e d u c a t i o n i n d e v e l o p i n g c o u n t r i e s . J o a n n e P. N e s t o r T i g h e i s P u b l i c a t i o n C o o r d i n a t o r f o r t h e I n t e r n a t i o n a l N u t r i t i o n S e r v i c e and E d i t o r o f N u t r i t i o n P l a n n i n g , a n i n t e r n a t i o n a l j o u r n a l o f a b s t r a c t s a b o u t f o o d a n d n u t r i t i o n p o l i c y , p l a n n i n g , and p r o g r a m m i n g .

T h i s b i b l i o g r a p h y w i l l a l s o a p p e a r as a B u l l e t i n o f t h e I n t e r n a t i o n a l B u r e a u o f E d u c a t i o n (No. 232, 3 r d Q u a r t e r 1 9 8 4 ) i n E n g l i s h , F r e n c h , and S p a n i s h , o b t a i n a b l e f r o m t h e n a t i o n a l d i s t r i b u t o r s o f Unesco p u b l i c a t i o n s .

The i d e a s and o p i n i o n s e x p r e s s e d i n t h e a n a l y s i s o f t h e s t a t e o f t h e a r t and a n n o t a t e d b i b l i o g r a p h y a r e t h o s e o f t h e a u t h o r s and d o n o t n e c e s s a r i l y r e p r e s e n t t h e v i e w s o f Unesco . The d e s i g n a t i o n s e m p l o y e d and t h e p r e s e n t a t i o n o f m a t e r i a l t h r o u g h o u t t h e monograph d o n o t i m p l y t h e e x p r e s s i o n o f a n y o p i n i o n w h a t s o e v e r o n t h e p a r t o f Unesco c o n c e r n i n g t h e l e g a l s t a t u s o f any c o u n t r y , t e r r i t o r y , c i t y o r a r e a o f i t s a u t h o r i t y o r c o n c e r n i n g i t s f r o n t i e r s a n d b o u n d a r i e s .

TABLE OF CONTENTS

Preface

ANALYSIS OF THE STATE OF THE ART OF NUTRITION EDUCATION

ANN OT ATED BIB L IOGR A PH Y

I.

II.

III.

I V .

V.

V I .

P o l i c y Issues

Conceptual Approaohes

Bas e l i n e I n f o r m a t i o n and E t hnogr aph i es

Case Stud ies

General A f r i c a Asia, Near East, P a c i f i c Europe L a t i n America and Caribbean Nor th America

Ex em p i a r y M a t e r i a l s

Ev a l u a t i o n

I n d i c e s

Geographic Top i c a l

4

11

12

23

43

56

56 58 64 73 75 84

88

99

107 111

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ANALYSIS OF THE STATE OF THE ART OF NUTRITION EDUCATION

The a r t and sc ience o f n u t r i t i o n educat ion has reached a m i l e s t o n e i n i t s development. The l i t e r a t u r e o f t h e l a s t f i v e years r e f l e c t s a growing focus on p a r t i c i p a t o r y t e a c h i n g and l e a r n i n g methodologies and on a commitment t o u s i n g educat ion and communications as i n t e r v e n t i o n s t o change t h e a t t i t u d e s , behaviors , and h e a l t h and n u t r i t i o n s t a t u s o f t a r g e t group communities. The emphasis has s h i f t e d away f rom a concern w i t h t h e s imp le d i s s e m i n a t i o n o f knowledge and i n f o r m a t i o n , p r i m a r i l y i n a one-to-one classroom o r c l i n i c a l s e t t i n g , t o t h e t ransmiss ion o f messages designed t o improve h e a l t h and n u t r i t i o n - r e l a t e d behavior th rough r e i n f o r c i n g channels o f communication. We have witnessed a broadening o f t h e p r o f e s s i o n a l base o f those who p r a c t i c e n u t r i t i o n educat ion; n u t r i t i o n i s t s and p u b l i c h e a l t h p r o f e s s i o n a l s inc reas ing- l y a re b e i n g j o i n e d b y exper ts i n educat ion, communication, and t r a i n i n g .

The major q u e s t i o n now has become how t o t r a n s l a t e t h i s new base o f exper ience i n t o more e f f e c t i v e p o l i c i e s and programs t h a t can h e l p so lve t h e wide range o f s e r i o u s n u t r i t i o n a l problems a f f e c t i n g t h e h e a l t h o f people around t h e wor ld. Few i f any c o u n t r i e s haye c l e a r l y d e f i n e d and budgeted n a t i o n a l n u t r i t i o n educat ion p o l i c i e s t h a t a r t i c u l a t e p r i o r i t y problems, t a r g e t groups, messages, t r a i n i n g goals, e tc . Antrobus (1977) i n t h e Caribbean, Quelch (1977) i n Canada, t h e Club Europeen De La Sante (19801, and t h e Un i ted Sta tes Department o f A g r i c u l t u r e (Cross, 1980) a l l speak o f t h e need f o r such a p o l i c y , but t h e r e a r e n o t many precedents o r p o l i c y models. I t i s hard enough i n most p laces t o develop consensus around what c o n s t i t u t e s a c o u n t r y ' s n u t r i t i o n p o l i c y , l e t a lone what i t s n u t r i t i o n educat ion p r i o r i t i e s should be ( t h e two a r e o f t e n confused).

One o f t h e more i n t e r e s t i n g e f f o r t s t o e s t a b l i s h a n a t i o n a l n u t r i t i o n educat ion p o l i c y was associated w i t h t h e Colombian PAN program ( M e j i a De Pizano, 1980), a unique m u l t i - s e c t o r a l e f f o r t designed t o combat m a l n u t r i t i o n . Much o f PAN has focused on t h e use o f e d u c a t i o n a l i n t e r v e n t i o n s t o improve t h e n u t r i t i o n - r e l a t e d s k i l l s o f h e a l t h care p r o v i d e r s and t o change t a r g e t group n u t r i t i o n a l behaviors . I n t h e Nether lands (1983), t h e Pr imary Educat ion Act o f 1985 w i l l make i t compulsory t o t e a c h " h e a l t h y l i v i n g , " i n c l u d i n g n u t r i t i o n , a t a l l l e v e l s i n t h e fo rmal school system.

B i l a t e r a l and i n t e r n a t i o n a l donor agencies have increased t h e i r p o l i c y and program commitment t o n u t r i t i o n educat ion i n r e c e n t years. The Un i ted S t a t e s Agency f o r I n t e r n a t i o n a l Development's suppor t f o r t h e a c t i v i t i e s o f t h e I n t e r n a t i o n a l N u t r i t i o n Communication S e r v i c e (INCS) r e p r e s e n t s t h e l a r g e s t donor agency programmatic commitment t o da te s p e c i f i c a l l y f o r t h e use o f educat ion and communication t o s o l v e n u t r i t i o n problems o f deve lop ing c o u n t r i e s . The World Bank (Horn ik , 1983) has inc reased i t s f u n d i n g f o r t h e educat iona l components o f n u t r i t i o n s e c t o r loans, n o t a b l y i n Indonesia ; UNICEF has prov ided e x t e n s i v e t e c h n i c a l and f i n a n c i a l suppor t f o r t h e b r a z i l i a n b r e a s t feed ing promot ion program; Unesco (1981, 1983) c o n t i n u e s t o p u b l i s h e x c e l l e n t case s tud ies , c u r r i c u l a , and source book m a t e r i a l s f o r t h e f i e l d . FAO (McNaughton) a l s o has stepped 'up i t s i n t e r e s t and commitment t o n u t r i t i o n educat ion.

The proper scope o f a n u t r i t i o n educator ' s focus has been a major p o l i c y i s s u e over t h e l a s t f i v e years. E ide (1982) and Gussow (1980) argue f o r

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expanding n u t r i t i o n educat ion 's area o f a c t i v i t y t o i n c l u d e a l l aspects o f t h e food c y c l e , n o t j u s t t h e consumer. Gussow and Contento (1983) suggest t h r e e p r i o r i t y areas o f concern f o r f u t u r e n u t r i t i o n educat ion a c t i v i t y : ( 1 1 e f f e c t s o f u r b a n i z a t i o n ; (2) t h e wider d i s t r i b u t i o n o f processed foods; and ( 3 ) t h e growing women's movement.

New approaches t o n u t r i t i o n educat ion i n b o t h substance and methodology imp ly new c o n s i d e r a t i o n s f o r t h e t r a i n i n g o f n u t r i t i o n educators. Wardlaw (1981) sees t h a t f u t u r e t r a i n i n g programs should address t h e r e l a t i o n s h i p s between b i o l o g i c a l and s o c i a l sciences, between n u t r i t i o n educat ion and h e a l t h educat ion, and between academia and f i e l d p r a c t i c e . I s r a e l ( 1 984) argues t h a t n u t r i t i o n educators ought t o b e g i n t o r e c e i v e t r a i n i n g i n s o c i a l marke t ing r e l a t e d s k i l l s .

A u s t i n and Z e i t l i n (1981 1 summarize many o f t h e new conceptual approaches t h a t have been a p p l i e d t o t h e f i e l d o f n u t r i t i o n educat ion over t h e l a s t decade, such as new uses o f mass media, t r a d i t i o n a l f o l k media, and nonformal educat ion. An i n t e r e s t i n g d i s t i n c t i o n i s made i n much o f t h e l i t e r a t u r e between n u t r i t i o n educat ion i n t h e more economical ly developed count r ies , which tends t o s t r e s s t h e p r o v i s i o n o f i n f o r m a t i o n f o r i n d i v i d u a l choice, and n u t r i t i o n educat ion i n develop ing c o u n t r i e s , which tends t o focus on behavior change o b j e c t i v e s .

The p r o s and cons o f u s i n g mass media a r e descr ibed b y L e s l i e ( 1 978). Manoff (1974, 1980, 1983) i s an a r t i c u l a t e spokesman f o r t h e use o f mass media t o s o l v e n u t r i t i o n problems. He argues t h a t t h e success o f a campaign depends p r i m a r i l y upon message conten t and reach and frequency o f d e l i v e r y .

The conceptua l need t o develop m u 1 t i - s e c t o r a l p romot iona l s t r a t e g i e s f o r n u t r i t i o n educat ion i s bes t e x e m p l i f i e d b y t h e exper ience t o da te w i t h b r e a s t feeding promot ion programs. WHO conferences i n Barbados, N i g e r i a , and B r a z i l (1 979), a m p l i f i e d b y subsequent exper ience i n many c o u n t r i e s around t h e wor ld , have d e f i n e d such a s t r a t e g y t o i n c l u d e s u p p o r t i v e government p o l i c y , such as a code r e g u l a t i n g t h e marke t ing o f b r e a s t m i l k s u b s t i t u t e s (WHO, I n t e r n a t i o n a l -' Code 1981 1; s u p p o r t i v e h e a l t h care p r a c t i c e s such as t h e es tab l i shment . o f rooming- in f a c i l i t i e s a t h o s p i t a l s and c l i n i c s ; t h e t r a i n i n g o f h e a l t h care p r o f e s s i o n a l s i n techniques o f l a c t a t i o n management; t h e development and t r a n s m i s s i o n o f b r e a s t feed ing behav io r change messages t o t a r g e t communities; and p r i v a t e s e c t o r p a r t i c i p a t i o n th rough t h e p r o v i s i o n o f creches o r day-care f a c i l i t i e s f o r n u r s i n g mothers. N u t r i t i o n educat ion has r o l e i n t h e des ign and implementat ion o f each component as w e l l as t h e s t r a t e g y as a whole. I n c o u n t r i e s where b r e a s t feed ing promot ion has been most success fu l , e.g. B r a z i l , n u t r i t i o n communications p r o f e s s i o n a l s have been i n v o l v e d with a l l aspects o f t h e program, n o t j u s t t h e des ign o f messages f o r t h e p u b l i c . T h i s model c o u l d be a p p l i e d t a t h e promot ion o f o t h e r impor tan t n u t r i t i o n behaviors , such as weaning p r a c t i c e s .

The d i f f i c u l t i e s i n v o l v e d i n c r o s s - c u l t u r a l n u t r i t i o n communications a r e descr ibed b y Fugelsang (1982) who admonishes us t o r e t h i n k some o f o u r b a s i c assumptions about language, l e a r n i n g , and understanding. The s t a r t i n g p o i n t i n a Western conceptua l model may be wrong. N ich ter and N i c h t e r (1981 o u t l i n e t h e r o l e t h a t anthropology can p l a y i n t h e des ign o f n u t r i t i o n educat ion p r o j e c t s . The N i c h t e r s b e l i e v e t h a t n u t r i t i o n messages need t o be n e g o t i a t e d within t h e c o n t e x t o f t r a d i t i o n a l b e l i e f systems about food and

7

h e a l t h . Berggren and Murray (1980), i n a conceptual framework f o r a n u t r i t i o n educat ion b a s e l i n e s tudy i n Cameroon, descr ibe a f u r t h e r impor tan t r o l e f o r ethnographers: t o research t h e a t t i t u d e s and behav io rs o f t h e t a r g e t community r e l a t e d t o a g i v e n n u t r i t i o n o r h e a l t h problem. Such q u a l i t a t i v e research i s e s s e n t i a l f o r t h e des ign o f p r o j e c t b a s e l i n e s tud ies , messages, and m a t e r i a l s . Target community invo lvement i n a l l phases o f a n u t r i t i o n educat ion p r o j e c t i s advocated b y Drummond (1975) who a p p l i e d t h e p a r t i c i p a t o r y e d u c a t i o n a l p r i n c i p l e s o f Paolo F r e i r e t o t h e des ign o f a p r o j e c t i n Nor theast B r a z i l .

A growing body o f l i t e r a t u r e p r o f i l e s t a r g e t group knowledge, a t t i t u d e s , and p r a c t i c e s i n v a r i o u s count r ies . I s r a e l and Tighe (1982-84) have e d i t e d a s e r i e s o f Materna l and I n f a n t N u t r i t i o n Reviews which summarize a v a i l a b l e da ta on materna l and i n f a n t n u t r i t i o n a l s t a t u s , b e l i e f s , p r a c t i c e s , p o l i c i e s , and programs i n t h i r t y - f i v e develop ing c o u n t r i e s . The World H e a l t h O r g a n i z a t i o n (Contemporary Pat terns. . . , 1981 1 o f f e r s a d e t a i l e d l o o k a t b r e a s t feed ing p r a c t i c e s i n n i n e c o u n t r i e s . FAO o f f e r s an e x c e l l e n t B i b l i o g r a p h y o f Food Consumption Surveys ( 1 981 ) f o r those i n t e r e s t e d i n documents on aggregate i n t a k e p a t t e r n s (FAO a l s o o f f e r s i t s b a s i c Food Composit ion Table r e f e r e n c e documents). The Popu la t ion Reference S e r v i c e and UNICEF a n n u a l l y p u b l i s h an e x c e l l e n t c h a r t , e n t i t l e d Wor ld 's C h i l d r e n Data Sheet, t h a t h i g h l i g h t s b a s i c e p i d e m i o l o g i c a l i n f o r m a t i o n about t h e n u t r i t i o n and h e a l t h s t a t u s o f t h e w o r l d ' s c h i l d r e n . CARE (Vemury, 1980) p r o v i d e s us w i t h in-depth knowledge about t r a d i t i o n a l n u t r i t i o n r e l a t e d b e l i e f s i n s i x c o u n t r i e s (Peru, Colombia, Guatemala, T u n i s i a , Jordan, and Bangladesh). I n s h o r t , t h e r e i s l e s s and l e s s excuse f o r n u t r i t i o n educators t o go i n t o t h e f i e l d w i t h o u t knowing c e r t a i n b a s i c f a c t s about a c o u n t r y ' s n u t r i t i o n a l problems and the knowledge, a t t i t u d e s , b e l i e f s , and p r a c t i c e s o f a t a r g e t community, though r e f e r e n c e d da ta should never be used a lone as a b a s i s f o r t h e development o f e d u c a t i o n a l messages o r m a t e r i a l s .

There a l s o a r e some e x c e l l e n t r e f e r e n c e s a v a i l a b l e on t o o l s t h a t w i l l h e l p t h e n u t r i t i o n educator c o l l e c t b a s e l i n e i n f o r m a t i o n . G r i f f i t h s ' c l a s s i c work on Growth M o n i t o r i n g (1981 descr ibes i n d e t a i l t h e techniques ä v a i l a b l e f o r weighing and measur ing c h i l d r e n . E s s e n t i a l d i e t a r y r e c a l l methodologies a r e referenced b y K r a n t z l e r e t a l . (1982). G r i f f i t h s ( i n p ress) and R i z v i ( i n press) b e l i e v e t h e y have developed u s e f u l ways t o c h a r t d i e t a r y i n t a k e and r e l a t e i t t o t h e des ign o f e d u c a t i o n a l i n t e r v e n t i o n s . M a r t o r e l l (1982) p r o f i l e s n u t r i t i o n and h e a l t h s t a t u s i n d i c a t o r s t h a t can be used f o r s tandard o f l i v i n g surveys i n develop ing c o u n t r i e s . Berggren and Murray (1980), P e l t o (19811, and Van E s t e r i k (1983) p r o f i l e ways i n which ethnographic r e s e a r c h c o n t r i b u t e s t o t h e des ign o f b a s e l i n e s tud ies . Sadsad (19791, h m l a o and Onate (19801, and Johnston and Schwartz (1978) descr ibe ways i n which b a s e l i n e s t u d i e s can be used t o a c q u i r e i n f o r m a t i o n about channels o f communication t h a t i n f l u e n c e t h e h e a l t h and n u t r i t i o n r e l a t e d va lues o f a community.

The l i t e r a t u r e on n u t r i t i o n b a s e l i n e surveys i s n o t a b l e f o r two conspicuous omissions. The f i r s t i s t h e absence t o da te o f any o v e r a l l b a s e l i n e s tudy d e s i g n manual t h a t i n t e g r a t e s e p i d e m i o l o g i c a l , anthropometr ic , ethnographic, communications and survey des ign and a n a l a y s i s techniques. The second i s t h e absence o f a s a l i e n t document h i g h l i g h t i n g t h e l i m i t a t i o n s o f b a s e l i n e research, e.g. i t i s f r e q u e n t l y c o s t l y , q u i c k l y becomes o u t o f date, can never a n t i c i p a t e a l l t h e r e l e v a n t quest ions, e t c . We hope someone w i l l r u s h i n t o f i l l these vo ids b e f o r e t o o long.

The c o n t r a d i c t i o n between t h e promise o f n u t r i t i o n educat ion and i t s r e a l i t y i s brought t o l i g h t b y a r e v i e w o f e x i s t i n g case s tud ies . Most o f t h e n u t r i t i o n educat ion case s tudy l i t e r a t u r e focuses on s m a l l exper imenta l p r o j e c t s whose v e r y n a t u r e i s o r i e n t e d more towards research than a c t i o n , o f l i m i t e d d u r a t i o n , i n v o l v i n g s m a l l groups o f people. E v a l u a t i o n o f impact i s u s u a l l y expressed i n terms o f changes i n knowledge and r a r e l y i n terms o f behav io r o r h e a l t h and n u t r i t i o n s ta tus . T h i s r e f l e c t s i n p a r t t h e f a c t t h a t few governments have made commitments t o a sus ta ined use o f e d u c a t i o n a l communications as a means o f changing group behavior and n u t r i t i o n s t a t u s .

I n r e c e n t years t h e r e have been a s m a l l but h i g h l y s i g n i f i c a n t number o f n a t i o n a l and r e g i o n a l - l e v e l p r o j e c t s which migh t serve as models and precedents t h a t o t h e r c o u n t r i e s can f o l l o w . The Indonesian N u t r i t i o n Improvement P r o j e c t (Mantra, 1982; Manoff I n t e r n a t i o n a l , 1983) i s a case i n p o i n t . The n u t r i t i o n educat ion component o f t h i s p r o j e c t succeeded i n demonstrat ing t h a t n u t r i t i o n educat ion alone, w i t h o u t any o t h e r complementary i n t e r v e n t i o n such as t h e p r o v i s i o n o f supplementary food,, c o u l d succeed i n improv ing t h e n u t r i t i o n a l s t a t u s o f t h e t a r g e t community. Z e i t l i n and Formacion (1977) document t h e p o s i t i v e impact t h a t t h e P h i l i p p i n e I l o i l o r a d i o a d v e r t i s i n g campaign had on c h i l d r e n ' s weight f o r age.

The Moroccan Food A id and N u t r i t i o n educat ion p r o j e c t (Gi lmore e t al. , 1980) i s another example o f a s u c c e s s f u l la rge-sca le n u t r i t i o n educat ion p r o j e c t . The i n c l u s i o n o f wel l -designed e d u c a t i o n a l i n t e r v e n t i o n i n a n a t i o n a l food and d i s t r i b u t i o n program r e s u l t e d i n a 69% r e d u c t i o n i n t h e i n c i d e n c e o f moderate and severe m a l n u t r i t i o n , a p p a r e n t l y th rough increases i n mothers ' knowledge and changes i n t h e i r food- re la ted p r a c t i c e s . S i m i l a r l y , t h e b r e a s t feeding promot ions i n B r a z i l ( J e l l i f f e and J e l l i f f e , 19831, T r i n i d a d (Gueri , 19781, and Yemen (Greiner, 1982) have been e f f e c t i v e i n i n c r e a s i n g b r e a s t feed ing d u r a t i o n and frequency l e v e l s among women o f a l l socioeconomic c lasses.

There a l s o a r e few c o u n t r y - l e v e l case s t u d i e s t h a t can serve as precedents f o r d e a l i n g w i t h h e a l t h problems r e l a t e d t o overconsumption. Lamm (1981 r e p o r t s on t h e achievements o f WHO'S card iovascu la r disease program i n Europe. Buh l (1980) r e p o r t s on t h e French exper ience i n p u b l i c n u t r i t i o n educat ion programs (wh ich has y e t t o be f o r m a l l y assessed). High Blood Pressure Educat ion Program i s beg inn ing t o exper iment w i t h e d u c a t i o n a l messages on d i e t as a way t o p revent and c o n t r o l h i g h b lood pressure, and t h e r e i s a base o f exper ience (e.g., Brownel l , 1982) r e l a t e d t o t h e use o f behav io r m o d i f i c a t i o n techniques f o r weight c o n t r o l programs which needs t o be analyzed more e x t e n s i v e l y . I n genera l , however, more emphasis and resources have been put i n t o e d u c a t i o n a l programs designed t o p revent o r remedy m a l n u t r i t i o n i n deve lop ing c o u n t r i e s than i n c o n t r o l l i n g overconsumption i n t h e West.

The Un i ted S t a t e s N a t i o n a l

The case s t u d y l i t e r a t u r e i s f i l l e d with examples o f t h e a p p l i c a t i o n o f d i f f e r e n t t e a c h i n g and l e a r n i n g methodologies t o n u t r i t i o n problems. Case s t u d i e s i n v o l v i n g t h e use o f mass media a r e b y now q u i t e abundant (Balayan and Minakar i , 1981; Debry, 1980; Duyf f , Marcante l and Ray, 1982; Z e i t l i n and Formacion, 1977). Gre iner and Latham (1982) descr ibed t h e way i n which commercial a d v e r t i s i n g can n e g a t i v e l y a f f e c t food p r a c t i c e s , focus ing on t h e i n a p p r o p r i a t e t r e n d t o e a r l y b o t t l e feed ing i n develop ing count r ies . C o l l e and C o l l e (198 descr ibe how modern aud io-v isua l technology, e.g. c a s s e t t e

9

recorders , can e f f e c t i v e l y be used b y n u t r i t i o n educators i n deve lop ing c o u n t r i e s . Berggren 's d e s c r i p t i o n o f n u t r i t i o n educat ion i n m o t h e r c r a f t cen ters i n H a i t i (1981) makes a case f o r u s i n g c a r e f u l l y designed demonstrat ion educat ion programs f o r t h e promot ion o f home based weaning foods; Sr in ivasan and Sawyer (1 980) descr ibe how p a r t i c i p a t o r y l e a r n i n g techniques a r e o f t e n needed t o i n v o l v e t h e t a r g e t community i n a n u t r i t i o n educat ion p r o j e c t .

An a r r a y o f exemplary n u t r i t i o n educat ion m a t e r i a l s now e x i s t s f rom most r e g i o n s o f t h e w o r l d ( t h e Near East i s one except ion) . These m a t e r i a l s a r e h i g h l i g h t e d b y I s r a e l and Lamptey (1C82) by G r i f f i t h s e t a l . (19841, t h e Uni ted States Department o f A g r i c u l t u r e (1982), and t h e U.S. Centers f o r Disease C o n t r o l (1982). T r a i n i n g manuals i n n u t r i t i o n have been w r i t t e n f o r a wide v a r i e t y o f t a r g e t audiences. Most o f them tend t o focus more on t h e t ransmiss ion o f t e c h n i c a l i n f o r m a t i o n about n u t r i t i o n and l e s s on t h e a r t and science o f n u t r i t i o n educat ion. Werner's He lp ing H e a l t h Workers Learn (1 982) and Save t h e C h i l d r e n ' s B r i d g i n g t h e Gap (1982) a re exept ions t o t h i s t rend. N u t r i t i o n educat ion needs t r a i n i n g m a t e r i a l s t h a t can be used t o i n c r e a s e t h e p r o j e c t des ign, management, and e v a l u a t i o n s k i l l s o f n u t r i t i o n educators.

The r a p i d l y expanding l i t e r a t u r e on e v a l u a t i o n o f n u t r i t i o n educat ion e v a l u a t i o n i s f i l l e d w i t h i n t e r e s t i n g a t tempts t o develop techniques t h a t w i l l document t h e impact o f communications i n t e r v e n t i o n s . I n an e r a when resources f o r s o c i a l programs are scarce, those i n charge o f p u b l i c s e c t o r h e a l t h and n u t r i t i o n p o l i c y must document t h e i r programs' e f f e c t i v e n e s s . Never the less, as e v a l u a t i o n p r o f e s s i o n a l s such as Green (1977) and H o r n i k ( i n p ress) have p o i n t e d o u t , t h e impact o f n u t r i t i o n educat ion i s ex t remely d i f f i c u l t (and c o s t l y ) t o document. The many fac to rs , i n t r i n s i c and e x t r i n s i c t o t h e program, t h a t a f f e c t t h e t a r g e t groups' knowledge, a t t i t u d e , behav io r , and h e a l t h s t a t u s make cause-and-effect r e l a t i o n s h i p s d i f f i c u l t t o e s t a b l i s h . Many p r o j e c t s operate w i t h o u t a w e l l - e s t a b l i s h e d b a s e l i n e o f i n f o r m a t i o n o r a c o n t r o l group. Even w i t h b a s e l i n e i n f o r m a t i o n and c o n t r o l groups, documented impacts s t i l l a re quest ioned. eva lua t ions , o f course, b u t n u t r i t i o n educators should l e a r n t o budget w i s e l y f o r t h i s phase o f t h e i r p r o j e c t s and t o r e v i e w and analyse q u a n t i f i e d outcomes b e f o r e r e a c h i n g f i n a l conc lus ions.

There w i l l always be a need t o conduct impact

Green, Horn ik , and o t h e r s emphasize t h e need f o r process e v a l u a t i o n s t o document p r o j e c t s ' success o r f a i l u r e i n c a r r y i n g o u t in tended a c t i v i t i e s . For example, does t h e t r a i n i n g o f p h y s i c i a n s and nurses i n c l i n i c a l techn iques o f l a c t a t i o n management r e a l l y make a d i f f e r e n c e i n t h e a b i l i t y o f h e a l t h p r o f e s s i o n a l s t o promote b r e a s t feeding, o r a re t h e r e b a s i c c o n s t r a i n t s o f t i m e and economic c o n s i d e r a t i o n s t h a t p rec lude them from doing so? Format ive e v a l u a t i o n and p r o j e c t m o n i t o r i n g should be g i v e n j u s t as much emphasis as impact o r summative e v a l u a t i o n , because i n a sus ta ined n u t r i t i o n a l i n t e r - v e n t i o n t h e r e i s always a need t o r e t r a i n s t a f f and t o redes ign messages and m a t e r i a l s . M o n i t o r i n g and i n f o r m a t i o n systems designed t o assure e f f e c t i v e p r o j e c t management f r e q u e n t l y a r e m i s s i n g from n u t r i t i o n educat ion p r o j e c t s .

I n conc lus ion , t h e l i t e r a t u r e o f t h e l a s t f i v e years r e f l e c t s a new s e t o f p r i o r i t i e s f o r n u t r i t i o n educat ion. There i s a growing commitment t o t h e systemat ic a p p l i c a t i o n o f s k i l l s from t h e f i e l d s o f anthropology, epidemiology, educat ion, communications, n u t r i t i o n , and t h e s o c i a l sciences, t o t h e s o l u t i o n o f n u t r i t i o n problems. N u t r i t i o n educators a r e say ing t h a t

1 0

educat ion, as an i n t e r v e n t i o n i n i t s own r i g h t , ought t o be taken s e r i o u s l y i n t h e f i e l d o f n u t r i t i o n and p u b l i c h e a l t h . There a r e now enough s u c c e s s f u l case s t u d i e s t o make t h a t c o n t e n t i o n seem p l a u s i b l e .

The f u t u r e l i e s i n c o n v i n c i n g pol icy-makers t h a t an investment i n n u t r i t i o n educat ion i s wor thwhi le , a d i f f i c u l t t a s k g i v e n t h e f a c t t h a t n u t r i t i o n i t s e l f tends t o be a r e l a t i v e l y undersupported i t e m i n most n a t i o n a l h e a l t h c a r e programs. T h i s l e a d s us t o suggest t h a t p o l i c y makers themselves ought t o be a p r i o r i t y t a r g e t audience f o r n u t r i t i o n educat ion. Lessons m i g h t be drawn from t h e f a m i l y p l a n n i n g f i e l d , where major resources have been devoted t o c o n v i n c i n g pol icy-makers o f t h e need t o i n v e s t i n f a m i l y p l a n n i n g programs. It i s i n t e r e s t i n g t o no te t h a t p resent f a m i l y p l a n n i n g programs have c o n s i d e r a b l y more program resources behind them t h a n do n u t r i t i o n programs. Perhaps i t i s t i m e t o recognize t h a t s c a l i n g up o f success fu l n u t r i t i o n educat ion exper ience t o date, based on c a r e f u l l y c r a f t e d bottom-up communications methodologies, w i l l never happen un less those a t t h e t o p become convinced o f t h e urgency o f n u t r i t i o n problems and o f t h e a b i l i t y o f n u t r i t i o n educators t o do something about it.

The m a t e r i a l s pr

11

ANNOTATED BIBLIOGRAPHY

t e d i n t h i s b i b l i o g r a p h y were drawn from t h a r c h i v e s o f i n s t i t u t i o n s around t h e w o r l d concerned w i t h n u t r i t i o n educat ion, i n c l u d i n g WHO, Unesco, UNICEF, n a t i o n a l n u t r i t i o n and h e a l t h m i n i s t r i e s and o r g a n i z a t i o n s , and p u b l i s h e d p e r i o d i c a l s and b i b l i o g r a p h i e s , as w e l l as t h e resources o f t h e I n t e r n a t i o n a l N u t r i t i o n Communication Serv ice. I n s e l e c t i n g m a t e r i a l s f o r s e c t i o n s such as "Case Studies," f o r which t h e r e were f a r more documents a v a i l a b l e than c o u l d be accomodated i n t h i s p u b l i c a t i o n , we have t r i e d t o p r o v i d e a s e l e c t i o n r e p r e s e n t i n g t h e f u l l range o f geographic and t o p i c a l resources, w h i l e i n c l u d i n g a l l m a t e r i a l s t h a t we considered exemplary. We have i n c l u d e d m a t e r i a l s over f i v e years o l d o n l y i f t h e y were exemplary o r unique. Thus, t h i s l i s t i n g presents o n l y a sample o f t h e vas t a r r a y o f r e c e n t l i t e r a t u r e on n u t r i t i o n educat ion. We hope t h a t i t w i l l adequately r e p r e s e n t t h e new d e p t h and breadth o f r e s e a r c h and developments i n t h i s growing f i e l d .

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I: P o l i c y Issues

1. ANTROBUS, A.C.K. The cha l lenge o f n u t r i t i o n educat ion i n t h e Caribbean. Cajanus, v o l . 10, 1977, pp. 22-31.

To avoid d isc repanc ies between n u t r i t i o n knowledge and t h e a p p l i c a t i o n o f t h i s knowledge, n u t r i t i o n educat ion must become p a r t o f n a t i o n a l and r e g i o n a l development. The key i s m o t i v a t i o n a t a l l l e v e l s : p r o f e s s i o n a l , s o c i a l , and p o l i t i c a l . Key problems t o be faced b y n u t r i t i o n educators i n t h e Caribbean are: p romot ion o f b r e a s t feeding; i n c r e a s i n g r e l i a n c e on l o c a l products ; b e t t e r use o f f a m i l y food resources; improv ing hygiene; and develop ing a b e t t e r m o n i t o r i n g system f o r mothers and t h e i r c h i l d r e n . N u t r i t i o n educat ion, p a r t i c u l a r l y mass media campaigns u s i n g r a d i o , w i l l p l a y a key r o l e ; development o f s u i t a b l e m a t e r i a l s should be a h i g h p r i o r i t y .

2. AUSTIN, J. E. Confront ing Urban M a l n u t r i t i o n : The Design o f N u t r i t i o n Programs. B a l t i m o r e , The Johns Hopkins U n i v e r s i t y Press, 1980. 11 4. (World Bank S t a f f Occasional Papers Number 28)

T h i s book d iscusses t h e f u l l range o f n u t r i t i o n i n t e r v e n t i o n s t o be considered i n address ing urban n u t r i t i o n problems. N u t r i t i o n educat ion, a l though i t can be a separate i n t e r v e n t i o n , i s a l s o one aspect o f any o t h e r i n t e r v e n t i o n , t o ensure t h a t i t reaches t h e a p p r o p r i a t e audience, t h a t they a r e aware o f i t s ex is tence and how t o take f u l l advantage o f i t . N u t r i t i o n educat ion alone i s a p p r o p r i a t e i n s i t u a t i o n s where a p o p u l a t i o n has ( o r r e a d i l y cou ld have) access t o a n u t r i t i o n a l l y adequate d i e t , but does n o t do so f o r l a c k o f i n f o r m a t i o n o r m o t i v a t i o n . Frequent ly , a fami ly w i l l have adequate resources but d i s t r i b u t e them i n a p p r o p r i a t e l y ; mothers and young c h i l d r e n a r e t h e most l i k e l y t o be s l i g h t e d . The book g i v e s guidance on development o f n u t r i t i o n messages, s e l e c t i o n o f media, and personnel requi rements f o r t h i s and e i g h t o t h e r i n t e r v e n t i o n s .

3. BAER, E.C. ; WINIKOFF, B., eds. Breas t feed ing : Program, p o l i c y , and research issues . S tud ies i n Fami ly Planning, v o l . 12, no. 4, A p r i l 1981, pp. 1 2 3 -20 6.

T h i s s p e c i a l i ssue o f t h e j o u r n a l p resents n i n e papers on t h e importance o f b r e a s t feed ing and t h e need t o i n t e g r a t e educat ion about b r e a s t feed ing i n t o h e a l t h and f a m i l y p l a n n i n g serv ices . Most p r o f e s s i o n a l s i n h e a l t h and p o p u l a t i o n acknowledge t h e s u p e r i o r i t y o f b r e a s t feeding; t h e r e i s i n c r e a s i n g agreement t h a t , if p o s s i b l e , l a c t a t i n g women should n o t be g iven hormonal c o n t r a c e p t i v e s ; and a consensus i s emerging on t h e need t o i n t e g r a t e suppor t f o r b r e a s t f e e d i n g i n t o t h e management o f b i r t h spacing. The a r t i c l e s rev iew t h e co inc idence o f program goa ls and s e r v i c e o p p o r t u n i t i e s i n fami ly p l a n n i n g and b r e a s t feeding. P o l i c y recommendations f o r f a m i l y p l a n n i n g workers a r e based on evidence presented i n t h e o t h e r papers. Breast feed ing promot ion and research a r e discussed; a model i s presented. C l a r i t y i n d e f i n i t i o n s w i l l improve t h e q u a l i t y o f research and t h e i n t e r p r e t a t i o n o f data. The s t r u c t u r e o f a woman's work ing c o n d i t i o n s i s i d e n t i f i e d as t h e p r i n c i p a l s o c i a l c o n s t r a i n t on her a b i l i t y t o b r e a s t feed.

13

\ 4. CLUB EUROPEEN DE LA SANTE. dans l a p révent ion , 1980.

Congres: R e s p o n s a b i l i t é i n d i v i d u e l l e e t s o c i a l e Revue França ise de l a Santé Publ ique, no. 15, 1981,

pp. 13-18.

5. COMMISSION DES COMMUNAUTES EUROPEE2NES. 1 'Ecole dans l e s Pays de l a Communaute Européenne.

L 'Educat ion N u t r i t i o n n e l l e a (Rapport EUR 7331 FR)

T h i s r e p o r t p resents f i n d i n g s and p l a n s f o r n u t r i t i o n educat ion i n t h e n i n e member c o u n t r i e s o f t h e European Economic Community (Belgium, Denmark, France, I r e l a n d , I t a l y , Luxemburg, German Federa l Republ ic , t h e U n i t e d Kingdom, and t h e Low Count r ies ) . The f i r s t s e c t i o n presents o u t l i n e s o f fo rmal n u t r i t i o n educat ion conducted i n each count ry , i n c l u d i n g t h e b a s i c s t r u c t u r e o f t h e educat ion system and t h e n u t r i t i o n program i n opera t ion . The second s e c t i o n presents n u t r i t i o n s t a t u s assessments and r i s k f a c t o r s on which t o base n u t r i t i o n p lanning. The f i n a l s e c t i o n proposes a methodology fo r i n t e r - ven t ions and e v a l u a t i o n , based on o b j e c t i v e s developed by e x p e r t s from a l l t h e c o u n t r i e s , o rgan ized as a lltreell t o be f o l l o w e d f o r development.

6. CROSS, A.T. USDA'S s t r a t e g i e s f o r t h e 80's: N u t r i t i o n educat ion. Journa l ofthe American D i e t e t i c Associat ion. , vo l . 76, no. 4, A p r i l 1980, pp. 3 33-3 37.

7. DANISH MINISTRY OF EDUCATION. Dansk Ernaer ings forskn ing : S t a t u s og f remt id . (Danish N u t r i t i o n Educat ion: S t a t u s and F u t u r e ) , Copenhagen, 1983. 83p.

T h i s r e p o r t c o n t a i n s chapters on human n u t r i t i o n research, a mapping o f c u r r e n t Danish n u t r i t i o n research and educat ion, t h e need f o r n u t r i t i o n research and educat ion, t h e p o s s i b i l i t i e s o f meet ing these needs, r e q u i r e d resources.

8. DIRECTIONS FOR NUTRITION EDUCATION RESEARCH-THE PENN STATE CONFERENCES. U n i v e r s i t y Park, Pennsylvania, Col lege o f Human Development, The Pennsylvania S t a t e U n i v e r s i t y , 1980. 108p.

T h i s book presents papers from f i v e conferences on n u t r i t i o n educat ion research: (1) e a t i n g p a t t e r n s ; (2) n u t r i t i o n communication; (3) f o r m a l n u t r i t i o n educat ion; (4 community n u t r i t i o n educat ion; and (5 1 e v a l u a t i o n research i n n u t r i t i o n educat ion. I n most panels, t h e r e was s t r o n g suppor t f o r i n v e s t i n g more t i m e and e f f o r t i n lltheory b u i l d i n g " r a t h e r than "hypothes is t e s t i n g " research. Panels a l s o agreed on t h e need f o r m u l t i d i s c i p l i n a r y c o l l a b o r a t i v e s t u d i e s t o develop s tandard ized i n s t r u m e n t a t i o n , s u b s t a n t i v e methodologies f o r e v a l u a t i o n measures, and common t o o l s and language fo r de termin ing deve ls o f behav io r change.

9. DUPIN, H. Rapports N u t r i t i o n n e l s C o n s e i l l e s pour l a Popu la t ion Francaise. P a r i s , Centre N a t i o n a l de l a Recherche S c i e n t i f i q u e , 1981. 101p. b i b l .

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10. D W ï E R , J. N a t i o n a l conference on n u t r i t i o n educat ion: D i r e c t i o n s f o r t h e 80s. Journa l o f N u t r i t i o n Educat ion, v o l . 12, no. 2, supplement 1, 1980, 54p.

T h i s s p e c i a l i s s u e o f t h e j o u r n a l p resents t h e proceedings o f a conference sponsored b y t h e U.S. Departments o f A g r i c u l t u r e and o f Heal th , Educat ion, and Wel fare t o examine t h e r o l e and f u t u r e o f n u t r i t i o n educat ion i n improv ing h e a l t h . Papers address t h e r o l e s o f v a r i o u s government agencies; changing d i e t s , n u t r i t i o n a l problems, and s t r a t e g i e s needed f o r t h e coming decade ; and t h e needs o f s p e c i a l groups such as adolescents and t h e e l d e r l y .

11. EIDE, W.B. The n u t r i t i o n educator ' s r o l e i n access t o food-from i n d i v i d u a l o r i e n t a t i o n t o s o c i a l o r i e n t a t i o n . Journa l o f N u t r i t i o n Educat ion, v o l . 14, no. 1, March 1982, pp. 14-17.

12. FIDANZA, F.; JELLIFFE, E.F.P.; BAGCHI, K. ; e t a l . N u t r i t i o n educat ion and t r a i n i n g f o r h e a l t h science p r o f e s s i o n a l s . World Review o f N u t r i t i o n and D i e t e t i c s , vo l . 38, Phys io logy and S o c i a l N u t r i t i o n and N u t r i t i o n a l Education, G.H. Bourne, ed. Basel , Swi tzer land, Karger, 1981. pp. 153-225.

13. GONZALEZ TORO, N. ; SANCHEZ RODRIGUEZ, H. ; BOCCARDO ZAPATA, H. A l imentac idn y n u t r i c i ó n [Food and n u t r i t i o n ] , Cuadernos Medico-Sociales , v o l . 21, no. 4, 1980, pp. 5-1 15.

T h i s s p e c i a l i ssue presents a s e r i e s o f a r t i c l e s on n u t r i t i o n issues o f p a r t i c u l a r concern t o Ch i le : p r e s e n t a t i o n o f t h e c u r r e n t n u t r i t i o n s t a t u s s i t u a t i o n ; t r a i n i n g o f n u t r i t i o n educat ion s t a f f ; i r o n and ascorb ic a c i d ( v i t a m i n C > supplementat ion o f baby foods; b r e a s t feed ing promot ion ; and n u t r i t i o n educat ion p r o j e c t s .

14. GUSSOW, J.D. Who pays t h e p i p e r ? Teachers Col lege Record, vo l . 81, no. 4, Summer 1980, pp. 448-466.

15. GUSSOW, J.D. ; CONTENTO, I. N u t r i t i o n educat ion i n a changing world: A c o n c e p t u a l i z a t i o n and s e l e c t i v e rev iew. World Review o f N u t r i t i o n and D i e t e t i c s , i n press; New York, Columbia U n i v e r s i t y Teachers Col lege. 1982. 4%.

Determin ing t h e s t a t e o f t h e a r t i n n u t r i t i o n educat ion i s n e a r l y imposs ib le because, n o t o n l y i s t h e f i e l d changing r a p i d l y , but t h e i n f o r m a t i o n o f t e n i s n o t p u b l i s h e d a t a l l , o r i s p u b l i s h e d i n i n f o r m a l r e p o r t s . N u t r i t i o n educat ion i s e s s e n t i a l i n t h e modern w o r l d because new food t e c h n o l o g i e s Prov ide an environment i n which i n d i v i d u a l s a r e c o n t i n u a l l y con f ron ted with t h e need t o make wel l - informed cho ices among d e c e p t i v e l y designed foods; one can no l o n g e r r e l y on t r a d i t i o n o r i n s t i n c t ( i f one ever cou ld ) . T h i s paper p resents t h e s c i e n t i f i c and e d u c a t i o n a l bases upon which n u t r i t i o n educat ion has developed. Sec t ions address formal , i n f o r m a l , and non-formal (mass media and community) approaches ; e v a l u a t i o n ; and t r e n d s i n t h e f i e l d . Throughout, t h e emphasis i s on develop ing a coherent concept and p r a c t i c a l approach, r a t h e r than a t t e m p t i n g an exhaust ive survey. Examples c i t e d cover a broad

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range o f l o c a t i o n s and i n c l u d e s e v e r a l examples o f e a r l y n u t r i t i o n research i n food behavior and change.

16. HAMBRAEUS, L., ed. N u t r i t i o n i n Europe: Proceedings o f t h e T h i r d European N u t r i t i o n Conference. Uppsala, Sweden, A lmqv is t & W i k s e l l , 1980. 150p.

The major t o p i c s o f t h i s conference inc luded: (1 Europe's c o n t r i b u t i o n s i n t h e area o f n u t r i t i o n research f o r develop ing c o u n t r i e s ; (2 ) food and n u t r i t i o n p o l i c i e s and p l a n n i n g i n i n d u s t r i a l i z e d c o u n t r i e s , p r i n c i p a l l y i n Europe; and (3 ) s p e c i f i c aspects o f n u t r i t i o n educat ion i n Europe, i n c l u d i n g i n t e g r a t i o n between school and community n u t r i t i o n educat ion a c t i v i t i e s i n Yugoslavia, p u b l i c educat ion r e l a t e d t o d i e t and e x e r c i s e i n Sweden, t h e s t r u c t u r e o f p u b l i c n u t r i t i o n educat ion i n t h e Federa l Republ ic o f Germany, t h e r o l e o f mass media i n n u t r i t i o n educat ion i n Swi tzer land, assessment o f a comuni ty-based n u t r i t i o n i n t e r v e n t i o n program i n F in land, and Norwegian approaches t o n u t r i t i o n and h e a l t h educat ion i n c l u d i n g mass screening programs. conference o f which 13 were p r i n c i p a l l y about n u t r i t i o n educat ion.

T h i s volume a l s o i n c l u d e s a b s t r a c t s o f papers presented a t t h e

17. HARTY, S. Hucksters i n t h e Classroom. Washington, D.C., Center f o r t h e Study o f Responsive Law, 1979.

T h i s r e p o r t p resents an account o f t h e e f f e c t s o f commercial ly-developed educat ion m a t e r i a l s i n n u t r i t i o n and o t h e r t o p i c s . M a t e r i a l s a v a i l a b l e a t l i t t l e o r no c o s t , developed and prov ided b y t h e food i n d u s t r y and o t h e r s p e c i a l i n t e r e s t s , o f t e n are b iased i n favor o f p a r t i c u l a r p roduc ts o r misrepresent t h e n u t r i t i o n a l va lue o f whole c a t e g o r i e s o f foods. The D a i r y Counci l i n t h e Un i ted States, f o r example, produces c u r r i c u l a which have even been adopted by s t a t e n u t r i t i o n educat ion departments, which overemphasize t h e need f o r d a i r y p roduc ts and i n c l u d e d i e t p l a n s t h a t f e a t u r e h i g h - f a t d a i r y products. Teachers should be s u f f i c i e n t l y educated i n n u t r i t i o n t o be a b l e t o assess t h e appropr ia teness o f o f f e r e d m a t e r i a l s .

18. HAUSMAN, P. Jack S p r a t ' s Legacy. Washington, D.C., Center f o r Science i n the Pub l ic I n t e r e s t , 1981. 288p.

T h i s book presents a v iew o f t h e food i n d u s t r y i n t h e U n i t e d Sta tes t h a t emphasizes i t s r o l e i n promot ing t h e consumption o f s p e c i f i c foods because o f t h e i r economic impact on t h e food i n d u s t r y r a t h e r than t h e i r n u t r i t i o n a l value. H igh- fa t foods, p a r t i c u l a r l y those from animal sources, a r e more expensive t o produce and use g r e a t e r q u a n t i t i e s o f farm resources per c a p i t a and per c a l o r i e e v e n t u a l l y consumed. The e f f e c t o f t h e food i n d u s t r y on food p o l i c y i n t h e Un i ted S t a t e s has r e s u l t e d i n a c o n f l i c t between a g r i c u l t u r a l and h e a l t h p o l i c i e s , p a r t i c u l a r l y i n t h e area o f f a t consumption.

19. qHORNIK, R.C. N u t r i t i o n Educat ion - A S t a t e o f t h e A r t Review. Washington, D.C., World Bank, 1983.

M a l n u t r i t i o n i s n o t a problem o f i n s u f f i c e n t food, but one o f equi ty- - the m a l d i s t r i b u t i o n o f food resources. N u t r i t i o n educat ion i s d e f i n e d as t h e

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a t tempt t o enable consumers t o use a v a i l a b l e resources o p t i m a l l y t o reach va lued ends. I f consumers a r e malnour ished i n s p i t e o f u s i n g resources o p t i m a l l y , then t h e r e i s no p l a c e f o r n u t r i t i o n educat ion. Th is paper p resents d i s c u s s i o n s o f t h r e e quest ions: i s t h e r e p o t e n t i a l f o r e d u c a t i o n a l i n t e r v e n t i o n s ? Do such i n t e r v e n t i o n s as have been evaluated have any w o r t h w h i l e consequence? And, i s i t p o s s i b l e t o extend e f f e c t i v e programming on a l a r g e scale? The author concludes t h a t t h e r e i s a " s a t i s f a c t o r y and p o s i t i v e answer" t o a t l e a s t t h e second o f these: case s t u d i e s o f s e v e r a l s u c c e s s f u l programs are presented. Knowledge o f t h e determinants o f n u t r i t i o n - r e l a t e d behav io rs i s l i m i t e d : f u r t h e r i n v e s t i g a t i o n i s needed. The conc lud ing s e c t i o n presents a summary o f t h e expected impact o f s e v e r a l p o s s i b l e i n t e r v e n t i o n s , i n c l u d i n g mass media and a g r i c u l t u r a l ex tens ion agents. F i n a l l y , s p e c i f i c s teps f o r implementat ion and research a r e g iven.

20. INSTITUT DE NUTRITION, HANOI. I1 F r u t un Plan de Recherches M u l t i d i c i p l i n a i r e s pour Resoudre l e Problzme de 1 ' A l i m e n t a t i o n au Vietnam. Hanoi, I n s t i t u t e o f N u t r i t i o n , 1981. I l p .

21. ISRAEL, R.C. Recent Developments i n S o c i a l Marke t ing and T h e i r I m p l i c a t i o n s f o r I n t e r n a t i o n a l P u b l i c H e a l t h and N u t r i t i o n Educat iqn . Newton, Massachusetts, Educat ion Development Center, 1984. 7p

S o c i a l marke t ing i s t h e a p p l i c a t i o n o f mass media and a d v e r t i s i n g p r i n c i p l e s t o t h e p u r s u i t o f s o c i a l goals. S k i l l s are a l s o borrowed from f i e l d s as d i v e r s e as anthropology, s o c i a l sciences, and p u b l i c a d m i n i s t r a t i o n . H e a l t h educators should l e a r n t o use s o c i a l marke t ing s k i l l s , as demonstrated b y s e v e r a l examples o f success fu l p r o j e c t s , but awareness o f these techniques has n o t y e t reached t h e classrooms where h e a l t h educators are t r a i n e d . The n a t u r e and scope o f c u r r e n t h e a l t h problems worldwide demands t h a t h e a l t h educators, med ica l p r o f e s s i o n a l s , and communications exper ts become aware o f c o s t - e f f e c t i v e means o f reach ing t h e p u b l i c .

22. MANOFF, R.K. Communications perspec t ives f o r t h e 1980s: The new p o l i t i c s o f n u t r i t i o n educat ion. Journa l o f N u t r i t i o n Educat ion, vo l . 12, supplement, 1980, pp. 112-15.

Mass media W i l l p l a y a growing r o l e i n b r i n g i n g n u t r i t i o n educat ion t o t h e popu la t ion . N u t r i t i o n educators must be aware o f t h e p o l i t i c s . o f mass media and must be prepared t o a c t . P o l i t i c a l a c t i o n f o r n u t r i t i o n educat ion c o m u n i c a t i o n s i s i l l u s t r a t e d i n two s p e c i f i c p o l i c y i n i t i a t i v e s t h a t should i n v o l v e n u t r i t i o n educators: t h a t a f i x e d share o f t e l e v i s i o n and r a d i o t i m e be mandated t o h e a l t h and n u t r i t i o n educat ion, and t h a t i t s h a l l be p u b l i c p o l i c y t h a t i t i s t h e r e s p o n s i b i l i t y o f t h e government t o promote d i e t a r y goa ls f o r t h e American people and engage i n t h e promot ion o f t h e d i e t a r y g o a l foods. Using these i n i t i a t i v e s as examples, t h e author p resents t h e u n d e r l y i n g p o l i t i c s and p o l i c i e s and o f f e r s suggest ions on implement ing change.

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23. MCNAUGHTON, J.W. l a fo rmat ion n u t r i t i o n n e l l e s . pp. 20-4.

A c t i v i t e s de l a FAO dans l e domaine de 1 '6ducat ion e t de

This a r t i c l e descr ibes FAO p r o j e c t s i n n u t r i t i o n development, i n c l u d i n g t h e o r i g i n s o f needs assessments, t e c h n i c a l ass is tance i n deve lop ing and conduct ing n u t r i t i o n educat ion programs, development o f n u t r i t i o n educat ion m a t e r i a l s , es tab l i shment o f n a t i o n a l and r e g i o n a l n u t r i t i o n i n s t i t u t e s (such as I N C A P and CFNI), and t r a i n i n g n u t r i t i o n i s t s . FAO p lans for f u t u r e a c t i v i t i e s i n n u t r i t i o n educat ion development focus on t h e r u r a l poor, because they are among t h e hardes t t o reach. FAO w i l l a s s i s t governments i n p l a n n i n g and n u t r i t i o n s u r v e i l l a n c e ; cooperate w i t h o t h e r UN agencies ' n u t r i t i o n a l goals and p r o j e c t s ; and promote s u i t a b l e " t r a i n i n g o f t r a i n e r s " f o r n u t r i t i o n program s.

24. MEJIA DE PIZANO, J. The e d u c a t i o n a l approach within Colombia's n u t r i t i o n _ _ p l a n (PAN). I n t e r n a t i o n a l Review o f Educat ion, v o l . 26, no. 1, 1980, pp. 17-29.

The Colombian Government s e t up i n 1976 a unique m u l t i s e c t o r a l p l a n (PAN) t o combat t h e c o u n t r y ' s s e r i o u s m a l n u t r i t i o n problems. Government agencies and p r i v a t e i n d u s t r i e s i n the s e c t o r s o f p r o d u c t i o n , d i s t r i b u t i o n , h e a l t h , s a n i t a t i o n , and educat ion have coord ina ted t h e i r p r e v i o u s l y independent e f f o r t s . Among t h e i n t e r e s t i n g aspects a r e t h e c o o r d i n a t i o n o f s e c t o r s through work a t v a r i o u s l e v e l s and th rough c o n t r o l o f t h e budget, t h e l i m i t a t i o n o f bureaucracy, and t h e d e c e n t r a l i z a t i o n o f decision-making. The ongoing a t tempts t o overcome t h e d i f f i c u l t i e s encountered i n c l u d e : d e c i s i o n s i n t h e face o f i n c o n c l u s i v e knowledge on what c o n s t i t u t e s a wel l -balanced d i e t ; combating p r o f e s s i o n a l s ' l a c k o f knowledge about t h e environment o f t h e poorest percentage o f t h e p o p u l a t i o n ; and r e v i s i n g the t r a d i t i o n a l t e a c h i n g method t o make i t more success fu l th rough a mul t i -media approach t o assure wider coverage and more impact f o r t h e l e a s t c o s t , u s i n g m a t e r i a l s such as games, puppets, pos ters , and r a d i o .

making

25. MOERLOOSE, J. DE: Food f o r I n f a n t s and Young Ch i ld ren : A Survey o f Relevant N a t i o n a l L e g i s l a t i o n . World H e a l t h Organ iza t ion , 1981. 38p. (HLE/FHE/8 1.1

T h i s r e p o r t p resents WHO, n a t i o n a l , r e g i o n a l , and agency g u i d e l i n e s and p o l i c i e s a f f e c t i n g i n f a n t foods. D e t a i l s are p rov ided on d e f i n i t i o n s o f t e c h n i c a l terms, l e g i s l a t i v e measures, l i c e n s i n g , marke t ing , q u a l i t a t i v e and q u a n t i t a t i v e standards, l a b e l l i n g requi rements, and a d v e r t i s i n g . Most c o u n t r i e s have a p p a r e n t l y n o t g iven t h i s i s s u e the s p e c i a l a t t e n t i o n i t deserves, based on i n f o r m a t i o n a v a i l a b l e a t t h e t ime t h i s paper was composed. Readers a r e caut ioned t o remember t h a t l e g i s l a t i o n must be viewed i n t h e l a r g e r c o n t e x t o f c h i l d feeding, i n c l u d i n g o v e r a l l socioeconomic development. A d v e r t i s i n g and l a b e l l i n g are major forms o f n u t r i t i o n communications t h a t must n o t be a l lowed t o d isseminate ' i n c o r r e c t o r h a r m f u l messages.

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26. MYRES, A.W. Breast- feeding-a n a t i o n a l p r i o r i t y f o r i n f a n t h e a l t h . Journa l o f t h e Canadian D i e t e t i c Assoc ia t ion , vo l . 42, no. 2, A p r i l 1981, I l p . b i b l .

P r i v a t e o r g a n i z a t i o n s such as t h e Canadian P e d i a t r i c S o c i e t y and the La Leche League o f Canada have j o i n e d t h e n a t i o n a l campaign t o promote awareness among h e a l t h p r o f e s s i o n a l s . The campaign, i n i t i a t e d i n 1979, p rov ided i n f o r m a t i o n k i t s t o 40,000 phys ic ians , h o s p i t a l s t a f f , and p u b l i c h e a l t h nurses. A fo l lowup s t u d y found t h a t t h e m a j o r i t y d i d use t h e m a t e r i a l s f o r s e l f - educat ion and f o r counse l ing mothers. Pro fess iona ls a l s o i n d i c a t e d an i n t e r e s t i n r e c e i v i n g f u r t h e r i n f o r m a t i o n on i n f a n t feeding.

27. NETHERLANDS. P o l i c y Document on N u t r i t i o n . The Hague, M i n i s t r y o f Welfare, Heal th , and C u l t u r a l A f f a i r s , M i n i s t r y o f Economic Af fa i rs , 1983. 94p.

n e main elements o f t h e p o l i c y document on n u t r i t i o n a r e t h e encouragement o f a s e n s i b l e d i e t and t h e measures necessary t o ensure a good supply o f h e a l t h y foods. It i s considered e s s e n t i a l t h a t n u t r i t i o n and e a t i n g h a b i t s should be i n c l u d e d i n p r i n c i p l e i n t h e s y l l a b u s a t a l l l e v e l s o f educat ion. The Pr imary Educat ion Act which w i l l come i n t o e f f e c t from 1 August 1985 w i l l make i t compulsory t o teach " h e a l t h y l i v i n g . " This w i l l i n c l u d e educat ion about n u t r i t i o n . I n September 1981 t a l k s began a t o f f i c i a l l e v e l between t h e M i n i s t r y o f Welfare, Heal th , and C u l t u r a l A f f a i r s and t h e M i n i s t r y o f Educat ion and Science about t e a c h i n g t h i s s u b j e c t i n t h e lower grades o f secondary schools. H e a l t h ed-ucat ion must be adequately ca tered f o r w i th in t h e c u r r i c u l u m .

28. OLSON, R.E. The Food and N u t r i t i o n Board's approach t o n u t r i t i o n educat ion. J o u r n a l o f N u t r i t i o n Educat ion, v o l . 12, no. 4, October-December 1980, pp. 188-89.

29. QUEBEC 'S P O L I C Y ON NUTRITION. M i n i s t e r e des A f f a i r e s Socia les, D i r e c t i o n Ggnérale de l a P l a n i f i c a c i o n , Serv ice des Etudes Epidemiologigues, 1977. 89p. b i b l .

T h i s document p resents t h e P r o v i n c e ' s e n t i r e n u t r i t i o n program, from assessments o f n u t r i t i o n s t a t u s and food consumption p a t t e r n s t o a n a l y s i s o f d i e t - r e l a t e d h e a l t h problems ( i n c l u d i n g t h e i r d o l l a r c o s t t o taxpayers) , change o b j e c t i v e s , work ing s t r a t e g i e s , implementat ion programs, p lans f o r program e v a l u a t i o n , and p r o v i s i o n f o r t r a i n i n g those who are t o conduct t h e programs.

30. QUELCH, A. The r o l e o f n u t r i t i o n i n f o r m a t i o n i n n a t i o n a l n u t r i t i o n p o l i c y . N u t r i t i o n Reviews, v o l 35, no. 11, 1977, pp. 289-293.

N a t i o n a l n u t r i t i o n p o l i c y must be developed t o t a k e i n t o account t h e complex r e l a t i o n s h i p s between n u t r i t i o n programs, s o c i a l we l fa re , genera l educat ion, a g r i c u l t u r e , energy, and i n t e r n a t i o n a l r e l a t i o n s . N u t r i t i o n educat ion i n t h e form of d e l i v e r y o f n u t r i t i o n i n f o r m a t i o n i s one o f many o p t i o n s a v a i l a b l e t o pol icy-makers. U n f o r t u n a t e l y , t h e i n f o r m a t i o n d e l i v e r e d b y many p r o j e c t s i s

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i n c o n s i s t e n t , d e l i v e r e d b y u n d e r q u a l i f i e d personnel , o r overwhelming i n quan- t i t y . T h i s a r t i c l e descr ibes s i x s teps b y which programs can be developed t o avoid these and o t h e r common p i t f a l l s . B e t t e r c o o r d i n a t i o n among i n t e r e s t e d p a r t i e s i s a p r e r e q u i s i t e t o success. Comparative s t u d i e s o f d i f f e r e n t approaches would be u s e f u l , p o s s i b l y l e a d i n g t o an inc rease i n e f f i c i e n c y .

31. RASMUSON, M. Current P r a c t i c e and Future D i r e c t i o n s o f N u t r i t i o n Educat ion i n Developing Countr ies: A Research and P o l i c y Assessment. Washington, D. C., Academy f o r Educat iona l Development, 1977. 66p. b i b l .

Sect ion I, Experience t o Date, rev iews research and a c t i o n programs, n o t i n g t h a t u n t i l t h e 1970s, most n u t r i t i o n educat ion was formal , d i d a c t i c , and aimed a t d i s s e m i n a t i n g i n f o r m a t i o n , r a t h e r t h a n a t changing behavior . Growing awareness o f t h e " n u t r i t i o n f a c t o r " i n socioeconomic development and t h e changing emphasis i n i n t e r n a t i o n a l medic ine from c u r a t i v e t o p r e v e n t i v e e leva ted a l l n u t r i t i o n i n t e r v e n t i o n s t o new importance. Mass media s t r a t e g i e s remedied former problems o f ou t reach and impact. Sec t ion II, Emerging Trends, p resents t h e s t a t e o f t h e a r t i n deve lop ing c o u n t r i e s and t r e n d s i n t h e purpose and scope o f t h e f i e l d , s p e c i f i c themes and o b j e c t i v e s , audiences, and methods. S e c t i o n III d e s c r i b e s changes i n donor agency p o l i c i e s , and S e c t i o n I V presents t r e n d s i n r e l a t e d f i e l d s , r a n g i n g f rom h e a l t h educat ion t o a p p l i e d anthropology and s o c i a l market ing. The f i n a l s e c t i o n d iscusses d i r e c t i o n s f o r f u t u r e research and programming. '

32. RESEARCH, EXTENSION AND HIGHER EDUCATION I N HUMAN NUTRITION. Washington, D.C., The J o i n t Counc i l o f Food and A g r i c u l t u r a l Sciences, March 1980. 12Op.

33. SINCLAIR, H.M. ; HOWAT, G.R., eds. World N u t r i t i o n and N u t r i t i o n Educat ion. Oxford, Oxford U n i v e r s i t y Press, (Med ica l P u b l i c a t i o n s Ser ies) and Par is , Unesco. 1980. 226p.

T h i s volume presents t h e work o f a conference organized b y t h e I n t e r n a t i o n a l Union o f N u t r i t i o n a l Sciences, w i t h suppor t from Unesco, t o examine t h e c u r r e n t s t a t u s o f n u t r i t i o n educat ion and present recommendations f o r f u t u r e work. Examples are prov ided from t h e Republ ic o f Korea, S i e r r a Leone, Guatemala, t h e U n i t e d Kingdom, I n d i a , Jamaica, and N i g e r i a .

34. SOLON, F. S. L o c a l government management o f n u t r i t i o n programs P h i l i p p i n e Journa l o f N u t r i t i o n , v o l . 36, no. 1, January-March 1983, pp. 2-8.

Th is paper, presented t o t h e P h i l i p p i n e A s s o c i a t i o n o f N u t r i t i o n i n 1982, 'descr ibes t h e background, p resent s t a t u s , and f u t u r e recommendations o f t h e n a t i o n a l P h i l i p p i n e N u t r i t i o n Program (PNP), which i s designed t o generate l o c a l r e s p o n s i b i l i t y and p a r t i c i p a t i o n . I n i t i a l l y , t h e e x t e n t o f m a l n u t r i t i o n was determined t h r o u g h a weighing program (Operat ion Timbang); l o c a l p r o j e c t s were developed based on l o c a l needs and resources. L o c a l mayors a r e r e s p o n s i b l e f o r t h e program, so a major goa l i s b o o s t i n g t h e i r m o t i v a t i o n and i n f o r m a t i o n about t h e program. T h i s paper proposes e x t e n s i v e t r a i n i n g programs t o be prov ided b y t h e government t o enable l o c a l execut ives t o s e l e c t t h e n a t i o n a l p r o j e c t s f o r t h e i r own areas, t o promote d e c e n t r a l i z a t i o n .

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35. TASK FORCE REPORTS: NATIONAL CONFERENCE ON NUTRITION EDUCATION. J o u r n a l o f N u t r i t i o n Educat ion, v o l . 12, no. 2, supplement 1980, pp. 117-137.

36. THOMAS, J. The p l a c e o f educat ion i n a n a t i o n a l n u t r i t i o n p o l i c y . Royal S o c i e t y o f H e a l t h Journal , 1979, pp. 189-195.

Formal and i n f o r m a l educat ion can s t r o n g l y i n f l u e n c e food h a b i t s , a l though t h e s t r i c t l y i n f o r m a t i o n a l approach has been shown t o be r e l a t i v e l y i n e f f e c t i v e . A combinat ion o f fo rmal n u t r i t i o n educat ion f o r school-age c h i l d r e n , t o g e t h e r w i t h i n f o r m a l educat ion f o r a d u l t s , would p r o v i d e a means t o implement n a t i o n a l n u t r i t i o n o b j e c t i v e s . The changing r o l e s o f women and t h e changing popu lar d i e t and a t t i t u d e s towards food must be monitored, and t h e i n f o r m a t i o n processed i n a t i m e l y way; c o o r d i n a t i o n o f i n f o r m a t i o n sources and implement- i n g agencies i s e s s e n t i a l . Groups w i t h s p e c i a l n u t r i t i o n a l needs must be approached by s p e c i a l l y t r a i n e d p r o f e s s i o n a l s work ing i n a team. We should remember t h a t t h e humble p o t a t o , suspected o f hav ing t o x i c o r aphrod is iac p r o p e r t i e s , became a s t a p l e food w i t h o u t any f o r m a l n u t r i t i o n educat ion encouragement.

37. TOWARDS BETTER HEALTH AND NUTRITION; REPORT OF A TECHNICAL WORKING GROUP MEETING. Unesco Regional O f f i c e f o r Educat ion i n Asia and t h e P a c i f i c , Asian Programme o f Educat iona l I n n o v a t i o n f o r Development, Techn ica l Working Group Meet ing on Cur r icu lum Development i n H e a l t h and N u t r i t i o n Educat ion, New D e l h i . Bangkok, Unesco Regional O f f i c e fo r Educat ion i n As ia and t h e P a c i f i c , 1981. 83p.

38. ULLRICH, H.D. Towards a n a t i o n a l n u t r i t i o n educat ion p o l i c y . Journa l o f N u t r i t i o n Educat ion, v o l . 11, 1979, p. 60.

39. UNESCO. N u t r i t i o n Educat ion: Relevance and Future . P a r i s , Unesco, 1983. 31p. ( D i v i s i o n o f Science, Techn ica l and V o c a t i o n a l Educat ion, N u t r i t i o n Educat ion Ser ies , 5 )

To be r e l e v a n t , n u t r i t i o n educat ion must take i n t o account n o t o n l y t h e n u t r i t i o n a l needs of a p o p u l a t i o n b u t a l s o t h e s o c i a l , economic, and c u l t u r a l c o n t e x t i n which food behavior occurs. Educat ion may be formal , but nonformal and i n f o r m a l n u t r i t i o n educat ion are b e t t e r s u i t e d t o many c o n t e x t s i n deve lop ing c o u n t r i e s , such as educat ing mothers o f young c h i l d r e n i n appropr i - a t e weaning p r a c t i c e s . A g r i c u l t u r a l l y - b a s e d n u t r i t i o n programs can p l a y a u s e f u l demonstrat ive e d u c a t i o n a l r o l e . Formal, school-based educat ion can reach o u t t o o t h e r community members. Food and n u t r i t i o n educat ion i s n o t a l u x u r y , n o r should i t be l i m i t e d t o home economics s tudents; we a l l need t o l e a r n t o e a t p r o p e r l y i n t h e complex contex t o f modern foods. T r a d i t i o n a l e a t i n g p a t t e r n s are n e c e s s a r i l y compat ib le w i t h s u r v i v a l a t l e a s t through t h e c h i l d b e a r i n g years, but t h e r e i s no reason t o b e l i e v e t h a t any c u l t u r e has developed an i d e a l e a t i n g p a t t e r n based on a v a i l a b l e resources. N u t r i t i o n sc ience a lone, composed o f s c i e n t i f i c f a c t s , i s necessary but n o t s u f f i c i e n t as a b a s i s f o r modern n u t r i t i o n educat ion; t h e l a r g e r s o c i a l c o n t e x t o f t h e i n d i v i d u a l and t h e w o r l d must be taken i n t o account. N u t r i t i o n educat ion must a l s o m o t i v a t e i n d i v i d u a l s t o consume t h e d i e t s t h e y know t o be a p p r o p r i a t e and

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should promote consumption o f a d i e t t h a t makes t h e most o f t h e w o r l d ' s scarce resources. As such, i t i s p a r t o f food p o l i c y . There i s a l a c k o f q u a l i f i e d teach ing personnel , even a t t h e school-age l e v e l ; p u b l i c educat ion must be expanded a t a l l l e v e l s .

40. UNESCO. Report on c o n s u l t a t i o n on N u t r i t i o n i n Educat iona l P o l i c y and Planning. Uppsala, Sweden, Department o f Educat ion and I n s t i t u t e o f N u t r i t i o n , Uppsala U n i v e r s i t y , 11-14 September 1979, 22p.

T h i s conference h e l d d i s c u s s i o n s on t h e r o l e o f m a l n u t r i t i o n and under- n u t r i t i o n i n p h y s i c a l , i n t e l l e c t u a l , and b e h a v i o r a l development, e s p e c i a l l y as t h e y a f f e c t e d u c a t i o n a l achievements and performance; and ways i n wh ich educat ion can decrease t h e prevalence o f n u t r i t i o n problems, p a r t i c u l a r l y among disadvantaged groups. T h i s r e p o r t i n c l u d e s summaries o f t h e papers presented b y p a r t i c i p a n t s from t h e f i e l d s o f educat ion, n u t r i t i o n , and i n t e r n a t i o n a l agencies.

41. VANDENBERG, L. ; KATEREGGA, C. ; e t a l . N u t r i t i o n and Food--Education , Pol icy , and Prac t ice : A Sected, Annotated B ib l iography . East Lansing, Michigan, Non-formal Educat ion I n f o r m a t i o n Center, C o l l e g e o f Educat ion, Michigan Sta te U n i v e r s i t y , 1982. 76p. (Annotated B i b l i o g r a p h y 119)

T h i s b i b l i o g r a p h y p r e s e n t s e x t e n s i v e d e s c r i p t i o n s o f dozens o f p u b l i c a t i o n s i n n u t r i t i o n educat ion, p o l i c y , and programs; t h e m a j o r i t y a re from o r about develop ing na t ions . I n a d d i t i o n t o books, a r t i c l e s , and government r e p o r t s , t h e document descr ibes n e w s l e t t e r s and p e r i o d i c a l s i n t h e f i e l d and has a s p e c i a l s e c t i o n on o r g a n i z a t i o n s i n v o l v e d i n n u t r i t i o n educat ion.

42. WARDLAW, J.M. Prepar ing t h e n u t r i t i o n educat ion p r o f e s s i o n a l f o r t h e 1980s. Journa l o f N u t r i t i o n Educat ion, v o l . 13, no. 1, March 1981, pp. 6-8.

This paper, presented t o t h e S o c i e t y ' s D i v i s i o n o f Higher Educat ion, d iscusses t h e t r a i n i n g needs o f n u t r i t i o n educators. P u b l i c h e a l t h i s e n t e r i n g a phase o f i n d i v i d u a l r e s p o n s i b i l i t y f o r one's wel l -be ing, and n u t r i t i o n educators must be a b l e t o prepare t h e p u b l i c t o make good d e c i s i o n s about t h e i r d i e t s . The paper addresses these needs from t h e p e r s p e c t i v e o f t h r e e i n t e r f a c e s : between t h e b i o l o g i c a l and s o c i a l sc iences, between n u t r i t i o n educat ion and h e a l t h educat ion, and between academia and f i e l d p r a c t i c e . New graduates ' backgrounds w i l l need t o be q u i t e d i f f e r e n t f rom t h e backgrounds o f those who t r a i n them, and " i n n o v a t i v e t h i n k i n g which w i l l enhance i n t e r a c t i o n a t these i n t e r f a c e s i s v i t a l " t o an e f f e c t i v e f u t u r e f o r n u t r i t i o n educat ion.

43. WHITEHEAD, F. E. N u t r i t i o n educat ion research. World Review o f N u t r i t i o n and D i e t e t i c s , v o l . 17, 1973, pp. 91-149.

Th is exhaust ive r e v i e w begins b y j u s t i f y i n g t h e need f o r n u t r i t i o n educat ion b y n o t i n g t h a t each new g e n e r a t i o n must be t a u g h t t o use an e x i s t i n g food supply i n t e l l i g e n t l y , and t h a t t h e body o f f a c t s which makes up t h e sc ience o f n u t r i t i o n i s e v o l v i n g . The a r t i c l e b y McKenzie and Mumford ( e n t r y 379) i s c r i t i q u e d . The r e v i e w o f t h e l i t e r a t u r e i n c l u d e s research on n u t r i t i o n

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educat ion 's e f f e c t s on d i e t a r y h a b i t s , i n c l u d i n g s t u d i e s f r o m 1900 t o 1970; t h e author assumes t h a t c e r t a i n r e p o r t s have n o t been e x t e n s i v e l y rev iewed and t h a t a comprehensive r e v i e w o f t h e l i t e r a t u r e i s a l o g i c a l f i r s t s tep toward deve lop ing a method t o use i n e v a l u a t i n g the e f f e c t i v e n e s s o f n u t r i t i o n educat ion. Indeed, one o f t h e most success fu l programs reviewed was descr ibed i n 1910; i t prov ided i n c e n t i v e s f o r c h i l d r e n t o p a r t i c i p a t e i n a weight- m o n i t o r i n g and improvement p r o j e c t , which inc luded home v i s i t s , group work, f a m i l y p a r t i c i p a t i o n , and supplementary meals, a l l o f which a r e among t h e i n t e r v e n t i o n components s t i l l promoted. The author p rov ides an ex tens ive summary and a n a l y s i s o f t h e l i t e r a t u r e reviewed. The b i b l i o g r a p h y i n c l u d e s over 250 re fe rences .

44. WHO. I n t e r n a t i o n a l Code o f Marke t ing o f Breast -mi lk Subs t i tu tes . Geneva, World H e a l t h Organ iza t ion , 1981. 36p.

T h i s Code r e p r e s e n t s WHO g u i d e l i n e s on t h e a p p r o p r i a t e use and promot ion o f i n f a n t formulas. A r t i c l e s s p e c i f i c a l l y cover t h e r o l e s o f h e a l t h care systems, manufacturers ' r e s p o n s i b i l i t i e s , food standards, l a b e l l i n g and q u a l i t y standards, and t h e proposed implementat ion and m o n i t o r i n g o f t h e Code. Since i t s p u b l i c a t i o n , most n a t i o n s have adopted t h e exact recommended Code o r v a r i a t i o n s o f i t , i n an e f f o r t t o c o n t r o l i n c r e a s i n g use o f b o t t l e feed ing i n t h e p l a c e o f b r e a s t feed ing throughout t h e wor ld .

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II: Conceptual Approaches

45. ABÚ SAQRA, G. wa-gihhat a l -g iba ' fT 31-watan al-%rabí. [ A d o s s i e r on n u t r i t i o n educat ion and t r a i n i n g and c o r r e c t n u t r i t i o n i n t h e Arab wor ld ] . Bãr ïs , Maktab al-yÜnaskÜ a l - i q l i m i l i - 8 t - t a r b i y a fi duwal al- 'arabiyya, 1984. 155p.

M i l a f f a t - t a r b i y a a l - z i d a ' i y y a wa-at - taLai f a l - g i d ä ' r

A doss ie r compi led b y t h e Unesco e x p e r t for env i ronmenta l educat ion i n t h e Arab S t a t e s and c o n s i s t i n g o f f o u r documents on n u t r i t i o n t r a i n i n g and i t s p lace i n t h e b i o l o g y c u r r i c u l u m , m a l n u t r i t i o n and i t s i n f l u e n c e s on h e a l t h , t h e body and t h e mind, n u t r i t i o n educat ion and i t s r e l a t i o n t o t h e cur r i cu lum, and t h e supply o f food and i t s consumption i n t h e Arab world.

46. ATTITUDE THEORY AND MEASUREMENT I N FOOD AND NUTRITION RESEARCH: PROCEEDINGS OF A SYMPOSIUM, 15-17 JUNE 1980. U n i v e r s i t y Park, Pennsylvania, The Pennsylvania S t a t e U n i v e r s i t y , 1981. 76p.

Th is symposium was h e l d t o exp lo re t h e r o l e o f a t t i t u d e s i n t h e fo rmat ion and maintenance o f food h a b i t s , and t o r e v i e w t h e methodology used i n s t u d y i n g these issues. C o n t r i b u t o r s f rom f i e l d s o f a p p l i e d n u t r i t i o n , food science, consumer behavior , r u r a l soc io logy , psychology, and home economics discussed t h e fo rmat ion and change o f a t t i t u d e s and t h e use o f a t t i t u d e assessment i n understanding consumer behavior .

47. BADOUAL, J. ; FRANCOUAL, C. ; CALDERA, R. L ' a l i m e n t a t i o n i n f a n t i l e . Table ronde. Par is , 1982. E n t r e t i e n s de B ichat . Thgrapeutique, 1982, pp. 307-31 1.

48. BARKER, L. ed. The Psychobiology o f Human Food Se lec t ion . Westport , Connect icut , A V I P u b l i s h i n g Co., 1982. 2 6 2 ~ .

49. BERGGREN, W.L. ; MURRAY, G.F. Consu l tan t Report f o r Cameroon (March 9-21, 1981; n e Feeding o f I n f a n t s i n Nor thern Cameroon: G u i d e l i n e s f o r a F i e l d Study. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Serv ice , Educat ion Development Center, 1981.

Planners and p o l i c y makers have recogn ized t h e va lue o f i n c l u d i n g a n t h r o p o l o g i c a l p e r s p e c t i v e s i n t h e i r p r o j e c t development but have l a c k e d g u i d e l i n e s f o r develop ing a p p r o p r i a t e i n f o r m a t i o n bases. T h i s team developed a survey i n s t r u m e n t and a methodo log ica l approach t h a t b lends anthropometr ics , socioeconomic i n d i c a t o r s , and observed behavior . A l though t h e model was developed i n response t o a government reques t f o r a s s i s t a n c e i n address ing a p a r t i c u l a r c h i l d n u t r i t i o n problem, i t can serve as a b a s i s o r model f o r development o f f u r t h e r surveys t o determine f a c t o r s r e l a t e d t o n u t r i t i o n problems t o serve as bases on wh ich t o p l a n a p p r o p r i a t e n u t r i t i o n p o l i c i e s and programs. The r e p o r t descr ibes t h e conceptual framework and hypothes is , pre'sents t h e r e s e a r c h des ign and da ta a n a l y s i s , and recommends s p e c i f i c a d m i n i s t r a t i v e d e c i s i o n s t o be made immediately.

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50. BOURNE, G.H., ed. N u t r i t i o n educat ion and modern concepts o f food assimi- l a t i o n . World Review o f N u t r i t i o n and D i e t e t i c s , v o l . 40, 1982, pp. 1-192.

51. BRYAN, M.S.; LOWENBURG, M.E. The f a t h e r ' s i n f l u e n c e on young c h i l d r e n ' s food preferences. Journal o f t h e American D i e t e t i c s Assoc ia t ion , vo l . 34, 1958, pp. 30-35.

52. BURT, J.V; HERTZLER, A.A. P a r e n t a l i n f l u e n c e on t h e c h i l d ' s food preference. J o u r n a l o f N u t r i t i o n Educat ion, v o l . I O , 1978, p. 127.

53. CAMPBELLAINDZEY, S. Consu l tan t Report f o r Sudan/Madagascar (May 6-30. 1983): Development o f a N u t r i t i o n Educat ion S t r a t e g y i n Each Country f o r a Seventh Day A d v e n t i s t World S e r v i c e (SAWS) M i n i s t r y o f H e a l t h PL-480 T i t l e II Program. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Serv ice , Educat ion Development Center, 1983. 48p.

SAWS i s committed t o i n t e g r a t i n g n u t r i t i o n educat ion i n t o i t s PL-480 f e e d i n g program t o improve t h e i r impact. The consu l tan t , as p a r t o f a three-person team, spent two weeks i n each country , working with l o c a l o f f i c i a l s and SAWS s t a f f t o analyse t h e programs and l o c a l n u t r i t i o n needs and resources. The r e s u l t i n g recommendations f o r program development focus on s p e c i f i c behav io r change o b j e c t i v e s . program.

Each c o u n t r y r e p o r t a l so presents a summary o f t h e o v e r a l l

54. CENTRE INTERNATIONAL DE L 'ENFANCE ( C I E 1; OMS. Symposium ( I n t e r n a t i o n a l >: L ' A l i m e n t a t i o n du Nourr isson e t du Jeune Enfant. S t r a t e g i e s pour l a Promot ion de l ' A l l a i t e m e n t Maternel . P a r i s , CIE, 1981. 81p.

55. CERQUEIRA, M.T. ; CASANUEVA, E. ; FERRER, A.M. ; FONTANOT, G. ; CHAVEZ, A. ; FLORES, R. A comparison o f mass media techniques and a d i r e c t method f o r n u t r i t i o n educat ion i n r u r a l Mexico. Journa l o f N u t r i t i o n Educat ion, v o l . Il, no. 2, July-September 1979, p. 133-37.

T r a d i t i o n a l , d i r e c t methods o f n u t r i t i o n educat ion a r e n o t always f e a s i b l e , e s p e c i a l l y i n c o u n t r i e s w i t h l i m i t e d resources. Th is s tudy t e s t e d t h e e f fec t i veness o f mass media r e l a t i v e t o d i r e c t , face-to-face n u t r i t i o n educat ion c o n s i s t i n g o f two two-hour sessions per week f o r t h r e e weeks. N u t r i t i o n knowledge improvements and n u t r i t i o n s t a t u s were s i m i l a r f o r t h e two exper imenta l groups, but t h e c o n t r o l group, which a l s o l i s t e n e d t o t h e r a d i o , inc reased i t s consumption o f food l o w i n n u t r i t i v e value. Thus, t h e r a d i o campaign was as e f f e c t i v e as i n t e n s i v e face-to-face educat ion.

56. CHANDRASEKAR, U. ; RAJALAKSHMI, R. ; DEVADAS, R. P.' Developing a n u t r i t i o n educat ion pr imer f o r a d u l t l i t e r a c y . I n d i a n Journal o f N u t r i t i o n and D i e t e t i c s , v o l . 17, 1980, pp. 117-122.

Evening l i t e r a c y c lasses f o r women were used as a v e h i c l e f o r n u t r i t i o n educat ion. A p r i m e r c o n t a i n i n g n u t r i t i o n educat ion messages was developed

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a f t e r a t e s t o f women's knowledge and used i n 48 c lasses f o r 22 women f o r 3 months. N u t r i t i o n knowledge improved s i g n i f i c a n t l y .

57. CHILDREN, TELEVISION ADVERTISEMENTS AND THE CONSUMPTION OF FOODS OF LOW NUTRITIONAL VALUE. Br isbane, A u s t r a l i a , K e l v i n Grove Co l lege o f Advanced Education, 1980. 2361,.

58. CHRISTOPHER, C.; SHANNON, B.; SIMS, L.S. A mu l t imed ia approach t o teach ing n u t r i t i o n . Journa l o f N u t r i t i o n Educat ion, v o l . 12, no. 1, January-March 1980, pp. 8-1 3.

59. CHURCH, M.; DOUGHTY, J. Value o f t r a d i t i o n a l food p r a c t i c e s i n n u t r i t i o n educat ion. Journa l o f Human N u t r i t i o n , v o l . 30, 1976, PP- 9-12.

N u t r i t i o n educat ion i n Western c o u n t r i e s i s u s u a l l y r e s t r i c t e d t o i m p a r t i n g f a c t s about food groups o r s p e c i f i c n u t r i e n t s . Wi thout assessing t h e ques t ionab le e f f e c t i v e n e s s o f t h i s p r a c t i c e i n i t s o r i g i n a l l o c a l e , i t i s c l e a r t h a t i t does n o t work i n t r a d i t i o n a l s o c i e t i e s . The socioeconomic and c u l t u r a l background o f food behav io r must be considered; i n t r a d i t i o n a l s o c i e t i e s , foods a r e produced a t t h e l o c a l l e v e l . They a t t a i n t h e i r own r o l e s i n t h e s o c i a l and sensory aspects o f peop le 's l i v e s . Food p r e p a r a t i o n f o l l o w s p a r t i c u l a r customs. N u t r i t i o n educat ion, t o be e f f e c t i v e , must take these l o c a l aspects i n t o account and should t r y t o meet i t s o b j e c t i v e s t h r o u g h i n t r o d u c i n g a m i n i m u m o f changes.

60. COMITE FRANCAIS D'EDUCATION POUR L A SANTE. La s a n t é dans l ' a s s i e t t e . P a r i s , Cornit6 d 'Educat ion pour l a Santé, 1982. 40p.

61. CONSEIL DE LIEUROPE. l ' i n t r o d u c t i o n e t a l a promot ion de 1 ' 6 d u c a t i o n n u t r i t i o n n e l l e en m i l i e u s c o l a i r e . Strasbourg, 1982.

Etude des methodes e t moyens nécessa i res à

T h i s s tudy i s based on t h e r e s u l t s o f a survey completed b y members o f t h e Consei l o r b y t h e i r experts. The f i r s t p a r t i s an a n a l y s i s o f t h e i n t r o d u c t i o n o f n u t r i t i o n educat ion i n t o schools, m o t i v a t i n g s tudents, and develop ing c u r r i c u l a . The second p a r t rev iews t h e school c a f e t e r i a : i t s r o l e , m a i n t a i n i n g hygiene, t h e q u a l i t y o f t h e food, e t c . A copy o f t h e q u e s t i o n n a i r e i s inc luded, as w e l l as a b i b l i o g r a p h y .

62. CONFERENCE SUR L'UTILIZATION DES MASS MEDIA DANS LE DOMAINE DE L'EDUCATION NUTRITIONNELLE. Rapport D d f i n i t i f . Washington, D. C., Roy L i t t l e j o h n Associates, 1979. 62p.

T h i s r e p o r t p resents t h e proceedings o f a workshop h e l d f o r n u t r i t i o n educators f rom 9 francophone A f r i c a n c o u n t r i e s . P r a c t i c a l guidance on t h e des ign and a d m i n i s t r a t i o n o f mass media n u t r i t i o n educat ion campaigns was conducted th rough d e t a i l e d o r i e n t a t i o n o f case s t u d i e s f rom T u n i s i a and group exerc ises and f i e l d work. The r e p o r t i n c l u d e s p a r t i c i p a n t s ' p r e s e n t a t i o n s o f

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n u t r i t i o n educat ion a c t i v i t i e s i n Wirundi , Cameroon, I v o r y Coast, C e n t r a l A f r i c a n Empire, Ma l i , Maur i tan ia , Niger, Rwanda, and Zai re.

63. CONTENTO, I. C h i l d r e n ' s t h i n k i n g about food and eat ing--a Piagetian-based study. J o u r n a l o f N u t r i t i o n Educat ion, v o l . 13, supplement 1, 1981, pp. S86490.

I n t h e development o f t h e i r r a t i o n a l a b i l i t i e s , c h i l d r e n do n o t always c a t e g o r i z e foods as a d u l t s would. The author s t u d i e d t h e c a t e g o r i z a t i o n s o f foods b y c h i l d r e n 5 t o 11 years o l d and found t h a t as t h e i r age increased, t h e i r c a t e g o r i z a t i o n o f foods approached t h a t o f adu l ts . She presents a t a b l e showing t h e c a t e g o r i z a t i o n s i n terms o f P iaget ' s c a t e g o r i e s o f p r e o p e r a t i o n a l and concre te o p e r a t i o n a l t h i n k i n g . D i f f i c u l t i e s i n teach ing n u t r i t i o n concepts t o c h i l d r e n t h e r e f o r e a r e n o t n e c e s s a r i l y remedied b y " b e t t e r " t e a c h i n g a i d s o r more f requent i n s t r u c t i o n , but b y o r g a n i z i n g i n s t r u c t i o n t o conform with c h i l d r e n ' s a b i l i t i e s t o understand. N u t r i t i o n educat ion f o r c h i l d r e n should i n c l u d e i n f o r m a t i o n and exper iences from t h e r e a l wor ld t h a t w i l l h e l p c h i l d r e n d i s t i n g u i s h between foods t o avoid and foods t o eat .

64. CONTENTO, I. Measuring and enhancing reasoning a b i l i t i e s o f n u t r i t i o n graduate students-a P i a g e t i a n appraoch. Journal o f N u t r i t i o n Educat ion, v o l , 11, 1979, pp. 184-88.

65. CONTENTO, I. T h i n k i n g about n u t r i t i o n educat ion: What t o teach, how t o t e a c h i t , and what t o measure. Teachers Co l lege Record, v o l . 81, no. 4, summer 1980, pp. 421-447.

T h i s a r t i c l e rev iews t h e c o n t e n t , teach ing methods, and e v a l u a t i o n c r i t e r i a used i n t h e Uni ted States, t o gu ide educators i n t h e s e l e c t i o n o f m a t e r i a l s o f f e r e d b y commercial, government, and academic sources. M a t e r i a l s designed t o convey f a c t s a re u s u a l l y based on a n u t r i e n t - o r i e n t e d approach, l e a v i n g food cho ices up t o t h e l e a r n e r , o r on s p e c i f i c foods o r food groups. Formal n u t r i t i o n educat ion, th rough t h e 1960s and 1970s, focused on i n f o r m a t i o n t r a n s f e r o n l y , w h i l e t h e food i n d u s t r y focused on promot ing behavior change. Educators a r e now l e a r n i n g t o promote behavior changes and t o evaluate t h e i r programs n o t o n l y on t h e b a s i s o f i n f o r m a t i o n gains, but a l s o on a t t i t u d e and behav io r changes, and even on t h e u l t i m a t e goa l o f n u t r i t i o n educat ion, improvement o f a c t u a l n u t r i t i o n s t a t u s . Recent ly designed m a t e r i a l s a l s o seem b e t t e r s u i t e d t o l e a r n e r s ' developmental l e v e l s .

66. COOKE, T.M.; CARROL, G.; DE HAILS, P.A.; ZE ITL IN , M.F. Consul tant Report f o r S i e r r a Leone ( A p r i l 27 - May 8, 1981 1: Report on t h e Anglophone A f r i c a n Regional N u t r i t i o n Educat ion Workshop. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Service, Educat ion Development Center, th rough subcont rac t t o Manoff I n t e r n a t i o n a l , Inc. , Washington, D. C., 1981. 175p.

Th is workshop prov ided t r a i n i n g i n n u t r i t i o n educat ion m a t e r i a l s development f o r r e p r e s e n t a t i v e s f rom 12 A f r i c a n c o u n t r i e s . P a r t i c i p a n t s were g iven an o p p o r t u n i t y t o l e a r n , th rough "hands on" experiences, t h e processes o f program management, message and m a t e r i a l s design, p r e - t e s t i n g , and e v a l u a t i o n . Radio s c r i p t s , f l i p c h a r t s , and o t h e r m a t e r i a l s developed d u r i n g t h e workshop a r e

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inc luded i n t h e r e p o r t . P a r t i c i p a n t s a l s o developed n u t r i t i o n educat ion p r o j e c t p lans f o r each count ry , t o be implemented upon t h e i r r e t u r n .

67. CORNELL UNIVERSITY; OLSON, C.M. ; GILLESPIE, A.H. Workshop: n u t r i t i o n educat ion research. Apply ing p r i n c i p l e s from I thaca, 1980. Journa l o f N u t r i t i o n Educat ion, v o l . 13, no. 1, supplement, 1981, pp. S l S 1 1 8 .

68. CUFFARO, C ; SHYMKO, D.L. Games and a u d i o v i s u a l a i d s i n preadolescent n u t r i t i o n educat ion. Journal o f N u t r i t i o n Educat ion, v o l . 12, no. 3, Ju lySeptember 1980, pp. 162-64.

69. DELAHAYE, M.C. Développement e t Sant'é, no. 33, June 1981, pp. 12-13.

L ' é d u c a t i o n n u t r i t i o n n e l l e adaptée au m i l i e u .

70. DEVADAS, R. P. ; CHANDRASEKHAR, U. N u t r i t i o n educat ion o f i l l i t e r a t e people. Journal o f N u t r i t i o n Educat ion, v o l . 1, 1970, pp. 13-16.

T h i s r e p o r t p resents an overv iew o f n u t r i t i o n techniques and programs t h a t have been used i n I n d i a , i n t h e c o n t e x t o f t h e e x t e n t and e f f e c t s o f I n d i a ' s m a l n u t r i t i o n problems. Methods used have i n c l u d e d demonstrat ions, p l a y s , songs, f i l m s , d i s c u s s i o n meet ings, e x h i b i t i o n s , f i e l d s t r i p s , gardening a c t i v i t i e s , and cooking contes ts . The r e p o r t compares t h e i r r e l a t i v e advantages, disadvantages, and e f fec t i veness . Economic, s o c i a l , and c u l t u r a l c o n d i t i o n s a l l must be considered i n t h e des ign o f i n t e r v e n t i o n p r o j e c t s ; e f f e c t i v e n e s s demands m u l t i f a c e t e d approaches, u s i n g many channels, r e p e t i t i o n o f messages, and f i r s t h a n d exper iences.

71. DODDS, J.M. The handy f i v e food guide. Journa l o f N u t r i t i o n Educat ion, v o l . 13, no. 2, June 1981, pp. 50-52.

72. DOKKUM, W.V. The a p p l i c a t i o n o f magic as an aud io-v isua l a i d i n n u t r i t i o n educat ion. Cajanus, v o l . 11, no. 4, p. 235-41.

Magic t r i c k s a re one o f many dramat ic forms t h a t can be used t o emphasize o r i l l u s t r a t e n u t r i t i o n p o i n t s . As a v i s u a l a i d , magic has an audience- a t t r a c t i n g aspect and can a l s o be used t o convey messages. For example, a t r i c k migh t n o t work a f t e r t h e demonstrator consumes a beverage o f l o w n u t r i t i v e va lue ; then t h e demonstrator d r i n k s t h e beverage b e i n g promoted, and t h e t r i c k works. The s k i l l r e q u i r e d i s no g r e a t e r than many o t h e r d ramat ic dev ices used i n n u t r i t i o n promotion. The author presents s e v e r a l examples i n an i n f o r m a l contex t .

73. .DRUMMOND, T. Using t h e Method o f Paulo F r e i r e i n N u t r i t i o n Education: A n Exper imental Plan f o r Community Ac t ion i n Nor theast ~ B r a z i l . - I thaca, ~~ New York, D i v i s i o n o f N u t r i t i o n a l Sciences, Co l lege o f Human Ecology, Co l lege o f A g r i c u l t u r e and L i f e Sciences, C o r n e l l U n i v e r s i t y , 1975. 55p. ( C o r n e l l I n t e r n a t i o n a l N u t r i t i o n Monograph Ser ies Number 3 )

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The author i n c l u d e s a generous amount o f d e s c r i p t i o n o f t h e ph i losophy o f F r e i r e , who was from Nor theast B r a z i l . Oppressed peoples, such as t h e poor and hungry o f t h i s area, i n t e r n a l i z e t h e low o p i n i o n o t h e r s h o l d o f them; they become " th ings" owned by t h e oppressor. To r e g a i n t h e i r humanity, t h e y must p a r t i c i p a t e i n a humanizing process, i n which n u t r i t i o n can p l a y a l a r g e p a r t . The d e s i r e f o r h e a l t h and s u r v i v a l i s undoubtedly a deep source o f m o t i v a t i o n f o r p a r t i c i p a t i o n i n t h e process o f humanization. The development o f consciousness can thus have a focus. The paper p resents t h e a u t h o r ' s exper iences deve lop ing and a p p l y i n g t h i s ph i losophy t o h e r work i n des ign ing a n u t r i t i o n program i n a poor community.

74. ECOLE D'INFIRMIERES DE SAINTaMER, PAS-DE-CALAIS. Des $ lèves i n f i r m i e r e s ent reprennent l ' g d u c a t i o n a l i m e n t a i r e des p e t i t s . Revue de l ' I n f i r m i è r e , no. 19, 1981, pp. 63-67.

The S a i n t Cher School (Pas-de-Calais, France) operates under a ph i losophy o f care t h a t sees t h e nurse as a " h e a l t h promot ing agent.'' Th is a r t i c l e descr ibes a n u t r i t i o n educat ion t r a i n i n g exper ience conducted a t t h e school i n 1980.

75. EDEMA, J.M.P. S o c i a l phenomena and t h e p lann ing o f a n u t r i t i o n educat ion programme. Soc. Sc i . Med., v o l . 15A, 1981, p. 713-19.

Since t h e u n d e r l y i n g purpose o f n u t r i t i o n educat ion i s t o a l t e r food consumption h a b i t s , i t i s u s e f u l f o r n u t r i t i o n educators t o examine t h e p r i n c i p l e s and g u i d e l i n e s o f behavior change s tud ies . T h i s a r t i c l e presents t h e Behavior M o d i f i c a t i o n Model o f Van Beugen and uses da ta from case s t u d i e s t o fo rmula te proposals f o r u s i n g s o c i a l da ta i n p l a n n i n g n u t r i t i o n educat ion programs. The process emphasizes t h e importance o f s t a t i n g c l e a r l y a l l u n d e r l y i n g premises and examining t h e proposed p r o j e c t ' s impact on t h e o v e r a l l c o n d i t i o n o f t h e audience. The p l a n n i n g .process i s presented schemat ica l l y .

76. EIDE, W. B. Reth ink ing food and n u t r i t i o n educat ion under changing socio-economic c o n d i t i o n s . Food and N u t r i t i o n B u l l e t i n , vo l . 2, no. 2, 1980, pp. 23-28.

T h i s paper p resents t h e proceedings o f a workshop h e l d i n Tanzania i n 1978 t o g e t n u t r i t i o n i s t s t o l o o k a t n u t r i t i o n educat ion as more than mere d isseminat ion o f i n f o r m a t i o n about good food and balanced d i e t . Educators should be aware t h a t t h e i r r o l e i s more than pedagogica l ; t h e y c o u l d p l a y an i m p o r t a n t r o l e i n t h e f o r m a t i o n o f food and n u t r i t i o n p o l i c i e s t h a t cou ld lead t o r e a l improvements i n n u t r i t i o n s ta tus . M a l n u t r i t i o n r e s u l t s n o t o n l y from inadequate q u a n t i t i e s o f food, but a l s o from i n a p p r o p r i a t e d i s t r i b u t i o n o f food and t h e means t o produce and process i t , a t t h e i n t e r n a t i o n a l , n a t i o n a l , l o c a l , and household l e v e l s . The r e p o r t c o n t a i n s s p e c i f i c recommendations t o t h e sponsor, t h e IUNS, f o r promot ing i n t e r e s t and progress i n n u t r i t i o n educat ion. P a r t i c i p a n t s concluded t h a t , a l though t h e r e i s a c o n t i n u i n g need f o r pedagogica l work, o t h e r approaches are a l s o needed. N u t r i t i o n i s t s should broaden t h e i r perce ived r o l e t o i n c l u d e i n f l u e n c i n g p u b l i c and agency p o l i c i e s t h a t a f f e c t n u t r i t i o n s t a t u s i n d i r e c t l y .

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77. FALCK, V.T. A p p l i c a t i o n o f t h e b e h a v i o r a l sciences t o n u t r i t i o n educat ion. Paper prepared for p r e s e n t a t i o n a t t h e Regional Counselor 's Conference, Rice U n i v e r s i t y , Houston, Texas, December 5, 1979, 13p.

T h e o r e t i c a l perspec t ives and problem-solv ing techniques d e r i v e d f rom t h e b e h a v i o r a l sc iences can be used t o enhance the e f f e c t i v e n e s s o f n u t r i t i o n educat ion. N u t r i t i o n educat ion has had l i t t l e demonstrable e f f e c t on food behav io r f o r many reasons, i n c l u d i n g : ( 1 ) ambigu i ty sur round ing t h e v a l i d i t y o f n u t r i t i o n i n f o r m a t i o n ; (2) l i m i t e d invo lvement o f o t h e r p ro fess ions , such as psychology; ( 3 ) l a c k o f adequate fund ing and p u b l i c suppor t : and ( 4 ) c u l t u r a l a t t i t u d e s and values. M u l t i - d i s c i p l i n a r y approaches would h e l p b o t h c o n c e p t u a l l y and methodo log ica l l y , f o r example, i n making food l a b e l s u s e f u l and understandable. B e h a v i o r a l l y - o r i e n t e d m u l t i d i s c i p l i n a r y p r o j e c t s have had e f f e c t s on d i e t a r y h a b i t s : one p r o j e c t focused on r e d u c i n g h e a r t d isease b y i n c r e a s i n g a v a i l a b i l i t y and encouraging consumption o f l o w - f a t foods ; o t h e r s used a systems approach i n v o l v i n g assessment o f t h e needs o f a p o p u l a t i o n and s o c i a l and p s y c h o l o g i c a l determinants o f food choices.

78. FARM R A D I O BROADCASTING: PLAYING A KEY ROLE I N DEVELOPMENT. A g r i c u l t u r a l I n f o r m a t i o n Development B u l l e t i n , v o l . 2, no. 4, December 1980, pp. 2-16.

Radio has been used i n s e v e r a l Asian c o u n t r i e s t o promote food and a g r i c u l t u r a l awareness. The Economic and S o c i a l Commission f o r Asia and t h e P a c i f i c developed "Regional Cooperat ion on Farm Broadcast ing" and c o u n t r y p r o j e c t d e s c r i p t i o n s a r e prov ided. D iscuss ion o f t h e c u r r e n t and p o t e n t i a l impacts o f farm r a d i o b roadcas t ing i n c l u d e s d e s c r i p t i o n s o f p r o j e c t s i n Bangladesh, Malays ia, and t h e P h i l i p p i n e s . Case s t u d i e s p r e s e n t t h e economic success o f a Thai farmer a ided b y government a g r i c u l t u r a l i n f o r m a t i o n s e r v i c e s , and t h e use o f drama i n Papua New Guinea t o s t i m u l a t e awareness and d i s c u s s i o n o f a g r i c u l t u r a l issues.

79. FINCH, I.E. Everyday meal-choosing systems f o r t h e U. K., judged b y educat ional , psycho log ica l , and n u t r i t i o n a l c r i t e r i a . Journa l o f Human N u t r i t i o n , v o l . 35, 1981, pp. 106-17.

80. FLEMING, P.L. ; BRCNN, J. E. Using market research approaches i n n u t r i t i o n educat ion. Journal o f N u t r i t i o n Educat ion, vo l . 13, no. 1, March 1981, pp. 4-5.

T h i s i n f o r m a l paper p o i n t s o u t t h e p r i n c i p l e s o f consumer research t h a t a r e f r e q u e n t l y ignored b y des igners o f n u t r i t i o n educat ion programs and m a t e r i a l s , which o f t e n f a i l because t h e y a r e i n a p p r o p r i a t e . Educators should consider audience concerns, understanding, i n t e r e s t s , and p r i o r i t i e s . For example, i f a group i s found t o va lue o r g a n o l e p t i c f a c t o r s over h e a l t h i n e s s i n choosing foods, a campaign would be b e t t e r - o f f i n emphasizing t h e t a s t i n e s s o f n u t r i t i o u s foods, r a t h e r than t h e i r h e a l t h b e n e f i t s . Format ive and summative eva lua t ions w i l l c o n t r i b u t e t o t h e development o f t h e f i e l d . A l though n u t r i t i o n educators o f t e n cannot d e l i v e r t h e messages audiences want t o hear-- t h e y o f t e n must t r y t o change deeply h e l d b e l i e f s and hab i ts - they can work with t h e i r audiences t o p resent t h e i r messages i n t h e manner most l i k e l y t o be e f f e c t i v e .

81. FONDATION FRANCIASE POUR LA NUTRITION; CENTRE INTERNATIONAL DE L'ENFANCE. Séminai re de R g f l e x i o n Pedagogique sur l 'Enseignement de l a N u t r i t i o n aux E t u d i a n t s en Medecine. P a r i s , Fondat ion Francaise pour l a N u t r i t i o n , 1981.

82. FOREYT, J.P.; SCOTT, L.W.; GOTTO, A.M. Weight c o n t r o l and n u t r i t i o n educat ion programs i n o c c u p a t i o n a l s e t t i n g s . P u b l i c Hea l th Reports, vo l . 95, no. 2, March-Apr i l 1980, pp. 127-136.

Vague d i e t a r y g u i d e l i n e s about t h e recommended p r o p o r t i o n s o f f a t and s a l t i n t h e d i e t a r e r a r e l y t r a n s l a t e d i n t o a c t i o n a b l e recommendations. Behavior m o d i f i c a t i o n p r i n c i p l e s were used i n we igh t l o s s programs i n a v a r i e t y o f s e t t i n g s , i n c l u d i n g t h e m i l i t a r y and l a r g e corpora t ions , t o r e v i e w s p e c i f i c techniques and t h e i r a p p l i c a t i o n . S p e c i f i c s t r a t e g i e s inc luded: (1 s e l f - m o n i t o r i n g o f weight and ea t ing ; (2 1 s t i m u l u s c o n t r o l : a l t e r i n g access t o food; (3) e a t i n g more s lowly ; and (4) cont ingency management u s i n g a re in fo rcement system and a fo rmal c o n t r a c t . The s t r u c t u r e s , c r i t e r i a f o r p a r t i c i p a t i o n , and r a t e s o f success v a r i e d f o r t h e s e v e r a l programs. F u t u r e work should focus on c o s t - e f f e c t i v e n e s s , a t t r i t i o n , fo l low-up, confounding v a r i a b l e s , and c o l l e c t i o n o f pre- and post - t reatment data.

83. FRANCOIS, A. L ' é d u c a t i o n n u t r i t i o n n e l l e . B i b l . Nutr. D ie ta , vo l . 28, 1979, pp. 213-220.

N u t r i t i o n educat ion should be considered a p a r t o f n u t r i t i o n p o l i c y and should be i n c l u d e d i n t h e elementary c u r r i c u l u m . The paper presents d i s c u s s i o n s o f t h e determinants o f n u t r i t i o n behavior , t h e var ious channels th rough which n u t r i t i o n - r e l a t e d i n f o r m a t i o n can be disseminated, and t h e need t o use as many c'hannels as p o s s i b l e . Messages a r e most l i k e l y t o be e f f e c t i v e i f t h e y a r e o b j e c t i v e and c o n s i s t e n t .

84. FUGLESANG, A. About Understanding: Ideas and observa t ions on cross- c u l t u r a l communications. New York, Decade Media Books, Inc., 1982. 231p.

A r i s t o t l e and o t h e r Westerners e x h i b i t arrogance i n b e l i e v i n g t h e r e i s but one s e t o f l o g i c a l p r i n c i p l e s , one s e t o f developmental standards. The author , an a u t h o r i t y on i n f o r m a t i o n , c r o s s - c u l t u r a l communication, and a d u l t educat ion i n T h i r d World c o u n t r i e s , d iscusses h i s exper iences with " i l l i t e r a t e " people, m o s t l y i n A f r i c a , w i t h many examples drawn from n u t r i t i o n educat ion p r o j e c t s . We must r e t h i n k some o f our b a s i c assumptions about language, l e a r n i n g , and understanding; t h e s t a r t i n g p o i n t i n a western conceptual model may be wrong. We should beg in w i t h a search f o r o t h e r models. People i n o t h e r c u l t u r e s may have u s e f u l ways o f communicating, o f which we are unaware. It i s p o s s i b l e t h a t one cannot d e s c r i b e o r understand another c u l t u r e w i t h o u t u s i n g i t s own language.

85. GIBSON, L.D. The psychology o f food: Why we e a t what we e a t when we e a t it. Food Technology, v o l . 35, no. 2, February 1981, pp. 54-56.

D i e t a r y behavior i s i n f l u e n c e d b y s o c i a l , economic, and emot ional fac to rs . T r a d i t i o n a l de terminants o f food h a b i t s i n c l u d e e t h n i c i t y , r e g i o n a l i t y , and

learned h a b i t s ; c u r r e n t concerns a l s o i n c l u d e t i m e c o n s t r a i n t s , concern f o r t h e environment, and i n t e r a c t i o n w i t h t h e many emot ional meanings of food, such as s t a t u s , h o s p i t a l i t y , and s e c u r i t y . The paper d iscusses s t u d i e s o f U. S. food behavior and i t s determinants ; i n d i v i d u a l m o t i v a t i o n s , r a t h e r than group f o r c e s , a r e expected t o p l a y t h e de termin ing r o l e i n American food consumption dec is ions .

86. GILLESPIE, A. App ly ing communication t h e o r y i n n u t r i t i o n educat ion research. J o u r n a l o f N u t r i t i o n Educat ion, v o l . 13, supplement, 1981, pp. S29S31.

Research i n n u t r i t i o n communications i s i n i t s e a r l y stages. Researchers should n o t t r y t o do t h e e q u i v a l e n t o f t r y i n g t o determine a l l t h e n u t r i e n t requi rements i n one exper iment; t h e y must n o t expect g r e a t advances i n a s h o r t t i m e o r f rom a s i n g l e experiment. A g r e a t d e a l o f l o n g i t u d i n a l s tudy w i l l be r e q u i r e d t o determine long-term e f f e c t s o f communications, j u s t as l o n g i t u d i n a l s t u d i e s a r e needed t o determine long-term e f f e c t s o f n u t r i e n t i n t a k e s . The author o f f e r s a model f o r n u t r i t i o n communication research and discusses t h e problems o f comprehensiveness v s . r e a l - w o r l d c o n s t r a i n t s , l a b o r a t o r y vs. f i e l d research, and problems i n measuring change.

87. GRIFFITHS, M. Consu l tan t Report f o r Indones ia (February 9 - March 1. 1981 1: S t r a t e g y f o r N u t r i t i o n Educat ion I n t e r v e n t i o n Component o f t h e Vi tamin A D e f i c i e n c y C o n t r o l P r o j e c t . Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Service, Educat ion Development Center, th rough subcont rac t t o Manoff I n t e r n a t i o n a l , Inc . , Washington, D. C., 1981. 41p.

The b l i n d n e s s p r e v e n t i o n programs o f Helen K e l l e r I n t e r n a t i o n a l i n c l u d e an Indonesian. p r o j e c t t o inc rease consumption o f v i t a m i n A. The o v e r a l l s t r a t e g y i n c l u d e s d i s t r i b u t i o n of capsules o f v i t a m i n A, m o t i v a t i o n , t r a i n i n g , and community educat ion. T h i s r e p o r t o u t l i n e s t h e a p p r o p r i a t e m a t e r i a l s f o r each t a r g e t group and a p l a n o f o p e r a t i o n s w i t h s p e c i f i c o u t p u t s and t i m e t a b l e s . Recommended a c t i v i t i e s i n c l u d e i n t e r s e c t o r a l meet ings t o develop implemen- t a t i o n s t r a t e g i e s , s p e c i f i c s t a f f i n g l e v e l s , conduct ing of workshops for community m a t e r i a l s development, and development o f an e v a l u a t i o n and p l a n f o r t h e f u t u r e o f t h e program.

88. GROGAN, J. Teacher i n s e r v i c e f o r n u t r i t i o n education--an i n t e r d i s c i p l i n a r y approach i n t h e school system. Journal o f N u t r i t i o n Educat ion, v o l . I O , 1978, p. 119.

89. GUSSOW, J. D., ed. Learn ing and ea t ing ; t h e new n u t r i t i o n educat ion. Teachers Co l lege Record, v o l . 81, no. 4, 1980. 124p.

90. GUSSOW, J. Some i m p r a c t i c a l thoughts on t e l e v i s i o n and n u t r i t i o n educat ion. Food Mon i to r , November/December 1980, pp. 10-1 3.

Mass media n u t r i t i o n educat ion i n a s o c i e t y plagued b y overconsumption must promote s e l f - r e s t r a i n t , which i s counter n o t o n l y t o t h e v a s t t i m e a l l o t e d t o food a d v e r t i s i n g , but t o a d v e r t i s i n g and most t e l e v i s i o n programming i n

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general . Food a d v e r t i s i n g promotes ideas counter t o those c h i l d r e n most need : where food comes from, how i t grows, and how t o s e l e c t a balanced and h e a l t h y d i e t . T e l e v i s i o n i s n o t v e r y good a t d e a l i n g with complex i s s u e s such as t h e slow c y c l e s of n a t u r e and our dependence on i t ; i t s n a t u r e i s t o separate watchers f rom r e a l exper ience. The author concludes b y wondering whether t h e bes t n u t r i t i o n educat ion m i g h t be t o run a t e l e v i s e d gardening program cont inuously-and when people ge t t i r e d o f i t , t h e y migh t go o u t and do some work i n t h e s o i l .

91. GUTHRIE, H.A. ; SCHEER, J.C. N u t r i t i o n a l adequacy o f s e l f - s e l e c t e d d i e t s t h a t s a t i s f y t h e four food groups guide. Journal o f N u t r i t i o n Educat ion, v o l . 13, no. 2, June 1981, pp. 46-49.

D i e t a r y r e c o r d s were analyzed f o r t h e i r adequacy i n terms o f b o t h t h e U.S. four food groups and t h e Recommended D a i l y Allowances o f 15 n u t r i e n t s . D i e t s t h a t met t h e food groups c r i t e r i a o f t e n d i d n o t s a t i s f y t h e RDAs, a l though t h e y met 80% o f t h e RDAs f o r a l l n u t r i e n t s . I f t h e goa l o f a food guide i s t o assure an i n t a k e equal o f t h e RDAs, a m o d i f i c a t i o n o f t h e f o u r food groups guide i s needed; o n l y one- th i rd o f t h e s u b j e c t s meet ing t h e four food group c r i t e r i a met t h e RDAs f o r i r o n , z i n c , and v i t a m i n s E and B6.

92. HOCHBAUM, G. S t r a t e g i e s and t h e i r r a t i o n a l e f o r changing peop le 's e a t i n g h a b i t s . Journa l o f N u t r i t i o n Educat ion, v o l . 13, supplement, 1981, pp. 59-65.

93. HORNIK, R.; SOLOMON, D. The Role o f Communication i n N u t r i t i o n . S tan ford , C a l i f o r n i a , I n s t i t u t e f o r Communication Research, S t a n f o r d U n i v e r s i t y , 1978. 109p.

T h i s paper summarizes suppor t f o r USAID's e f f o r t t o turn from a l i m i t e d concept o f n u t r i t i o n educat ion as face-to-face t ransmiss ion o f n u t r i t i o n knowledge t o a broader concept o f n u t r i t i o n educat ion as an a c t i v i t y aimed a t changing behav io r , o f t e n most e f f e c t i v e l y accomplished th rough mass media a c t i v i t i e s . I n improv ing programs, i t i s f i r s t necessary t o determine t h e d e s i r e d outcome and whether i t i s t o be achieved through educat ion alone, o r together w i t h t h e i n t r o d u c t i o n o f some new resource. The charac ter o f t h e audience w i l l a l s o a f f e c t s t r a t e g y dec is ions . The paper rev iews t y p e s o f outcomes l i k e l y t o be sought and descr ibes n i n e n u t r i t i o n communication s t r a t e g i e s , ca tegor ized as mass-communication, i n t e r p e r s o n a l communication, o r combinat ions. The paper concludes t h a t n u t r i t i o n communications i s s t i l l a t t h e exper imenta l stage but i s wor th i n v e s t i g a t i n g f u r t h e r , th rough b o t h e v a l u a t i o n o f ongoing p r o j e c t s and adding t e s t s t o a c t i v i t i e s i n t h e p lann ing s t ages.

94. ISRAEL, R.C., ed. Using Communications t o Solve N u t r i t i o n Problems. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Serv ice, Educat ion Development Center, i n press.

T h i s compendium o f papers b y e x p e r t s i n many f i e l d s r e l a t e d t o n u t r i t i o n communications presents a v a r i e t y o f perspec t ives on t h e v i t a l r o l e communications can p l a y i n improv ing n u t r i t i o n s t a t u s . It i n c l u d e s case

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s t u d i e s on n u t r i t i o n educat ion p r o j e c t s i n Bangladesh, B r a z i l , B o l i v i a , t h e Congo, Indonesia, and Morocco; and a n a l y t i c a l a r t i c l e s on work ing with t r a d i t i o n a l d i e t a r y b e l i e f systems, message des ign, m a t e r i a l s development, t h e use o f a d v e r t i s i n g agencies f o r n u t r i t i o n educat ion, new t o o l s f o r assessing d i e t a r y i n t a k e , and n u t r i t i o n educat ion eva lua t ion .

95. ISRAEL, R.; ZEITLIN, M.F. Consul tant Report f o r Ghana (September 12-19, 1982 1: A Workshop on How t o Adapt Prototype N u t r i t i o n Educat ion M a t e r i a l s . Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Serv ice, Educat ion Development Center, th rough subcont rac t t o Manoff I n t e r n a t i o n a l , Inc., Washington, D.C., 1982. lop.

The World Hea l th Organ iza t ion has pub l ished Gu ide l ines f o r t h e T r a i n i n g i n N u t r i t i o n o f Community Hea l th Workers, an e x c e l l e n t t e c h n i c a l frame o f re fe rence f o r n u t r i t i o n i s t s , t r a i n e r s , and c u r r i c u l u m developers. As a prototype, i t i s t o be used i n t h e n e x t s tep, development o f p r imary h e a l t h care n u t r i t i o n t r a i n i n g m a t e r i a l s as a s e r i e s o f v i l lage-based modules, geared t o t h e c u r r e n t l e v e l s o f knowledge, s k i l l s , and t i m e c o n s t r a i n t s f o r h e a l t h workers. T h i s r e p o r t p resents t h e r e s u l t s o f a workshop h e l d t o implement t h i s s tep ; i t presents t h r e e p r o t o t y p e Ghanaian-speci f ic v i l l a g e modules as exxnples o f t h e k i n d s o f supplemental c u r r i c u l a t o be designed.

96. JANI, S.N.; JANI, L.A. N u t r i t i o n a l t o o l s f o r L D teachers. Acad. Ther., v o l . 14, no. 2, 1978, pp. 165-77.

97. KALLEL, . Z ; MAHJOUB, A.; MEZHOUD, F.; BAHRI, A.M.; BEN A L I , C. Educat ion n u t r i t i o n n e l l e de l ' e n f a n t . Revue Tun. Ped., v o l . 3, 1979, p. 199-206.

Good n u t r i t i o n i s e s s e n t i a l for e a r l y c h i l d development, but many T u n i s i a n c h i l d r e n , p a r t i c u l a r l y those under 3 years o l d , a r e undernour ished o r have problems such as anemia o r r i c k e t s . Th is a r t i c l e presents t h e n u t r i t i o n a l s t a t u s o f chs ld ren i n age groups up t h r o u g h school age, i n c l u d i n g s o c i a l commentary on causes, and n o t e s t h e need f o r n u t r i t i o n educat ion o f mothers. P h y s i c a l and psychomotor development m o n i t o r i n g a r e o u t l i n e d .

98. KIDD, R.; KUMAR, K. Co-opting F r e i r e : A C r i t i c a l Ana lys is o f Pseudo-Freirean A d u l t Educat ion. I n t e r n a t i o n a l Foundat ion f o r Development A l t e r n a t i v e s , Doss ier 24, July/August 1981.

99. KING, J.C.; e t a l . E v a l u a t i o n and m o d i f i c a t i o n o f t h e b a s i c f o u r food guide. Journa l o f N u t r i t i o n Educat ion, v o l . I O , 1978, p. 27.

100. LACHANCE, P.A. A suggest ion 'on food guides and d i e t a r y g u i d e l i n e s . Journa l o f N u t r i t i o n Educat ion, v o l . 13, no. 2, June 1981, p. 56.

101. LARSON, L.B.; MASSOTH, D.M.; CHASE, H.P. Using t h e d i s c o v e r y method i n teach ing n u t r i t i o n . Ecology o f Food and N u t r i t i o n , v o l . 3, 1974, pp. 179-183.

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The d i s c o v e r y method was a p p l i e d t o t h e t r a i n i n g o f n u t r i t i o n a ides f o r n u t r i t i o n educat ion o f m i g r a n t workers. Aides s t u d i e d t h e i r own d i e t a r y h a b i t s and dev ised ways t o inc rease t h e i r own consumption o f s p e c i f i c foods, w i t h o u t i n c r e a s i n g t h e i r expendi tures. Thus, t h e y "discoveredt1 t h e b a s i c p r i n c i p l e s o f a wel l -ba lanced d i e t . They then t r a n s l a t e d t h e i r exper iences i n t o drawings t o be used w i t h m i g r a n t Mexican workers. They had acqu i red m o t i v a t i o n th rough t h e i r own exper iences t o t r a n s f e r the m o t i v a t i o n and i n f o r m a t i o n t o o thers .

102. LESLIE, J. The use o f mass inedia i n h e a l t h educat ion campaigns. E d u c a t i o n a l Broadcas t ing I n t e r n a t i o n a l , v o l . 11, no. 3, 1978, pp. 136-1 42.

Mass media, e s p e c i a l l y newspapers and r a d i o , reach l a r g e p o r t i o n s o f t h e p o p u l a t i o n i n many deve lop ing c o u n t r i e s and represent t h e most e f f i c i e n t means o f reach ing l a r g e audiences. Th is paper p resents a r e v i e w o f 9 p r o j e c t s i n which t h e mass media have been used t o promote h e a l t h and n u t r i t i o n messages i n low-incarne c o u n t r i e s . Two t a b l e s present t h e p r o j e c t s ' major fea tures , such as name, media used, d u r a t i o n , t a r g e t audience and major messages, and e v a l u a t i o n r e s u l t s i n terms o f out reach, a t ta inment o f educat iona l o b j e c t i v e s , e f f e c t s on h e a l t h s t a t u s , and costs . Comparison i s d i f f i c u l t , s i n c e c r i t e r i a d i f f e r e d , 'out most p r o j e c t s d i d reach i s r s e audiences a t r e l a t i v e l y low costs . The r e s u l t s i n d i c a t e , a l t h o u g h n o t c o n c l u s i v e l y , t h a t s p e c i f i c messages can enable audiences t o mod i fy t h e i r behavior and t h a t t h i s m o d i f i e d behavior c o u l d improve h e a l t h o r n u t r i t i o n s t a t u s o f t h e community.

103. LEVY, S. R. ; IVERSON, B. K. ; WALBERG, H. J. N u t r i t i o n educat ion research: an i n t e r d i s c i p l i n a r y e v a l u a t i o n and review. Heal th Educat ion Q u a r t e r l y , v o l . 7, 1980, pp. 107-26.

104. LOVE, R. ; KALNIS, I. I n d i v i d u a l i s t and s t r u c t u r a l i s t p e r s p e c t i v e s on n u t r i t i o n educat ion f o r Canadian c h i l d r e n . Soc. Sci., vo l . 18, no. 3, 1984, pp. 199-204.

The i n d i v i d u a l i s t p e r s p e c t i v e i n h e a l t h educat ion focuses on l i f e s t y l e change; t h e s t r u c t u r a l i s t p e r s p e c t i v e focuses on changing socioeconomic c o n d i t i o n s seen as u n d e r l y i n g n u t r i t i o n problems. The two perspec t ives a r e compared i n t h e c o n t e x t o f n u t r i t i o n educat ion f o r Canadian c h i l d r e n , w i t h r e s p e c t t o ( 1 ) t h e r o o t s o f poor h e a l t h , ( 2 ) a p p r o p r i a t e s t r a t e g i e s f o r h e a l t h programs, and (3 ) t h e t r a i n i n g and subsequent r o l e o f t h e h e a l t h educator i n h e a l t h promot ion. The au thors d iscuss t h e c o n f l i c t s between the p e r s p e c t i v e s and suggest t h a t a s y n t h e s i s i s needed i f progress ive h e a l t h promot ion i s t o occur .

105. MANOFF, R.K. New t o o l f o r n u t r i t i o n educat ion: A d v e r t i s i n g technique. Ceres, v o l . 16, no, 2, March-Apr i l 1983, p. 40-43. [A lso pub l ished i n Spanish and French]

Using examples from a campaign i n t h e P h i l i p p i n e s , t he author presents t h e p r i n c i p l e s o f marke t ing research and development as they can be a p p l i e d t o n u t r i t i o n communications. Key a c t i v i t i e s n o t u s u a l l y i n c l u d e d i n n u t r i t i o n

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program development t h a t c o u l d make a d i f f e r e n c e i n c l u d e t h e use o f focus groups r a t h e r than f i x e d q u e s t i o n n a i r e s ; uncover ing r e s i s t a n c e p o i n t s t o t h e des i red b e h a v i o r a l change; d e s i g n i n g t h e b e h a v i o r a l message t o overcome t h e s p e c i f i c p o i n t s o f r e s i s t a n c e ; p r e t e s t i n g t h e message f o r comprehension, b e l i e v a b i l i t y , r e c e p t i v i t y , a c t i o n a b i l i t y , and m o t i v a t i o n ; and t r a c k i n g t h e campaign's impact and r e v i s i n g i t as necessary t o enhance impact.

106. MANOFF, R.K. The e f f e c t i v e use o f mass media i n n u t r i t i o n educat ion. PAG B u l l . , v o l . 4, no. 1, 1974, pp. 12-17.

The "reach-and-frequency" technique c o n s i s t s o f p l a n t i n g b r i e f messages i n t o and between o t h e r programming. Mass media assure broad out reach, c o n t r o l o f message d e l i v e r y , and i n f l u e n c e over l a r g e groups. They a l s o enhance o t h e r means employed i n n u t r i t i o n educat ion. Success o f a campaign depends on t h e niessage conten t , which t h e r e f o r e must be developed w i t h utmost care. T e s t i n g must be conducted t o assure t h a t t h e messages a r e understood and t h a t t h e y convey t h e message they should. L i m i t a t i o n s and c o u n t e r i n d i c a t i o n s i n c l u d e food shortages, language d i f f i c u l t i e s , and inadequate income t o implement t h e recommended change.

107. MCNAUGHTON, J. Les programmes d' i n t e r v e n t i o n n u t r i t i o n n e l l e : p ièges e t p o t e n t i a l i t e s . Ceres, v o l . 16, no. 2, March-Apr i l 1983, p. 28-33.

N u t r i t i o n educat ion, among a l l n u t r i t i o n i n t e r v e n t i o n s , has t h e most p o t e n t i a l and y e t i s t h e most o f t e n misapp l ied . T h i s a r t i c l e i n f o r m a l l y rev iews t h e r o l e o f v a r i o u s n u t r i t i o n i n t e r v e n t i o n s i n t h e improvement o f c h i l d r e n ' s n u t r i t i o n s t a t u s . N u t r i t i o n educat ion o f t e n f a i l s because i t i g n o r e s good communications p r i n c i p l e s , o r because i t i s a p p l i e d t o i n a p p r o p r i a t e s i t u a t i o n s , such as l a c k o f access t o needed foods. I t i s e s p e c i a l l y impor tan t t o reach mothers w i t h n u t r i t i o n educat ion, because o f t h e i r impact on b o t h t h e h e a l t h and t h e f u t u r e food h a b i t s o f t h e i r c h i l d r e n , and t o reach school c h i l d r e n , w h i l e t h e y are s t i l l f o m i n g t h e i r l i f e l o n g h a b i t s o f h e a l t h and ea t ing .

108. NESTOR, J.P.; GLOTZER, J.A., edc. Teaching N u t r i t i o n : -I --.--___ A Review o f Programs and Research. Cambridge, Massachusetts, Abt Books, 1981.

The Uni ted Sta tes e s t a b l i s h e d t h e n a t i o n a l N u t r i t i o n Educat ion and T r a i n i n g Program i n 1979; a s p a r t o f i t s f i r s t e v a l u a t i o n , a l i t e r a t u r e search o f n u t r i t i o n educat ion programs and research was compiled. T h i s book presents t h e f i n d i n g s o f t h e search, f o r c h i l d r e n o f preschool , e lementary, and h i g h school age; f o r teachers; and f o r school food s e r v i c e personnel . A d d i t i o n a l chapters p resent t h e s t a t e o f t h e a r t i n e v a l u a t i o n o f n u t r i t i o n educat ion programs, and a conceptual framework f o r n u t r i t i o n educat ion, f o c u s i n g on t h e knowledge-at t i tude-behavior-status format , but n o t i n g t h a t t h e r e l a t i o n s among t h e stages are n o t casal. The major f i n d i n g s o f t h e book are t h a t n u t r i t i o n educat ion, a t t h a t t ime, was n o t a wel l -organized f i e l d and was i n need o f sound methodo log ica l g u i d e l i n e s f o r program development and e v a l u a t i o n ; and t h a t a vas t v a r i e t y o f programs and agencies o p e r a t i n g n u t r i t i o n educat ion programs were i n need o f c o o r d i n a t i o n and o r g a n i z a t i o n .

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109. NICHTER, M; NICHTER, M. An A t h r o p o l o g i c a l Approach t o N u t r i t i o n Educat ion. Serv ice, Educat ion Development Center, 1981. 117p. b i b l .

Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication

A l though g u i d e l i n e s f o r n u t r i t i o n educat ion admonish educators t o take l o c a l food b e l i e f s i n t o account, t h e r e has been l i t t l e guidance on h o w t o accompl ish t h i s . T h i s paper p resents a methodology f o r de termin ing l o c a l conceptual models f o r food and n u t r i t i o n , and suggest ions Cor educators desirin!: t o w a r k w i th in t h e e x i s t i n g food system, r a t h e r than work ing o u t s i d e i t o r counter t o i t . The paper p resents major food and n u t r i t i o n conceptua l models i d e n t i f i e d b y t h e authors, p a r t i c u l a r l y i n I n d i a . The "Community Diagnosis irlethodology'' i s presented i n d e t a i l i n an appendix t h a t i n c l u d e s s p e c i f i c ques t ions t o ask i n t h e f i e l d ; t h e system i n c o r p o r a t e s p r i n c i p l e s o f p a r t i c i p a t o r y research and s o c i a l marke t ing techniques.

11 O. NON-FORMAL EDUCATION INFORMATION CENTER. Ch i ld ren : Heal th, Educat ion, - and Changs. A Selected, Annotated B i b l i o g r a p h y . East Lansing, Michigan, Non-formal Educat ion I n f o r m a t i o n Center, Co l lege o f Educat ion, Michigan S t a t e U n i v e r s i t y , 1981. 40p. (Annotated B i b l i o g r a p h y 116)

Sect ions o f t h i s b i b l i o g r a p h y i n c l u d e : educat ion and c h i l d development; i s s u e s and p o l i c i e s i n c h i l d r e n ' s p r o j e c t s and educat iona l programs ; pr imary h e a l t h care; f i g h t i n g hunger, m a l n u t r i t i o n , and i n f a n t m o r t a l i t y ; j o u r n a l s , n e w l e t t e r s , %-~:?::\a7. issues, and b i b l i o g r a p h i e s ; and l a t e a c q u i s i t i o n s The s e c t i o n on hunger i n c l u d e s r e f e r e n c e s from developing c o u n t r i e s .

11 1. NON-FORMAL EDUCATION INFORMATION CENTER. Non-Formal * ---- Educat ion and Heal th : A Selected, Annotated B ib l iography . East Lansing, Michigan, Non-formai Educat ion I n f o r m a t i o n Center, Co l lege o f Education, Michigan S t a t e U n i v e r s i t y , 1981. 56p. (Annotated B i b l i o g r a p h y #2)

T h i s annotated b i b l i o & r a p k y i n c l u d e s s e c t i o n s on h e a l t h educat ion and on n u t r i t i o n and h e a l t h .

11 2. OFICINA REGIONAL PARA EUROPA. A l imentac ión y Salud. Pamplona, S a l v a t S.H. de Edic iones, 1981.

Enciclop-%dia S a l v a t de l a Salud,--Tom_o_nl~

113. OLSON, C.M.; GILLESPIE, A., eds. Proceedings o f t h e workshop on n u t r i t i o n educat ion research. Journa l o f N u t r i t i o n Educat ion, vo l . 13, no. 1, supplement 1, 1981, 118p.

114. OLSON, L.K. ; REDICAM, K. J. ; KRUS, P.H. The school h e a l t h c u r r i c u l u m p r o j e c t : a r e v i e w o f research s tud ies . H e a l t h Education, January/February, 1980, p. 16.

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115. PARLATO, R. Consul tant Report f o r I n d i a (June 16 - July 18, 1982): Design f o r t h e N u t r i t i o n and H e a l t h Educat ion Component o f USAïD/India 's I n t e g r a t e d Maternal and C h i l d N u t r i t i o n P r o j e c t . Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Serv ice, Educat ion Development Center, through subcont rac t t o Manoff I n t e r n a t i o n a l , Inc. , Washington, D.C., 1982. 57p.

T h i s r e p o r t p resents t h e c o n s u l t a n t ' s work i n the n u t r i t i o d h e a l t h educat ion (NHED) p o r t i o n o f t h e I n t e g r a t e d C h i l d Development Scheme (ICDS) , i n c l u d i n g : ( 1 ) an e v a l u a t i o n o f t h e NHED e f f o r t w i th in t h e e x i s t i n g ICDS program, based on government da ta and d iscuss ions w i t h I C D S o f f i c i a l s ; ( 2 ) a r e v i e w o f major issues. concern ing NHED, such as l a c k o f p lanning, l a c k o f f u l l u t i l i z a t i o n o f resources, and i n s u f f i c i e n t community p a r t i c i p a t i o n ; (3) a program a n a l y s i s , c r i t i c a l l y r e v i e w i n g a l l n a t i o n a l i n s t i t u t i o n s w i th in ICDS and s t a t e ICDS o p e r a t i o n s i n G u j a r a t and Maharashtra; (4 ) d e s i g n o f a renewed p r o j e c t t o remedy problems i d e n t i f i e d through t h e processes descr ibed above; and ( 5 ) a budget f o r t h e p r o j e c t . Gu ide l ines s e t o u t b y t h e M i n i s t r y o f S o c i a l Wel fare s t a t e t h a t NHED i s t o p r o v i d e educat ion t o a l l women o f c h i l d b e a r i n g age, and t o p rov ide f o l l o w u p t o mothers whose c h i l d r e n are malnour ished or f r e q u e n t l y ill. The key person i n t h i s process i s t h e anganwadi worker i n t h e community, who conducts t h e face-to-face educat ion.

116. PETERS, J. Teaching n u t r i t i o n i n schools: do our s tudents p r a c t i c e what we teach? Cajanus, v o l . 13, no. 2, p. 77-84.

Research has demonstrated t h a t improv ing s tudents ' n u t r i t i o n knowledge does n o t n e c e s s a r i l y l e a d t o improvements i n t h e i r n u t r i t i o n a t t i t u d e s o r p r a c t i c e s . To improve t h e e f f e c t i v e n e s s o f n u t r i t i o n teaching, t h e f o l l o w i n g f a c t o r s should be considered: t h e s tudents ' own p e r c e p t i o n s o f t h e i r n u t r i t i o n problems, s tudent a c t i o n and involvement i n t h e p r i n c i p l e s t a u g h t ( f o r example, conduct ing t h e i r own n u t r i t i o n s t a t u s survey) , and p r e s e n t i n g i n f o r m a t i o n t h a t t h e s tudents w i l l see as u s e f u l and r e l e v a n t t o t h e i r l i v e s . Much o f t h e "educat ion" s tudents r e c e i v e i s mass media promot ion o f foods o f ques t ionab le n u t r i t i o n a l va lue; n u t r i t i o n educators must a l s o use t h e media t o counterac t t h i s n e g a t i v e i n f 1 uenc e.

117. PLAT, P. Habi tudes a l i m e n t a i r e s e t educat ion n u t r i t i o n n e l l e . [Food H a b i t s and N u t r i t i o n a l Educat ion] , V ie Medica le au Canada Franca is , v o l . 10, no. 3, March 1981, pp. 232-42.

11 8. RAIMBAULT, A.M. N u t r i t i o n Educat ion o f pre-school c h i l d r e n ; Suggest ions t o teachers and parents : A ids t o programming UNICEF ass is tance t o educat ion. Par is , UNESCO U n i t f o r Cooperat ion w i t h UNICEF and WFP. November 1981, lop .

Ch i ld ren a c q u i r e l i f e l o n g h a b i t s a t an e a r l y age; t h e e a r l y i n t r o d u c t i o n o f p r i n c i p l e s o f h e a l t h and hygiene i - s t h e r e f o r e c r u c i a l , b o t h a t home and at, school. Th is paper p resents n o t o n l y a l i s t i n g o f t h e p r i n c i p l e s c h i l d r e n should master a t an e a r l y age. N u t r i t i o n educat ion should n o t be a

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supplementary a c t i v i t y but should be i n t e g r a t e d with o ther a c t i v i t i e s , such as language s k i l l s , games, and sensory experiences. The b a s i c g o a l must be t o i n c r e a s e c h i l d r e n ' s awareness and t o enable them t o e a t w e l l and consume l o c a l products . Examples o f u s e f u l games and a c t i v i t i e s a re prov ided.

119. RAMSEY, C.E. ; CLOYD, M. M u l t i p l e o b j e c t i v e s and the success o f e d u c a t i o n a l programs. J o u r n a l o f N u t r i t i o n Educat ion, v o l . 11, 1979, p. 141.

120. REDMAN, B. J. Consumer Behavior: Theory and A p p l i c a t i o n s . Westport , Connect icut , A V 1 P u b l i s h i n g Company, Inc. , 1979. 253 p. b i b l .

T h i s work, designed f o r economists, fuses v a r i o u s s o c i a l sc ience approaches t o t h e t h e o r y and p r a c t i c e o f consumer behavior. Inc luded are C a t t e l l ' s " f a c t o r a n a l y s i s approach," D o l l a r d and M i l l e r ' s " s o c i a l l e a r n i n g approach,'! and Roger's llhumanisticll approach. The case s tudy o f s o c i a l i n f l u e n c e s on t h e " d i e t i n g consumer" examines t h e r o l e s o f r e f e r e n c e groups and o f se l f -concepts i n d e t e r m i n i n g d i e t a r y p r a c t i c e s .

121. RITCHIE, J.A. S. Combler l a lacune-que lques problèmes de communication e t d'empathie auxquels se h e u r t e l ' é d u c a t i o n n u t r i t i o n n e l l e . v o l . 5, 1979, pp. 11-1 9.

Al iment. Nutr.,

N u t r i t i o n educat ion has had l i t t l e impact on m a l n u t r i t i o n , f o r a number o f reasons. In a d d i t i o n t o socioeconomic and o r g a n i z a t i o n a l causes, t h e background, s e l e c t i o n , t r a i n i n g , and use of n u t r i t i o n educators themselves i s o f t e n i n a p p r o p r i a t e . Many are n o t s u f f i c i e n t l y f a m i l i a r w i t h t h e p o p u l a t i o n s t h e y a r e supposed t o serve and cannot o r w i l l n o t b r i d g e t h a t gap. The educat ion t h e y t r y t o g i v e i s t h u s n o t s u i t e d t o l o c a l c o n d i t i o n s and t o t h e b a s i c needs and p e r c e p t i o n s o f t h e t a r g e t p o p u l a t i o n . The au thor makes s e v e r a l recommendations f o r improv ing n u t r i t i o n educators ' p r e p a r a t i o n f o r t h e i r r o l e .

122. SANTOS, W. ; e t a l . N u t r i t i o n Educat ion and Food Science Technology. New York, Plenum Press, 1980. 950p.

T h i s i s t h e second o f t h r e e volumes o f proceedings o f t h e Eleventh I n t e r n a t i o n a l Congress o f N u t r i t i o n , h e l d i n 1978. Among t h e papers on n u t r i t i o n educat ion are d e s c r i p t i o n s o f programs and p r o j e c t s i n I s r a e l , t h e P h i l i p p i n e s , t h e Nether lands, t h e Un i ted Kingdom, and Tanzania. Other p r e s e n t a t i o n s examine e v a l u a t i o n issues, a p p r o p r i a t e n u t r i t i o n educat ion goa ls f o r develop ing c o u n t r i e s , and t r a i n i n g f o r s p e c i a l groups such as med ica l personnel , h e a l t h workers, and community n u t r i t i o n i s t s .

123. SEVENHUYSEN, G. P. I n f o r m a l n u t r i t i o n educat ion: thoughts on i t s use. Food and N u t r i t i o n , v o l . 4, no. 1-2, 1978, pp. 25-26.

I n f o r m a t i o n about n u t r i t i o n i s n o t s u f f i c i e n t t o change n u t r i t i o n behavior ; m o t i v a t i o n i s a l s o e s s e n t i a l . Design ing a m o t i v a t i o n program depends on understanding t h e p r i o r i t i e s and concerns o f t h e p o p u l a t i o n addressed;

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F r e i r e ' s methodology c a l l s f o r t h e educator t o accept t h e concerns o f t h e community as paramount. Economic o r convenience concerns may outweigh n u t r i t i o n a l awareness, and a program cannot be successfu l w i t h o u t t a k i n g these i n t o account. N u t r i t i o n educat ion messages should be b r i e f , d i r e c t e d t o t h e concerns o f t h e community, and educators should c o n s u l t l o c a l p r o f e s s i o n a l s i n r e l a t e d f i e l d s , such as a g r i c u l t u r e , i n l e a r n i n g about t h e community.

124. SHACK, K.W., ed. Teaching N u t r i t i o n i n Developing Countr ies. Meals f o r M i l l i o n s Foundat ion, 1977. 193p.

Th is book presents papers from a workshop conducted t o e s t a b l i s h p r i n c i p l e s and g u i d e l i n e s f o r p a r t i c i p a t o r y n u t r i t i o n educat ion i n developing c o u n t r i e s , t o promote r e c o g n i t i o n t h a t m a l n u t r i t i o n i s n o t due o n l y t o l a c k o f n u t r i t i o n i n f o r m a t i o n . Communities must be i n v o l v e d i n i d e n t i f y i n g t h e i r own problems and t h e s o l u t i o n s t o them. Case s t u d i e s from A f r i c a , Asia, and C e n t r a l America descr ibe t h e i n t e g r a t e d approach t o n u t r i t i o n educat ion, t r a i n i n g n u t r i t i o n i s t s , mass media approaches, e d u c a t i o n a l t o o l s , and d i r e c t i o n s f o r e v a l u a t i o n o f n u t r i t i o n educat ion p r o j e c t s . The s e l f - r e l i a n c e p r i n c i p l e s o f Paulo F r e i r e a r e r e l i e d upon throughout .

125. SINGER, E.A. F o l k l o r e f o r n u t r i t i o n educat ion. Journal of N u t r i t i o n Educat ion, v o l . 14, no. 1, March 1982, pp. 12-13.

126. STANFIELD, J.P. Improv ing c h i l d n u t r i t i o n a t t h e v i l l a g e l e v e l . C h i l d Care, H e a l t h and Development, v o l . 7, no. 2, March-Apr i l 1981, pp. 85-89.

127. SWEENEY, W.O. Us ing Radio f o r Pr imary H e a l t h Care. Washington D.C., American P u b l i c Hea l th Associat ion, 1982. 56p. b i b l . (Pr imary Hea l th Care Issues , s e r i e s 1, no. 1 )

The au thors reviewed 88 media p r o j e c t s and s e l e c t e d 47 f o r d e t a i l e d p r e s e n t a t i o n and a n a l y s i s , based on re levance and completeness o f t h e i n f o r m a t i o n a v a i l a b l e . Char ts and t a b l e s present t h e a c t i v i t i e s o f t h e p r o j e c t s so t h e y can be compared. The au thors conclude t h a t c a r e f u l l y designed and t a r g e t e d programs can p r o v i d e u s e f u l i n f o r m a t i o n , promote t h e use o f h e a l t h products and serv ices , a i d i n p a r t i c i p a b o r y process, and produce r e s u l t s i n c l u d i n g change and a c t i o n . The second p a r t p resents g u i d e l i n e s f o r development o f r a d i o p r o j e c t s , based on t h e lessons i l l u s t r a t e d i n t h e cases reviewed. Appendices present 47 p r o j e c t summaries and a l i s t o f USAID resources f o r f i e l d suppor t o f r a d i o p r o j e c t s .

128. THE USE OF MASS MEDIA I N FOOD AND NUTRIT ION PROGRAMMES: GUIDELINES FOR PLANNERS AND DECISION MAKERS. Kingston, Jamaica, Caribbean Food and N u t r i t i o n I n s t i t u t e , Pan American H e a l t h Organ iza t ion , 1978. 32p.

This document c o n c i s e l y p resents g u i d e l i n e s on problem i d e n t i f i c a t i o n , c o o r d i n a t i o n o f program p lann ing , problem a n a l y s i s , f o r m u l a t i o n o f o b j e c t i v e s , i d e n t i f i c a t i o n o f audience c h a r a c t e r i s t i c s , message des ign, media s e l e c t i o n , research, and e v a l u a t i o n . I n a d d i t i o n t o a d e t a i l e d d e s c r i p t i o n o f t h i s

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process, t h e r e p o r t i n c l u d e s l i s t s o f t r a i n i n g and research needs, proposals f o r a c t i o n , and r e p o r t s on r e c e n t n u t r i t i o n educat ion development a c t i v i t i e s i n t h e r e g i o n .

129. TRAGLER, A.T. ; BHATT, S.S. ; FERNANDEZ, A. Assessment o f h e a l t h educat ion i n n u t r i t i o n . J o u r n a l o f T r o p i c a l P e d i a t r i c s , v o l . 27, no. 4, August 1981, pp. 221-223.

130. VESIN, P. ; AGHI, M. ; MOREL, G., eds. C h i l d N u t r i t i o n / M a l n u t r i t i o n I n f o r m a t i o n and Mass Media: A Workshop h e l d a t t h e F i l m and TV I n s t i t u t e o f I n d i a , January 28-February 1, 1982. P a r i s , The I n t e r n a t i o n a l C h i l d r e n ' s Centre, 1983. 176p.

The papers presented a t t h i s conference i n c l u d e s e v e r a l case s t u d i e s o f p i l o t p r o j e c t s o r exper iments i n t h e e f f e c t i v e n e s s o f n u t r i t i o n educat ion i n t e r v e n t i o n s i n v a r i o u s l o c a t i o n s and c o n t e x t s i n I n d i a . D e s c r i p t i o n s i n c l u d e methodologies and d e t a i l s o f implementat ion, such as t r a i n i n g programs and e d u c a t i o n a l m a t e r i a l s developed, as w e l l as e v a l u a t i o n s o f t h e programs' e f f e c t i v e n e s s . Other papers present guidance on t h e use and development o f mass media a c t i v i t i e s and sample t e l e v i s o n and r a d i o s c r i p t s produced b y conference work ing groups.

131. WHEELER, E.F. Teaching n u t r i t i o n i n schools: Can r e a l da ta be used? Human N u t r i t i o n : A p p l i e d N u t r i t i o n , v o l . 36A, 1982, pp. 11-17.

Th is a r t i c l e presents s t a t u s , r i s k , and t r e n d i n f o r m a t i o n d e r i v e d from B r i t i s h n u t r i t i o n surveys and proposes t h a t an e x c e l l e n t avenue f o r d isseminat ing t h i s i n f o r m a t i o n t o t h e genera l p u b l i c i s th rough secondary-school- level s tudents . They a r e aware o f e x i s t i n g p u b l i c i t y about t h e survey f i n d i n g s and a r e u s u a l l y eager t o h e l p promote t h e p u b l i c welfare.. A t t h i s stage i n t h e i r l i v e s , t h e y a r e fo rming l i f e l o n g h a b i t s i n n u t r i t i o n . School-based n u t r i t i o n educat ion can put n u t r i t i o n problems i n t o t h e i r s o c i a l and economic c o n t e x t s th rough classroom d iscuss ion , t o promote f u r t h e r p u b l i c awareness and understanding o f n u t r i t i o n problems and t h e i r under1 y i n g causes.

132. WHO. Gu ide l ines f o r Developing S t r a t e g i e s t o Promote Success fu l Breas t feed ing . Repor t o f a Techn ica l Group Meet ing, Barbados, 1979. 26p. (MCH/RW/BF/79.1)

These g u i d e l i n e s were developed b y a group o f e x p e r t s se lec ted f o r t h e i r knowledge, exper ience, and concern about b r e a s t feeding. Gu ide l ines cover areas i n h e a l t h , i n c l u d i n g h o s p i t a l p o l i c i e s t h a t encourage b r e a s t feeding; l e g i s l a t i o n and n a t i o n a l p l a n n i n g p o l i c i e s ; and educat ion o f p r o f e s s i o n a l s and t h e genera l p u b l i c . F u r t h e r i n f o r m a t i o n i s needed on the knowledge, a t t i t u d e s , and p r a c t i c e s o f h e a l t h p r o f e s s i o n a l s ; on materna l n u t r i t i o n ; and on t h e va lue o f t h e mass media i n promot ing b r e a s t feeding. Appendices descr ibe t h e phys io logy o f b r e a s t feeding, p e r i n a t a l p r a c t i c e s i n t e r f e r i n g w i t h l a c t a t i o n , and m o d i f i c a t i o n s i n h e a l t h s e r v i c e s t o avoid such i n t e r f e r e n c e .

133. WHO. 1n.Pant and Young --- -- C h i l d Feeding: I---- Curren t Issues. Geneva, WHO, 1981, 114p.

134. WHO Na t iona l - 'uJcrkshop - f o r t h e Promotion o f __-. Breas t feed ing , _---- Niger ia , 25-29 November 1979. 1 I p . (MCH/NW/BF/79.2)

Representat ives f rom 4 A f r i can n a t i o n s convened t o d i scuss t h e i s s u e o f b r e a s t feed ing and the s t a t u s o f women and t o propose s teps towards improv ing the s t a t u s o f i n f a n t aiid young c h i l d feeding. I n t h e c o n t e x t o f decreas ing b r e a s t feeding r a t e s and a r a p i d l y changing s o c i e t y and h e a l t h se rv i ces , recominenda- t i o n s were made i n t h e areas o f h e a l t h serv ices , s o c i a l l e g i s l a t i o n , weaning foods, t h e i n f a n t food i n d u s t r y , mass media and the promot ion o f b reas t feeding, t h e s t a t u s o f women, and t h e r o l e o f t h e government i n safeguard ing c h i l d n u t r i t i o n .

135. WHO. Report o f a Regional Workshop f o r t h e Promotion -- o f Breast feeding, B r a z i l , 4-7 Septeniber 1978. 2%. (MCH/RW/BF/78. 1)

The World Hea l th Organ iza t i on convened t h i s workshop f o r r e p r e s e n t a t i v e s from e i g h t c o u n t r i e s t h a t had expressed i n t e r e s t i n deve lop ing n a t i o n a l prograins t o promote b reas t feed ing and reve rse t h e t r e n d away f rom b r e a s t feeding. Tables present c u r r e n t i n f o r m a t i o n on t h e s t a t u s o f b r e a s t f eed ing p r a c t i c e s i n t h e e i g h t c o u n t r i e s , i n c l u d i n g reasons g i v e n f o r e a r l y weaning. Working groups developed g u i d e l i n e s f o r research, l e g i s l a t i o n , t r a i n i n g h e a l t h p r o f e s s i o n a l s , and t h e r o l e s o f t h e h e a l t h sec to r and o f educat ion i n promot ion o f b r e a s t feeding. Educat ion should i n c l u d e fo rmal educat ion i n t h e h e a l t h sec to r and t h e popu la t i on i n genera l , and i n f o r m a l p u b l i c educat ion, i n c l u d i n g t h e mass media, s i n c e p u b l i c suppor t , i n c l u d i n g t h e suppor t o f f a t h e r s , i s e s s e n t i a l .

136. WIGHT, J.A. Non-formal n u t r i t i o n educat ion f o r r u r a l development i n L a t i n America. Arch. Latinoam. N u t r . , v o l . 37, no. 3, 1977, PP. 285-293-

-I-

Nonformal educat ion programs should take i n t o account t h e n u t r i t i o n a l and s a n i t a t i o n needs o f t h e r u r a l p o p u l a t i o n s t h e y address. R u r a l teachers and educa t iona l agents can use nonfonna l educat ion t o improve t h e n u t r i t i o n a l s t a t u s , f a m i l y h e a l t h , and s o c i a l development o f t h e i r communities. Nonformal i n s t r u c t i o n can r e i n f o r c e fo rmal educat ion o f t h e schools.

137. WODARSKI, L. A. ; e t a l . Teaching n u t r i t i o n b y teams-games-tournaments. Jou rna l -.- . 1 1 - - -- o f - -- N u t r i t i o n --- Educat ion, v o l . 12, 1980, p. 61.

138. YARBORO!JGH, P. Communication t h e o r y and n u t r i t i o n educat ion research. Journa l o f N u t r i t i o n Educat ion, v o l . 13, supplement, 1981, pp. S16S27.

Th is paper o u t l i n e s t h r e e o f t h e many pe rspec t i ves on c o m i i m i c i t i o n s t h e o r y and b r i e f l y p rov ides a p p l i c a t i o n s t o n u t r i t i o n educa t ion research. Communications t h e o r i e s a re based p r i m a r i l y on e s t a b l i s h e d s o c i a l sciences, n o t a b l y psychology and soc io losy . F o r t y years o f research has y i e l d e d a v a r i e t y o f pe rspec t i ves and t h e o r i e s . The comniunications e f Pects p e r s p e c t i v e

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p r o b a b l y has t h e g r e a t e s t p o t e n t i a l f o r e v a l u a t i n g the short- term e f f e c t s o f e d u c a t i o n a l e f f o r t s , but t'ne s o c i a l r e l a t i o r i s h i p s perspec t ive , e s p e c i a l l y adopt ion-d i f fus ion concepts, should a l l o w f o r longer- term program eva lua t ion . The programat ic p e r s p e c t i v e reminds us t h a t communications i s an ongoing, dynamic, and r e c i p r o c a l process. It i s p robab ly t h e most d i r e c t l y a p p l i c a b l e t o w s e s o f ongoing face-to-face c o m u n i c a t i o n s . 139, ZEITLIN, M.F. ; FORMACION, C. S. N u t r i t i o n I n t e r v e n t i o n i n Developing Countr ies ; Study II: N u t r i t i o n Education. Prepared b y t h e Harvard I n s t i t u t e f o r I n t e r n a t i o n a l Development f o r O f f i c e o f N u t r i t i o n , U. S. Agency f o r I n t e r n a t i o n a l Development. Cambridge, Massachusetts, Oelgeschlager, Gunn & 'rlsin, Publ ishers , 1981. 34%.

T h i s volume p r e s e n t s thorough d iscuss ions o f t h e r o l e o f n u t r i t i o n educat ion as an independent i n t e r v e n t i o n and as p a r t o f o t h e r i n t e r v e n t i o n s ; i t s forms and usage; e lements o f i n t e r v e n t i o n design; t h e channels f o r t r a n s m i t t i n g n u t r i t i o n a l adv ice and f o r teach ing new behav io rs ; and eva lua t ion , i n terms o f c o s t and t e c h n i c a l cons idera t ions . "he f i n a l s e c t i o n presents a d e t a i l e d case s tudy o f a P h i l i p p i n e r a d i o campaign t o teach enrichment o f r i c e p o r r i d g e used as a weaning food. The case s tudy i n c l u d e s a d e t a i l e d d i s c u s s i o n and a n a l y s i s o f t h e campaign's background, design, and eva lua t ion .

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III: Basel ine I n f o r m a t i o n and Ethnographies

140. ANANTHARAMAN, K. Report ( F i n a l ) : N u t r i t i o n and Food Cond i t ions -------- o f t h e C h i l d i n __c__- t h e A f r i c a n -_-- -- I Fami ly , - I n t e r - A f r i c a n Seminar, Dakar, 1980. P a r i s , I n t e r n a t i o n a l Union o f Family Organizat ions, 1982, 74p.

141. A SUMMARY REPORT ON U.S. CONSUMERS' KNOWLEDGE, ATTITUDES AND PRACTICES ABOUT NUTRITION--1980. Minneapol is, General M i l l s , N u t r i t i o n and Marke t ing Research Departments, 1981. 45p.

142. BALDERSTON, J.B. ; WILSON, A.B. ; FHEIRE, 14. E. ; SIMONEN, M.S. Malnour ished C h i l d r e n o f t h e Rura l P o o r G e Web o f Food, Heal th, Educationr-cert_&gky, and Agr i c u l tur a l Product ion. 1981. 223p.

Bo s t o n , Ma ssa chus e t t s, Aub Ur n Pub 1 i s h i n g Corn pan y,

A l though t h e i n t e r r e l a t i o n s o f m a l n u t r i t i o n , d isease, educat ion, income, and f a m i l y s i z e are commonly acknowledged, t h e r e i . 3 1 . i t t l e understanding o f how t h e y i n t e r a c t . Such an understanding would c o n t r i b u t e t o t h e e f f e c t i v e a l l o c a t i o n o f scarce resources ; i f hungry c h i l d r e n cannot l e a r n , an investment i n educat ion i s wasted. The au thors use data from Guatemala t o examine t h e p o s s i b l e c o r r e l a t i o n s . Among t h e conc l us ions and observa t ions : p a r e n t a l l i t e r a c y i s c o r r e l a t e d with q u a l i t y o f c h i l d r e n ' s d i e t s ; h i g h c a l o r i e i n t a k e s are p o s i t i v e l y c o r r e l a t e d w i t h school per formance; Ch i ld re i î o f lower b i r t h order a re more l i k e l y t o be e n r o l l e d i n school ; when economic and f a m i l y background f a c t o r s are h e l d constant , t h e s i z e and h e a l t h o f t h e c h i l d a re s t r o n g l y c o r r e l a t e d with p a r t i c i p a t i o n and performance i n school . Female l i t e r a c y was c o r r e l a t e d w i t h decrease i n f e r t i l i t y , a f t e r c o n t r o l l i n g for socioeconomic s t a t u s . The au thors conclude t h a t educat ion i s c r u c i a l t o t h e adopt ion o f a g r i c u l t u r a l i n n o v a t i o n s and t o t h e success o f f a m i l y p l a n n i n g programs. They p r e s e n t f i v e types o f program i n t e r v e n t i o n s and p o s s i b l e implementat ion combinat ions f o r d i f f e r e n t c i rcumstances, t o be determined b y p o l i c y makers who, depending on t h e i r va lues, wi1.1. have t o dec ide on the r i g h t balance between competing c r i t e r i a o f e q u i t y and e f f i c i e n c y .

143. BIRCH, L. L. The r e l a t i o n s h i p between c h i l d r e n ' s food preferences and those o f t h e i r parents . ~ o - ~ r - ~ a ~ - _ * o . f _ ~ t r i t i o n Educat ion, v o l . 12, no. 1, January-March 1980, pp. 14-1 8.

144. COMMITTEE ON FOOD CûNSUiF'TION PATTEHNS, FOOD AND NUTRITION BOARD, NATIONAL RESEARCH COUNCIL. Washington, D.C., N a t i o n a l Acadeny Press, 1981. 2 8 4 ~ .

k s - s s s i n g &angin!? Food Cons-Em&ki-o.n- _P_atterns.

T h i s s tudy examined e x i s t i n g means o f de termin ing U.S. food consumption p a t t e r n s and n u t r i t i o n a l s t a t u s and proposes a l t e r n a t i v e methods f o r o b t a i n i n g t h i s data. The proposed system u t i l i z e s government and commercial sources o f i n f o r m a t i o n t o mon i to r s t a t u s and d i e t a r y h a b i t s . A f i ve-year c y c l e would r e v e a l t rends . I n t a k e would be measured by 24-hour r e c a l l s ; e x i s t i n g food composi t ion da ta would be used; m o r b i d i t y and m o r t a l i t y d a t a would be t h e chosen h e a l t h s t a t u s i n d i c a t o r s ; t h e s u b j e c t s s t u d i e d would be s t r a t i f i e d b y

4 4

age, p h y s i o l o g i c a l s t a t e , r e g i o n , socioeconomic l e v e l , race , and e t h n i c i t y . Some anthropometr ic and b iochemica l nnessures o f n u t r i t i o n s t a t u s would be taken, o f a subsample. Background papers p resent method f o r c o l l e c t i n g food c o n s m p t i o n data, and n u t r i t i o n and h e a l t h s t a t u s i n d i c a t o r s .

145. DEN HARTOG, A.P. Urban iza t ion , food h a b i t s and n u t r i t i o n . World Review -- o f N u t r i t i o n and D i e t e t i c s , -- -- v o l . 38, 1981, pp. 133-152.

U r b a n i z a t i o n i s proceeding r a p i d l y i n developir ig c o u q t r i e s , caus ing changes i n p o p u l a t i o n food h a b i t s and access and r e s u l t i n g i n new n u t r i t i o n problems. Urban m i g r a n t s encounter p ro5 lans 1dLkh Access t o food, f o r i t cannot be grown, and a cash income i s r e q u i r e d . Mothers, o f t e n fo rced by c i rcumstances t o seek p a i d work, a re l e s s l i k e l y t o b r e a s t f e e d - r e s u l t i n g i n in fau i t m a l n u t r i t i o n . Foods may b e s e l e c t e d f o r t h e i r s t a t u s o r ease o f p r e p a r a t i o n (due t o l a c k o f f u e l ) r a t h e r than n u t r i t i o n a l va lue. I i u r a i areas are i n t u r n a f f e c t e d b y t h e l o s s o f able-bodied workers, and food p r o d u c t i o n may decrease; urban ideas about food s t a t u s are imported. Nevertheless, urban d w e l l e r s have some advantages: t h e y do have a more v a r i e d d i e t than i n r u r a l areas; t h e y a r e o f t e n a n b i t i o u s and c r e a t i v e , open t o new ideas. Successfu l programs o f t e n a r e undertaken on a s e l f - h e l p b a s i s , but u l t i m a t e l y , long-term improvement depends on removal o f t h e u n d e r l y i n g causes o f m a l n u t r i t i o n .

146. DESAI, I .D. ; SWANN, M.A. ; GARCIA TAVARES, M.L. ; e t a l . N u t r i t i o n a l C h a r a c t e r i s t i c s and Suggestions f o r Iinprovement o f a T y p i c a l Peri-Urban . A g r i c u l t u r a l M igran t Worker's D i e t i n Southern B r a z i l . I n Aspects o f Human and N a t i o n a l N u t r i t i o n . P a r i s , S. Karger, 1980. pp. 76-96.

147. DUGDALE, A. E. ; CHANDLER, D. ; ENGHURST, K. Knowledge and b e l i e f i n n u t r i t i o n . The American II Journa l o f C l i n i c a l N u t r i t i o n , I vo l . 3 2 , February 1979, p. 441-45.

N u t r i t i o n knowledge t e s t s f r e q u e n t l y r e q u i r e s in ip le yes/no o r t r u e / f a l s e responses; these are easy t o score but f a i l t o measure t h e s t u d e n t ' s "perce ived" knowledge. T h i s s t u d y admin is te red a t e s t with t h r e e p o s s i b l e repsonses: yes, no, and d o n ' t know. The h i g h l e v e l o f i n c o r r e c t responses r e v e a l s t h a t those t e s t e d n o t o n l y l a c k e d c o r r e c t i n f o r m a t i o n but possessed i n c o r r e c t i n f o r m a t i o n t h a t t h e y r e l i e d upon. Since c o r r e c t i n g f a l l a c i e s i s more d i f f i c u l t t h a t p r o v i d i n g i n f o r m a t i o n , n u t r i t i o n educators have a d i f f i c u l t t a s k i n a s s i s t i n g t h e l a y p u b l i c i n a c q u i r i n g accurate n u t r i t i o n knowledge. Most o f those t e s t e d were phys ic ians , med ica l s tudents , o r n u r s i n g s tudents.

148. DUMLAO, M.F. ; ONATE, L. U. N u t r i t i o n icnowl.odge, a t t i t u d e s and p r a c t i c e s o f p u b l i c elementary school teachers i n Los Baños, Laguna. P h i l i p p i n e Journa l o f N u t r i t i o n , v o l . 33 , no. 2 , Apr i l -June 1980, pp. 108-117.

Th is s tudy i n t e r v i e w e d 198 teachers from 11 p u b l i c elementary schools. The teachers were judged t o be wel l - informed; a p o s i t i v e c o r r e l a t i o n was found between n u t r i t i o n knowledge scores and 'chose on a t t i t u d e s and p r a c t i c e s . N e a r l y a l l teachers used mass media as t h e i r p r i n c i p a l source o f n u t r i t i o n

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in fo rmat ion , b u t exposure was n o t c o r r e l a t e d with increases i n knowledge, ;i.t%j.%ude, o r p r a c t i c e scores. Age, educat ion, and teach ing exper ience a l s o ' d i r e n o t c o r r e l a t e d with any o f t h e t h r e e measures. Prev ious n u t r i t i o n t r a i n i n g i n h i g h school was c o r r e l a t e d w i t h knowledge and a t t i t u d e s b u t n o t w i th p r a c t i c e s . A l l t h r e e measures were h i g h l y a f f e c t e d by i n - s e r v i c e workshops, and n o t b y c o l l e g e n u t r i t i o n t r a i n i n g .

149. DUTRA DE O L I V E I R A , J.E.; P I L E G G I VINHA, V.H.; MOURA DUARTE, F.A. 2eaFarching preschool c h i l d r e n th rough a c o r n u n i t y food program. Ecology o f Food and N u t r i t i o n , v o l . 9, no. 4, August 1980, pp. 223-228. b i b l . [A lso pub l ished i n French and Spanish]

150. WYER, J.T. ; FELJMAN, J. J. ; MAYER, J. N u t r i t i o n l i t e r a c y o f h i g h school s tudents . -- J o u r n a l -_ -1 -.-- o f - N u t r i t i o n Educat ion, v o l . 2, 1970, pp. 59-66.

151. EDEMA, J.M.P. S o c i a i :]??enornena and t h e p l a n n i n g o f a n u t r i t i o n educat ion programme.. S o c i a l Science and Medicine. Ser ies A, vol . 15A, no. 5, September 1981, pp. 713-19, b i b l .

152. EKEH, H.E. Some major o b s t a c l e s t o t h e p r a c t i c e o f sound n u t r i t i o n i n N i g e r i a . L \ t z r n a t i o n a l J o u r n a l o f XeAl-Gh-EAucation, v o l . 23, no. 4, 1980, pp. 236-24 1.

F a c t o r s r e l a t e d t o n u t r i t i o n p r a c t i c e s and t h e e f f e c t s o f n u t r i t i o n educat ion were inye.;:; ;gated i n Ibadan, N iger ia . Mothers were i n t e r v i e w e d about t h e i r n u t r i t i o n knowledge, f e e d i n g p r a c t i c e s , wat,er supply, cook ing f a c i l i t i e s , and o ther household backgrouqd. V e d i c a l ,o-rsonnel from l o c a l h e a l t h f a c i l i t i e s p rov ided i n f o r m a t i o n about c h i l d r e n ' s h e a l t h s t a t u s and t h e i r p e r c e p t i o n s o f materna l h a b i t s . A l though 93% o f t h e mothers in t roduced feed ing b o t t l e s w i t h i n the f i r s t t h r e e months o f l i f e , o n l y h a l f knew how t o keep them c lean. Al though n u t r i t i o n knowledge was adequate, most d i d n o t p rov ide adequate weaning d i e t s . Med ica l personnel a t t r i b u t e d t h e p o p u l a r i t y o f b o t t l e s t o t h e i n f l u e n c e s o f f r i e n d s and commerical advert isements. Many food b e l i e f s d e l e t e r i o u s t o c h i l d wel fare were i d e n t i f i e d , P i e s tudy p r o v i d e s s p e c i f i c suggest ions f o r improv ing mothers ' h a b i t s , such as adding powdered m i l k t o t h e weaning food, a s t a r c h y g r u e l , t o improve c h i l d r e n ' s i n t a k e s s a f e l y . Other P w o m e n d a t i o n s cover food storage and p r e p a r a t i o n and personnel t r a i n i n g ri e ed :3 . 153. ENGBAEK, S. ; FOLDSPANG, A. Fedrnens ep idemino log i b l a n d t skoleb#-n (The epidemology o f over-weight among school ch i ld ren ! . I l g e s k r i f t f o r laeger , v o l . 143, 1981, pp. 701-706.

154. FAO. B i b l i o g y q h y - _---- o f Food Consunption Surveys. Rome, I t a l y , S t a t i s t i c s D i v i s i o n , Econoinic and S o c i a l P o l i c y Department, Food and A g r i c u l t u r e Organ iza t ion o f t h e ( In i ted Nations, 1981. 85p. b i b l . (FAO Food and N u t r i t i o n Paper No. 18)

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T h i s document p resents t h e r e s u l t s and major f e a t u r e s o f 'noushold budget and food c o n s u n p t i m surveys conducted i n 85 c o u n t r i e s between 1968 and 1978. The o r i g i n a l sources f o r t h e i n f o r m a t i o n a r e provided. P a r t I p r e s e n t s a l i s t , b y r e g i o n and count ry , o f t h e surveys, g i v i n g t h e sources o f t h e p u b l i c a t i o n s and a n o t e on t h e genera l con ten t , i n c l u d i n g main o b j e c t i v e s , da tes undertaken, scope and coverage o f t h e survey, and main s t a t i s t i c a l r e s u l t s . c o n s i s t s o f a summary t a b l e l i s t i n g t h e surveys as i n P a r t I but g i v i n g t h e i r c o n t e n t s i n a sys temat ic and ccmparable form, c o v e r i n g t y p e o f survey, geographic areas and socieconomic groups s tud ied , sample s i z e , d u r a t i o n o f t h e survey, and t h e n a t u r e o f t h e r e s u l t s . The f i n a l columns present some d e t a i l s o f t h e t a b u l a t e d and a n a l y t i c a l r e s u l t s o f t h e surveys.

P a r t II

155. FITZGERALD, T. K., ed. Nutrition-an-d Anthropology i n Act ion. Assen, Amsterdam, Van Gorcwn, 1977.

155. FOLY, C.; HERTZLER, A.A.; ANDERSON, H.L. A t t i t u d e s and food habi ts--a rev iew. Journa l o f t h e American D i e t e t i c Assoc ia t ion , v o l . 75, 1979, pp. 13-1 8.

157. G I L L I S , D. E.G. ; SABRY, J.H. Daycare teachers: N u t r i t i o n knowledge, o p i n i o n s , and use o f food. Journa l o f N u t r i t i o C E d u c a t i o n , v o l . 12, no. 4, October-December 1980, pp. 200-204.

158. GRIFFITHS, M. A r a p i d assessment t o o l f o r d i e t a r y adequacy: I t s development and use i n Indonesia. In: I s r a e l , R.C., ed., Using Communications t o So lve N u t r i t i o n Problems. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Service, Educat ion Development Center, i n press

T h i s paper p resents t h e development and use o f a d i e t a r y r e c a l l form designed e s p e c i a l l y f o r a n u t r i t i o n survay c a r r i e d o u t as p a r t o f t h e Indonesian N u t r i t i o n Communication and Behavior Change Component o f t h e n a t i o n a l n u t r i t i o n program. Since a p r e l i m i n a r y survey o f s t a t u s had a l ready i d e n t i f i e d d e f i c i e n c i e s o f p r o t e i n , c a l o r i e s , and v i t a m i n A a s t h e p r i n c i p a l problems t h a t cou ld be addressed t h r o u g h educat ion, t h e r o m was designed t o accommodate food c a t e g o r i e s based on t h e i r c a l o r i e , p r o t e i n , o r v i t a m i n A content . Amounts were recorded on a sca le r e a d i l y understood b y f i e l d workers with l i m i t e d l i t e r a c y and mrk exper ience. F i e l d t e s t i n g l e d t o some adapta t ions , r e s u l t i n g i n a r e l i a b l e survey inst rument . The paper p resents t h e development a c t i v i t i e s i n d e t a i l and i n c l u d e s a sample o f t h e f i n a l form.

159. GRIFFITHS, M. Growth Mon i to r inq . Pr imary H e a l t h Care Issues, Ser ies I, Number 3. Washington, D.C., American Pub l ic Hea l th Associat ion, 1981. 7%.

Growth m o n i t o r i n g i s a u s e f u l educat iona l t o o l , f o r i t can a c t i v e l y i n v o l v e a mother i n her c h i l d ' s h e a l t h care, and weighing programs can promote n u t r i t i o n awareness on a community l e v e l . ' h i s comprehensive work p resents t h e t e c h n i c a l b a s i s and techniques o f growth mon i to r ing , i n c l u d i n g d e s c r i p t i o n s o f v a r i o u s c h a r t s and scales. G u i d e l i n e s a r e presented f o r program o r g a n i z a t i o n a t t h e c e n t r a l , c o m u n i t y , and fami ly l e v e l s . A d d i t i o n a l chapters d i s c u s s

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u s i n g m o n i t o r i n g r e s u l t s f o r f a m i l y educat ion, t h e t r a i n i n g o f p r imary h e a l t h c a r e workers, problem i d e n t i f i c a t i o n , and program eva lua t ion . An appendix p r o v i d e s a step-by-step p r o t o c o l f o r weighing and measuring.

160. GRIFFITHS, M. Mothers Speak and N u t r i t i o n Educators L i s t e n : Format ive E v a l u a t i o n f o r a N u t r i t i o n Communications P r o j e c t i n S p e c i a l T e r r i t o r y o f Yogyakarta, C e n t r a l Java, South Sumatra. New York, Manoff I n t e r n a t i o n a l Inc., 1980. Vol. 1, 287p.

---- --

T h i s volume, one o f t h e f i v e c i t e d i n the Case S t u d i e s s e c t i o n (Manoff I n t e r n a t i o n a l , 1 9 8 3 , descr ibes i n d e t a i l t h e household i n t e r v i e w s and f i e l d t r i a l s conducted i n the developmental phase o f t h e p r o j e c t . The open-ended, p a r t i c i p a n t - o b s e r v e r i n t e r v i e w s w i t h 328 households served as t h e b a s i s o f t r i a l s o f new weaning foods. The r e s u l t s o f t h e t r i a l s a r e discussed i n d e t a i l , p r o v i d i n g an example o f t h e exhaust ive f o r m a t i v e research which was one reason f o r t h e program's success. The mass o f i n f o r m a t i o n about t h e women's knowledge, a t t i t u d e s , and p r a c t i c e s i n c l u d e s d a t a c o n t r a r y t o t h a t which would have been assumed w i t h o u t such advance research.

161. GUPTA, R.; SHARMA, I. An overv iew o f t h e d i e t a r y ' c o n s m p t i o n p a t t e r n o f pregnant and l a c t a t i n g mothers o f Haryana reg ion , Hissar . The IndiAn- J o u r n a l o f N u t r i t i o n and D i e t e t i c s , v o l . 17, 1980, p . 13-9.

A s tudy o f t h e d i e t s o f b r e a s t feed ing mothers found t h a t most were inadequate, but t h a t mothers were l a c t a t i n g s u c c e s s f u l l y and d i d n o t show o v e r t s i g n s o f m a l n u t r i t i o n . One p o s s i b l e reason i s t h a t d i e t s a re most r e s t r i c t e d d u r i n g l a c t a t i o n , p r i n c i p a l l y because o f food- re la ted b e l i e f s , such as t h e b e l i e f t h a t s p e c i f i c foods ( f r u i t , tea, l e n t i l s ) would be harmfu l t o t h e mother 's o r c h i l d ' s h e a l t h . Some b e l i e f s were c o n s t r u c t i v e , promot ing t h e use o f m i l k and n u t s t o inc rease t h e mother 's m i l k supply. The author concludes t h a t because these food r e s t r i c t i o n s a r e v o l u n t a r y and due t o b e l i e f s r a t h e r than l a c k o f access t o foods, t h e r e i s a need t o " r e c t i f y t h e knowledge gap" th rough a n u t r i t i o n program t h a t should be i n c o r p o r a t e d i n t o t h e s t a t e - l e v e l n u t r i t i o n p o l i c y .

162. HERTZLER, A.A.; VAUGHAN, C.E. The r e l a t i o n s h i p o f f a m i l y s t r u c t u r e and i n t e r a c t i o n t o n u t r i t i o n . 74, no. 1, 1974, pp. 23-27.

1- Journa l --- --I o f t h e American Dietet ic-As-Co-ciat ion, v o l .

Some n u t r i t i o n educat ion programs f a i l because n u t r i t i o n educators do no t examine t h e c o n t e x t o f t h e i n d i v i d u a l ' s d i e t , t h e r e f o r e m i s s i n g c o n s t r a i n t s .and in f luences t h a t can enhance o r impede implementat ion o f new food behavior . Th is a r t i c l e rev iews a l a r g e number o f a r t i c l e s d e a l i n g w i t h v a r i a b l e s w i t h i n t h e household, i n c l u d i n g socieconomic f a c t o r s ( f a m i l y s i z e and composi t ion, race, e t h n i c i t y , educat ion, employment, income, sex o f f a m i l y head) and persona l i n t e r a c t i o n v a r i a b l e s (paren t - c h i l d i n t e r a c t i o n par e n t a l i n t e r - ac t ion , s a t i s f a c t i o n w i t h marr iage, and c o n j u g a l decis ion-making) . The authors recommend t h a t f u r t h e r research be conducted i n t o t h e impact o f these v a r i a b l e s .

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163. MOPKINS, S. ; e t a l . N u t r i t i o n i n f o r m a t i o n sources among A u s t r a l i a n s and I t a l i a n s i n Perth. Community Hea l th Studies, vo l . 4, no. 3, 1980, Pp. 21 5-2 19.

A random sample o f I t a l i a n - b o r n and n a t i v e A u s t r a l i a n s was surveyed. Open- ended q u e s t i o n n a i r e s r e g a r d i n g sources o f n u t r i t i o n i n f o r m a t i o n were supplemented with data on s u b j e c t s ' h e i g h t s and w i g h t s . Responses were c a t e g o r i z e d as llinsidell ( f a m i l y o r persona l exper ience) o r lloutsidell (media, schools, h e a l t h p r o f e s s i o n a l s ) ; 71% o f t h e I t a l i a n s and 44% o f t h e A u s t r a l i a n s r e l i e d more h e a v i l y on llinsidell sources. Obesi ty was much more common among I t a l i a n s . Obese i n d i v i d u a l s o f b o t h groups tended t o have fewer "ou ts ide" sources o f i n f o r m a t i o n . The r e s u l t s , which must be i n t e r p r e t e d c a u t i o u s l y because o f t h e s m a l l number o f v a r i a b l e s s tud ied , p o i n t t o c o r r e l a t i o n s between o b e s i t y and language problems, t r a d i t i o n a l va lues i n food consunpt ion and persona l appearance, and s o c i a l c lass . N u t r i t i o n educators must examine u n d e r l y i n g causes o f problems such as o b e s i t y , f o r s imple d i s s e m i n a t i o n o f i n f o r m a t i o n , p a r t i c u l a r l y t h r o u g h t h e mass media, may n o t reach o r m o t i v a t e t h e audience t h a t needs i t most.

164. ISRAEL, R.; TIGYE, J., eds. Materna l and I n f a n t N u t r i t i o n Reviews. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Serv ice P u b l i c a t i o n s , Educat ion Development Center, 1982-83. b ib1 . The INCS has produced 34 c o u n t r y - s p e c i f i c monographs summarizing pub l ished and unpubl ished r e p o r t s on n u t r i t i o n s t a t u s , b e l i e f s , p r a c t i c e s , programs , and c o r r e l a t i o n s . Sources i n c l u d e government p lans, r e p o r t s from p r i v a t e agencies, and i n f o r m a l f i e l d r e p o r t s ; an anno%ated b i b l i o g r a p h y supplements the body o f t h e work, which presents t h e i n f o r m a t i o n b y t o p i c . The s e r i e s was c o n t r a c t e d by U.S.A.I.D. t o be used as b r i e f i n g documents f o r overseas n u t r i t i o n educat ion c o n s u l t a n t s and has a l s o been used by p r o f e s s i o n a l s and f i e l d workers i n t h e c o u n t r i e s surveyed. The s e r i e s i n c l u d e s separate r e p o r t s on Bangladesh, B o l i v i a , Burma, Cameroon, Costa Rica, Cominican Republ ic , Ecuador, Egypt, Ghana, Guatemala, Kenya, H a i t i , Honduras, I n d i a , Indonesia, Jamaica, Jordan, Lesotho, L i b e r i a , M a l i , Morocco ( a v a i l a b l e i n E n g l i s h and French), Nepal, Pakistan, Panama, Peru, P h i l i p p i n e s , Senegal and Gambia ( i n one volume), S r i Lanka, Sudan, Tanzania, Thai land, Yemen, Za i re , and e i g h t n a t i o n s o f t h e South P a c i f i c r e g i o n .

165. JOHNSON, A. ; BEHRENS, C.A. N u t r i t i o n a l c r i t e r i a i n Machiguenga food p r o d u c t i o n dec is ions: A ï i n e a r - p r o g r a m i n g ana lys is . Human Ecology, vo l . 10, no. 2, 1982, pp. 167-89.

A mathemat ica l model was developed t o analyze t h e f a c t o r s considered by t h i s Amazonian t r i b e i n making food p r o d u c t i o n dec is ions . I n p u t s i n c l u d e d foods used, w i t h t h e i r assoc iated l a b o r cos ts ; n u t r i t i o n a l c o n s t r a i n t s a f f e c t i n g p r o d u c t i o n d e c i s i o n s ; t h e est imated n u t r i t i o n a l v a l u e o f each t y p e o f food; and the es t imated n u t r i t i o n a l requi rements o f t h e popu la t ion . Output data were ob ta ined b y observ ing hunt ing , ga ther ing , and f i s h i n g a c t i v i t i e s ; measuring gardens; and randomly sampl ing c rop d e n s i t i e s and harves t y i e l d s . Assumptions are s tated. L inear p r o g r a m i n g y i e l d e d severa l o p t i m a l s o l u t i o n s t h a t would p e r m i t t h e s a t i s f a c t i o n o f n u t r i t i o n a l requi rments; none resembled t h e group 's a c t u a l a l l o c a t i o n o f e f f o r t . Nevertheless, t h e i r food p r o d u c t i o n

i s adequate and s igns o f n u t r i t i o n a l d e f i c i e n c i e s are r a r e . The reasons f o r the d isc repanc ies were apparent ly n o n q u a n t i f i a b l e f a c t o r s such as s e c u r i t y , drudgery, d i v e r s i t y , and t a s t e . The au thors conclude t h a t t h e p a t t s r n o? food p r o d u c t i o n i s n o t determined s imp ly b y c o s t - e f f i c i e n c y , and t h a t t h e Machiguenga are w i l l i n g and able t o expend e x t r a l a b o r t o meet needs and wants beyond those o f n u t r i t i o n a l requi rements.

166. JOHNSTON, E.M. ; SCHWARTZ, N. E. Phys ic ians ' o p i n i o n s and counse l ing p r a c t i c e s i n materna l and i n f a n t n u t r i t i o n . __-I Journal o f The American D i e t e t i c Assoc ia t ion , v o l . 73, September 1978, p. 246-51.

A se l f -admin is te red q u e s t i o n n a i r e was m a i l e d t o p h y s i c i a n s i n B r i t i s h C o l m b i a , Canada, t o determine how w e l l p e d i a t r i c i a n s , o b s t e t r i c i a n s , and genera l p r a c t i t i o n e r s inc luded n u t r i t i o n educat ion i n t h e i r counse l ing o f p a t i e n t s . Opin ions and p r a c t i c e s were e l i c i t e d . The a r t i c l e p resents t a b l e s showing t h e ques t ions asked and t h e scores o f t h e t h r e e groups; t h e d i s c u s s i o n r e l a t e s o p i n i o n s and p r a c t i c e scores t o c o r r e l a t i o n s with l e n g t h o f t i m e p r a c t i c i n g , use o f p r o f e s s i o n a l n u t r i t i o n i s t s , at tendance a t n u t r i t i o n workshops and courses, and sex, but none o f t h e v a r i a b l e s s t u d i e d i n d i c a t e d a c o n s i s t e n t , s i g n i f i c a n t e f f e c t on b o t h o p i n i o n and p r a c t i c e scores.

167. KRANTZLER, N. J. ; MULLEN, B. J. ; CavlSTOCK, E.M. ; HOLDEN, C.A. ; SCHUTZ, H.G. ; GRIVETTI, L. E. ; MEISELMAN, H. L. Methods o f food i n t a k e asszssrnent--An annotated b i b l i o g r a p h y . Journal o f - -.----- N u t r i t i o n Educat ion, vo l . 14, no. 3, 1982, pp. 108-1 19.

S tud ies o f methods o f assessing food i n t a k e a r e s c a t t e r e d throughout t he l i t e r a t u r e o f t h e many r e l e v a n t d i s c i p l i n a r y f i e l d s . T h i s generously annotated b i b l i o g r a p h y c o l l e c t s 87 i t e m s o f research l i t e r a t u r e on methodology o f i n t a k e assessinent , m o s t l y from f i v e U. S. n u t r i t i o n j o u r n a l s , a l though f o r e i g n j o u r n a l s a r e a lso represented. Tables summarize t h e s t u d i e s ' demographics, dates, sampling p r o t o c o l s , and s tudy des ign fea tures .

168. MANCEBO, J.F. ; ONATE, L.U. The n u t r i t i o n a l behav io r o f some mothers o f d i f f e r e n t income l e v e l s and t h e n u t r i t i o n a l s t a t u s o f t h e i r pre-school c h i l d r e n . P h i l i p p i n e Journal o f N u t r i t i o n , .--- Apr i l -June 1979, pp. 80-6. --- N u t r i t i o n educat ion p r o j e c t s need t o krlow t h e r e l a t i o n s h i p s between income, n u t r i t i o n a l behavior , and n u t r i t i o n a l s ta tus . T h i s s tudy examined how income and n u t r i t i o n a l behavior o f r u r a l mothers i n t e r a c t e d with t h e n u t r i t i o n a l s t a t u s o f preschool c h i l d r e n . The h e a l t h and n u t p i 5 i o n s t a t u s o f 99 c h i l d r e n was measured, and t h e i r 59 mothers were i n t e r v i e w e d t o determine t h e i r r~i.i?,ri.tio+-~ knowledge, a t t i t u d e s , and p r a c t i c e s . Wokhers i n a l l income c a t e g o r i e s scored b e t t e r i n knowledge than i n p r a c t i c e s , but t h e d e s c r i p t i o n o f t h e ins t rument des ign does n o t p e r m i t conc lus ions about t h e r e l a t i o n s h i p o f these scores. Mothers i n the middle-income group had more p o s i t i v e behav io r t h a ? lod-income nothers , but t h e r e was no s i g n i f i c a n t d i f f e r e n c e i n t h e numbers o f malnour ished c h i l d r e n a t d i f f e r e n t income l e v e l s . m e r e was a c o r r e l a t i o n between p o s i t i v e n u t r i t i : i n a l ' x h a v i o r and c h i l d ' s n u t r i t i o n a l s t a t u s . Thus, mothers ' n u t r i t i o n knowledge, a t t i t u d e s , and p r a c t i c e s a r e

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impor tan t i n d e t e r m i n i n g n u t r i t i o n s t a t u s , independent o f income, and n u t r i t i o n educat ion i s t h e i n t e r v e n t i o n o f cho ice t o improve t h i s s i t u a t i o n .

169. MARTORELL, R. N u t r i t i o n and H e a l t h Status I n d i c a t o r s : Suggest ions f o r Surveys o f t h e Standard o f L i v i n g i n Developing Countr ies. Washington, D.C., Development Research Center, The World Bank, February 1982. 97p. b i b l . ( L i v i n g Standards Measurement Study Working Paper No. 13)

Th is r e p o r t examines n u t r i t i o n and h e a l t h i n d i c a t o r s a p p r o p r i a t e f o r cross- s e c t i o n a l surveys o f households i n develop ing c o u n t r i e s , t o h e l p p lanners des ign a p p r o p r i a t e surveys. Parameters are examined i n seven areas: anthropometry, b i r t h weight , c l i n i c a l examinat ion, b i o c h e m i s t r y , food and n u t r i e n t i n t a k e , b r e a s t feeding, and i l l n e s s . S p e c i f i c standards such as t h e Water low and Gomez growth c a t e g o r i e s a r e discussed. The r e l a t i v e use fu lness and i n t e r r e l a t i o n s h i p s o f v a r i o u s i n d i c e s are reviewed.

170. MITTAL, M. ; CHARI , P.S. ; RANA, A. Educat iona l needs o f r u r a l mothers o f Gagret v i l l a g e i n Himachal Pradesh f o r forming d e s i r a b l e food h a b i t s i n c h i l d r e n o f 4-6 years o f age. The I n d i a n Journal o f N u t r i t i o n and D i e t e t i c s , v o l . 19, 1982, p. 14-19.

A q u e s t i o n n a i r e was developed u s i n g exper t o p i n i o n on adv isab le n u t r i t i o n knowledge, a t t i t u d e s , and p r a c t i c e s , and was admin is tered t o i l l i t e r a t e mothers o f young c h i l d r e n . Categor ies i n c l u d e d the es tab l i shment o f d e s i r a b l e e a t i n g h a b i t s , a p p r o p r i a t e d i e t f o r t h e c h i l d , develop ing f a v o r a b l e a t t i t u d e s towards food, and s e r v i n g o f food. Mothers a l s o were asked t h e i r major source o f n u t r i t i o n i n f o r m a t i o n . The r e s u l t s are presented i n t h i s a r t i c l e and used as t h e b a s i s f o r recommendations f o r h e a l t h and n u t r i t i o n workers i n the community t o h e l p mothers make b e t t e r use o f a v a i l a b l e resources.

171. MORRIS, S.S.; FARRIER, S.C.; ROGERS, C.S. e t a l . Feeding behaviors , food a t t i t u d e s , and body fa tness i n i n f a n t s . Journal o f the American D i e t e t i c A s s o c i a t i o n , v o l . 80, no. 2, A p r i l 1982, p. 330-334, b i b l .

172. MORSE, W.; SIMS, L.S.; GUTHRIE, H.A. Mothers' compliance w i t h p h y s i c i a n s ' recommendations on i n f a n t feeding. Journal o f The American D i e t e t i c Assoc ia t ion , v o l . 75, August 1979, p. 140-48

Mothers i d e n t i f i e d b y t h e i r p h y s i c i a n s as hav ing one c h i l d under 15 months o l d completed a mai led q u e s t i o n n a i r e on c u r r e n t feed ing p r a c t i c e s o f t h e i r i n f a n t s , t h e i r n u t r i t i o n knowledge, h e a l t h - r e l a t e d a t t i t u d e s and b e l i e f s , and demographic data. The a r t i c l e p r e s e n t s a d e t a i l e d d e s c r i p t i o n o f t h e f i n d i n g s , i n c l u d i n g a copy o f t h e q u e s t i o n n a i r e and t h e sum o f responses. Compliance i t e m s i n c l u d e d i n s t r u c t i o n s on i n t r o d u c t i o n o f s o l i d foods and the use o f v i t a m i n supplements, i r o n - f o r t i f i e d i n f a n t formula, and cow's m i l k . Most p h y s i c i a n s themselves d i d n o t comply with one o r more o f t h e recommenda- t i o n s o f t h e American Academy o f P e d i a t r i c s Committee on N u t r i t i o n , n o t a b l y i n recommend i n g v i t a m i n supplements f o r i n fan t s fed commercial v i tamin- f o r t i f i e d formula, and e a r l y i n t r o d u c t i o n o f s o l i d foods and whole and skimmed cow's m i l k . Mothers ' n u t r i t i o n knowledge scores c o r r e l a t e d n e g a t i v e l y with

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compliance scores and p o s i t i v e l y w i t h most a t t i t u d e i tems. n u t r i t i o n knowledge were more l i k e l y t o b r e a s t feed t h e i r i n f a n t s , w a i t l o n g e r b e f o r e g i v i n g whole m i l k , and d e l a y t h e i n t r o d u c t i o n o f s o l i d s . Compliance was n e g a t i v e l y c o r r e l a t e d w i t h t h e l e n g t h o f t ime a inother had gone t o a p a r t i c u l a r p h y s i c i a n . The d i s c u s s i o n o f t h e r e s u l t s focuses on t h e phenomenon o f compliance, i g n o r i n g tho f a c t t h a t t h e areas i n which t h e mothers d i d n o t comply were the ones i n which t h e i r p h y s i c i a n s were wrong, and does n o t probe t h e i r o t h e r sources o f in fo r tna t ion .

Mothers with more

173. MOUTEL, M. A l i m e n t a t i o n e t SevrageA-lspects Rencontres au Sein ---- d u Serv ice de P e d i a t r i e e t de l a FMI --1_- de l ' t l o g i t a i -- Departemental de M o k i l o -_ (Cameroun). U n i v e r s i t é d 'Aix-Marsei l le-rnemoire !4&lecine T r o p i c a l e , 1981-82. 43p.

174. NATIONAL ACADEMY OF SCIENCES. Recommended D i e t a r y ------- Allowances. 9th e d i t i o n . Washington, D. C., N a t i o n a l Academy o f Sciences, 1980. 185p.

T h i s book presents t h e n in th e d i t i o n o f Recommended D i e t a r y Al lowances updated t o p resent s tandards based on t h e b e s t s c i e n t i f i c knowledge a v a i l a b l e . The al lowances are designed t o serve as g u i d e l i n e s f o r i n t e r p r e t i n g food consumption r e c o r d s o f groups and e v a l u a t i n g the adequacy o f food s u p p l i e s i n meet ing n u t r i t i o n a l needs, p l a n n i n g and p r o c u r i n g food s u p p l i e s Cor groups and e s t a b l i s h i n g guides f o r p u b l i c food ass is tance programs, development o f new food produc ts b y i n d u s t r y , e s t a b l i s h i n g g u i d e l i n e s f o r n u t r i t i o n a l l a b e l i n g o f foods, and develop ing n u t r i t i o n educat ion programs. '!As t h e a p p l i c a t i o n s o f RDA cont inue t o expand, i t i s i n c r e a s i n g l y in ipor tan t t h a t t h e i r s i g n i f i c a n c e and l i m i t a t i o n s be c l e a r l y understood" (p. VI.

175. OACE, S.M., ed. Perspec t ives on n u t r i t i o n educat ion i n s t r u m e n t a t i o n J o u r n a l o f N u t r i t i o n Educat ion, v o l . 13, no. 3, Septemebr 1981, pp. 83-114.

176. OJOFEITIMI, E.O. Causes o f p r o t e i n energy m a l n u t r i t i o n as viewed b y t h e c l i e n t f s mother. Journal o f T r o p i c a l P e d i a t r i c s , vo l . 28, no. 3, June 1982, pp. 147-48. [ A l s o pub l i shed i n French1

A survey o f 28 N i g e r i a n mothers o f malnour ished ch i1dr-w found t h a t none a t t r i b u t e d the c o n d i t i o n t o i n a p p r o p r i a t e d i e t , but most blamed s u p e r n a t u r a l powers. F a m i l i a r i t y w i t h p r e v a i l i n g b e l i e f s and customs i s v i t a l t o e f f e c t i v e n u t r i t i o n educat ion.

177. OLSON, J.C. ; SIMS, L. S. Assessing n u t r i t i o n knowledge from an i n f o r m a t i o n process ing perspec t ive . Journal o f X u t r i t i o n Educat ion, v o l . 12, no. 3, July-September 1980, pp. 157-16f,----

178. ONUOHA, G.B.I. The changing scene o f food h a b i t s and b e l i e f s among the Mbaise people o f N i g e r i a . Ecology o f Food and N u t r i t i o n , v o l . 11, 1982, pp. 2 4 5 -2 5 O.

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A survey of 1,506 i n d i v i d u a l s found t h a t food p r o h i b i t i o n s are n o t as i n f l u e n t i a l as t h e y once were. Younger respondents were more l i k e l y t o i g n o r e p r o h i b i t i o n s . The au thors conclude t h a t t rends i n food h a b i t s and b e l i e f s c o u l d be sus ta ined i n a posi i t i -de way b y n u t r i t i o n educat ion t o reduce the n e g a t i v e impacts o f o l d food taboos.

179. PELTO, G. H. A n t h r o p o l o g i c a l c o n t r i b u t i o n s t o n u t r i t i o n educat ion research. Journa l o f Nu_Cr_i t iLonoucat ion, v o l . 13, supplement 1, 1981, pp. S 2 S 8 .

A n t h r o p o l o g i c a l approaches t o n u t r i t i o n educat ion research i n c l u d e the f o l l o w i n g components o f research s t r a t e g y : p a r t i c i p a n t o3seruat ion o f p o p u l a t i o n char a c t e r i s t i c s ; c o l l e c t i o n o f q u a l i t a t i v e and q u a n t i t a t i v e data ; development o f a broad d a t a base; use o f o b s e r v a t i o n a l and unobt rus ive neasures; development o f new d a t a c o l l e c t i o n t o o l s f o r nieasuring i n t a k e , b e l i e f s , values, and a t t i t u d e s ; approaches t o cornrnunity p a r t i c i p a t i o n ; research des igns t h a t operate on severa l l e v e l s , r a n g i n g from the i n d i v i d u a l t o t h e broader s o c i e i y ; s t a t i s t i c a l methods t h a t avoid a s s m p t i o n s o f homogeneity i n h e r e n t i n t h e use o f averages; and the use o f m u l t i v a r i a t e s t a t i s t i c a l techniques t o e l u c i d a t e t h e i n t e r a c t i o n s among f a c t o r s t h a t a f f e c t peop le 's d i e t a r y behav io r .

180. PELTO, G.H. Consul tant Report f o r Cameroon (March 9-23; August 12-25, 1983): The E f f e c t o f Food A v a i l a b i l i t y and I n f a n t Feeding T r a c t i c e s on t h e N u t r i t i o n a l S t a t u s o f C h i l d r e n I .-- 0-23 __ - -- Months: - - I_I A Progress Report. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Serv ice, Educat ion Development Center, 1983. 47p.

180. PELTO, G. H. Consul t a n t Report 1983): The E f f e c t o f Food A v a i l a b i l i N u t r i t i o n a l S t a t u s of Childrzn--O-?_? Massachusetts , I n t e r n a t i o n a l Nu t r i t i Development Center, 1983. 47p.

f o r Cameroon (March 9-23; . t y .and I n f a n t Feeding Trac Months: A Progress Report. .on Communication Serv ice , _--_I_I

Aug u s t 12 -2 5, : t i c e s on t h e

Newton , Educat ion

T h i s r e p o r t p resents an a n t h r o p o l o g i c a l approach t o a b a s e l i n e s tudy o f t h e n u t r i t i o n a l needs , b e l i e f s , and p r a c t i c e s o f a n u t r i t i o n a l l y v u l n e r a b l e group. The study, over two years, w i l l e n l i s t a n t h r o p o l o g i s t s , p u b l i c h e a l t h s p e c i a l i s t s , and n u t r i t i o n i s t s t o document and assess these fea tures . V a r i a b l e s t o b e s t u d i e d i n c l u d e i n f a n t feeding p r a c t i c e s , t h e community's p e r c e p t i o n o f t h e developmental s tages o f e a r l y ch i ldhood, fami ly food a v a i l a b i l i t y , and food u t i l i z a t i o n , aspects o f t h e p r e v a i l i n g food b e l i e f system, and s o c i a l r e l a t i o n s h i p s . P r e l i m i n a r y f i n d i n g s show t h a t many babies a r e g i v e n water o r m i l l e t water a t an e a r l y age and a widespread b e l i e f i n the concept o f '!bad m i l k . "

181. PLAT, P. Habi tudes a l i m e n t a i r e s e t educat ion n u t r i t i o n n e l l e . La Vie Médica le au Cansda Français , v o l . 10, March 1981, p . 233-42.

T h i s a r t i c l e d iscusses t h e n a t u r a l wiseness o f young i n f a n t s about t h e i r n u t r i t i o n needs; p a r e n t s should s imp ly p r o v i d e food o f s u f f i c i e n t q u a l i t y . Bu t as c h i l d r e n reach school age, t h e y come under many i n f l u e n c e s on t h e i r n a t u r a l i n s t i n c t s and need t o be prepared t o make conscious d e c i s i o n s about what t o eat . Thus, t h e need f o r n u t r i t i o n educat ion a t t h e elementary l e v e l . S p e c i f i c n u t r i t i o n educat ion p r o j e c t s f o r c h i l d r e n i n France a r e presented.

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182* POLLITT, E. ; LENIS, N. N u t r i t i o n and Educat iona l Achievement,. ------- _- - U n i t e d Nat ions A d m i n i s t r a t i v e Committee on Coord ina t ion , Subcommittee on N u t r i t i o n , S i x t h Session, Par is , 25 February-1 March 1980. 29p. bibi-

T h i s paper p resents an e x t e n s i v e r e v i e w on t h e l i t e r a t u r e about t h e r o l e o f m a l n u t r i t i o n as a determinant o f s tudent achievement w i t h i n t h e formal educat iona l process, i n c l u d i n g the r o l e o f n u t r i t i o n i n shaping t h e a p t i t u d e s and a b i l i t i e s o f t h e preschool c h i l d . Even i n p o p u l a t i o n s where m a l n u t r i t i o n has n o t been considered a major p u b l i c h e a l t h problem, t h e r e may be f u n c t i o n a l consequences secondary t o normal n u t r i t i o n a l v a r i a b i l i t y .

183. RAO, K.S. J. A t t i t u d e s t o women and n u t r i t i o n p r o g r a m e s i n I n d i a . The Lancet, v o l . 22, no. 29, December 1979, p. 1357-58.

I n d i a n a t t i t u d e s towards g i r l s and women are r e s p o n s i b l e f o r t h e h i g h e r death r a t e s o f females o f a l l ages, n o t j u s t women o f c h i l d - b e a r i n g age. Development programs have favored men, as shown by i h e i r g r e a t e r r e l a t i v e g a i n i n l i f e expectancy, w h i l e programs aimed a t women, such as feed ing programs, have n o t succeeded. "The wisdom 0-T a na t ionwide ne-twork o f supplementary n u t r i t i o n programmes f o r pregnant and l a c t a t i n g mothers, wherein t h e woman i s seen o n l y i n t h e r o l e o f a mother, needs t o be reviewed."

184. SADSAD, G.T. Mass media h a b i t s o f r u r a l people i n a P h i l i p p i n e M u n i c i p a l i t y . Annals o f --_.I T r o j i c a l -----I Research, v o l . 1, no. 2, October-December 1979, pp. 104-111.

T h i s paper p resents t h e r e s u l t s o f a s tudy o f mass media p r a c t i c e s conducted i n a town i n t h e P h i l i p p i n e s as a b a s e l i n e s tudy f o r a n u t r i t i o n educat ion p r o j e c t . The i n v e s t i g a t o r s found t h a t r a d i o was t h e most p r e v a l e n t form o f mass media, b o t h f o r en ter ta inment and f o r i n f o r m a t i o n . Income, educat ion , occupat ion, and p lace o f res idence were a l l s i g n i f i c a n t v a r i a b l e s i n de termin ing l i s t e n i n g p a t t e r n s . I n v e s t i g a t i o n o f t h e i r p re fe rences i n programming served as t h e b a s i s f o r develop ing a campaign t h a t would reach t h e in tended audience w i t h messages t h a t t h e y would be i n t e r e s t e d i n l i s t e n i n g to .

185. SCHWERIN, H.S. ; STATNTON, J.L. ; RILEY, A.M. ; e t a l . Food e a t i n g p a t t e r n s and h e a l t h : a reexaminat ion o f t h e Ten-State and Hanes I surveys. American J o u r n a l o f C l i n i c a l N u t r i t i o n _ , v o l . 34, no. 4, A p r i l 1981, pp. 568-80.

186. SHANNON, B. ; MARBACH, E. S. ; GRAVES, K. ; SIMS, L.S. N u t r i t i o n knowledge, a t t i t u d e s , and teaching e f f e c t i v e n e s s o f K-6 teachers. Journa l o f N u t r i t i o n Educat ion, v o l . 13, no. 4, December 1981, pp. 145-49.

187. VALDECANAS, O.C. ; QUM?O, C.F; ; BALOLOY, S.B. Operat ion Nut r ibooth : a f e a s i b i l i t y study. P h i l i p p i n e Journal o f N u t r i t i o n , I v o l . 33, no. 1, J a n u a r y 4 a r c h 1980, pp. 48-56.

N u t r i t i o n i n f o r m a t i o n c e n t e r s were s t a f f e d b y n u t r i t i o n s tudents t o inc rease n u t r i t i o n knowledge amD!7g h.manaI.:ers and t o p r o v i d e l o c a l groups w i t h an

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i n n o v a t i v e model f o r n u t r i t i o n educat ion. Surveys o f p o p u l a t i o n s i n t h e v i c i n i t y o f t h e booths found t h a t users were l o w income middle-aged women w i t h f o u r o r more c h i l d r e n . I n f o r m a t i o n gained was used f o r meal p lanning, food budget ing, and p r e p a r a t i o n o f new r e c i p e s . N u t r i b o o t h was deemed a success i n r e a c h i n g i t s in tended audience, which perce ived i t as c r e d i b l e . The combinat ion o f persona l c o n t a c t and handout m a t e r i a l s was e s p e c i a l l y e f f e c t i v e .

188. VAN ESTERIK, P. I n t e g r a t i n g Ethnographic and Survey Research: A Review -- o f t h e --I E t h n 3 r a p h i c Ccmponent o f a Study o f Î ñ f a n t Feeding P r a c t i c e s i n Developing Countr ies. New York, The Popu la t ion Counci l , January 1983. 42p. ( I n t e r n a t i o n a l Programs Working Paper No. 17).

T h i s paper d e s c r i b e s t h e methodology f o r i n c o r p o r a t i n g ethnographic p r i n c i p l e s i n t o a s tudy o f f a c t o r s r e l a t e d t o i n f a n t feed ing p r a c t i c e s i n f o u r c o u n t r i e s (Kenya, Indonesia, Thai land, and Colombia). The purpose o f t h i s paper i s n o t t o d e s c r i b e t h e s tudy bu t t o e x p l a i n t h e assunpt ions u n d e r l y i n g t h e ethno- g r a p h i c component, t o show how i t was used i n the study, t o o u t l i n e t h e steps f o l l o w e d i n implement ing t h e f i e l d work, and t o show how a n t h r o p o l o g i c a l concepts can be adapted and used i n i n t e r d i s c i p l i n a r y research.

189. VEMlJRY, M. B e l i e f s and P r a c t i c e s A f f e c t i n g Food - -- H a b i t s i n R u r a l Colombia. New York, CARE, 1980. 132p.

The purpose o f t h i s phase o f t h e n a t i o n a l food h a b i t s survey was t o g a i n an understanding o f t h e s o c i a l and c u l t u r a l f a c t o r s t h a t a f f e c t food behav io r and food consumption p a t t e r n s i n t h e r u r a l areas, p a r t i c u l a r l y women and c h i l d r e n . The r e s u l t s o f t h e survey a r e presented i n d e t a i l , i n c l u d i n g s t a t u s and b e l i e f f i n d i n g s , socioeconcmic c h a r a c t e r i s t i c s , and food produc t ion , purchasing, cooking, and consumption p a t t e r n s .

190. VFNURY, M. Environmental and S o c i a l I n f î u e n c e s I---- on Food c- Consumption' P a t t e r n s i n S ix Developing Countr ies. -.-_-.--.--I New York, CARE, 1980.

T h i s survey i n t e r v i e w e d mothers about t h e i r food- re la ted b e l i e f s , p r a c t i c e s , and socioeconomic s t a t u s . Resu l ts are presented i n t a b u l a r form f o r Peru, Colombia, Guatemala, Tun is ia , Jordan, and Bangladesh.

191. VERMEERSCH, J. A. ; SNENERTON, H. I n t e r p r e t a t i o n s o f n u t r i t i o n c la ims i n food a d v e r t i s e n e n t s b y low-income consumers. Journal o f N u t r i t i o n Education, v o l . 12, no. 1, J a n u a r y d a r c h 1980, pp. 19-24.

192. VERMILLION, J. Consul tant Report f o r T u n i s i a ( J u l y 11-22, 1982): Recommendations --- I -- f o r a'-KAP Survey Ins t rument and Data Ana lys is System. ìdassachusetts, I n t e r n a t i o n a l N u t r c t i o n Communication Service, Educat ion

Newton,

Lkvelopment Center, 1982.

T h i s r e p o r t p resents recommendations f o r a survey o f knowledge, a t t i t u d e s , and p r a c t i c e s as t h e b a s i s o f a n a t i o n a l n u t r i t i o n p r o j e c t . The sampl ing

55

methodology and r a t i o n a l e f o r s e l e c t i o n o f da ta process ing equipment a re a l s o presented; t h e q u e s t i o n n a i r e t o b e used i s i n c l u d e d as an appendix.

193. WALIA , B. N. S. ; GAMBHIR, S. K. The r e l a t i o n s h i p between ch i ldhood m a l n u t r i t i o n and materna l knowledge and b e l i e f s r e g a r d i n g n u t r i t i o n . I n d i a n P e d i a t r i c s , v o l . 12, no. 7, 1975, pp. 563-568.

A comparison o f t h e d i e t s o f wel l -nour ished and malnour ished c h i l d r e n o f s i m i l a r socioeconomic s t a t u s found t h a t t h e former group had s i g n i f i c a n t l y h i g h e r c a l o r i c in takes , a t t r i b u t e d t o t h e e a r l i e r i n t r o d u c t i o n o f semi -so l id foods t o t h e i r d i e t s . Mothers o f wel l -nour ished c h i l d r e n d i d n o t score !?e t te r t h a n mothers o f malnour ished c h i l d r e n on an i n f o r m a l knowledge and b e l i e f t e s t . The d i f f e r e n c e s i n n u t r i t i o n s t a t u s t h e r e f o r e were due t o t r a d i t i o n a l h a b i t s , n o t t o s u p e r i o r knowledge.

194. WHO. Contemporary P a t t e r n s o f Breast- feeding: _II Report on t h e WHO C o l l a b o r a t i v e Study on Breast- feeding. Geneva, Swi tzer land, World H e a l t h Organ iza t ion , 1981. 22%.

To assess t h e s t a t u s o f b r e a s t feed ing throughout t h e wor ld , WHO s e l e c t e d n i n e r e p r e s e n t a t i v e c o u n t r i e s t o s tudy i n d e t a i l . T h i s r e p o r t p resents t h e r a t i o n a l e , methodology, and f i n d i n g s o f t h e s tudy o f t h e prevalence and d u r a t i o n o f b r e a s t feeding, b r e a s t feed ing and reproduc t ion , f a m i l y c h a r a c t e r i s t i c s , b i r t h weights , supplementary foods, h e a l t h serv ices , and the marke t ing and d i s t r i b u t i o n o f b r e a s t m i l k s u b s t i t u t e s . f i n d i n g s i n t a b u l a r form and the q u e s t i o n n a i r e s and data c o l l e c t i o n guides used i n t h e surveys. The c o u n t r i e s s t u d i e d ( E t h i o p i a , N i g e r i a , Za i re , C h i l e , Guatemala,. I n d i a , P h i l i p p i n e s , Hungary, and Sweden) were s e l e c t e d t o represent a range o f socioeconomic p r o f i l e s and t o i n c l u d e c o u n t r i e s known t o have h i g h o r low, i n c r e a s i n g o r decreas ing r a t e s o f b r e a s t feeding. Tne survey has been used as t h e b a s i s o f programs and f u r t h e r research.

Appendices present t h e

195. WOOLCOTT, D. M. ; KAWASH, G. F. ; SABRY, J. H. C o r r e l a t e s o f n u t r i t i o n knowledge i n Canadian Businessmen. Journa l o f N u t r i t i o n Educat ion, v o l . 13, no. 4, December 1981, pp. 153-56.

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I V : Case Stud ies

GENERAL

196. AUSTIN, J.E.; Z E I T L I N , M.F. N u t r i t i o n I n t e r v e n t i o n i n Developing Countr ies: An Overview. Cambridge, Massachusetts, Oelgeschlager, Gunn & Hain, 1981. 227p.

197. FIELDHOUSE, P. N u t r i t i o n and educat ion o f t h e s c h o o l c h i l d . World Review o f N u t r i t i o n and D i e t e t i c s , v o l . 40, 1982, pp. 83-112.

198. GRIFFITHS, M.; COOKE, T.; MANOFF, R.K.; ZE ITL IN , M.F. A Case f o r an A n t h r o p o l o g i c a l Perspec t ive i n N u t r i t i o n Educat ion M a t e r i a l s Design. Paper presented a t I n t e r n a t i o n a l Congress o f N u t r i t i o n , San Diego, C a l i f o r n i a , 1981. Washington, D.C., Manoff I n t e r n a t i o n a l , Inc., 1981. 6p,

1.

199. MORLEY, D.; CHANG, C.Y. I n a p p r o p r i a t e n u t r i t i o n educat ion i n t h e v i l l a g e s . Lancet, vo l . 1, no. 8213, January 24, 1981, p. 209.

T h i s l e t t e r t o t h e e d i t o r p resents t h e r e s u l t s o f a survey o f 155 a r t i c l e s p u b l i s h e d between 1975 and 1980 i n 6 j o u r n a l s , emphasizing t h e 25 a r t i c l e s on p r o t e i n - c a l o r i e m a l n u t r i t i o n . Most o f t h e a r t i c l e s d iscuss p r o t e i n r e q u i r e - ments by t do n o t ment ion t h e c a l o r i e needs o f young c h i l d r e n . Only one a r t i c l e ' d e a l t w i t h t h e a d d i t i o n o f f a t s and o i l s t o inc rease t h e c a l o r i e c o n t e n t o f weaning foods. Because most p r o f e s s i o n a l s , i n c l u d i n g s o c i a l workers, d e r i v e t h e i r i n f o r m a t i o n f rom such a r t i c l e s , i t i s mis lead ing t o p l a c e such an emphasis on p r o t e i n .

200. SCHURCH, B; WILQUIN, L. N u t r i t i o n Educat ion i n Communities o f t h e T h i r d World. Lausanne, Swi tzer land, N e s t l e Foundat ion, 1982. 208p.

T h i s annotated b i b l i o g r a p h y presents summaries o f over 150 a r t i c l e s on n u t r i t i o n educat ion, pub l i shed between 1965 and 1981. I n a d d i t i o n t o f u l l b i b l i o g r a p h i c re fe rences and a b s t r a c t s ( i n E n g l i s h and French), c h a r t s a re p r o v i d e d t o i d e n t i f y each i t e m ' s major t o p i c s and t h e c o u n t r i e s s tud ied.

201. UNESCO. N u t r i t i o n Educat ion: Case Study Exper iences i n Schools. P a r i s , Unesco, 1983. 95p'. ( D i v i s i o n o f Science, Techn ica l and Vocat iona l Educat ion, N u t r i t i o n Educat ion S e r i e s , . l )

T h e s e , t e n a r t i c l e s p resent r e c e n t developments i n formal n u t r i t i o n educat ion a t t h e pr ïmary l e v e l i n I n d i a , S i e r r a Leone, Oman, and Ghana; a t t h e secondary l e v e l i n . t h e U n i t e d Sta tes , t h e Dominican Republ ic , and Scot land; and a t t h e t e r t i a r y l e v e l i n t h e Sudan, N i g e r i a , and t h e Un i ted States. The i n t r o d u c t i o n s t r e s s e s t h a t n u t r i t i o n educat ion prov ided by knowledgeable p r o f e s s i o n a l s i s v i t a l t o t h e h e a l t h o f a l l i n t h e face o f changing food resources and t h e

..

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prevalence o f o p p o r t u n i s t s who w i l l take advantage o f t h e p u b l i c ' s i n t e r e s t i n n u t r i t i o n i f r e s p o n s i b l e and competent i n d i v i d u a l s do n o t meet t h i s demand.

202. UNESCO. N u t r i t i o n Educat ion: Cur r icu lum P l a n n i n g and Selected Case Studies. P a r i s , Unesco, 1982. 144p. (Sc ience and Technology Educat ion Document Ser ies No. 3; and D i v i s i o n o f Science, Technica l and V o c a t i o n a l Educat ion, N u t r i t i o n Educat ion Ser ies , 4. )

T h i s document i s designed t o h e l p p r i m a r y school teachers i n t e g r a t e n u t r i t i o n educat ion i n t o t h e i r e x i s t i n g c u r r i c u l a . It can be used as pre-serv ice o r i n s e r v i c e guidance, t o promote t h e exchange o f i n f o r m a t i o n and ideas about n u t r i t i o n educat ion a t t h e pr imary l e v e l . P a r t I p r e s e n t s b a s i c n u t r i t i o n f a c t s and concepts f o r t h e teacher n o t t r a i n e d i n n u t r i t i o n . P a r t II p r e s e n t s p r a c t i c a l examples o f case s t u d i e s and g u i d e l i n e s developed i n s e v e r a l c o u n t r i e s , i n c l u d i n g t h e Un i ted States, Cyprus, Jamaica, Maur i tan ia , S i e r r a Leone, and Great B r i t a i n . I n Cyprus, n u t r i t i o n was i n t e g r a t e d i n t o lessons on home economics, hygiene, science, and schoo l gardening. I n Jamaica, an o u t l i n e presents n u t r i t i o n as a u n i f y i n g theme i n courses i n mathematics, s o c i a l s tud ies , and science. The document i s i l l u s t r a t e d w i t h drawings, f i g u r e s , and tab les .

203. UNESCO. N u t r i t i o n Education: Role o f Col leges i n Education. P a r i s , Unesco, 1983. 84p. ( D i v i s i o n o f Science, Techn ica l and V o c a t i o n a l Educat ion. N u t r i t i o n Educat ion Ser ies, 2)

Col leges o f educat ion p l a y a unique r o l e i n formal n u t r i t i o n educat ion, because they are t h e t r a i n e r s o f t r a i n e r s . Those whom they t r a i n and m o t i v a t e should be ab le t o pass on t h e i r knowledge, and t h e i r commitment, t o t h e i r students. T h i s volume presents four papers: a survey o f n u t r i t i o n educat ion t r a i n i n g by c o n t i n e n t and n a t i o n ; a d e s c r i p t i o n o f i n n o v a t i v e p r o j e c t s f o r t r a i n i n g I s r a e l i school teachers i n t e a c h i n g n u t r i t i o n ; d e s c r i p t i o n o f a P h i l i p p i n e exper ience i n t h e i n t r o d u c t i o n o f n u t r i t i o n educat ion components i n h e a l t h educat ion; and a d e s c r i p t i o n o f t h e r o l e o f c o l l e g e s o f educat ion i n n u t r i t i o n educat ion i n t h e Un i ted States.

204. UNICEF. The S t a t e o f t h e Wor ld 's Ch i ld ren , 1984. New York, UNICEF, and Oxford, Oxford U n i v e r s i t y Press, 1984. 126p.

Recent advances i n b i o l o g i c a l sc ience and s o c i a l o r g a n i z a t i o n a r e making p o s s i b l e a C h i l d S u r v i v a l Revolut ion, which w i l l be ab le t o save m i l l i o n s o f l i v e s annua l ly th rough i n t e r v e n t i o n s t h a t can make a d i f f e r e n c e w i t h a m i n i m u m o f resource investment: growth m o n i t o r i n g , o r a l r e h y d r a t i o n therapy , b r e a s t feed ing promot ion, and immunization. T h i s r e p o r t descr ibes t h e UNICEF campaign, i n c l u d i n g case s t u d i e s o f p r o j e c t s i n which n u t r i t i o n educat ion p layed a r o l e .

205. WHO. A n a c t i o n - o r i e n t e d research, development and t r a i n i n g programme i n n u t r i t i o n . WHO Chron ic le , v o l . 33, no. 6, June 1979, PP. 225-27.

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AFRICA

206. BARAKAT, M.R. Report t o t h e Government o f t h e Sudan on es tab l i shment and s t rengthen ing o f p r o v i n c i a l n u t r i t i o n educat ion cent res i n Sudan. Review o f t h e programme a c t i v i t i e s d u r i n g t h e p e r i o d May 1978 - February 1980. Rome, FAO, 1980. 52p.

207. BARAKAT, M.R. Report t o t h e Government o f t h e Sudan on establ ishment and s t r e n g t h e n i n g o f p r o v i n c i a l n u t r i t i o n educat ion cent res i n t h e Sudan, phase 2, March 24-June 23, 1981. Rome, FAO, 1981. 88p.

These r e p o r t s present t h e c o n s u l t a n t ' s observa t ions and recommendations r e g a r d i n g assessment and expansions o f n u t r i t i o n educat ion and t r a i n i n g i n an area i n c l u d i n g Kordofan, Gezira, and t h e prov inces o f Khartoum and Blue N i l e . Programs i n c l u d e d supplementary feed ing f o r pregnant and n u r s i n g mothers and c h i l d r e n and t h e es tab l i shment and s t rengthen ing o f p r o v i n c i a l t r a i n i n g c e n t e r s f o r n u t r i t i o n educat ion.

208. CAVUSGIL, S. T.; AMINE, L. S.; VITALE, E. Marke t ing supplementary food produc ts i n LDCs: A case s tudy i n Morocco. Food P o l i c y , May 1983, pp. 11 1-1 20.

Marke t ing procedures t o i n t r o d u c e weaning foods a r e examined i n t h e c o n t e x t o f a r e c e n t e f f o r t t o develop and market a new i n f a n t c e r e a l i n Morocco. Ass is tance from UNICEF and a l o c a l manufacturer o f t a b l e o i l s l e d t o p r o d u c t i o n o f a new product , but t h e p r o j e c t f a i l e d . The market p r i c e o f t h e p r o d u c t was lower than t h e p r i c e o f competing brand-name cerea ls , such as Nest lé , but t h e d i f f e r e n c e was n o t s u f f i c i e n t t o promote adequate sa les, and t h e manufacturer was f o r c e d t o s e l l o u t t o t h e government. Free s u p p l i e s p r o v i d e d b y h e a l t h c e n t e r s conta ined t h e same product , but lower grade packaging l e d t o popu lar p e r c e p t i o n s o f an i n f e r i o r product . No p o i n t - o f - puchase promot ion was attempted. new food balanced on a sca le w i t h s e v e r a l foods, i n c l u d i n g f i s h , which i s perce ived as an i n f e r i o r food n o t a p p r o p r i a t e t o feed t o young c h i l d r e n . Adopt ion o f modern promot iona l techniques should be app l ied : " i d e n t i f y needs; e s t a b l i s h product acceptance; p r o p e r l y m o t i v a t e consumers; ensure e f f i c i e n t d i s t r i b u t i o n ; suppor t t h e b a s i c product ; and achieve e f f e c t i v e p r i c i n g l e v e l s . I 1

The mass media promot ion campaign showed t h e

209. CHALE, F. ; KAUNDA, J. ; DIRORIMWE, C. ; MUNTEMBA, D. Namibia - T r a i n i n g f o r Food D i s t r i b u t i o n . Report. Rome, FAO, 1981. 45p.

21 O. COMITE ANTI-BWAKI. 9eme Rapport Annuel 1980-1 981. Bukavu/Kivu, Republ ique du Za i re , 1982. 87p.

T h i s r e p o r t rev iews t h e budget and a c t i v i t i e s o f t h e C o m i t é pour l a L u t t e c o n t r e l e Kwashiorkor e t l a P r o t e c t i o n de l 'Enfance au K i v u ( a b b r e v i a t e d Comité Anti-Bwaki) d u r i n g 1980 and 1981. Repor ts a r e presented from h e a l t h and n u t r i t i o n c e n t e r s f i n a n c i a l l y supported b y the Comi té Anti-Bwaki . H e a l t h

59

care, food d i s t r i b u t i o n , and n u t r i t i o n educat ion are t h e p r i n c i p a l a c t i v i t i e s . Topics i n n u t r i t i o n educat ion a r e l i s t e d f o r some centers , and e v a l u a t i o n o f t h e n u t r i t i o n educat ion methodology i s inc luded. Home v i s i t s had proved t o be t h e most e f f e c t i v e way t o communicate n u t r i t i o n i n f o r m a t i o n i n t h e v i l l a g e s e t t i n g .

21 1. FRANKISH, J.G. N u t r i t i o n r e h a b i l i t a t i o n i n Transkei , an e v a l u a t i o n . South A f r i c a n Medica l Journa l , v o l . 53, 1978, pp. 507-511.

Th is r e p o r t presents f i n d i n g s on t h e e f f e c t i v e n e s s o f n u t r i t i o n r e h a b i l i t a t i o n u n i t s i n improv ing long-range n u t r i t i o n s t a t u s r e l a t i v e t o t rea tment i n t h e usua l h o s p i t a l s e t t i n g . c h i l d r e n f o r m a l n u t r i t i o n , p r o v i d i n g n u t r i t i o n educat ion i n a d d i t i o n t o h o s p i t a l care. A t 6- and 14-month fo l lowups, t h e c h i l d r e n were no b e t t e r o f f than 14 c o n t r o l c h i l d r e n , a l t h o u g h t h e educat ion d i d seem t o have had some e f f e c t s , such as inc reased home gardening b y parents . The s m a l l ga ins achieved th rough educat ion seemed t o have been overwhelmed b y t h e o v e r r i d i n g problems o f economic, s o c i a l , a g r i c u l t u r a l , and o t h e r needs.

R e h a b i l i t a t i o n u n i t s a t two h o s p i t a l s t r e a t e d 78

212. GILMORE, J.W. ; ADELMAN, C.C. ; MEYER, A. J. ; THORNE, M.C. Morocco: Food A id and N u t r i t i o n Educat ion. A.I . D. Washington, D. C., U. S. Agency f o r I n t e r n a t i o n a l Development, 1980. 62p. ( P r o j e c t Impact Eva lua t ion Report No 8 )

T h i s p r o j e c t s u c c e s s f u l l y i n t e g r a t e d n u t r i t i o n educat ion i n t o a supplementary feed ing program admin is te red b y C a t h o l i c R e l i e f Services. Educators were t r a i n e d th rough a h i e r a r c h y o f n u t r i t i o n p r o f e s s i o n a l s , superv isors , and local- leve). teachers. A f t e r i n i t i a l suppor t from USAID, t h e p r o j e c t was admin is tered b y t h e M i n i s t r y o f S o c i a l A f f a i r s t h r o u g h a wel l -organized system o f 300 centers . The l o c a l c o s t s o f t h e c e n t e r s and t h e teachers ' wages were f inanced b y t h e p a r t i c i p a t i n g mothers. E v a l u a t i o n 14 months a f t e r e x p i r a t i o n o f t h e i n i t i a l USAID g r a n t showed t h a t t h e s o c i a l educat ion c e n t e r s had p o s i t i v e l y i n f l u e n c e d t h e n u t r i t i o n a l l e v e l s o f t h e c h i l d r e n . According t o one ana lys is , t h e program r e s u l t e d i n a 69% r e d u c t i o n i n t h e inc idence o f moderate and severe m a l n u t r i t i o n , a p p a r e n t l y t h r o u g h increases i n mothers ' knowledge and r e s u l t i n g changes i n t h e i r food- re la ted p r a c t i c e s . Another c o n t r i b u t i n g f a c t o r was t h e r e l a t i v e l y l a r g e s i z e o f t h e rat ion--45 k i l o s per r e c i p i e n t per year and t h r e e r a t i o n s per fami ly , which probab ly he lped reduce t h e e f f e c t s o f s h a r i c g within t h e f a m i l y and served as a major income subsidy. Lessons learned th rough t h i s p r o j e c t i n c l u d e t h e need f o r a u n i f i e d and c e n t r a l i z e d record-keeping system t o document program a c t i v i t i e s and progress, and t h e recommendation t h a t dependency on impor ted foods be minimized.

213. GITHAGUI , N. Bu tu la Family L i f e T r a i n i n g Centre (Busia D i s t r i c t ) . N a i r o b i , Kenya, A f r i c a n Medica l and Research Foundat ion, 1980. 22p.

The B u t u l a Family L i f e T r a i n i n g Center i s one o f s e v e r a l c e n t e r s th roughout Kenya t h a t o f f e r n u t r i t i o n r e h a b i l i t a t i o n and i n s t r u c t i o n f o r mothers o f t h e malnour ished c h i l d r e n . Three-week courses i n c l u d e h e a l t h educat ion, a g r i c u l t u r e , n u t r i t i o n , and f a m i l y p lanning. T h i s s t u d y i n c l u d e d home i n t e r v i e w s w i t h 53 mothers and found t h a t poor f e e d i n g p r a c t i c e s , such as

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s k i p p i n g b r e a k f a s t , and pover ty were t h e major c o n t r i b u t i n g f a c t o r s t o ch i ldhood m a l n u t r i t i o n . M a l n u t r i t i o n was o f t e n a t t r i b u t e d t o n o n - n u t r i t i o n a l causes such as e v i l s p i r i t s , and t rea tment b y t r a d i t i o n a l h e a l e r s o f t e n delayed o r p rec luded n u t r i t i o n a l i n t e r v e n t i o n . E f f e c t s o f t h e educat ion program were mixed: t h e r e was some increase i n knowledge, but l i t t l e change i n behav io r , p a r t l y because o f c r u c i a l m iss ing knowledge. For example, mothers cou ld name t h e t h r e e food groups but c o u l d n o t g i v e examples o f t h e foods and d i d n o t base meals on them. Recommendations i n c l u d e b e t t e r s t a f f t r a i n i n g , increased community demonstrat ions (such as gardening), and encouragement o f s u c c e s s f u l p a r t i c i p a n t s t o become r o l e models i n t h e community, e x p l a i n i n g lessons (such as causes o f m a l n u t r i t i o n ) t o o t h e r mothers. Fol lowup and r e c r u i t m e n t programs c o u l d improve t h e e f f e c t i v e n e s s o f ex tens ion workers.

214. HOORWEG, J.C. ; NIMEIJER, R. The Impact o f N u t r i t i o n Educat ion a t Three Hea l th Centers i n C e n t r a l Province, Kenya. Leiden, The Nether lands, A f r i c a n S t u d i e s Centre, 1980. 65p. (Research r e p o r t s No. I O )

N u t r i t i o n i n s t r u c t i o n prov ided a t m a t e r n a l and c h i l d h e a l t h c e n t e r s b y t r a i n e d nurses was eva lua ted b y i n t e r v i e w i n g K ikuyu mothers o f c h i l d r e n 6 months t o 5 years o ld . Data were c o l l e c t e d on materna l n u t r i t i o n knowledge, c h i l d food consumption, and anthropometr ic measures. Impact o f t h e program was evaluated b y comparing a group who at tended f r e q u e n t l y w i t h a group o f mothers who were i n f r e q u e n t v i s i t o r s t o t h e h e a l t h centers . There were few d i f f e r e n c e s between t h e groups' food preferences, i n f a n t feed ing p r a c t i c e s , and c h i l d r e n ' s n u t r i t i o n a l s t a t u s , but t h e f requent v i s i t o r s were more l i k e l y t o i n t r o d u c e weaning foods a t an e a r l y , a p p r o p r i a t e age. Frequency o f v i s i t a t i o n was a s i g n i f i c a n t f a c t o r o n l y i n t h e r e l a t i v e n u t r i t i o n knowledge o f t h e mothers. Therefore, a l though n u t r i t i o n educat ion d i d succeed i n i n c r e a s i n g knowledge, t h e r e was no s i g n i f i c a n t e f f e c t on behavior o r n u t r i t i o n s ta tus . S ince t h e m a l n u t r i t i o n r a t e i n t h e area was h i g h (30% o f t h e c h i l d r e n were underweight f o r t h e i r h e i g h t s ) , t h e au thors conclude t h a t more e f f e c t i v e i n t e r v e n t i o n s should be sought. Greater s u p e r v i s i o n and o r g a n i z a t i o n a l suppor t fo r n u t r i t i o n workers a r e recommended, as w e l l as t h e i n t r o d u c t i o n o f growth c h a r t s .

215. HOORWEG, J.C.; NIEMEIJER, R. The N u t r i t i o n a l Impact o f t h e Pre-School & Leiden, The Nether lands, A f r i c a n Stud ies Centre, 1980. 69p. (Research r e p o r t s No. 11 )

The program presented i n t h i s paper o f f e r e d b o t h n u t r i t i o n educat ion and supplemental food t o mothers and c h i l d r e n 6 months t o 5 years o l d . I n t e r v i e w s w i t h long-term p a r t i c i p a n t s and newcomers t o t h e program showed t h a t at tendance d i d improve mothers' n u t r i t i o n knowledge and food preferences, but t h a t t h e i r c h i l d r e n were c o n t i n u i n g t o grow a t t h e same r a t e as before e n t e r i n g t h e program, and educat ion d i d n o t i n f l u e n c e c h i l d r e n ' s d i e t s . Therefore, t h e s t r e n g t h o f t h e program appeared t o be supplementat ion r a t h e r than educat ion.

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216. KOECHE, M.K. The Impact o f Improved N u t r i t i o n on t h e H e a l t h o f Rura l Kenyans: The Use o f Nonformal Educat iona l Technology. Edwards, A.L. e t a l . , eds. New Dimensions o f Appropr ia te Technology. Ann Arbor, Mich igan, U n i v e r s i t y o f Michigan, 1980, pp. 159-173.

217. MINETT, N. A Successful Hea l th Educat ion Program i n West A f r i c a . Freetown, S i e r r a Leone, CARE/Sierra Leone, 1980. 28p.

The o b j e c t i v e o f t h i s p r o j e c t was t o develop e d u c a t i o n a l m a t e r i a l s f o r use i n r u r a l v i l l a g e s and measure t h e i r a b i l i t y t o produce b e h a v i o r a l changes i n l a c t a t i n g women. Pregnant mothers were i n t e r v i e w e d about t h e i r demographic and household c h a r a c t e r i s t i c s , h e a l t h and n u t r i t i o n p r a c t i c e s , and d i e t a r y in takes . Survey f i n d i n g s were used t o develop t e n group d i s c u s s i o n sess ions about h e a l t h and n u t r i t i o n . A f l i p c h a r t presented photographs i l l u s t r a t i n g t h e lessons, and h e a l t h educat ion teams were t r a i n e d i n communications and e v a l u a t i o n . The lessons were adapted accord ing t o f i n d i n g s o f c u l t u r a l a c c e p t a b i l i t y , ease o f t r a n s l a t i o n i n t o l o c a l languages, and semantic c l a r i t y . Fol lowup i n t e r v i e w s w i t h women f i t t i n g t h e same socioeconomic backgrounds as t h e o r i g i n a l groups found t h a t those r e c e i v i n g educat ion th rough t h i s program had made s e v e r a l changes, n o t a b l y more mothers b o i l e d d r i n k i n g water, and b o t h mothers and t h e i r i n f a n t s a t e more f r u i t s , vegetables, and p r o t e i n foods. Changes were smal l , and a l o n g e r t e s t i n t e r v a l i s needed t o determine whether more s i g n i f i c a n t behavior changes can be obta ined.

218. MUNGER, S. J. Mass Media and Nonformal N u t r i t i o n Education: F i n a l Study Report. A l l i s o n Park, Pennsylvania, S y n e c t i c s Corpora t ion , f o r A I D Development Support Bureau, 1978. 133p.

T h i s s t u d y was conducted i n order t o develop a demonstrat ion o f a conniunicat ion model t o gu ide t h e des ign o f educat ion programs for improvement o f n u t r i t i o n a l behav io r , p a r t i c u l a r l y ways t o combine mass media and nonformal educat ion t o achieve g r e a t e r impact than e i t h e r alone. A model was developed based on address ing f o u r domains o f concern: educat ion, communication, behavior , and eva lua t ion . A p p l i c a t i o n o f t h e model t o a t r i a l i n T u n i s i a inc luded use o f s h o r t r a d i o messages and e x i s t i n g nonformal n u t r i t i o n educat ion a c t i v i t y i n t h e h e a l t h centers . I n t e r e s t i n t h e mass media component became a n a t i o n a l concern o f g r e a t p o p u l a r i t y , and t h e d o c t o r charac ter who d e l i v e r e d t h e messages became a f o l k hero. I n t e r v i e w s w i t h mothers a t t e n d i n g h e a l t h c e n t e r s y i e l d e d no c o n c l u s i v e evidence o f behav io r changes, but t h e t e s t p e r i o d was shor t . There were some knowledge and a t t i t u d e changes. The model was judged t o be a u s e f u l genera l framework wi th in which conceptual and methodo log ica l improvements m i g h t be c a r r i e d o u t . The s tudy d i d i n d i c a t e t h a t a comprehensive communication model can l e a d t o more r i g o r o u s development o f media campaigns than m i g h t o therw ise be achieved.

219. PIELEMEIER, N.R.; JONES, E.M..; MUNGER, S.J. Use o f t h e C h i l d ' s Growth Char t as an Educat iona l Tool. A l l i s o n Park, Pennsylvania, S y n e t i c s Corpora t ion f o r A I D O f f i c e o f N u t r i t i o n Development Support Bureau, 1978. 121p. b i b l .

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I n Ghana and Lesotho, mothers a r e l e a r n i n g t o i n t e r p r e t t h e i r c h i l d r e n ' s growth c h a r t s and a r e l e a r n i n g t h r o u g h them t h e p r i n c i p l e s o f c h i l d n u t r i t i o n a l needs. T h i s r e p o r t presents t h e r e s u l t s o f a year- long s tudy o f growth c h a r t use i n h e a l t h centers . C o n t r o l l e d exper imenta t ion i s needed, however, t o determine t h e e x t e n t o f e f f e c t s on mothers ' knowledge, a t t i t u d e s , and p r a c t i c e s , and on t h e i r c h i l d r e n ' s h e a l t h s t a t u s . Such i n v e s t i g a t i o n s c o u l d then be used as t h e b a s i s o f t r a i n i n g o f h e a l t h workers who use t h e c h a r t s and make them more e f f e c t i v e n u t r i t i o n educat ion t o o l s .

220. SAINT4í1LEUX, M. S a n d Rura le en A f r i q u e Noi re: Une Exper ience dans un Cent re Médical au Gabon. Thkse pour l e d o c t o r a t en @decine. P a r i s , F a c u l t 6 de Mgdicine S t . Antoine, 1982. 101p. b i b l .

T h i s t h e s i s o u t l i n e s t h e med ica l s i t u a t i o n i n Gabon; one chapter concerns t h e inc idence o f m a l n u t r i t i o n i n c h i l d r e n and t h e importance o f n u t r i t i o n educat ion. I n t h e m a j o r i t y o f m a l n u t r i t i o n cases, t h e cause i s l a c k o f knowledge and poor u t i l i z a t i o n o f l o c a l resources. The most e f f e c t i v e p r e v e n t i v e measure a g a i n s t m a l n u t r i t i o n would be t o develop e f f e c t i v e n u t r i t i o n educat ion programs f o r t h e Maternal and C h i l d Hea l th Care Centers, b u t t h i s would r e q u i r e government suppor t .

221. SMITH, I.F. R e h a b i l i t a t i o n o f prote in-energy metabol ism and hormonal s t a t u s i n N i g e r i a n c h i l d r e n . N u t r i t i o n Reports I n t e r n a t i o n a l , vo l . 24, no. 3, September 1981, pp. 602-1 3. b i b l . [ A l s o pub l ished i n French]

Th is s tudy showed t h a t two weeks o f h o s p i t a l i z a t i o n were n o t s u f f i c i e n t f o r t h e n u t r i t i o n a l and hormonal r e h a b i l i t a t i o n o f i n f a n t s s u f f e r i n g from p r o t e i n - energy m a l n u t r i t i o n . I n a d d i t i o n , t h e t rea tment o f these c h i l d r e n i n smal le r r e h a b i l i t a t i o n c e n t e r s s c a t t e r e d throughout t h e c o u n t r y would be more e f f e c t i v e , making i t p o s s i b l e t o p rov ide some n u t r i t i o n educat ion for t h e i r mothers, which was imposs ib le i n t h e h o s p i t a l s e t t i n g .

222. STEPHENS, A. J.H. The impact o f h e a l t h care and n u t r i t i o n a l educat ion i n an urban community i n Zambia th rough t h e under f i v e c l i n i c s . Journal o f T r o p i c a l Medic ine and Hygiene, v o l . 78, no. 5, 1975, pp. 97-105.

An assessment o f t h e under- f i v e s c l i n i c s compared i n f o r m a t i o n ob ta ined from mothers o f c h i l d r e n w i t h kwashiorkor and from a c o n t r o l group o f mothers o f h e a l t h y c h i l d r e n w i t h t h e same socioeconomic background. Fac tors examined i n c l u d e d f a m i l y s t a t u s , socioeconomic f a c t o r s ( f a t h e r ' s p r o f e s s i o n , wages, res idence, l e n g t h o f s t a y i n town), feed ing h a b i t s , number o f v i s i t s a t t h e c l i n i c , h o s p i t a l i z a t i o n o f t h e c h i l d , and reasons f o r n o t a t t e n d i n g t h e c l i n i c s . The c l i n i c s ' impact on m a l n u t r i t i o n was found t o be inadequate, d e s p i t e t h e l a r g e number o f c l i n i c s a v a i l a b l e , and t h e author recommends t h a t t h e y be r e d i r e c t e d and used as a t r i s k c l i n i c s r a t h e r than be ing d i r e c t e d t o - a l l under- f ives. The problem o f p reschoo l m a l n u t r i t i o n should a l s o be approached a t t h e community l e v e l th rough i t s leaders t o encourage t h e development o f l o c a l food resources.

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223. TANDBERG, A. Sumer P r o j e c t 1980: F i n a l Report on t h e P a r t i c i p a t i o n i n t h e Implementat ion o f t h e Mass Media N u t r i t i o n Educat ion P r o j e c t i n Kinshasa, Z a i r e . New Orleans, N u t r i t i o n Department, School o f P u b l i c H e a l t h and T r o p i c a l Medicine, Tulane U n i v e r s i t y , 1980. 126p. (NTR. 799 Spec ia l Studies: F i e l d Research Study)

T h i s c o n s u l t a n t r e p o r t s on one p a r t o f t h e development o f t h e mass media campaign. Extens ive b a s e l i n e i n f o r m a t i o n was c o l l e c t e d on food knowledge, a t t i t u d e s , and p r a c t i c e s , and on r a d i o l i s t e n e r s h i p . Radio and t e l e v i s i o n m a t e r i a l s were developed, based on o b j e c t i v e s d e r i v e d from t h i s data. P r e t e s t i n g o f t h e E n g l i s h r a d i o spots was a p p a r e n t l y l i m i t e d t o 3 s t a f f members; development was conducted almost e x c l u s i v e l y wi th in t h e c e n t r a l o f f i c e , w i t h l i t t l e o r no community i n v e s t i g a t i o n o f t h e e f f e c t i v e n e s s o f t h e spots. T h i s l a c k o f p r e t e s t i n g and t h e l a c k o f e v a l u a t i o n o f t h e i r impact b e f o r e t h e c o n s u l t a n t ' s depar tu re r e s u l t s i n a l a c k o f d e f i n i t e conc lus ions about t h e i r e f f e c t i v e n e s s i n ach iev ing t h e goa l o f improv ing n u t r i t i o n knowledge and thus a f f e c t i n g n u t r i t i o n s t a t u s . He suggests t h a t , based on t h e i n i t i a l survey f i n d i n g s , t h e problem i s n o t l a c k o f n u t r i t i o n knowledge, but socioeconomic f a c t o r s such as access t o food and f u e l , o r t i m e c o n s t r a i n t s .

224. TISA, B. Consu l tan t Report f o r The People 's Republ ic o f t h e Congo (Mav 1 9 - June 15, 1982): Report on a Consul tancy t o Help Design Messages and M a t e r i a l s f o r t h e CARE/Congo H e a l t h and N u t r i t i o n P r o j e c t . Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Service, Educat ion Development Center, t h r o u g h subcont rac t t o Manoff I n t e r n a t i o n a l , Inc. , Washington, D.C., 1982. 37p.

T h i s r e p o r t b y a media c o n s u l t a n t p resents a b a s i c methodology f o r t h e design, p r e t e s t i n g , and e v a l u a t i o n o f p r i n t and a u d i o v i s u a l n u t r i t i o n educat ion m a t e r i a l s : F i v e Congo-based agencies p a r t i c i p a t e d i n t h i s p r o j e c t , which began w i t h a survey o f n u t r i t i o n s t a t u s and food h a b i t s . T h i s r e p o r t c o n t a i n s t h e e d u c a t i o n a l o b j e c t i v e s based on t h e f i n d i n g s o f t h a t survey, as w e l l as step-by-step s t r a t e g y f o r t h e program's development and design.

225. TISA, B. Consul tant Report f o r The People 's Republ ic o f t h e Congo (November 5 - December 8, 1981 1: The Resu l ts o f a Workshop t o Develop N u t r i t i o n Educat ion M a t e r i a l s . Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Serv ice, Educat ion Development Center, th rough subcont rac t t o Manoff I n t e r n a t i o n a l , Inc. , Washington, D. C., 1982. 87p.

Th is r e p o r t presents a fo l lowup v i s i t b y a media c o n s u l t a n t a s s i s t i n g i n t h e development o f a mass media n u t r i t i o n educat ion campaign b y 5 Congo-based agencies. E a r l i e r r e p o r t s descr ibe t h e survey des ign, da ta c o l l e c t i o n and e v a l u a t i o n , i d e n t i f i c a t i o n o f p r i o r i t y problems, and a workshop t o t e a c h s k i l l s i n message des ign and m a t e r i a l s development. Th is r e p o r t d e s c r i b e s t h e m a t e r i a l s developed f o r p r e t e s t i n g , t h e b a s i c messages conveyed, t h e l o c a t i o n s and r e s u l t s o f t h e p r e t e s t i n g , and recommendations f o r r e v i s i o n and f o r new m a t e r i a l s and new i n f o r m a t i o n needs uncovered i n t h e development process. For example, more i n f o r m a t i o n was needed on r a d i o a v a i l a b i l i t y and l i s t e n i n g h a b i t s i n o r d e r t o r e f i n e t h e conten t and a i r i n g o f r a d i o messages.

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226. WONE, I. ; LAUTURE, H.DE; PERIER-SCHEER, M. ; e t a l . Premiers r e s u l t a t s d'une enquète p r é a l a b l e une a c t i o n d 'éducat ion n u t r i t i o n n e l l e a Dakar [The f i r s t r e s u l t s o f an i n v e s t i g a t i o n p r i o r t o a n u t r i t i o n a l educat ion campaign1 Dakar S o c i e t 6 Mgdicale d ' A f r i q u e Occidenta le Française, vo l . 26, no. 3, 1981, PP. 338-346.

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T h i s r e p o r t p resents t h e r e s u l t s o f a survey o f n u t r i t i o n p r a c t i c e s and s t a t u s designed t o serve as a b a s e l i n e f o r a n u t r i t i o n educat ion campaign i n Dakar, Senegal. I n t e r v i e w s w i t h 77 mothers o r c a r e t a k e r s o f 100 c h i l d r e n under 3 years o l d revea led t h a t economic c o n d i t i o n s were r e l a t i v e l y acceptable, and t h a t t h e p r i n c i p a l causes o f i n a p p r o r i a t e c h i l d r e n ' s d i e t s were e s s e n t i a l l y s o c i o c u l t u r a l , e s p e c i a l l y among c h i l d r e n whose mothers had r e c e i v e d l i t t l e f o r m a l educat ion.

227. WONE, I. ; LAUTURE, H. DE; PENOT, C. ; PERIERSCHEER, M. ; COHEN, M. Première é v a l u a t i o n d'une a c t i o n d 'éducat ion n u t r i t i o n n e l l e dans l a Medina de Dakar, Dakar Médical . Dakar Societ6 Médicale d ' A f r i q u e Occidenta le Francaise, v o l . 26, no. 4, 1981, pp. 420-26, b i b l .

I n March 1978, a n u t r i t i o n c l i n i c was begun i n t h e Medina d i s t r i c t o f Dakar, Senegal. c h i l d r e n were i d e n t i f i e d as s u f f e r i n g from f i r s t degree m a l n u t r i t i o n . T h i s r e p o r t descr ibes an i n i t i a l survey taken o f t h e p a r t i c i p a t i n g mothers) t h e survey f i n d i n g s t h a t i n d i c a t e d t h a t m a l n u t r i t i o n was r e l a t e d more t o soc io - c u l t u r a l reasons than socio-economic c o n d i t i o n s : and t h e ensuing n u t r i t i o n educat ion program and i t s eva lua t ion . The e v a l u a t i o n i n v o l v e d o n l y r e q u e s t i o n i n g t h e mothers on p r e - n u t r i t i o n educat ion survey quest ions. t h e percent o f c o r r e c t answers increased a f t e r t h e n u t r i t i o n educat ion was completed, t h e au thors suggest t h a t an i n v e s t i g a t i o n i n t o t h e behavior o f t h e mothers should be done b e f o r e an accurate e v a l u a t i o n can be made o f t h e n u t r i t i o n educat ion program.

The c l i n i c o f f e r e d a n u t r i t i o n educat ion program t o 77 mothers whose

"hough

ASIA, NEAR EAST, PACIFIC

228. BUTT, H.W. Towards s e l f sus ta ined and l o c a l l y managed h e a l t h educat ion and n u t r i t i o n programs f o r c h i l d w e l f a r e (The Cheval la Experiment). Paper presented a t t h e XII annual meet ing o f t h e N u t r i t i o n S o c i e t y o f I n d i a , Chandigarh, 3-4 March 1979. 27p.

T h i s p r o j e c t used an i n t e g r a t e d approach t o h e a l t h , educat ion, and n u t r i t i o n , emphasizing l o c a l i n i t i a t i v e , l o c a l manpower, and l o c a l i n g r e d i e n t s , focus ing on improv ing t h e genera l q u a l i t y o f l i f e . shared b y p a r t i c i p a n t s , t h e community, and concerned government agencies. Operat ing i n se lec ted s e c t i o n s o f t h e Cheval la b lock , near Hyderabad, t h e p r o j e c t emphasized h e a l t h programs, prov ided day care fo r i n f a n t s , Pr imary schoo ls f o r c h i l d r e n , and nonformal educat ion f o r those 12 t o 16 years o l d . Income-generating p r o j e c t s were s t a r t e d wherever t h e y seemed r e l e v a n t t o t h e concerns o f t h e l o c a l women, and n u t r i t i o n demonstrat ion u n i t s were s e t up t o promote use o f new v a r i e t i e s o f seeds.

Costs and r e s p o n s i b i l i t i e s were

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229. CHADHA, R. The i n t e g r a t e d c h i l d h e a l t h scheme--an i n t e g r a t i o n o f a preschool n u t r i t i o n programme w i t h h e a l t h and educat ion serv ices . I n d i a n Journal o f N u t r i t i o n and D i e t e t i c s , vo l . 17, 1980, pp. 84-89.

The I n t e g r a t e d C h i l d H e a l t h Scheme served 1000 low-income c h i l d r e n i n C a l c u t t a as a p i l o t p r o j e c t t o improve n u t r i t i o n a l s ta tus . Serv ices i n c l u d e d n u t r i t i o n supplements, v a c c i n a t i o n s , and c u r a t i v e h e a l t h s e r v i c e s f o r c h i l d r e n and n u t r i t i o n and h e a l t h educat ion f o r t h e i r mothers. Serv ices were p r o v i d e d th rough 10 centers which prov ided care f o r c h i l d r e n under t h r e e years o l d i n t h e mornings and those 3 t o 5 years o l d i n t h e af ternoons. An e v a l u a t i o n conducted a t t h e end o f one year found at tendance a t 90%. D e l i v e r y r a t e s o f v a r i o u s s e r v i c e s inc luded: food supplements, 60% (impeded b y food shor tages and l o g i s t i c a l problems) ; v i t a m i n A supplements, 79%; deworming drugs, 898; and i r o n and f o l d a c i d t a b l e t s f o r anemia, 50% ( f o r a t l e a s t 90 days). N u t r i t i o n a l s t a t u s assessment o f a random sample o f 50% o f p a r t i c i p a n t s found t h a t most c h i l d r e n had improved t h e i r weight f o r age and weight f o r h e i g h t s t a t u s , a l though t h e r e was no change i n h e i g h t f o r age, n o t s u r p r i s i n g i n t h i s s h o r t t i m e frame. There a l s o were marked r e d u c t i o n s i n prevalence o f n u t r i t i o n a l d e f i c i e n c i e s and i n f e c t i o u s diseases.

230. CHAUDHURI, S. N. N u t r i t i o n educat ion through under f i v e s ' c l i n i c s I n d i a n Pediat r . , v o l . 12, 1977, pp. 339-341.

Hea l th c l i n i c s f o r c h i l d r e n under 5 years o ld , l o c a t e d i n r u r a l and urban areas, p r o v i d e n u t r i t i o n educat ion t o mothers b o t h i n t h e c l i n i c s and i n t h e i r homes, th rough t r a i n e d c h i l d h e a l t h workers. The au thor recommends t h a t , t o be more e f f e c t i v e , these s e r v i c e s should be i n t e g r a t e d b e t t e r w i t h h e a l t h c a r e serv ices , a s s e r t i n g t h a t t h e c o s t / b e n e f i t r a t i o o f t h e c l i n i c s i s h i g h because each p r o v i d e s care f o r 1000 c h i l d r e n and n u t r i t i o n educat ion f o r about 450 mothers.

231. DEVADAS, R. P. I n t e g r a t i n g n u t r i t i o n educat ion i n t o t h e p r i m a r y school c u r r i c u l u m i n I n d i a . J o u r n a l o f N u t r i t i o n Educat ion, v o l . I O , no. 3, 1978, pp. 113-115.

T h i s p i l o t p r o j e c t was conducted i n 666 p r i m a r y schoo ls i n Tamil Nadu. An i n t e g r a t e d s y l l a b u s was designed, and 3,600 teachers were t r a i n e d i n i t s use and i n t h e r e c o g n i t i o n o f s i g n s o f m a l n u t r i t i o n . The b a s e l i n e survey, o b j e c t i v e s , program development, m a t e r i a l s development, teacher t r a i n i n g , and p r e l i m i n a r y e v a l u a t i o n a r e descr ibed. I n i t i a l r e s u l t s showed improvements i n n u t r i t i o n knowledge and d i e t a r y p r a c t i c e s , an i n c r e a s e i n gardening, and reduced m a l n u t r i t i o n .

232. DURONGDEJ, S. ; ISRAEL, R.C. Consul tant Report f o r Tha i land (December 10-24, 1983 1: D e s c r i p t i o n o f a Forthcoming Bangkok Breas t feed ing Promot ion P r o j e c t . Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Service, Educat ion Development Center, 1984. 22p.

I n response t o s t u d i e s showing t h a t decreas ing b r e a s t feed ing r a t e s were a t t r i b u t a b l e i n p a r t t o l a c k o f med ica l support , a program has been designed t o promote b r e a s t feed ing i n t h e 9 h o s p i t a l s where 70% o f a l l Bangkok b i r t h s

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occur. Each h o s p i t a l w i l l e s t a b l i s h goa ls f o r e s t a b l i s h i n g rooming-in, f o r t r a i n i n g s t a f f i n c l i n i c a l techniques o f b r e a s t feeding management, and f o r r e d u c i n g hosp i ta l -based promot ion o f formula feeding. To h e l p h o s p i t a l s determine and reach these goals, t h e p r o j e c t w i l l t r a i n h o s p i t a l s t a f f i n l a c t a t i o n management and develop hospi ta l -based n u t r i t i o n educat ion suppor t m a t e r i a l s f o r h e a l t h p r o f e s s i o n a l s and mothers. The p r o j e c t w i l l be conducted b y t h e F a c u l t y o f P u b l i c H e a l t h and Mahidol U n i v e r s i t y , w i t h ass is tance from I N C S ( I n t e r n a t i o n a l N u t r i t i o n Communication Serv ice) and from a p r i v a t e a d v e r t i s i n g f i r m i n Bangkok. Th is paper p resents i n d e t a i l p r o j e c t goals , planned a c t i v i t i e s , schedules, and p o l i c y statements.

233. GHOSH, S.; MANMOHAN; YAYATHI, T. Domestic v i s u a l i s a t i o n : An i n n o v a t i v e approach t o n u t r i t i o n educat ion. Journal o f T r o p i c a l P e d i a t r i c s , v o l . 23, 1977, pp. 282-285.

The p e d i a t r i c o u t p a t i e n t department o f a h o s p i t a l i n New D e l h i , I n d i a , moni tored c h i l d r e n ' s growth and n u t r i t i o n a l s t a t u s , r e c o r d i n g weights on t h e !'Road t o Hea l th " c h a r t . Each mother rece ived counsel ing w h i l e w a i t i n g her turn t o see t h e doc tor . Counsel ing was prov ided by s p e c i a l l y t r a i n e d h e a l t h a u x i l i a r i e s u s i n g models and p o s t e r s t o e x p l a i n the types and q u a n t i t i e s o f foods needed by young c h i l d r e n . Fol lowup o f 913 c h i l d r e n found t h a t 77.4% improved t h e i r weight s t a t u s .

234. GOPALDAS, T. Supplementary f e e d i n g program. Food N u t r i t i o n , v o l . 4, no. 1/2, 1978, pp. 15-19.

T h i s a r t i c l e draws on t h e lessons o f P r o j e c t Poshak, conducted i n r u r a l areas o f Madhya Pradesh, I n d i a f rom 1971 t o 1975, t o p resent t h e reasons f o r i n c l u d i n g n u t r i t i o n educat ion campaigns i n supplementary f e e d i n g programs. Take-home food supplements were d i s t r i b u t e d t o c h i l d r e n 6 t o 36 months o l d and t o pregnant and l a c t a t i n g women t o supplement b a s i c h e a l t h s e r v i c e s and n u t r i t i o n educat ion. Educat iona l t o o l s used inc luded f l i p c h a r t s , growth c h a r t s , and demonstrat ions, as w e l l as mass media. Resu l ts and lessons l e a r n e d f rom t h e p r o j e c t are presented here i n genera l terms.

235. GOPALDAS, T. T r a i n i n g Research i n N u t r i t i o n - H e a l t h Educat ion (NHE) f o r t h e Superv isors and Organizers o f t h e Baroda Spec ia l N u t r i t i o n Programme (SNP). Baroda, G u j a r a t , I n d i a , Department o f Foods and N u t r i t i o n , M.S. U n i v e r s i t y o f Baroda, n.d. 28p.

The SNP i s t h e l a r g e s t supplementary f e e d i n g program f o r c h i l d r e n and pregnant and l a c t a t i n g women i n t r i b a l r u r a l areas and urban slums i n I n d i a and i s admin is te red th rough t h e c e n t r a l government. T h i s t r a i n i n g program was h e l d i n Baroda f o r p a r t - t i m e o r g a n i z e r s i n charge o f feeding c e n t e r s f o r 200 t o 250 p a r t i c i p a n t s and f o r t h e f u l l - t i m e superv isors , each o f whom oversees 20 t o 25 organizers. About 80% o f p a r t i c i p a t i n g o r g a n i z e r s a t t e n d i n g t h e workshop r e p o r t e d never r e c e i v i n g any t y p e o f j o b t r a i n i n g w h i l e employed i n t h e SNP, w h i l e none o f t h e s u p e r v i s o r s had r e c e i v e d any formal on-the-job t r a i n i n g . The workshop used classroom t r a i n i n g and take-home read ings t o p resent 14 lessons on b a s i c n u t r i t i o n and h e a l t h concepts. The g o a l was t o p resent s imple, c l e a r lessons t h a t would be e a s i l y understood and r e t a i n e d . Pre- and p o s t - t e s t showed s u b s t a n t i a l knowledge ga ins , and t h a t t h e most e f f e c t i v e

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teach ing procedure was a combinat ion o f l e c t u r e u s i n g an i l l u s t r a t e d c h a r t fo l lowed b y a demonstrat ion w i t h a c t u a l m a t e r i a l s .

236. GREINER, T. A p r e l i m i n a r y r e p o r t o f a p o s i t i v e outcome o f b r e a s t f e e d i n g promot ion i n Ibb, Yemen Arab Republ ic. I t h a c a , New York: C o r n e l l U n i v e r s i t y , 1982. 8p.

A b r e a s t f e e d i n g promot ion p r o j e c t sponsored b y C o r n e l l U n i v e r s i t y and R o c k e f e l l e r Foundat ion f rom 1978 t o 1981 apparent ly was s u c c e s s f u l i n i n c r e a s i n g t h e prevalence o f b r e a s t f e e d i n g i n an urban area, w h i l e t h e prevalence was decreas ing i n another urban area. The promot ion c o n s i s t e d o f l e c t u r e s , group d iscuss ions, and a f i l m i n materna l and c h i l d h e a l t h centers . The p r o j e c t was s t a f f e d b y one man, who a l s o h e l d c o m u n i t y meet ings t o organize r e s i s t e n c e t o t h e s a l e o f m i l k powder, and b y two women, who conducted home v i s i t s and served as b r e a s t f e e d i n g counselors i n t h e c l i n i c s . The prevalence o f b r e a s t f e e d i n g o f i n f a n t s 3 months o l d rose from 52% t o 83%.

237. GUTHRIE, G.M. P r i z e s f o r prudent mothers. Development Forum, vo l . 9, no. 3, 1981, pp. 6-7.

Mothers i n 3 v i l l a g e s i n t h e P h i l i p p i n e s were taught 5 r u l e s about c h i l d care: con t inue b r e a s t feeding, supplement b r e a s t m i l k , p l a n t green l e a f y vegetables, o b t a i n weight g a i n i n c h i l d r e n , and v i s i t t h e h e a l t h c e n t e r monthly. I n one v i l l a g e , mothers each month r e c e i v e d " h e a l t h coupons , I 1 redeemable fo r food, soap, o r c l o t h i n g , f o r each r u l e t h e y fo l lowed. I n t h e second v i l l a g e , mothers r e c e i v e d c o l o r photographs f o r themselves and t h e i r babies, if t h e baby gained weight s a t i s f a c t o r i l y . I n t h e t h i r d v i l l a g e , n u t r i t i o n educat ion s e r v i c e an.d med ica l care were a v a i l a b l e , but no reward system was es tab l i shed. Babies i n t h e f i r s t t w o v i l l a g e s grew e q u a l l y w e l l and b e t t e r than those i n t h e t h i r d v i l l a g e . The two reward systems b o t h worked, and e q u a l l y w e l l .

238. KARUNANAYAKE, H. C. Community-level n u t r i t i o n i n t e r v e n t i o n s i n S r i Lanka: A case study. Food and N u t r i t i o n B u l l e t i n , v o l . 4, no. 1, January 1982, pp. 7-1 6.

T h i s a r t i c l e p resents t h e genera l s t a t e o f n u t r i t i o n i n S r i Lanka and descr ibes t h e n a t i o n a l - l e v e l programs, i n c l u d i n g a food stamp scheme, a s c h o o l - b i s c u i t d i s t r i b u t i o n p r o j e c t , and t h e " th r iposha" program. Thr iposha i s a f o r t i f i e d food, made up o f c o r n and soy m i l k powder, maize and soy f l o u r , d i s t r i b u t e d t o c h i l d r e n , m o s t l y preschoolers , who have second o r t h i r d degree m a l n u t r i t i o n . A t t h e c o m u n i t y l e v e l , t h e t h r i p o s h a program i s run b y v o l u n t e e r s i n charge o f t h e preschools . They t y p i c a l l y have n i n e years o f schoo l ing and r e c e i v e a s p e c i a l n u t r i t i o n course t h a t covers c h i l d development, p r i n c i p l e s o f n u t r i t i o n , o r g a n i z a t i o n o f community k i t c h e n s , bas ic h e a l t h care, and p r e v e n t i v e measures. The program a c t i v e l y i n v o l v e s t h e mothers i n t h e p r o v i s i o n and p r e p a r a t i o n o f t h e food, as a means o f i n s t r u c t i n g them i n t h e n u t r i t i o n a l needs o f t h e i r c h i l d r e n . The a r t i c l e a l s o descr ibes t h e Norwegian Save t h e C h i l d r e n (Redd Barna) and U.S. Save t h e C h i l d r e n n u t r i t i o n programs and ment ions t h a t t h e y i n c l u d e n u t r i t i o n educat ion components, w i t h o u t d e s c r i b i n g them i n d e t a i l .

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239. LAMBERT, J. P o l i t i q u e n a t i o n a l e a l i m e n t a i r e e t n u t r i t i o n n e l l e de l a Papouasie-Nouvelle-Guinée. Al iment. Nutr., vo l . 6, no. 1, 1980, pp. 32-37.

N u t r i t i o n s t u d i e s and campaigns conducted i n Papua New Guinea s ince 1947 are descr ibed i n t h i s paper, which i d e n t i f i e d p r o t e i n - c a l o r i e m a l n u t r i t i o n among c h i l d r e n as t h e p r i n c i p a l n u t r i t i o n problem o f t h e n a t i o n . The c u r r e n t n a t i o n a l a p p l i e d n u t r i t i o n program uses r a d i o , p lays , debates, slogans, and p o s t e r s t o promote n u t r i t i o n messages. A s t u d y o f the combined e f f e c t s o f t h e mass media campaign and a school f e e d i n g program est imated t h a t t h e mal- n u t r i t i o n r a t e c o u l d be reduced b y 30%. N u t r i t i o n r e h a b i l i t a t i o n c e n t e r s a t h o s p i t a l s teach mothers t o make t h e b e s t use o f cheap l o c a l resources. The s a l e o f i n f a n t feed ing b o t t l e s has been l e g a l l y l i m i t e d t o s a l e b y med ica l p r e s c r i p t i o n t o mothers who can demonstrate t h a t they have t h e means and knowledge t o b o t t l e feed c o r r e c t l y .

240. MANOFF INTERNATIONAL, I N C . N u t r i t i o n Communication and Behavior Change Component, Indonesian N u t r i t i o n Development Program. Washington, D.C., Manoff I n t e r n a t i o n a l , Inc. , 1983. 5 volumes.

T h i s s e r i e s p resents i n g r e a t d e t a i l t h e process o f develop ing, implement ing, and e v a l u a t i n g a p r o j e c t t o improve young c h i l d n u t r i t i o n . Using s o c i a l marke t ing techniques, l o c a l needs and a t t i t u d e s were explored, and a l t e r n a t i v e s o l u t i o n s were tes ted . For example, proposed r e c i p e s f o r a weaning food were n o t o n l y exp la ined t o mothers who were then quest ioned t o determine whether they understood t h e message, but a l s o t h e mothers he lped i n t h e p r e p a r a t i o n o f t h e foods and were asked t o prepare t h e foods a t home f o r a week. A t t h e end o f t h e week, t h e r e c i p e s were again t e s t e d and adapted. a t t e n t i o n t o a l l d e t a i l s r e s u l t e d i n a p r o j e c t t h a t succeeded i n improv ing t h e n u t r i t i o n s t a t u s o f t h e c h i l d r e n th rough educat ion alone. A summary o f t h e p r o j e c t i s presented b y Mantra, 1982 (no. 241).

T h i s exhaust ive

241. MANTRA, I.B. ; MARKU, T.; DOLAKSARIBÚ, D. P r o j e c t D e s c r i p t i o n : N u t r i t i o n Educat ion and Behavior Change Component Indonesian N u t r i t i o n Improvement Program. Washington, D. C., Manoff I n t e r n a t i o n a l , Inc. , 1982. 27p.

Th is p r o j e c t , p a r t o f t h e Indonesian N u t r i t i o n Improvement Program, was conducted i n f o u r stages, b e g i n n i n g i n 1977: ( 1 1 t r a i n i n g and equipping 2,000 v o l u n t e e r v i l l a g e n u t r i t i o n workers; (2) i n i t i a t i n g u weighing program i n each v i l l a g e , r e a c h i n g 52,000 c h i l d r e n ; ( 3 ) develop ing a communications s t r a t e g y , based on research i n t h e community and developing and producing m a t e r i a l s ; and (4 1 d isseminat ion o f t h e m a t e r i a l s , with cont inuous implementat ion and eva lua t ion . T h i s paper descr ibes i n d e t a i l t h e development o f t h e comunica- t i o n s s t r a t e g y , p r o v i d i n g a case s t u d y o f t h e a p p l i c a t i o n o f p r i n c i p l e s o f concept t e s t i n g , e s t a b l i s h i n g behav io r change o b j e c t i v e s based on household i n t e r v i e w s , community p a r t i c i p a t i o n i n development o f messages and m a t e r i a l s , and des ign o f mass media ( r a d i o ) s c r i p t s . Examples o f t h e s c r i p t s , posters , and o ther m a t e r i a l s a r e prov ided. E v a l u a t i o n o f t h e p r o j e c t i n 1981 found t h a t p a r e n t s i n t h e p r o j e c t area v i l l a g e s knew more s p e c i f i c i n f o r m a t i o n about n u t r i t i o n problems and what t o do about them, t h a t t h e y o f f e r e d t h e i r c h i l d r e n more o f t h e foods s t ressed i n t h e messages, t h a t t h e i r c h i l d r e n had h i g h e r p r o t e i n and c a l o r i e i n t a k e s , and t h a t t h e i r c h i l d r e n grew s i g n i f i c a n t l y b e t t e r a f t e r 5 months o f age than c h i l d r e n o f f a m i l i e s p a r t i c i p a t i n g i n o t h e r

n u t r i t i o n programs. Thus, t h i s p r o j e c t demonstrated t h e e f f e c t i v e n e s s o f t h i s method i n improv ing n u t r i t i o n knowledge, b e h a v i o r , and s t a t u s , u s i n g n u t r i t i o n educat ion alone, w i t h o u t food supplements o r o t h e r common a d j u n c t s t o educa- t i o n . The p r o j e c t i s descr ibed i n g r e a t e r d e t a i l i n Manoff I n t e r n a t i o n a l , Inc., 1983.

242. MENON, K. ; RAU, P. ; DAMODARAN, M. ; NAIDU, A.N. An i n v e s t i g a t i o n i n t o t h e reasons f o r mothers n o t u t i l i s i n g home made weaning foods. The I n d i a n J o u r n a l o f N u t r i t i o n and D i e t e t i c s , v o l . 17, 1980, p. 437-42.

I n t h i s study, a supplement was prov ided free f o r s e v e r a l months and was t h e n o f f e r e d f o r s a l e i n l o c a l shops. The m a j o r i t y o f t h e mothers who had used the f r e e produc t but who d i d n o t purchase i t i n t h e shops s a i d t h a t t h e y c o u l d n o t a f f o r d it, a l t h o u g h t h e y were spending an e q u i v a l e n t amount on c h i l d r e n ' s snacks.

243. MITTAL, M. ; C H A R I , P.S. ; RANA, A. E d u c a t i o n a l needs o f r u r a l mothers of Lagret v i l l a g e i n Himachal Pradesh f o r forming d e s i r a b l e food h a b i t s i n c h i l d r e n o f 4-6 years o f age. I n d i a n Journa l o f N u t r i t i o n and D i e t e t i c s , v o l . 19, no. 1, January 1982, pp. 14-19.

244. NEWMAN, J.M. ; CONTENTO, I. ; KRIS, E. Perspec t ives on food and n u t r i t i o n i n t h e People 's Republ ic o f China. no. 2, June 1981, pp. 43-45. b i b l .

J o u r n a l o f N u t r i t i o n Educat ion, v o l . 13,

245. OROZCO, R.; TORRES, E.; NUBE, M., eds. Proceedings o f t h e f i r s t FNP Workshop towards Strengthening Food and N u t r i t i o n Components i n Development Programs ( i n South East Asia), 20-24 A p r i l 1981, Los Banos, P h i l i p p i n e s . FAO; U n i v e r s i t y o f t h e P h i l i p p i n e s ; Nether lands U n i v e r s i t i e s Foundat ion f o r I n t e r n a t i o n a l Cooperation, 1981. 144p.

246. QUIMPO, C.F. ; VALDECANAS, O. C. Rad io-pr in t s y n c h r o n i z a t i o n and p a r t i c i p a t i o n i n t h e n u t r i t i o n school o f t h e a i r . P h i l i p p i n e Journal o f N u t r i t i o n , v o l . 32, no. 2, Apr i l -June 1979, pp. 99-107.

The Food and N u t r i t i o n I n s t i t u t e o f t h e P h i l i p p i n e s conducted a synchronized r a d i o and p r i n t media campaign t o determine whether t h e y would enhance one another. Weekly r a d i o broadcasts were synchronized w i t h p r e s e n t a t i o n o f t h e s c r i p t s i n popu lar magazines; coupons f o r enro l lment i n t h e n u t r i t i o n school were presented. Af ter 16 weeks, a t e s t admin is te red t o 114 o f t h e 130 graduates showed t h a t a l though course comple t ion r a t e s were g r e a t e r f o r those who used b o t h media, a t t i t u d e s were b e t t e r among those u s i n g o n l y one medium. T h i s was a t t r i b u t e d t o t h e manner o f p r e s e n t a t i o n , c o n s i s t e n c y problems, and c o n t i n u i t y needs. Scores were h i g h on knowledge, a t t i t u d e s , and p r a c t i c e s , and t h e r e was a s i g n i f i c a n t r e l a t i o n s h i p between h o w l e d g e and p r a c t i c e scores. Knowledge was r e l a t e d t o occupat ion and age; a t t i t u d e s were in f luenced b y geographic o r i g i n , c i v i l s t a t u s , and media h a b i t s .

247. RAMPRASAD, V. ; WILLIAMS, V.W. N u t r i t i o n educat ion th rough n u t r i t i o n r e h a b i l i t a t i o n . Journa l o f T r o p i c a l P e d i a t r i c s , v o l . 26, June 1980, p. 123-26.

Mothers i n 285 f a m i l i e s from 14 v i l l a g e s i n I n d i a were shown a p i c t u r e o f a malnour ished c h i l d t o s t i m u l a t e d i s c u s s i o n o f t h e i r understanding o f t h e disease. These f i n d i n g s were used as t h e b a s i s o f a n u t r i t i o n educat ion program a t a r e h a b i l i t a t i o n h o s p i t a l , where 90 c h i l d r e n and t h e i r mothers were i n v o l v e d i n p r e p a r i n g a n u t r i t i o n a l l y adequate and a f f o r d a b l e food. Fol lowup found t h a t o n l y 20% o f t h e mothers learned t h e p r i n c i p l e s o f t h e program; o f t h e c h i l d r e n admi t ted t o t h e un i t , 6% had d i e d and 20% l e f t b e f o r e showing improvement. The r e s t ga ined an average o f 1.5 t o 2 kg. d u r i n g t h e i r s t a y s o f two t o t h r e e weeks.

248. R I Z V I , N. N i rog-Pro jec t Progress Report. I n R.C. I s r a e l , ed., Us ing ~ -_

Communications t o Solve N u t r i t i o n Problems. Newton, Massachusetts, I n t e r n a t i o na1 N u t r i t i on Commun i c a t i o n Ser v i c e , Ed uc a t i o n De v e 1 o pm en t Center , i n press.

P r o j e c t N i r o g addresses t h e major cause o f m a l n u t r i t i o n i n young c h i l d r e n i n Bangladesh-although t h e y are b r e a s t fed, they become malnour ished when b r e a s t m i l k i s no l o n g e r s u f f i c i e n t and t h e i r mothers do n o t p r o v i d e s u f f i c i e n t s o l i d foods. The p r o j e c t used b a s e l i n e i n f o r m a t i o n about mothers ' food- re la ted resources, knowledge, b e l i e f s , and p r a c t i c e s t o develop an e d u c a t i o n a l campaign t o d i r e c t them t o a p p r o p r i a t e weaning p r a c t i c e s . This paper p resents t h e methodology o f t h e study, p a r t i c u l a r l y t h e sample s e l e c t i o n des ign and the ins t ruments used i n t h e surveys.

249. SHAH, P.M. N u t r i t i o n educat ion th rough d o m i c i l i a r y management o f energy-prote in m a l n u t r i t i o n . I n d i a n Journal o f N u t r i t i o n and D i e t e t i c s , v o l . 15, 1978, pp. 228-232.

T h i s i n t e n s i v e p r o j e c t p rov ided n u t r i t i o n counse l ing t o a l l mothers o f .

c h i l d r e n under 6 years o l d i n 60 v i l l a g e s i n I n d i a , w i t h home v i s i t s a t l e a s t once weekly b y one o f t h e 29 s o c i a l workers. T h e i r main message was t h a t increased weight g a i n r e s u l t e d i n b e t t e r h e a l t h ; t h e y n o t o n l y used d i s c u s s i o n but a l s o k e p t growth c h a r t s f o r each c h i l d and discussed t h e i r i m p l i c a t i o n s w i t h t h e mothers. A f t e r one year o f program implementat ion, 500 mothers were surveyed. The f o l l o w i n g improvements had occurred: t h e p r o p o r t i o n o f mothers who knew t h a t r i c e p o r r i d g e and s o f t r i c e cou ld be used as a weaning food increased from 0.5% t o 27.4% and from 0.5% t o 28.0%, r e s p e c t i v e l y ; and t h e p r o p o r t i o n o f mothers who fed t h e i r c h i l d r e n 4 t imes a day increased from none t o 48%. The e f f e c t on "mother s u b s t i t u t e s " was g r e a t e r : t h e p r o p o r t i o n f e e d i n g c h i l d r e n f o u r o r f i v e t imes a day increased f rom 38% t o loo%, and t h e p r o p o r t i o n who i n t r o d u c e d s o l i d foods a t the a p p r o p r i a t e age increased from O t o 83%.

250. SHAH, P.M.; SHAH, K.P. P r o v i s i o n o f h e a l t h - n u t r i t i o n s e r v i c e s a t t h e grass-roots l e v e l i n t h e Palghar and Kasa P r o j e c t s and t h e p o s s i b i l i t y o f t h e i r r e p l i c a t i o n . Food and N u t r i t i o n B u l l e t i n , vo l . 3, no. 1, January 1981, pp. 1-7.

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Two community-based h e a l t h p r o j e c t s were developed i n I n d i a t o address t h e problem o f underuse o f h e a l t h care c e n t e r s by mothers o f malnour ished c h i l d r e n , and t o promote home-based t rea tment approaches. The Palghar P r o j e c t , begun i n 1972, used s o c i a l workers t o i d e n t i f y malnour ished c h i l d r e n and prov ide n u t r i t i o n supplements t o them. Severe cases were r e f e r r e d fo r h o s p i t a l care. B i r t h and i n f a n t m o r t a l i t y r a t e s dropped, and t h e average weight-for-age improved. The Kasa P r o j e c t , begun i n 1974 t o r e p l i c a t e t h e Palghar P r o j e c t , p a r t i c u l a r l y b e n e f i t t e d working mothers. N u t r i e n t supplements, i m u n i z a t i o n , f a m i l y p lann ing , h e a l t h and n u t r i t i o n educat ion and env i ronmenta l s a n i t a t i o n s e r v i c e s were prov ided. Desp i te d i f f i c u l t c o n d i t i o n s such as poor road access, dropouts among t r a i n e e s , and management problems, t h e p r o j e c t succeeded i n improv ing c h i l d r e n ' s n u t r i t i o n s t a t u s : i n t h e f i r s t 18 months o f opera t ion , 62.9% o f t h e "very underweight" c h i l d r e n improved. There were problems w i t h t h e t r a n s i t i o n o f t h e p i l o t p r o j e c t t o government management i n 1977, and t h e au thors recommend t h a t f u t u r e p r o j e c t s work more c l o s e l y with t h e government i n t h e p i l o t stages.

251. SOLON, M.A. The r o l e o f educat ion i n t h e p r e v e n t i o n o f v i t a m i n A d e f i c i e n c y . World H e a l t h O r g a n i z a t i o n Meeting on V i tamin A D e f i c i e n c y and Xerophthalmia, Jakarta, 13-17 October 1980. 1%. b i b l . (NUT/80.15)

T h i s paper p resents an e x t e n s i v e overv iew o f t h e n a t u r e o f t h e v i t a m i n A d e f i c i e n c y problem; t h e f a c t o r s a f f e c t i n g t h e problem; i n t e r v e n t i o n s which have been used, w i t h mixed Yesul ts ; and t h e r o l e o f educat ion as a s t r a t e g y f o r p r e v e n t i o n o f v i t a m i n A d e f i c i e n c y . This problem i s one u n i q u e l y s u i t e d t o e d u c a t i o n a l i n t e r v e n t i o n because i t i s commonly found among p o p u l a t i o n s with adequate resources o r access t o v i t a m i n A sources, but w i t h o u t t h e knowledge and m o t i v a t i o n t o use them e f f e c t i v e l y . A d e t a i l e d account o f t h e P h i l i p p i n e .experience i n v i t a m i n A i n t e r v e n t i o n i s presented.

252. SUGIHARTO, T. Vitamin A Week, Lombok-Nusa Tenggara Barat , 3-6 March - 1982. Jakar ta , Indonesia, D i r e c t o r a t e o f N u t r i t i o n , M i n i s t r y o f Heal th , 1982, 17p.

B l indness a t t r i b u t a b l e t o v i t a m i n A d e f i c i e n c y i s common i n Indonesia d e s p i t e adequate s u p p l i e s o f vegetables c o n t a i n i n g t h e v i t a m i n . The government conducted a p romot iona l campaign t o promote vegetab le consumption. Pos ters and a r a d i o campaign were used t o i n f o r m parents , government personnel , and community l e a d e r s about t h e problem, i t s causes, and i t s s o l u t i o n s . The p lann ing and implementat ion are descr ibed i n d e t a i l , such as i n c l u d i n g a d e s c r i p t i o n o f t h e n e g o t i a t i o n s f o r r a d i o a i r t ime. An e v a l u a t i o n was planned t o determine t h e comprehension and e f f e c t i v e n e s s o f t h e m a t e r i a l s . F u t u r e p r o j e c t s w i l l i n c l u d e teach ing a vitamin-A r e l a t e d song i n the elementary schools.

253. SUNG, K. T. I n t e g r a t i n g n u t r i t i o n a l and f a m i l y p l a n n i n g educat ion with food s e r v i c e s i n Korean day care centers : An eva lua t ion . I n t e r n a t i o n a l Heal th , v o l . 93, 1978, pp. 177-85.

The I n t e g r a t e d Day Care Program, wh ich e n r o l l s 301 o f t h e nat i0nI .s 501 day care centers , p rov ides n u t r i t i o n and f a m i l y p l a n n i n g educat ion as w e l l as food

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serv ices . Mothers f rom a random sample o f 30 p a r t i c i p a t i n g c e n t e r s and 15 n o n - p a r t i c i p a n t s were i n t e r v i e w e d about t h e i r n u t r i t i o n knowledge and p r a c t i c e s . P a r t i c i p a t i n g mothers had b e t t e r knowledge o f weaning p r a c t i c e s , n u t r i e n t s , and t h e proper foods f o r babies and pregnant women, and served t h e i r c h i l d r e n more n u t r i t i o n a l l y balanced foods. Working p a r t i c i p a n t s were more l i k e l y t o have s t a r t e d feed ing m i l k supplemented w i t h baby foods a t about 5 months (58% vs. 22%).

254. TISA, B.J.; BAKER, D. Consul tant Report f o r t h e South P a c i f i c (November 2-1 2, 1982 ): Regional Media Message Workshop. Newton, Massachusetts, I n t e r n a - t i o n a l N u t r i t i o n Communication Serv ice, Educat ion Development Center, t h r o u g h subcont rac t t o Manoff I n t e r n a t i o n a l , Inc., Washington, D.C., 1982, 11 2 p .

T h i s workshop was an ou tgrowth o f a 1981 conference on materna l and i n f a n t n u t r i t i o n ; media s p e c i a l i s t s and n u t r i t i o n i s t s f rom 9 South P a c i f i c c o u n t r i e s were convened. The o b j e c t i v e was t o inc rease t h e a b i l i t i e s o f p a r t i c i p a n t s t o des ign e f f e c t i v e n u t r i t i o n educat ion messages and m a t e r i a l s ; f o r most p a r t i c i p a n t s , t h i s was t h e f i r s t exper ience o f a n u t r i t i o n p r o f e s s i o n a l working w i t h a media s p e c i a l i s t . Contents o f t h i s r e p o r t i n c l u d e i n d i v i d u a l c o u n t r y papers, t h e d a i l y schedule and a c t i v i t i e s o f t h e workshop, and the p a r t i c i p a n t s ' recommendations, i n c l u d i n g t h e need f o r e v a l u a t i o n o f c o u n t r i e s ' media resources; s t r a t e g i e s f o r o p t i m i z i n g r a d i o t i m i n g and resource use; a c t i v e p a r t i c i p a t i o n i n M i n i s t r i e s ' a c t i v i t i e s , i n order t o promote t h e i r i n t e r e s t ; and t h e development o f p r e l i m i n a r y m a t e r i a l s f o r p r e t e s t i n g . Fol lowup w i l l be conducted th rough s a t e l l i t e broadcasts w i t h three-way connect ions f o r t h e count ry , t h e r e g i o n a l n u t r i t i o n i s t , and t h e communications s p e c i a l i s t . The p a r t i c i p a n t s a l s o wanted a fo l lowup media workshop i n which t h e y cou ld b u i l d upon t h e s k i l l s developed here.

255. VALDECANAS, O.C. ; CASTANEDA, C. Q. ; VICENTE, L.M. Operat ion Nutr ibooth--Par t II. A fol low-up s tudy o f San Juan c l i e n t s . P h i l i p p i n e J o u r n a l o f N u t r i t i o n , v o l . 34, no. 2, Apr i l -June 1981, pp. 93-98.

"Nut r ibooths" were s e t up a t s t r a t e g i c p u b l i c l o c a t i o n s i n San Juan, Metro Mani la , t h e P h i l i p p i n e s , t o p r o v i d e b a s i c n u t r i t i o n i n f o r m a t i o n . An economical ly r e p r e s e n t a t i v e sample o f N u t r i b o o t h v i s i t o r s was surveyed; average age was 37 years , and most were housewives. Top ics on which adv ice was sought ranged from meal p l a n n i n g t o n u t r i t i o n needs d u r i n g pregnancy. Most respondents had p o s i t i v e a t t i t u d e s toward t h e booths, f e l t t h a t t h e personnel were knowledgeable and t h a t t h e i n f o r m a t i o n g i v e n had been h e l p f u l . D i e t a r y changes suggested i n m a t e r i a l s handed ou t had been implemented b y 87%; 89% s a i d t h e y would recommend t h e booths t o others. Frequency o f v i s i t i n g i n f l u e n c e d b o t h knowledge and l i k e l i h o o d o f r e p o r t i n g d i e t a r y changes. Thus, N u t r i b o o t h s are a s t i m u l u s for seeking n u t r i t i o n i n f o r m a t i o n , promote b e t t e r f a m i l y n u t r i t i o n , and demonstrate a v i a b l e community i n t e r v e n t i o n .

256. WISE, A.; BOROUMAND-NAINI, M.; FARIVAR, H.; e t a l . Prevent ion o f m a l n u t r i t i o n i n I ran : 1. Vitamins. Acta Medica I r a n i c a , vo l . 22, no. 2, November 1980, pp. 165-79. b i b l .

The h i g h d i e t a r y i n t a k e o f bread r e s u l t s i n d e f i c i e n c i e s o f r i b o f l a v i n and v i t a m i n s A, C, and D. Improv ing n u t r i t i o n s t a t u s should be approached th rough

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severa l i n t e r v e n t i o n s , i n c l u d i n g t h e use o f v i tamin-enr iched foods and t h e promot ion o f n u t r i t i o n educat ion, e s p e c i a l l y th rough t r a i n i n g o f teachers.

257. Z E I T L I N M.F. ; FORMACION, C. The H I I D A I . P. Col lege, I l o i l o , E v a l u a t i o n o f the I n t e r n a t i o n a l N u t r i t i o n Educat ion Radio A d v e r t i s i n g Campaign i n I l o i l o , P h i l i p p i n e s , October 1975-0ctober 1976. Cambridge, Massachusetts, Harvard I n s t i t u t e f o r I n t e r n a t i o n a l Development. 1977. 13Op.

T h i s mass media campaign was sub jec ted t o r i g o r o u s e v a l u a t i o n procedures which found p o s i t i v e c o r r e l a t i o n s between i n f a n t s ' n u t r i t i o n s t a t u s and t h e i r mothers' n u t r i t i o n knowledge scores, and t h e i r c o n t a c t w i t h h e a l t h and n u t r i t i o n serv ices , even a f t e r c o n t r o l l i n g f o r paren ts ' educat ion l e v e l , income, and o ther sociodemographic fac to rs . Therefore, t h e n u t r i t i o n educat ion had a d i r e c t measurable impact on c h i l d r e n ' s weight f o r age. No impact was found among those r e c e i v i n g o n l y t h e r a d i o educat ion; r e v i s i o n o f t h e r a d i o campaign c o u l d enhance i t s e f f e c t i v e n e s s , s i n c e messages d i d n o t s p e c i f y q u a n t i t i e s o f t h e recommended foods b u t s i m p l y s a i d t o feed more.

E UR0 PE

258. BUHL, F. The n u t r i t i o n a l educat ion o f t h e p u b l i c : French exper ience. Journa l o f Human N u t r i t i o n , v o l . 34, no. 6, December 1980, pp. 439-444.

The French n a t i o n a l n u t r i t i o n educat ion campaign was begun i n 1977, sponsored b y t h e French Committee on H e a l t h Educat ion, a p r i v a t e o r g a n i z a t i o n f inanced w i t h p u b l i c funds which t r a i n s p u b l i c h e a l t h personnel and p u b l i s h e s documents f o r b o t h t h e genera l p u b l i c and e d u c a t i o n a l i n s t i t u t i o n s . The focus i n t h e f i r s t year was materna l and i n f a n t n u t r i t i o n , i n c l u d i n g t h e promot ion o f d i e t a r y g u i d e l i n e s f o r expectant mothers. I n 1978, t h e campaign i n t r o d u c e d a card game, "Eat R igh t , I1 which t a u g h t b a s i c food groups, w i t h emphasis on f r e s h f r u i t s and vegetables and on avoidance of excess ive f a t , sugar, and s a l t . The success o f t h i s program has s t i m u l a t e d i n t e r e s t i n s e v e r a l o t h e r c o u n t r i e s w i t h s i m i l a r n u t r i t i o n problems. The 1979 campaign focused on feed ing c h i l d r e n aged s i x t o t w e l v e years, employing d i s t r i b u t i o n o f suppor t m a t e r i a l s and mass media spots. The g o a l s were t o teach c h i l d r e n t o be r e s p o n s i b l e f o r t h e i r own e a t i n g and t o s t i m u l a t e f a m i l y educat ion on proper n u t r i t i o n . There i s a l s o a b o o k l e t f o r h e a l t h workers. The campaigns have been w e l l rece ived, a l though t h e r e had been no formal assessment o f t h e i r impact on t h e n a t i o n a l d i e t a t t h e t i m e o f t h i s p u b l i c a t i o n . It i s hoped t h a t a n a t i o n a l n u t r i t i o n p o l i c y w i l l be developed c o n t a i n i n g concre te o b j e c t i v e s , a p p r o p r i a t e i n t e r v e n - t i o n s , and o r g a n i z a t i o n a l and t r a i n i n g requi rements f o r t h e i r implementat ion.

259. DEBRY, G. La campagne d ' i n f o r m a t i o n d u p u b l i c sur l ' a l i m e n t a t i o n de l ' e n f a n t . C.M., v o l . 102, no. 36, 11 October 1980, p. 5252-61.

260. DEBRY, G. Les campagnes d ' i n f o r m a t i o n d u p u b l i c en n u t r i t i o n . m, v o l . 102, v o l . 4, 26 January 1980, p. 323-25.

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261. HOCHSTRASSER, B. ; ABELIN, T. ; DIETSCHI, S. ; e t a l . E i n verhäl tens- t her apeu t i sches t r a i n i n g zur ge w i c h t s r ed ukt ion , I n W i ssen schaf t l i c h e Arbe i ts tagung 1981: A k t u e l l e Probleme der Sozia l - und Právent iumediz in . Z u r i c h , S o z i a l und Pravent iumediz in , v o l . 26, no. 5, October 1981, pp. 354-56.

262. HûWIE. S.M. N u t r i t i o n educat ion f o r c h i l d r e n under 12 years o l d i n Nor th S t a f f o r d s h i r e . Human N u t r i t i o n : App l ied N u t r i t i o n , v o l . 37A, no. 1, February 1983, pp. 54-57.

263. KIRK, T.R. A p p r a i s a l o f t h e e f fec t i veness o f n u t r i t i o n educat ion i n t h e c o n t e x t o f i n f a n t feeding. J o u r n a l o f Human N u t r i t i o n , v o l . 34, no. 6, December 1980, pp. 429-438.

England 's Department o f H e a l t h and S o c i a l S e c u r i t y (DHSS) pub l i shed t h e f o l l o w i n g recommendations t o promote breas t feed ing : b r e a s t feed f o r t h e f i r s t 4 t o 6 months o f l i f e ; i n t r o d u c e s o l i d food o n l y a f t e r 4 months; and avoid s a l t and sugar i n weaning foods. Before and a f t e r widespread d i s s e m i n a t i o n o f these g u i d e l i n e s , surveys were conducted o f mothers o f i n f a n t s 4 t o 12 months o l d who used c h i l d w e l f a r e c l i n i c s . The second group o f mothers had r e c e i v e d much more i n f o r m a t i o n , e s p e c i a l l y encouragement t o b reas t feed. Much o f t h e i n f o r m a t i o n about weaning was i n c o r r e c t : many mothers were t o l d t o b e g i n weaning e a r l i e r than t h e o f f i c i a l l y recommended f o u r months; 30% o f mothers i n b o t h groups were advised t o add sugar t o foods; and no mother was adv ised a g a i n s t adding s a l t t o foods. Breas t feed ing increased from 44% t o 68%; t h e inc rease was g r e a t e r among midd le -c lass mothers than lower-class. Promotion o f b reas t feed ing was a p p a r e n t l y success fu l , but more e f f o r t should be conducted i n weaning educat ion f o r p r o f e s s i o n a l s as w e l l as mothers.

264. LAMM, G. The Card iovascular Disease Programme o f WHO i n Europe. Copenhagen, Denmark, World H e a l t h Organ iza t ion Regional O f f i c e f o r Europe, 1981. 143p. b i b l . ( P u b l i c H e a l t h i n Europe Ser ies No. 15)

I n response t o t h e "epidemic" o f m o r t a l i t y from card iovascu la r causes, WHO- in t h e 1960s i n i t i a t e d a program o f research and prevent ion. Th is b o o k l e t p resents t h e h i s t o r y , o p e r a t i o n s , and r e s u l t s o f t h e program from 1968 t o 1980. Research revea led t h a t t h e inc idence o f CHD cou ld be reduced b y r e l a t i v e l y cheap and s imple methods o f address ing f o u r major r i s k f a c t o r s : h i g h b lood pressure, smoking, e leva ted b lood c h o l e s t e r o l , and overweight. Programs i n 10 c o u n t r i e s i n c l u d e d p r i m a r y p r e v e n t i o n such as changing smoking and e a t i n g h a b i t s and b r i n g i n g modern r e h a b i l i t a t i o n c e n t e r s c l o s e r t o t h e p a t i e n t s . T h i s document, d i r e c t e d t o h e a l t h p r o f e s s i o n a l s , p r o v i d e s d e s c r i p t i o n s o f t h e r e g i s t r a t i o n and s u r v e i l l a n c e system, t h e r o l e o f mob i le coronary u n i t s , t h e long-term e f f e c t s o f coronary bypass surgery, and recommendations f o r research and t h e r o l e o f s o c i a l s e r v i c e s i n c a r d i o v a s c u l a r d isease c o n t r o l .

265. LAURANCE. B.: LAWRIE. B. H e a l t h and n u t r i t i o n educat ion un i t i n a c h i l d r e n ' s h o s p i t a l . B r i t i s h Med ica l Journa l , v o l . 2, no. 615, 25 November 1978, pp. 1469-71.

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266. REGINSTER-HANEUSE, G. ; DEGIMBE, J. l ' é c o l e dans l e s pays de l a Communauté Européenne. Communaut6s Européennes, 1981. 88p. b i b l .

Rapport : 1 'Educat ion n u t r i t i o n n e l l e % Luxembourg, Commission des

LATIN AMER I C A AND CARIBBEAN

267. BERGGREN, G. G. Home-prepared food supplements, m o t h e r c r a f t cen t res , and n u t r i t i o n i n H a i t i . Food and N u t r i t i o n B u l l e t i n , v o l . 3, no. 4, October 1981, pp. 29-33.

The h i g h r a t e o f m a l n u t r i t i o n among young c h i l d r e n was determined t o be a t t r i b u t a b l e i n p a r t t o mothers' cho ices o f weaning foods. A commercial weaning food had proved u n a f f o r d a b l e , so m o t h e r c r a f t c e n t e r s developed a weaning food based on l o c a l g r a i n s ( r i c e , corn, sorghum) and beans. Mothers learned t o p repare and use such foods e f f e c t i v e l y . '!From 1968 t o 1975 ( h o s p i t a l ) admissions f o r severe prote in-energy m a l n u t r i t i o n f e l l t o l e s s t h a n h a l f t h e i r i n i t i a l l e v e l i n t h e 100,000-person d i s t r i c t served b y M o t h e r c r a f t Centres ( w h i l e ) admissions from nearby d i s t r i c t s . . .remained cons tan t o r tended t o r i s e . " These e f f e c t s p e r s i s t e d even a f t e r t h e c e n t e r s were c losed. The au thors recommend t h a t n u t r i t i o n educat ion f o r urban mothers should teach "how t o buy t h e b e s t combinat ion o f n u t r i e n t s per un i t o f cos t " and t h a t r u r a l e f f o r t s should promote t h e use o f h m e gardens.

268. COLLE, R.D.; COLLE, S.F. The communication f a c t o r i n h e a l t h and n u t r i t i o n programmes: A case s tudy f rom Guatemala. Cajanus, vo l . 11, no. 3, 1978, pp. 151-96.

T h i s 1ong.and d e t a i l e d r e p o r t p resents a case s t u d y o f t h e development and e v a l u a t i o n o f a mass media educat ion c m p a i g n i n Guatemala. The p r o j e c t focused on one " f i n c a " ( p l a n t a t i o n ) . B a s e l i n e i n f o r m a t i o n c o l l e c t e d inc luded: t h e owner's p o l i c y concern ing t h e h e a l t h and n u t r i t i o n o f h i s workers; knowledge o f t h e l e g a l requi rements o f t h e l a n d l o r d ; h e a l t h and n u t r i t i o n problems o f t h e c o m u n i t y ; and resources such as p r o f e s s i o n a l s , women o f t h e " f i n c a ,I' and e x p e r t s such as t h e l o c a l school teacher . F i n a l l y , persona l e x p l o r a t i o n o f t h e community prov ided a d d i t i o n a l i n s i g h t s . Some research had a l r e a d y been done on s i m i l a r communit ies' a t t i t u d e s ; t h i s , combined with s p e c i f i c s about t h i s " f i n c a ," p e r m i t t e d t h e development o f a communications s t r a t e g y . T h i s a r t i c l e p r o v i d e s a d e t a i l e d account o f t h e methods o f s e l e c t i n g media, develop ing t h e a c t u a l messages t o be used, implement ing t h e s t ra tegy , p roduc ing t h e m a t e r i a l s used, conduct ing an e v a l u a t i o n t o determine t h e e x t e n t o f t h e p r o j e c t ' s i n f l u e n c e on t h e wanen, and u s i n g t h e r e s u l t s o f t h e e v a l u a t i o n f o r improv ing t h e program. Appendices present t h e h e a l t h and n u t r i t i o n survey ques t ionna i res , t h e n u t r i t i o n and h e a l t h message c o n t e n t s o f t h e e d u c a t i o n a l program, a c h a r t o u t l i n i n g t h e a n a l y s i s o f t h e survey, and t h e e v a l u a t i o n quest ions. The medium s e l e c t e d for t h e s tudy was p o r t a b l e , bat tery-operated audiocasset te p l a y e r s . The a r t i c l e d iscusses problems enoountered, such as l a c k o f b a t t e r i e s and p o t e n t i a l p a r t i c i p a n t s ' f e a r o f b reak ing t h e machines, and how such d i f f i c u l t i e s were overcome t o r e s u l t i n a p r o j e c t t h a t used an i n n o v a t i v e technique as a means o f m o t i v a t i n g p a r t i c i p a t i o n and outreach.

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269. CCMITE GUADELOUPEEN POUR L A JOURNEE MONDIALE DE L 'ALIMENTATION. - Pour Mieux se N o u r r i r en Guadeloupe. Comite pour l a Journee Mondiale de l ' A l i m e n t a t i o n , 1981. 52p.

270. DEANDRACA, A.M.; MAGENDZO, S. E l Programa de F m e n t o de l a Lac tanc ia Materna: Una E x p e r i e n k P i l o t o en e l Area Or ien te de Salud de Santiago. (The Program t o Promote Breast feeding: A P i l o t P r o j e c t i n t h e Eastern Hea l th Sector o f Santiago.) Sant iago, C h i l e , N a t i o n a l Food and N u t r i t i o n Counc i l (CONPAN), 1978. 285p.

The " i n t e r p e r s o n a l " approach t o promot ing b r e a s t feed ing was t e s t e d i n one p r e n a t a l c l i n i c i n 1974, i n an e f f o r t t o reduce i n f a n t m a l n u t r i t i o n . The approach i n c l u d e d group p r e s e n t a t i o n s t o pregnant women and new mothers, d e t a i l i n g t h e advantages and techniques o f b r e a s t feeding: a month ly rev iew o f i n f a n t s f o r t h e f i r s t s i x months o f l i f e , and c o n s u l t a t i o n w i t h new mothers b y n u r s i n g personnel and t r a i n e d vo lun teers . Resul ts were t h a t b r e a s t feed ing was pro longed and m o r b i d i t y decreased, so t h e program was expanded t o s i x c l i n i c s i n 1975. T h i s document presents a d e t a i l e d e v a l u a t i o n o f t h i s expanded t e s t . E labora te s t a t i s t i c a l procedures assured c r e d i b i l i t y o f the f i n d i n g s . The e v a l u a t i o n found t h a t c h i l d r e n who had never p a r t i c i p a t e d i n t h e program had been a t g r e a t e r r i s k o f m a l n u t r i t i o n from b i r t h , because o f f a c t o r s such as mother 's age and prematur i t y . They and c h i l d r e n who dropped o u t o f t h e program d i d n o t b r e a s t feed as l o n g as those who p a r t i c i p a t e d f u l l y . L i t t l e e f f e c t was de tec ted on t h e average number o f months o f e x c l u s i v e b r e a s t feed ing o r on t h e percent s t i l l b r e a s t feed ing a t s i x months o ld . Breast fed i n f a n t s grew b e t t e r u p - t o 3 o r 4 months o f age, but t h e r e was l i t t l e o r no advantage i n those b r e a s t feeding 6 months o r more. B i r t h w e i g h t c o r r e l a t e d w i t h d u r a t i o n o f b r e a s t feeding; heav ie r i n f a n t s b r e a s t f e d longer . The s t u d y recommends t h a t e f f o r t s t o inc rease t h e n u t r i t i o n a l s t a t u s o f pregnant women and new mothers be implemented and evaluated as p a r t o f f u t u r e b r e a s t feed i n g promot ion p r o g r am s.

271. DEOLIVEIRA, J.E.D; e t a l . Reaching preschool c h i l d r e n th rough a community food program. Ecology o f Food and N u t r i t i o n , v o l . 9, no. 4, August 1980, pp. 223-228.

T h i s p r o j e c t , conducted i n a p e r i u r b a n area around t h e c i t y o f Ribera0 Preto i n Southern B r a z i l , prov ided b o t h supplementary m i l k and n u t r i t i o n educat ion. O f t h e 368 f a m i l i e s i n t h e area, 84% p a r t i c i p a t e d i n t h e study. M i l k was prov ided t o s t o r e s b y t h e l o c a l p a s t e u r i z a t i o n p l a n t , and f a m i l i e s w i t h smal l c h i l d r e n were g i v e n coupons w o r t h two g lasses o f m i l k per day; t h e c h i l d r e n consumed t h e m i l k a t t h e s tores. Mothers and c h i l d r e n at tended o r i e n t a t i o n meet ings a t which t h e c h i l d r e n were t o l d s t o r i e s demonstrat ing t h e importance o f h e a l t h , hygiene, and food, e s p e c i a l l y m i l k . The r o l e o f s t o r e owners i n p r e v e n t i n g m a l n u t r i t i o n was s t ressed. L o c a l workers conducted t h e c lasses and c o n t r o l l e d t h e program. A t t h e end o f t h e 9-month study, 45% had dropped o u t , but almost a l l t h i s a t t r i t i o n was due t o f a m i l y r e l o c a t i o n . O f t h e c h i l d r e n remain ing, 80% showed r e g u l a r attendance. Absenteeism was due t o d i s t a n c e from t h e s t o r e s o r c h i l d r e n ' s d i s t a s t e f o r t h e m i l k . Attendance a t t h e e d u c a t i o n a l meet ings was much h i g h e r f o r c h i l d r e n than f o r t h e i r mothers. T h i s program was e f f e c t i v e i n r e a c h i n g i t s t a r g e t audience economical ly and had b u i l t - i n m o n i t o r i n g mechanisms, such as redemption o f t h e s t o r e s ' coupons.

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272. DE GODINEZ, C.M. 7 f o r I n c l u s i o n i n a Guatemalan M i n i s t r y o f H e a l t h T r a i n i n g Manual f o r Midwives. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Serv ice, Educat ion Development Center, 1980. Volume II. I n Spanish.

T h i s r e p o r t presents t h e c o n s u l t a n t ' s suggest ions f o r i n c o r p o r a t i n g n u t r i t i o n i n t o a t r a i n i n g c u r r i c u l u m f o r midwives b e i n g developed b y t h e Guatemala M i n i s t r y o f Heal th. I t i n c l u d e s an Informe F i n a l ( l i s t o f g e n e r a l recommendations), Guia para l a Enfermera Responsable d e l Programa ( f r o m t h e o r i g i n a l M i n i s t r y manual), a summary o f t h e r e a c t i o n s o f midwives and nurses t o t h e t r a i n i n g program, and a d d i t i o n a l s p e c i f i c recommendations f o r develop ing t h e n u t r i t i o n t e c h n i c a l con ten t o f t h e manual and a p p r o p r i a t e suppor t m a t e r i a l s .

273. EVENSEN, S. An I n v e n t o r y o f N u t r i t i o n Educat ion A c t i v i t i e s i n B e l i z e . New Orleans, Department o f N u t r i t i o n , Tulane U n i v e r s i t y , School o f P u b l i c Hea l th and T r o p i c a l Medicine, 1981. 175p. b i b l .

T h i s document p resents an exhaust ive , thorough, and exemplary survey o f n u t r i t i o n needs, s t a t u s , programs, and resources i n B e l i z e , a C e n t r a l American c o u n t r y o f 144,000 people. N o t i n g t h a t surveys o f n u t r i t i o n educat ion a c t i v i t i e s were v i r t u a l l y n o n e x i s t e n t and t h a t t h e r e was no p r o t o c o l for n a t i o n a l n u t r i t i o n educat ion i n v e n t o r i e s , t h e au thor spent 3 months s t u d y i n g t h i s n a t i o n i n d e t a i l . He presents f i n d i n g s o f h e a l t h and n u t r i t i o n surveys, i d e n t i f i e s i n s t i t u t i o n s t h a t d e a l with n u t r i t i o n educat ion, and i n d i c a t e s a c o n t a c t person a t each, as w e l l as d e s c r i b i n g n u t r i t i o n educat ion a c t i v i t i e s and i n s t i t u t i o n s ' purposes. Ex tens ive appendices p r e s e n t t h e survey ins t rument and f i n d i n g s . F i n a l l y , t h e r e are an a n a l y s i s o f t h e d i s c r e p a n c i e s between e x i s t i n g n u t r i t i o n a l problems and a v a i l a b l e educat ion programs, and recommendations f o r each o f t h e i n s t i t u t i o n s surveyed and f o r t h e n a t i o n as a whole. Recommendations a t t h e n a t i o n a l l e v e l cover p lann ing , t h e need f o r c o o r d i n a t i o n and c o l l a b o r a t i o n , t r a i n i n g o f personnel , teach ing a i d s , i n c r e a s i n g and improv ing manpower, use o f t h e mass media, development o f new programs and a c t i v i t i e s , and eva lua t ion . Al though t h i s methodology m i g h t n o t be r e l e v a n t a t t h e n a t i o n a l l e v e l f o r l a r g e r p o p u l a t i o n s , i t presents an exemplary format f o r r e g i o n a l o r l o c a l work i n deve lop ing n u t r i t i o n educat ion resources.

274. FEDERACION DE DESARROLLO JUVENIL CCMUNITARIA, I N C . Programa p a r a Elaborac ión de Métodos para l a Enseñanza de Salud/Nutr ic iÓn: Resultado Pr imer T a l l e r de Metodologfa P a r t i c i p a t i v a para e l D e s a r r o l l o de Programas Comunitarios. V i l l a Mel la, Agosto 8-1 5, 1979. Santo Domingo, Dcminican Republ ic , 1980. 3%. T h i s r e p o r t p resents t h e proceedings o f t h e f i r s t o f t h r e e t r a i n i n g sess ions h e l d f o r " h e a l t h promoters," who work a t t h e community l e v e l . The f i r s t p a r t o f t h i s sess ion was an a n a l y s i s o f p a r t i c i p a n t s ' c u r r e n t work ing c o n d i t i o n s , t o serve as a b a s i s f o r p lanning. ,The second p a r t in t roduced t h e concepts o f p a r t i c i p a t o r y educat ion, and t h e t h i r d was t h e development o f p l a n s f o r a c t i o n and p r e p a r a t i o n o f m a t e r i a l s f o r p r e t e s t i n g i n t h e community. The r e p o r t i n c l u d e s examples o f t h e m a t e r i a l s and photographs o f t h e sessions.

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275. FRANCE, S.O. La a t e n c i ó n p r i m a r i a en e l s e r v i c i o de sa lud met ropo l i tano- o r i e n t e . (Pr imary care i n t h e East Sant iago Heal th Serv ice) . Cuadernos Medico-Sociales, v o l . 22, no. 3, September-December 1 981, pp. 31 -35, b i b l .

The i n t e r d i s c i p l i n a r y h e a l t h teams used i n t h e materna l and c h i l d h e a l t h s e r v i c e s i n Sant iago, C h i l e , p r o v i d e vacc ina t ions , pregnancy s u r v e i l l a n c e , d e n t a l care, and sys temat ic h e a l t h checkups. The n u t r i t i o n program prov ides r e h a b i l i t a t i o n f o r t h e malnour ished p o p u l a t i o n : 11% o f t h e c h i l d r e n a r e m i l d l y malnour ished; O. 9%, moderately ; and O. 0 3 , severe ly .

276. FUNDACION PARA EL DESARROLLO CCMUNITARIO. Programa para E laborac ión de Métodos para l a Enseñanza de Salud/Nutr ic iÓn: Resultado Segundo T a l l e r de Metodologca P a r t i c i p a t i v a para e l D e s a r r o l l o de Programas Comunitarios. Las Matas de Far fan , 26 Noviembre-7 Dic iembre 1979. Santo Domingo, Dominican Republ ic, 1980. 62p.

T h i s seminar, t h e second i n a s e r i e s o f t h r e e h e l d f o r community h e a l t h workers, was conducted i n a semi- rura l conanunity which served as a t e s t s i t e f o r m a t e r i a l s development and p r a c t i c e with p a r t i c i p a t o r y educat ion. P a r t i c i p a n t s presented t h e work t h e y had done s ince t h e f i r s t session, new m a t e r i a l s were presented, and, f i n a l l y , s p e c i a l i z e d m a t e r i a l s and work p l a n s were developed. The r e p o r t presents t h e a c t i v i t i e s o f t h e workshop i n d e t a i l , i n c l u d i n g lesson p l a n s and o b j e c t i v e s , examples o f m a t e r i a l s tes ted , an e v a l u a t i o n q u e s t i o n n a i r e , and guidance i n t e c h n i c a l aspects o f community n u t r i t i o n , such as de termin ing c h i l d r e n ' s ages.

277. FUNDACION PARA EL DESARROLLO CCMUNITARIO. Métodos para l a Enseñanza de Salud/Nutr ic iÓn: Resultado Tercer T a l l e r d z Metodología P a r t i c i p a t i v a para e l D e s a r r o l l o de Programas Comunitarios. Haras Nacionales, V i l l a Me l la , 15-25 A b r i l , 1980. Santo Domingo, Dominican Republ ic, 1980. 59p.

Programa para E laborac ión de

T h i s r e p o r t p resents t h e proceedings i n t h e t h i r d and f i n a l sess ion o f workshops h e l d t o t r a i n comnunity h e a l t h promoters i n n u t r i t i o n and n u t r i t i o n educat ion s k i l l s . The s t a t e d o b j e c t i v e o f t h i s sess ion was t o enable t h e p a r t i c i p a n t s t o p l a n and evaluate p r o j e c t s t h a t would h e l p t h e i r communit ies i d e n t i f y , analyze, and r e s o l v e t h e i r major h e a l t h and n u t r i t i o n problems. The program i n c l u d e d f o u r p a r t s : i n d i v i d u a l comnunity p l a n s and resources ; p r o j e c t p lanning; use o f m a t e r i a l s , i n c l u d i n g adapta t ion ; and t e c h n i c a l n u t r i t i o n i n f o r m a t i o n such as food va lues and t h e causes and t rea tment o f d i a r r h e a .

278. GREINER, T.; LATHAM, M.C. The i n f l u e n c e o f i n f a n t food a d v e r t i s i n g on i n f a n t feed ing p r a c t i c e s i n S t . Vincent. I n t e r n a t i o n a l Journal o f H e a l t h Serv ices , v o l . 12, no. 1, 1982, pp. 53-75.

Th is study was conducted i n response t o t h e i n f a n t formula i n d u s t r y ' s c o n t e n t i o n t h a t t h e r e was no p r o o f t h a t i n f a n t food a d v e r t i s i n g measurably i n f l u e n c e d i n f a n t feed ing p r a c t i c e s . A q u e s t i o n n a i r e was admin is tered t o mothers o f 200 c h i l d r e n 1 t o 2 years o l d , n e a r l y t h e whole sample i n each o f two towns. The t y p i c a l i n f a n t feed ing p a t t e r n , l a r g e l y a combinat ion o f b o t h

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b r e a s t and b o t t l e feeding, had e x i s t e d f o r decades. I n f a n t food a d v e r t i s i n g had d e c l i n e d i n t h e years immediate ly p reced ing t h e study, and b o t t l e feed ing was w e l l es tab l i shed, so i t was d i f f i c u l t t o measure t h e i n f l u e n c e o f promot ion. There was no s t a t i s t i c a l l y s i g n i f i c a n t a s s o c i a t i o n between brand names o f adver t isements r e c a l l e d b y t h e mothers and t h e brands a c t u a l l y purchased. Formula was considered a food b y 46% o f t h e mothers; a t o n i c , b y 471; and a medicine, b y 7%. The r e s u l t s o f two m u l t i p l e r e g r e s s i o n analyses suggested t h a t t h e more a mother was i n f l u e n c e d b y i n f a n t food a d v e r t i s i n g , t h e sooner she began t o b o t t l e feed and t h e sooner she stopped b r e a s t feeding. The au thor concludes t h a t t h i s i n d i c a t e s a need f o r t h e c e s s a t i o n o f a l l promot ion o f commercial i n f a n t foods.

279. GUERI, D.M. ; JUTSUM, P. ; WHITE, A. E v a l u a t i o n o f a breast - feeding campaign i n T r i n i d a d . B u l l e t i n o f t h e Pan American H e a l t h Organ iza t ion , v o l . 12, no. 2, 1978, pp. 112-115.

T h i s a r t i c l e descr ibes t h e conduct and e v a l u a t i o n o f a mass-media campaign i n i t i a t e d i n 1974 b y the Housewives' A s s o c i a t i o n o f T r i n i d a d and Tobago. Dur ing t h e f i v e weeks o f t h e campaign, 5 p o s t e r s appeared i n d a i l y newspapers and 6 r a d i o spots were broadcast 4 t imes d a i l y . immediate ly f o l l o w i n g t h e campaign, i n t e r v i e w s were conducted with mothers d e l i v e r i n g babies a t t h e two l a r g e s t p u b l i c h o s p i t a l s . Knowledge scores were h i g h l y p o s i t i v e l y c o r r e l a t e d w i t h f requency o f at tendance a t p r e n a t a l c l i n i c s . A h i g h p r o p o r t i o n o f t h e mothers (93%) recognized a t l e a s t one of t h e newspaper advert isements, but most had read o n l y t h e l a r g e - p r i n t s logan ("Every baby deserves t h e breast t1) . Nevertheless, an i n v e r s e c o r r e l a t i o n , s i g n i f i c a n t a t t h e 10% l e v e l , was found between t h e r e c o g n i t i o n score and the i n t r o d u c t i o n o f b o t t l e feed ing before t h e age o f two months. Since t h e Sample was f a i r l y homogeneous f o r educat ion and economic s t a t u s , t h e d i f f e r e n c e i n knowledge i s p robab ly a t t r i b u t a b l e t o t h e campaign.

Dur ing t h e 6 weeks

280. HARDY, E. E. ; VICHI, A.M. ; SARMENTO, R.C. B reas t feed ing promot ion: e f f e c t o f an e d u c a t i o n a l program i n B r a z i l . S tud ies i n Fami ly Planninq, v o l . 13, no. 3, March 1982, p. 79-86, b i b l .

Breast feeding prevalence was p a r t i c u l a r l y l o w among younger, p o o r l y educated women w i t h young husbands, p robab ly because t h i s group was most s u s c e p t i b l e t o env i ronmenta l in f luences on t h e i r feeding choices. H e a l t h workers were s u c c e s s f u l i n promot ing a h i g h e r r a t e o f b reas t feed ing , p a r t i c u l a r l y t h r o u g h educat ion d u r i n g t h e p r e n a t a l p e r i o d .

281. INFORME DEL TALLER SOBRE METODOLOGIA DE EDUCACION NO FORMAL EN SALUD Y NUTRICION, BASADA EN LA PARTICIPACION DE LAS CCMUNIDADES LLEVADO A CABO EN LA CIUDAD DE GUATEMALA, 3-1 2 November 1980. Guatemala, C o n s u l t o r i a Regional de Salud y N u t r i c i ó n (CORSANU), 1981. 34p.

Th is r e p o r t p resents a day-by-day account o f a workshop h e l d t o i n t r o d u c e t h e SARAR n u t r i t i o n educat ion p r i n c i p l e s t o a group o f p r o f e s s i o n a l s i n Guatemala. Dr . S r i n i v a s a n ' s i n t r o d u c t i o n t o t h e sess ion d e l i n e a t e s t h e p r i n c i p l e s o f t h e system: (1 ) p l a n n i n g e d u c a t i o n a l exper iences t h a t a re based on p a r t i c i p a n t s ' a b i l i t i e s t o draw t h e i r own concu ls ions th rough c r e a t i v e , a n a l y t i c a l , and

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s e l f - d i r e c t e d work; ( 2 ) u s i n g m a t e r i a l s t o s t i m u l a t e and mot iva te p a r t i c i p a - t i o n ; (3) fo rming smal l groups i n which members can express themselves and exper iment with new forms o f p a r t i c i p a t i o n ; and ( 4 ) s t r e s s i n g t h e importance o f e v a l u a t i o n as t h e b a s i s f o r f u t u r e ac t ion . T h i s r e p o r t shows how t h e workshop was conducted along these p r i n c i p l e s t o i n t r o d u c e them t o t h e p a r t i c i p a n t s .

282. KING, K.W.; e t a l . P r e v e n t i v e and t h e r a p e u t i c b e n e f i t s i n r e l a t i o n t o cos t : Performance over 10 years o f M o t h e r c r a f t Centers i n H a i t i . American J o u r n a l o f C l i n i c a l N u t r i t i o n , v o l . 31, 1978, pp. 679-690.

Most o f t h e M o t h e r c r a f t Centers i n H a i t i were run b y t h e N u t r i t i o n Bureau o f t h e Department o f H e a l t h between 1964 and 1975. The author p resents t h i s s tudy o f t h e Centers i n o r d e r t o make a d e s c r i p t i o n o f t h e i r o p e r a t i o n s more r e a d i l y a v a i l a b l e and t o compare them t o o t h e r a p p l i e d n u t r i t i o n programs. The p r e v e n t i v e e f f e c t was judged t o exceed t h e t h e r a p e u t i c e f f e c t : average c e n t e r t r e a t e d 105 c h i l d r e n each year f o r m a l n u t r i t i o n , but prevented m a l n u t r i t i o n i n 306 o f t h e i r younger s i b l i n g s , a t a c o s t o f U.S. $4034 per year per c e n t e r . The c e n t e r s were l i m i t e d i n t h e i r impact on m a l n u t r i t i o n because o f f a c t o r s such as i n f e c t i o n s and mothers' l a c k o f m o t i v a t i o n o r a b i l i t y t o l e a r n i n t h e centers .

t h e

283. KUBOTA, N. ; e t a l . Ava l iacão de m a t e r i a l educat ivo. Adequacão de qyat ro vo lan tes sobre al imentacão da c r i a n v a de 10 a 12 meses de idade. P u b l i c a , v o l . 14, 1980, pp. 101-122.

Rev. Saude

T h i s a r t i c l e descr ibes t h e f i e l d t e s t i n g o f four pamphlets on i n f a n t n u t r i t i o n developed f o r t h e C h i l d Care Program o f t h e Department o f H e a l t h o f t h e Sta te o f Sao Paulo, B r a z i l . Mothers and a u x i l i a r i e s were i n t e r v i e w e d t o determine whether t h e y understood t h e m a t e r i a l s and thought they were p r a c t i c a b l e . A l though t h r e e o f t h e l e a f l e t s were wel l -understood, b o t h mothers and a u x i l i a r i e s quest ioned t h e a p p l i c a b i l i t y o f t h e i r recommendations. The f i e l d t e s t thus i d e n t i f i e d some l i m i t s i n comprehension and f e a s i b i l i t y , and t h e r e p o r t c o n t a i n s recommendations on improv ing t h e m a t e r i a l s f o r g e n e r a l a p p l i c a t i o n .

284. OkWESA, B.A. Mass media and community-centered approaches i n Jamaica's n u t r i t i o n educat ion programme. Cajanus, v o l . 15, no. 1, 1982, pp. 19-27.

T h i s a r t i c l e , i l l u s t r a t e d w i t h photographs, descr ibes t h e p lanning, implementat ion, and e v a l u a t i o n o f a n a t i o n a l i n t e g r a t e d h e a l t h and n u t r i t i o n educat ion program. The goa l was t o improve t h e n u t r i t i o n s t a t u s o f c h i l d r e n and pregnant women; t h e o b j e c t i v e s i n c l u d e d reduc ing anemia among women and decreas ing t h e inc idence o f m a l n u t r i t i o n among c h i l d r e n under 4 years o ld . Planning, b y a committee o f r e p r e s e n t a t i v e s from p u b l i c and p r i v a t e agencies, was based on a b a s e l i n e survey o f n u t r i t i o n a l needs. Most mothers began feeding supplementary foods e a r l y , b e f o r e 4 months, and the foods were o f t e n n u t r i t i o n a l l y inadequate. Data on resources inc luded household ameni t ies and major sources o f h e a l t h - r e l a t e d i n f o r m a t i o n . The r e s u l t s l e d t o p l a n n i n g o f t h r e e i n t e r v e n t i o n s : (1) e d u c a t i o n a l seminars f o r h e a l t h p r o f e s s i o n a l s and community l e a d e r s ; ( 2 ) a mass-media campaign d i r e c t e d a t t h e genera l p u b l i c ;

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and ( 3 ) household counsel ing by f i e l d workers. Themes i n c l u d e d advantages o f b r e a s t feeding, improved weaning p r a c t i c e s , and n u t r i t i o u s foods f o r pregnant women. Media i n c l u d e d b i l l b o a r d s , bumper s t i c k e r s , and ca lendars. Opera t ion o f t h e program ended i n 1979. E v a l u a t i o n o f t h e program showed t h a t a l though the o b j e c t i v e s were w e l l w r i t t e n , t h e r e was no worked-out and we l l -de f ined s t r a t e g y i n accordance w i t h t h e aims o f t h e programme," and no system f o r c o l l e c t i n g impact data, a l t h o u g h some e f f o r t s had apparent ly been more e f f e c t i v e than o thers . The p r o j e c t was r e v i s e d and r e i n s t i t u t e d i n 1981, w i t h g rea ter emphasis on f a m i l y p lann ing , materna l and c h i l d h e a l t h s e r v i c e s , and i n f a n t immunizat ion.

285. OVERHOLT, C.; SELLERS, S.G. ; MORA, J.O. ; e t a l . The e f f e c t s o f n u t r i t i o n a l supplementat ion on t h e d i e t s o f low-income f a m i l i e s a t r i s k o f m a l n u t r i t i o n . American Journa l o f C l i n i c a l N u t r i t i o n , vo l . 36, no. 6, December 1982, pp. 1153-61. [A lso pub l ished i n French and Spanish]

This s tudy e n r o l l e d 456 f a m i l i e s i n low-income neighborhoods o f Bogota, Colombia, who were judged a t r i s k o f m a l n u t r i t i o n . S i x t rea tment groups r e c e i v e d v a r i o u s combinat ions o f f r e e med ica l care, food supplements, and home educat ion. Home educat ion a lone was found n o t t o i n f l u e n c e consumption, presumably because o f economic c o n s t r a i n t s , s i n c e f a m i l i e s r e c e i v i n g b o t h educat ion and supplements d i d improve t h e i r d i e t s , showing t h a t t h e supplement was used as such and n o t as a s u b s t i t u t e f o r foods o therw ise purchased. Al though l lsupplementation a lone enhanced c h i l d growth, supplementat ion and educat ion together had a s i g n i f i c a n t l y g r e a t e r e f f e c t " (p. 1161).

286. P ILEGGI VINW4, V.H. ; OLIVEIRA, J.E. D. Programa c o m u n i t a r i o de al imenta$&, B o l e t i n de l a O f i c i n a S a n i t a r i a Panamericana, v o l . 90, no. 3, March 1981, pp. 189-99.

T h i s r e p o r t descr ibes community food programs i n suburban R i b e i r o Pre to , i n t h e S t a t e o f Sa0 Paulo, B r a z i l , s e r v i n g 555 preschool c h i l d r e n w i t h food supplements and n u t r i t i o n educat ion f o r mothers.

287. POLLIT, E. Simposio Regional sobre l a Pobreza C r í t i c a en l a Nifíez. Sant iago2,979; - & Proyecto I n t e r i n s t i t u c i o n a l de Probreza C r i t i c a en America L a t i n a . Es tud ios exper imenta les y programas p i l o t o s de i n t e r v e n c i o n y a l i v i o a l a n inez pobre en America La t ina : Un examen de l o avanzado. Sant iago, CEPAL, 1979. 39p.

288. PRAUN, A. N u t r i t i o n educat ion: Development o r a l i e n a t i o n ? Human N u t r i t i o n : App l ied N u t r i t i o n , v o l . 36A, 1982, pp. 28-34.

"Outsiderst1 conduct ing n u t r i t i o n educat ion i n deve lop ing c o u n t r i e s a r e u s u a l l y i n e f f e c t i v e , because t h e y do n o t understand t h e c o n t e x t i n which t h e y a r e working and do n o t l e a r n about t h e h a b i t s and concerns o f t h e p o p u l a t i o n . S t r a i g h t d e l i v e r y o f i n f o r m a t i o n , even on t h e chance t h a t i t i s r e l e v a n t , i s n o t s u f f i c i e n t t o induce c o n s t r u c t i v e changes. N u t r i t i o n educators must r e v i s e t h e i r a t t i t u d e s i n a v e r y b a s i c way, t o i n c l u d e community p a r t i c i p a t i o n i n des ign ing and conduct ing t h e i r programs. Th is paper p resents a d e t a i l e d

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d e s c r i p t i o n o f t h e e f f e c t i v e des ign and conduct o f a community-based p r o j e c t i n an u n s p e c i f i e d C e n t r a l American country . The author descr ibes her i n i t i a l f r u s t r a t i o n s and f a i l u r e s as w e l l as her success i n e s t a b l i s h i n g a p r o j e c t designed on F r e i r e ' s p r i n c i p l e s

289. SELLERS, S.G. ; MORA, J.O.; n u t r i t i o n a l supplement a t i o n and Repor ts I n t e r n a t i o n a l , v o l . 26, p u b l i s h e d i n French1

o f i n c r e a s i n g awareness.

SUPER, C.M.; e t a l . The e f f e c t s o f home educat ion on c h i l d r e n ' s d i e t s . N u t r i t i o n no. 4, October 1982, pp. 727-41. [ A l s o

T h i s study, conducted i n Colombia, found t h a t n u t r i t i o n supplements and hme-based n u t r i t i o n educat ion d i d n o t have much e f f e c t on b r e a s t f e e d i n g r a t e s b u t d i d i n f l u e n c e weaning p r a c t i c e s , r e s u l t i n g i n a s i g n i f i c a n t improvement i n t h e n u t r i t i o n a l i n t a k e o f c h i l d r e n 18 t o 36 months o l d . The p o s s i b l e i m p l i c a t i o n s o f t h i s e f f e c t f o r t h e development o f t h e c h i l d r e n are discussed.

290. SIMMONS, W.K. N u t r i t i o n a l anemia i n Jamaica: 2. Programme f o r i t s p r e v e n t i o n and c o n t r o l . Cajanus, v o l . 14, no. 1, 1981, pp. 20-30. b i b l .

I n o r d e r t o cope w i t h i t s h i g h r a t e o f i r o n - d e f i c i e n c y anemia, Jamaica f o r t i f i e s f l o u r w i t h i r o n and i s c o n s i d e r i n g f o r t i f y i n g sugar and corn meal. Other a c t i v i t i e s i n c l u d e d i s t r i b u t i o n o f i r o n supplements t o those most a t r i s k , such as pregnant women, and a n t i - p a r a s i t e campaigns. Complementing and supplement ing these a c t i v i t i e s a r e n u t r i t i o n educat ion programs. The N u t r i t i o n U n i t o f t h e M i n i s t r y o f H e a l t h conducts n u t r i t i o n educat ion courses f o r D i s t r i c t Midwives, p u b l i c h e a l t h nurses, and c o m u n i t y h e a l t h aides, who i n turn adv ise women who are pregnant o r l a c t a t i n g , o r who have preschoolers . They p a r t i c u l a r l y encourage foods h i g h i n i r o n o r i n ascorb ic a c i d ( v i t a m i n C > , t o enhance t h e body 's a b i l i t y t o absorb t h e i r o n i n foods.

291. SRINIVASAN, L. ; SAWYER, R. Consu l tan t Report f o r Guatemala (October 25-31, 1980). Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Service, Educat ion Development Center, through subcont rac t t o Save t h e C h i l d r e n Federa t ion , 1980.

The s e n i o r author has developed a p a r t i c i p a t o r y approach t o s o l v i n g n u t r i t i o n problems and a s e r i e s o f techniques f o r e l i c i t i n g t h e p a r t i c i p a t i o n o f v i l l a g e r s i n t h e des ign o f n u t r i t i o n educat ion programs t h a t a f f e c t them. Her approach was f i r s t developed i n c o n j u n c t i o n w i t h Save t h e C h i l d r e n Federa t ion p r o j e c t s i n Indones ia and t h e Dominican Republ ic. T h i s r e p o r t p resents t h e a p p l i c a t i o n o f these techn iques ( i n c o l l a b o r a t i o n w i t h an a d d i t i o n a l exper t i n non-formal educat ion) t o workshops h e l d t o t r a i n t r a i n e r s i n learner-centered techniques i n n u t r i t i o n educat ion. The t r a i n i n g inc luded: e x p e r i e n t i a l e x e r c i s e s t o acqua in t p a r t i c i p a n t s w i t h t h e techniques t o be used; i d e n t i f i c a - t i o n o f h e a l t h , n u t r i t i o n , and genera l problems t o be addressed; development and a d a p t a t i o n o f e d u c a t i o n a l m a t e r i a l s ; comparison of f o u r non-formal educat ion models ; and t e c h n i c a l educat ion o f t h e p a r t i c i p a n t s i n s p e c i f i c h e a l t h and n u t r i t i o n t o p i c s . The second phase i n c l u d e d f i e l d work i n m a t e r i a l s development ; t h e t h i r d , r e v i e w and p l a n s f o r fo l low-up.

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292. TOUREAU, S. ; PIZZARELLO, L. ; LEONE, S.E. E v a l u a t i o n o f a Program t o Prevent Xerophthalmia i n H a i t i . New York, Helen K e l l e r I n t e r n a t i o n a l , 1979. 99p.

T h i s massive campaign t o p revent c h i l d b l i n d n e s s i n H a i t i focused on adequate n u t r i t i o n , because v i t a m i n A d e f i c i e n c y was i d e n t i f i e d as a major cause o f c h i l d b l indness . A c t i v i t i e s i n c l u d e d promot ion o f massive supplementat ion w i t h v i t a m i n A capsules; r a d i o messages; and d i r e c t educat ion prov ided by d i s t r i c t a u x i l i a r y n u t r i t i o n i s t s a t t h e capsule d i s t r i b u t i o n centers . E v a l u a t i o n o f t h e r a d i o campaign was compl ica ted b y t h e e f f e c t s o f popu lar awareness and support of t h e capsule d i s t r i b u t i o n campaign. A f l i p c h a r t developed f o r f i e l d use has been d i s t r i b u t e d w o r l d wide as a p rop to type a i d i n p r e v e n t i o n o f xerophthalmia. S ince the 1974-75 i n i t i a l assessment o f need, t h e r e has been a " t e n f o l d decrease" i n o c u l a r symptoms o f v i t a m i n A d e f i c i e n c y .

293. WEBB, R.E.; FOUGERE, W.; PAPILLON, Y. An e v a l u a t i o n o f t h e e d u c a t i o n a l b e n e f i t s o f n u t r i t i o n a l r e h a b i l i t a t i o n c e n t r e s as measured b y t h e n u t r i t i o n a l s t a t u s o f s i b l i n g s . Journa l o f T r o p i c a l P e d i a t r i c s , vo l . 21, no. 1, 1975, pp. 7-1 O.

Malnour ished c h i l d r e n t r e a t e d a t r e h a b i l i t a t i o n c e n t e r s i n H a i t i gained i n t h e i r r e l a t i v e weight- for-age d u r i n g t h e i r s t a y s i n t h e r e h a b i l i t a t i o n c e n t e r s and had made f u r t h e r ga ins 21 months a f t e r d ischarge. P a i r e d s i b l i n g s o f these c h i l d r e n had b e t t e r n u t r i t i o n s t a t u s than t h e o l d e r c h i l d had when admi t ted f o r m a l n u t r i t i o n . A comparison of p a i r s o f c o n t r o l c h i l d r e n showed no s i g n i f i c a n t d i f f e r e n c e s between them i n weight s ta tus . The au thors concluded t h a t the s u p e r i o r s t a t u s o f t h e younger s i b l i n g s o f t h e malnour ished c h i l d r e n i g a t t r i b u t a b l e t o t h e e d u c a t i o n a l e f f e c t i v e n e s s o f t h e r e h a b i l i t a t i o n centers .

294. WIT, J.M. ; DAVIES, S. C.V.A A home- and c l i n i c - b a s e d growth c h a r t f o r Dominica. Cajanus, v o l . 15, no. 1, 1982, pp. 42-52.

The home-based ' 'Chi ld H e a l t h Passport" was i n t r o d u c e d in 1980 a f t e r c o n s u l t a t i o n with h e a l t h c a r e personnel . Older c h a r t des igns were m o d i f i e d t o i n c l u d e n u t r i t i o n educat ion messages, such as m o n i t o r i n g i n f a n t s ' food i n t a k e and reminders o f t h e a p p r o p r i a t e ages a t which t o i n t r o d u c e s p e c i f i c foods. P r e t e s t i n g r e v e a l e d mothers ' con fus ion about some o f t h e messages and t h e i r o b j e c t i o n t o hav ing c o n t r a c e p t i o n i n f o r m a t i o n recorded on home c h a r t s . The c h a r t s were designed t o min imize t h e amount o f w r i t i n g t o be done; as many i t e m s as p o s s i b l e a r e s i m p l y t o be checked o f f . Reg iona l ly , home-based c h a r t s a r e r e p o r t e d t o be l o s t l e s s f r e q u e n t l y t h a n h e a l t h r e c o r d s and p r o v i d e mothers with a f e e l i n g of r e s p o n s i b i l i t y f o r and p a r t i c i p a t i o n i n t h e i r c h i l d r e n ' s h e a l t h care. Such c h a r t s a l s o f a c i l i t a t e home v i s i t s and a r e appropr ia te i n the many areas where people move f r e q u e n t l y and d e a l with many d i f f e r e n t h e a l t h care p r o v i d e r s .

295. WRIGHT, M. ; HORNER, M.R. ; C H A R I N I , L.H. Approaches € o r i n c r e a s i n g soybean use b y low-income B r a z i l i a n f a m i l i e s . Journal o f N u t r i t . i o n Educat ion, v o l . 14, no. 3, 1982, pp. 105-107.

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T h i s campaign, d i r e c t e d a t f a m i l i e s w i t h preschool c h i l d r e n , i n c l u d e d b o t h educat ion and d i s t r i b u t i o n . Two approaches were used i n t h e educat ion component: group d i s c u s s i o n s were found more e f f e c t i v e than l e c t u r e o r i n d i v i d u a l i n f o r m a t i o n approaches t o changing food h a b i t s . I n i t i a l l y , none o f t h e f a m i l i e s used soy products . A f t e r educat ion and one month o f r e c e i v i n g f r e e soybeans, 90% o f t h e p a r t i c i p a n t s had used t h e soybeans a t l e a s t o c c a s i o n a l l y ; 40% had used them within the preceding 24 hours. A f t e r 4 months, soybeans occur red in 25% o f t h e 24-hour r e c a l l s . The au thors assume t h a t p a r t i c i p a n t s would n o t have been so success fu l i n i n c o r p o r a t i n g a new food i n t o t h e i r d i e t s w i t h o u t t h e educat ion, but t h e r e was no c o n t r o l group r e c e i v i n g o n l y t h e soybeans and no educat ion i n t h e i r use.

NORTH AMERICA

296. BLAKEWAY, S.F.; KNICKREHM, M.E. N u t r i t i o n educat ion i n the L i t t l e Rock School Lunch Program. Journa l o f The American D i e t e t i c Assoc ia t ion , v o l . 72, A p r i l 1978, p. 389-91.

297. BCWERING, J.; LOWENBERG, R.L. ; MORRISON, M.A.; PARKER, S.L.; TIRADO, N. I n f l u e n c e o f a n u t r i t i o n educat ion program (EFNEP) on i n f a n t n u t r i t i o n i n eas t - - Harlem. Journa l o f The American D i e t e t i c Assoc ia t ion , vo l . 72, A p r i l 1978, p. 392-97.

298. BROWNELL, K.D. ; KAYE, F. S. School-based behav io r m o d i f i c a t i o n , n u t r i t i o n educat ion, and p h y s i c a l a c t i v i t y program f o r obese c h i l d r e n . American J o u r n a l o f C l i n i c a l N u t r i t i o n , v o l . 35, no. 2, February 1982, pp. 277-83.

A program u s i n g behav io r m o d i f i c a t i o n and m o d i f i c a t i o n o f d i e t a r y and p h y s i c a l a c t i v i t y h a b i t s was a p p l i e d t o obese c h i l d r e n i n c l o s e c o l l a b o r a t i o n wi th teachers, parents , and t h e school nurse. S i g n i f i c a n t weight l o s s occur red i n 95% of cases. The au thors recommend f u r t h e r use and development o f these techniques.

299. DAELHOUSEN, B.B. ; GUTHRIE, H. A. S e l f - i n s t r u c t i o n n u t r i t i o n program f o r pregnant women. October 1982, pp. 407-12.

Journa l o f t h e American D i e t e t i c & s o c i a t i o n , v o l . 81, no. 4,

300. WHRMANN, H. N u t r i t i o n educat ion i n t h e Santa Ana teen mother program. J o u r n a l o f The American D i e t e t i c Assoc ia t ion , v o l . 74, June 1979, p. 665-67.

This program was e s t a b l i s h e d t o p rov ide a s p e c i a l a r r a y o f c lasses t o address t h e many needs o f pregnant minors. The n u t r i t i o n program, r e c o g n i z i n g t h e poor sel f -esteem and poor e a t i n g h a b i t s o f many pregnant teens, focuses on t h e e f f e c t s o f p r e n a t a l n u t r i t i o n on t h e f e t u s , s i n c e a l l the g i r l s d i d want h e a l t h y babies. A c t i v i t i e s i n c l u d e d i s c u s s i o n groups, a c t i v e maintenance o f weight ga in c h a r t s , food consumption c h a r t s , and f i l m s t r i p s and movies. The s tudents a l s o p l a n and prepare t h e i r own lunches and opera te a c a f e i n t h e summer. T h i s i s p r o b a b l y t h e s tudents ' o n l y exper ience w i t h p lann ing and

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p r e p a r i n g n u t r i t i o u s meals. R e s u l t s o f t h e program, i n i t s e i g h t h year o f opera t ion , show a much lower-than-average r a t e o f low-b i r th -we igh t i n f a n t s , a decreased dropout r a t e , j o b placement, and improved n u t r i t i o n s t a t u s and self-esteem.

301. DUYFF, R.L. : MARCANTEL, V. : RAY, M.L. : e t a l . Soup-to-Nuts: a t e l e v i s i o n approach t o n u t r i t i o n educat ion. Journa l o f the American D i e t e t i c Assoc ia t ion , v o l . 80, no. 2, Feb. 1982, p. 157-59.

302. ELLESTAD-SAYED, J. J. ; HAWORTH, J.C. ; COODIN, F. J. : e t a l . Growth and n u t r i t i o n o f preschool I n d i a n c h i l d r e n i n Manitoba: 2. N u t r i e n t i n t a k e s . Canadian Journa l o f P u b l i c Hea l th , v o l . 72, no. 2, March-Apr i l 1981, pp. 127-1 33.

A s t u d y o f 150 c h i l d r e n i n two l o c a t i o n s , one w i t h a meat-based d i e t and t h e o ther , a more v a r i e d d i e t , found t h a t c h i l d r e n i n b o t h l o c a t i o n s l a c k e d v i t a m i n D i n t h e i r d i e t s : over h a l f had low i r o n i n t a k e s . C h i l d r e n i n t h e c o m u n i t y w i t h a meat-based d i e t were a l s o l a c k i n g o t h e r v i t a m i n s and minera ls . Because access t o food i s adequate, t h i s problem should be addressed th rough a p p r o p r i a t e n u t r i t i o n educat ion.

303. FISK, D. A s u c c e s s f u l program f o r changing c h i l d r e n ' s e a t i n g h a b i t s . N u t r i t i o n Today, May/June 1979, p. 6.

304. GALST, J. P. T e l e v i s i o n food commercials and p r o - n u t r i t i o n a l p u b l i c s e r v i c e announcements as de terminants o f young c h i l d r e n ' s snack choices. C h i l d Development, v o l . 51, 1980, pp. 935-38.

C h i l d r e n 3 t o 6 years o l d were shown car toons w i t h commercials f o r foods w i t h added sugar, o f commercials f o r foods w i t h no added sugar, and p r o - n u t r i t i o n p u b l i c s e r v i c e announcements, w i t h o r w i t h o u t a d u l t comments about t h e p r o d u c t por t rayed. Dur ing the four-week study, t h e c h i l d r e n were a l lowed d a i l y t o s e l e c t a snack a f t e r watching t e l e v i s i o n . The i n t e r v e n t i o n most e f f e c t i v e i n promot ing s e l e c t i o n o f snacks with no added sugar was exposure t o commercials f o r foods w i t h o u t added sugar combined w i t h p r o - n u t r i t i o n p u b l i c s e r v i c e announcements and accompanying p o s i t i v e comments b y an a d u l t Co-observer . 305. GOLDBERG, S.J.: e t a l . Use o f h e a l t h educat ion and at tempted d i e t a r y change t o mod i fy a t h e r o s c l e r o t i c r i s k f a c t o r s : a c o n t r o l l e d t r i a l . American Journa l o f C l i n i c a l N u t r i t i o n , v o l . 33, no. 6, June 1980, pp. 1272-1278.

Th is i n v e s t i g a t i o n was conducted t o determine whether n u t r i t i o n educat ion a t t h e elementary-school l e v e l could produce d i e t a r y changes t h a t m u l d reduce c h i l d r e n ' s r i s k f a c t o r s . I n t e n s i v e educat ion, focus ing on i n c r e a s i n g knowledge and access t o d e s i r a b l e foods ( t h r o u g h school c a f e t e r i a o f f e r i n g s and a n e w s l e t t e r f o r paren ts ) produced increases i n knowledge ( r e l a t i v e t o a c o n t r o l group), but a f t e r t h r e e years o f t h e study, t h e r e were no s i g n i f i c a n t changes between t h e groups' serum c h o l e s t e r o l , h e i g h t , weight , o r arm s k i n f o l d th ickness . F a i l u r e i s a t t r i b u t e d t o the r e l a t i v e l y l o w r i s k s t a t u s o f t h e

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p o p u l a t i o n and the p o s s i b i l i t y t h a t t h e p r e s c r i b e d d i e t a r y changes cou ld n o t i n f l u e n c e t h e r i s k f a c t o r s measured.

306. GRIEG, S. N u t r i t i o n educat ion i n school foodserv ice i n Kansas. Journa l o f ' h e American D i e t e t i c Assoc ia t ion , v o l . 73, October 1978, p. 422-28.

307. HICKS, L. E. ; LANGHAM, R.A. ; TAKENAKA, J. Cogn i t i ve and h e a l t h measures f o l l o w i n g e a r l y n u t r i t i o n a l supplementat ion: A s i b l i n g study. American J o u r n a l o f P u b l i c Hea l th , v o l . 72, no. I O , 1982, pp. 1110-18.

Th is s tudy measured t h e growth and development o f 21 s i b l i n g p a i r s i n t h e W I C Program (U. S. Spec ia l Supplemental Food Program f o r Women, I n f a n t s , and C h i l d r e n ) f i v e t o seven years a f t e r t h e y had p a r t i c i p a t e d i n t h e program. The " e a r l y supplement" group had begun i n t h e t h i r d t r i m e s t e r o f pregnancy; t h e lllatel' group, a f t e r one year o f age. S i g n i f i c a n t between-group d i f f e r e n c e s were found f o r a v a r i e t y o f c o g n i t i v e t e s t s , but he ight - for -age was t h e o n l y h e a l t h measure t o be s i g n i f i c a n t l y a f f e c t e d ; t h e "ear ly1I group was s i g n i f i c a n t 1 y t a l l e r . The f i n d i n g t h a t n u t r i t i o n a l supplements can a f f e c t l a t e r i n t e l l e c t u a l performance i s shown t o be compat ib le w i t h o t h e r s t u d i e s i n t h e l i t e r a t u r e .

308. KAMHI, M.M. Making d i e t s h e a l t h y a t P.S. 166. N u t r i t i o n Act ion, vo l . 7, 1980, p. 3

T h i s p a r e n t - i n i t i a t e d p r o j e c t developed an e x p e r i e n t i a l c u r r i c u l u m based on t h e U.S. D i e t a r y Goals, reduc ing sugar, s a l t , and f a t i n t a k e . Classrooms and c a f e t e r i a were used as l e a r n i n g l a b o r a t o r i e s ; f o o d used f o r lunches and p a r t i e s conformed t o t h e new goals. Classroom exper iences were used t o i n t r o d u c e c h i l d r e n t o new foods and new ideas, such as hav ing f r u i t r a t h e r than sweets f o r desser t . Parents and teachers deemed t h e p r o j e c t a success because o f t h e c h i l d r e n ' s enthusiasm f o r implement ing the new behaviors . The c h i l d r e n compi led a notebook on t h e ways i n which t h e program a f f e c t e d them.

309. KAPLOWITZ, D.D. ; OLSON, C.M. The e f f e c t o f an educat ion program on the d e c i s i o n t o b reas t feed. Journa l o f N u t r i t i o n Educat ion, v o l . 15, no. 2, June 1983, pp. 61-65.

310. RUPPENTHAL, B.; GIBBS, E. T r e a t i n g ch i ldhood o b e s i t y i n a p u b l i c school s e t t i n g . The --- ---- Journa l o f School Hea l th , v o l . 49, no. I O , December 1979, p. 569-71.

311. SCHURMAN, M. Community teamwork i n n u t r i t i o n educat ion: An example i n Canada's North. Human N u t r i t i o n : A p p l i e d N u t r i t i o n , v o l . 37A, 1983, pp. 1 72 -1 7 9.

The Hudson's Bay Company sponsors a n u t r i t i o n educat ion program i n remote n o r t h e r n c o m u n i t i e s , b o t h I n u i t and Ind ian . The program i d e n t i f i e s n u t r i t i o u s foods i n company s to res , u s i n g the c o l o r codes o f t h e Canadian Food

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Guide. A n u t r i t i o n i s t works w i t h s t o r e personne l and community members t o promote awareness t h r o u g h a c t i v i t i e s such as a n e w s l e t t e r and workshops emphasizing nonverba l messages. A s m a l l e v a l u a t i o n survey found a h i g h r a t e o f r e c o g n i t i o n o f m a t e r i a l s used, and some understanding. R e c a l l o f r a d i o and t e l e v i s i o n spots was e s p e c i a l l y encouraging. The au thors conclude t h a t repeated, c o n s i s t e n t messages from a v a r i e t y o f sources c o n f i r m and r e i n f o r c e t h e b a s i c messages and c o u l d promote t h e adopt ion o f new behav io r and l e a d t o improved n u t r i t i o n a l s t a t u s .

V: Exemplary M a t e r i a l s

31 2. BETTER NUTRITION THROUGH NUTRITION CIRCLES-A PROGRAM MANUAL. Solo, Java, Indonesia, Yayasan Indonesia Sejahtera, 1978. 19p.

T h i s manual p r o v i d e s g u i d e l i n e s f o r o p e r a t i o n o f community- level programs. D i r e c t e d t o h e a l t h and f a m i l y p lann ing workers, v i l l a g e o f f i c i a l s , teachers, and w e l f a r e o r g a n i z a t i o n s , i t beg ins with a l i s t o f c r i t e r i a t o determine t h e need f o r community n u t r i t i o n i n t e r v e n t i o n s . The program descr ibed p r o v i d e s meals and n u t r i t i o n educat ion f o r mothers and t h e i r c h i l d r e n under 5 years o ld . Loca l foods a r e emphasized, and mothers are helped t o develop r e c i p e s t h a t w i l l f it i n t o f a m i l y menus. Implementat ion i n c l u d e s e s t a b l i s h i n g b a s e l i n e i n f o r m a t i o n , development o f community coopera t ion and involvement, and methods o f e v a l u a t i o n . S p e c i f i c g u i d e l i n e s a r e prov ided f o r cop ing with common problems such as f i n a n c i a l resources and a l l o c a t i o n o f r e s p o n s i b i l i t y f o r food shopping, cook ing, and s e r v i n g and d e l i v e r y o f t h e e d u c a t i o n a l component.

313. BOLIVIA. Buena Madre (Good Mother) Pro jec t . La Paz, Departamento de A l imentac ión y N u t r i c i b n , M i n i s t e r i o de Planemiento y Coordinación.

The p i l o t p r o j e c t f o r t h i s campaign, conducted among Mothers ' Clubs, developed modules on each o f f o u r t o p i c s o f n a t i o n a l concern: b r e a s t feeding, weaning, c h i l d h o o d d i a r r h e a , and g o i t e r . For each module, t h r e e r e g i o n a l v e r s i o n s were developed i n t h e forms o f f l i p c h a r t s , p o s t e r s , r a d i o s c r i p t s , and o t h e r m a t e r i a l s based on l o c a l languages and a r t i s t i c t a s t e s . The campaign was found t o have s u c c e s s f u l l y changed a t t i t u d e s and some p r a c t i c e s i n r u r a l areas, p a r t i c u l a r l y those r e l a t e d t o b r e a s t feeding.

31 4. BRAZIL. B r a s i l i a .

Breast Feeding Promotion Campaign. INAN, M i n i s t é r i o da Sadde,

T h i s campaign i n c l u d e d m a t e r i a l s d i r e c t e d t o changing t h e o p i n i o n s o f p o l i c y - makers, as w e l l as m a t e r i a l s f o r t h e urban mother who has no persona l suppor t a f t e r r e t u r n i n g home f rom t h e h o s p i t a l . The theme, " s i x months t h a t a r e wor th a l i f e t i m e ,I1 emphasized t h e importance o f b r e a s t f e e d i n g f o r s i x months. C e l e b r i t i e s from s p o r t s and t e l e v i s i o n p a r t i c i p a t e d i n r a d i o and t e l e v i s i o n promot iona l spots which had v a r i o u s messages on d u r a t i o n , immunological advantages, and t h e need f o r f a m i l y suppor t .

315. BRIDGING THE GAP: A PARTICIPATORY APPROACH TO HEALTH AND NUTRITION EDUCATION. Westport , Connect icut , Save t h e C h i l d r e n Federat ion, 1982. 103p.

T h i s handbook descr ibes s imple techniques f o r t r a i n i n g f i e l d s t a f f and l o c a l s u p e r v i s o r s t o approach communit ies more s e n s i t i v e l y , and t o i n v o l v e them i n t h e process o f a c h i e v i n g b e t t e r h e a l t h . The s teps i n v o l v e d i n developing a community-based n u t r i t i o n educat ion program are: t r a i n i n g community h e a l t h and n u t r i t i o n workers b y s e l e c t i n g t h e p a r t i c i p a n t s and p lann ing workshops: h e l p i n g communit ies uncover h e a l t h and n u t r i t i o n problems b y s e n s i t i z n g community workers, i n c r e a s i n g c o m u n i t y awareness, and e x p l o r i n g t h e problems :

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developing l e a r n i n g a c t i v i t i e s and m a t e r i a l s ; p l a n n i n g f o r f u t u r e a c t i v i t i e s ; e v a l u a t i o n ; and fo l lowup. S p e c i f i c examples o f m a t e r i a l s and a c t i v i t i e s a r e g i v e n as i l l u s t r a t i o n s .

316. CHILE. Campaña p&s&-Promoci6n de l a Lac tanc ia M a t e r - . Sant iago, CONPAN (Consejo Nacional para l a A l imentac idn y N u t r i c i ó n ) .

The Chi lean b r e a s t feed ing promot ion campaign i n c l u d e d posters , t e l e v i s i o n spots, and a manual f o r h e a l t h workers. As an ongoing e f f o r t o f t h e h e a l t h system, t h e campaign addresses r u r a l and urban wcmen o f low o r m i d d l e income, with m a t e r i a l s a p p r o p r i a t e f o r each. A b o o k l e t f o r l i t e r a t e mothers i n v i t e s p a r t i c i p a t i o n b y i n c l u d i n g spaces f o r them t o f i l l i n persona l in fo rmat ion . The f l i p c h a r t t o be used i n group d iscuss ions was t h o r o u g h l y p r e t e s t e d , c o n t a i n s no p r i n t e d words, and i s a good t o o l t o s t i m u l a t e mothers ' involvement i n d iscuss ion .

317. COLOMBIA. Campaña para Promover l a Lac tanc ia Materna (Breas t Feeding Promotion Campaign). Bogota, PAN (Plan Nacional de A l imentac ión y N u t r i c i ó n ) .

Th is campaign, which r a n f o r about a year and a h a l f , coord ina ted t h e e f f o r t s o f s e v e r a l m i n i s t r i e s i n i t s des ign and implementat ion. Regional workshops were used t o develop l o c a l m a t e r i a l s and t r a i n s t a f f . The m a t e r i a l s were produced t o p r o f e s s i o n a l standards, and were wel l - received. Anecdotal i n f o r m a t i o n i n d i c a t e s t h a t t h e campaign has i n f l u e n c e d p r o f e s s i o n a l s ' a t t i t u d e s and the adv ice they g i v e on b r e a s t feeding. A t t i t u d e s o f urban and r u r a l women have a l s o been improved.

31 8. COLOMBIA. N a t i o n a l z a r r h e a Prevent ion Campaign. Bogota, PAN (P lan Nacional de Al imentac ión y M i t r i c i b n ) .

Th is campaign, t h e f - i r s t undertaken b y Colombia's N a t i o n a l Food and N u t r i t i o n Program, coord ina ted i n t e r p e r s o n a l and r a d i o messages. The emphasis was on p r e v e n t i o n and r e c o g n i t i o n o f symptoms o f d i a r r h e a ; p r e v e n t i o n messages focused on Sreast feed ing and improv ing h y g i e n i c c o n d i t i o n s . Al though t h e m a t e r i a l s were pre tes ted , the campaign i t s e l f was r io t evaluated. The campaign's b o o k l e t , "Usted Puede Salvar e l Nino de l a D i a r r e a (You Can Save a C'nild From Diarrhea)," a l s o d e s c r i b e s t r e a t i n g an ill c h i l d with o r a l r e h y d r a t i o n s o l u t i o n .

31 9, DQqINICAN REPUBLIC. Mass Media N u t r i t i o n @-!clion Campaign. Santo Dmingo, SESPAS ( S e c r e t a r i a de Estado de Salud P u b l i c a y A s i s t e n c i a S o c i a l ) , D i v i s i ó n de N u t r i c i ó n .

T h i s campaign r e l i e d e n t i r e l y upon r a d i o messages t o encourage mothers t o improve t h e i r weaning p r a c t i c e s , t o t r e a t d i a r r h e a a p p r o p r i a t e l y ( w i t h o r a l r e h y d r a t i o n ) , and t o use h e a l t h serv ices . The s c r i p t s were designed t o appeal t o mothers ' sense o f s e l f - s u f f i c i e n c y and are s t a t e d s imp ly i n b e h a v i o r a l ( r a t h e r than t h e o r e t i c a l ) te ras . The p r i n c i p a l charac ter o f t h e r a d i o spots i s Rosa, a mother who i s proud t o always be l e a r n i n g something and t o be a b l e t o manage her household a f f a i r s h e r s e l f . A l though t h e spots do n o t employ a

slogan, t h e i r appeal t o mothers t o improve t h e i r c h i l d r e n ’ s h e a l t h with what t h e y have o r can do a t hone, and t h e use o f t h e c e n t r a l c h a r a c t e r s i v e them a campaign sound. Rosa o f t e n says she w i l l pass a long new i n f o r m a t i o n t o a f r i e n d o r ne ighbor .

323. GRIFFITHS, M. ; MANOFF, H.K. ; TIGHE, J. P.N. ; ISRAEL, R.C. ; SHARP, Guide t o Mass Media and Support M a t e r i a l s ------------- f o r -u------ N u t r i t i o n Educat ion i n Develo_ping -~-.-.---- Countr ies. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n , ------------ -:--- -----. ---------

320. DUMOUCHEL, D. N u t r i t i o n Educat ion f o r t h e --- Wei l E l c l e r l y ~ ~ ” A n - A n n o t a t e d L i s t o f Resource M a t e r i a l s and ~a~qd&n~gpt-~. Vancouver, Canada, H e a l t h Promot ion a i r e c t o r a t e , Department o f N a t i o n a l H e a l t h and Welfare, r e v . ed., 1980. I O & .

L.

321. ECUADOR. Mejores Madres, Mejores Ninos <----z- ( 8 e t t e r Mothers, B e t t e r C h i l d r e n ) . S . i i to , I n s t i t u t o Nacional de N u t r i c i ó n , N i n i s t e r i o de Sa1,ud.

T h i s campaign used p o s t e r s and t e l e v i s i o n spots, but r e l i e d p r i n c i p a l l y on r a d i o spots. The audience was r u r a l f a m i l i e s , and the t o p i c s includeid d i a r r h e a and o r a l r e h y d r a t i o n , b r e a s t feed ing and weaning, m a l n u t r i t i o n , and i o d i n e de f ic iency . The r a d i o spots were d ia logues, m o s t l y between a d o c t o r and a mother ; each d iscussed t h e consequences o f a d e l e t e r i o u s h e a l t h p r a c t i c e and the e x t r a work o r expense o f a neb4 p r a c t i c e . Household i n t e r v i e w s o f t h e p r o j e c t ’ s impact found t h a t t h e campaign was most e f f e c t i v e i n c r e a t i n g awareness o f t h e causes o f d i a r r h e a and i n g e t t i n g people t o cover t h e i r d r i n k i n g water. Awareness o f t h e importance o f i o d i z e d s a l t a l s o increased; i n g o i t r o u s areas, s a l e s o f i o d i z e d s a l t increased.

322. FAO. T r a i n i n g C u r r i c u l a -- i n A f r i c a . o f t he Un i ted Nat ions, 1982. 213 p. (Food and N u t r i t i o n Paper no. 22)

Food, -_--- N u t r i t i o n , arid Agricul>Le--hidelines f o r A g r i c u l t u b a l - Rome, I t a l y , Food and A g r i c u l t u r e Orgah iza t ion

A g r i c u l t u r a l development programs o f t e n f a i l t o take i n t o account t h e eventua l r u t r i t i o n a l impact o f t h e i r a c t i v i t i e s . These c u r r i c u l u m g u i d e l i n e s lpresent two o p t i o n s f o r i n t r o d u c i n g n u t r i t i o n a l c o n s i d e r a t i o n s i n t o the c u r r i l c u l a o f a g r i c u l t u r a l s tudents a t t h e diploma and c e r t i f i c a t e l e v e l s . Food anp n u t r i t i o n may be taught as a separate course, a l l o w i n g f o r u n i t y and ~

completeness, o r t h e y may be worked i n t o e x i s t i n g courses, p e r m i t t i n g a d a p t a t i o n t o the needs o f d i f f e r i n g i n s t i t u t i o n s . Both alterna ti ves^ i n v o l v e t e a c h i n g methods o f i n c r e a s i n g food p r o d u c t i o n and improv ing t h e a v a i l a b i l i t y and d i s t r i b u t i o n o f t h e products . Some o f t h e t e c h n i c a l s k i l l s and knowledge i n c l u d e n u t r i t i o n a l cons i d e r a t i o n s f o r des ign ing a g r i c u l t u r a l and r U r a l development p r o j e c t s , and how t o s e l e c t and implement a p p r o p r i a t e n u t r i t i o n i n t e r v e n t i o n s .

T h i s gu ide presents over 100 exemplary m a t e r i a l s , m o s t l y from developing c o u n t r i e s , w i t h rev iews and i l l u s t r a t i o n s . M a t e r i a l s are organized b y t o p i c : genera l , materna l , young c h i l d ( i n c l u d i n g breas t feed ing and weaning), growth mon i to r ing , and s p e c i f i c n u t r i t i o n - r e l a t e d h e a l t h problems. Supplementary

sec t ions present p r i n c i p l e s o f m a t e r i a l s development, a game t o teach program design p r i n c i p l e s , a g lossary , and l i s t s o f common messages f o r each t o p i c a l sec t ion . I n d i c e s i n c l u d e l i s t s o f m a t e r i a l s b y language, geographic o r i g i n , and s p e c i a l audience, and a l i s t o f names and addresses o f t h e agencies t h a t developed t h e m a t e r i a l s .

324. GUATEMALA. Manual G r a f i c o de Al imentac ión para Comadronas Adiest radas ( I l l u s t r a t e d Manual on Food f o r Tra ined Midwives) . Westpor t , Connect icut , Save t h e Ch i ld ren .

Th is s i inp ly designed b o o k l e t f o r t r a i n e d midwives uses i l l u s t r a t i o n s and a m i n i m u m s u p p o r t i n g t e x t t o show b a s i c food groups and t h e s p e c i a l needs o f some groups, such as young c h i l d r e n and pregnant women; s a n i t a t i o n ; and

n t o f d i a r r h e a . I

325. GUATEMALA. M a t e r i a l e s Marca Maya. Quedzaltenango.

These m a t e r i a l s c o n s i s t o f guidebooks w i t h l a r g e , detached b l a c k and h i t e i l l u s t r a t i o n s , an i n s t r u c t i o n book, and a pamphlet on group work. Topics i n c l u d e weaning, g rowth m o n i t o r i n g , and d i a r r h e a and o r a l r e h y d r a t i o n . Each guidebook i n c l u d e s background i n f o r m a t i o n f o r t h e h e a l t h worker , w i t h examples o f ques t ions t h e y a r e l i k e l y t o be asked and suggest ions f o r s p e c i f i c educat iona l a c t i v i t i e s t o conduct. Continuous t e s t i n g w i t h t h e in tended audience (Mayan mothers) l e d t o e x t e n s i v e adapta t ions t o t h e Mayan b e l i e f system. Promoters responded e n t h u s i a s t i c a l l y t o t h e m a t e r i a l s ; demand f o r t h e m a t e r i a l s was h i g h . They were a l s o used with Western-trained d o c t o r s t o educate them about Mayan b e l i e f s .

326. GUIDELINES FOR CURRICULUM CONTENT I N FOOD AND NUTRITION PLANNING AND MANAGEMENT. Proceedings o f t h e Second FNP Workshop, 8-1 3 November 1982, Jakar ta , Indonesia. Indonesia, Akademi G i z i , Center f o r Educat ion and Tra in ing, M i n i s t r y of Heal th; Los Banos, P h i l i p p i n e s , Regional T r a i n i n g Programme on Food and N u t r i t i o n Planning; Nether lands U n i v e r s i t i e s Foundat ion f o r I n t e r n a t i o n a l Cooperation. 222p.

327. HELSING, E.; KING, F.S. Breas t - feed ing i n P r a c t i c e : A Manual f o r H e a l t h Workers. Oxford, Oxford U n i v e r s i t y Press, 1982, 271p. b i b l .

Th is manual was developed t o a s s i s t h e a l t h workers i n c o u n t r i e s t h a t have mounted campaigns t o encourage b r e a s t feeding. Chapters d e a l n o t o n l y w i t h p h y s i o l o g i c a l p r i n c i p l e s and problems, but a l s o w i t h t h e s o c i a l and emot ional knf luences on a mother 's c a p a c i t y t o b r e a s t feed s u c c e s s f u l l y . Many s p e c i f i c b e l i e f s r e g a r d i n g t h e need t o t e r m i n a t e b r e a s t feed ing a r e r e f u t e d , and t h e au thors p r o v i d e ways i n which workers can h e l p mothers g a i n conf idence. N u t r i t i o n a l concerns i n c l u d e weaning foods' q u a l i t y and i n t r o d u c t i o n , n u t r i t i o n a l requi rements o f t h e mother, and s p e c i f i c food choices and p r e p a r a t i o n methods. Appendices present a d e s c r i p t i o n o f methods f o r management o f l a c t a t i o n f a i l u r e and d i r e c t i o n s f o r p r e p a r a t i o n o f a v a r i e t y o f n u t r i t i o n a l l y sound weaning foods.

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328. HENDRATA, L.; JOHNSTON, M. Manual f o r C o m m u n i t y Based Under f i ves Weighing Program. Indonesia, Yayasan Indonesia Sejahtera, 1978. 28p.

Weighing programs can be used n o t o n l y t o mon i to r t h e n u t r i t i o n a l s t a t u s o f c h i l d r e n i n a community, but a l s o as an educat iona l and m o t i v a t i o n a l t o o l . T h i s manual, p a r t o f a la rge-sca le Indonesian campaign, descr ibes how r e c o r d s should be k e p t and how p o t e n t i a l problems o f a program can be overcome. Other r e l a t e d h e a l t h and n u t r i t i o n a c t i v i t i e s are a l s o recommended.

329. INDIA . Tami l Nadu I n t e g r a t e d N u t r i t i o n Pro jec t . Madras.

This campaign developed pos ters , f l i p c h a r t , f lanne lgraph, s t i c k e r s , f l a s h card se ts , and manuals t o address problems such as weaning foods, growth m o n i t o r i n g , v i t a m i n d e f i c i e n c y , and o r a l r e h y d r a t i o n therapy. The m a t e r i a l s a re meant t o be used b y community n u t r i t i o n workers; cons iderab le emphasis i s p laced on communications s k i l l s f o r t h e workers. The m a t e r i a l s were pre tes ted , and p r e l i m i n a r y r e p o r t s on p r o j e c t impact were p o s i t i v e .

330. INDONESIA. Nonformal P a r t i c i p a t o r y N u t r i t i o n Educat ion P r o j e c t . Westport , Connect icut , Save t h e Ch i ld ren .

To promote non fo rmal p a r t i c i p a t o r y n u t r i t i o n educat ion, t h i s p r o j e c t developed a v a s t a r r a y o f suppor t m a t e r i a l s : games, c h a r t s , puppets, s l i d e s , s t o r y books, comic books, and s e r i e s o f p i c t u r e s t o be used t o e l i c i t group p a r t i c i p a t i o n and development o f i d e a s about n u t r i t i o n problems and ways t o c o r r e c t them. The m a t e r i a l s are s p e c i f i c t o t h e needs and standards o f t h e r e g i o n s i n which t h e y were produced, but can serve as models f o r promot ing p a r t i c i p a t o r y educat ion. (See a l s o B r i d g i n g t h e Gap).

331. INDONESIA. N u t r i t i o n Educat ion Improvement Pro jec t . Jakarta Selatan, Proyek Pengembangan Penyuluhan G i z i , D i r e c t o r a t Penyuluhan Kesehatan Masyarakat . T h i s p r o j e c t developed pos ters , r a d i o spots, a f l i p c h a r t , and a manual, u s i n g ex tens ive p r e l i m i n a r y r e s e a r c h on l o c a l food h a b i t s and b e l i e f s , as w e l l as i n v o l v i n g i n d i v i d u a l s i n t h e development o f t h e messages used. One o f t h e m a t e r i a l s ' s t r e n g t h s i s t h a t each i t e m (pos ter , r a d i o spot , e tc . ) focuses s p e c i f i c a l l y on one problem, t r a n s m i t t i n g a s p e c i f i c message; t h e p o s t e r s a l so adv ise mothers t o seek f u r t h e r i n f o r m a t i o n f rom h e a l t h workers. The p i l o t p r o j e c t e v a l u a t i o n found p o s i t i v e a s s o c i a t i o n s among knowledge o f t h e major messages, a c t u a l implementat ion o f t h e recommendations, increased p r o t e i n and c a l o r i e consumption, and improved growth s t a t u s o f t h e c h i l d r e n .

332. INDONESIA. UPGK F a m i l y N u t r i t i o n Improvement Program. Jakar ta Pusat, D i v i s i o n o f N u t r i t i o n , M i n i s t r y of Heal th .

Coord inated manuals and f l i p c h a r t s were developed f o r use b y t h r e e c o l l a b o r a t i n g agencies-the M i n i s t r i e s o f Heal th, R e l i g i o n , and A g r i c u l t u r e , Tne emphasis o f t h i s program, begun i n 1979, has been on t r a i n i n g community workers i n a s e r i e s o f core n u t r i t i o n a c t i v i t i e s and i n p r o v i d i n g them w i t h

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simple, c l e a r messages f o r f a m i l i e s . For example, workers i n a g r i c u l t u r e a r e t r a i n e d i n home gardening. The community v o l u n t e e r s i n t h e h e a l t h s e c t o r focus on growth m o n i t o r i n g and make s p e c i f i c recommendations f o r behav io r changes i n c h i l d feeding o r f a m i l y n u t r i t i o n . The m a t e r i a l s used b y r e l i g i o u s leaders no te t h a t t o g l o r i f y God, p a r e n t s must do t h e i r b e s t t o keep t h e i r c h i l d r e n hea l thy .

333. INDONESIA. Yayasan Indonesia Sejahtera. Badran, Solo.

T h i s campaign produced games f o r teach ing c h i l d r e n n u t r i t i o n p r i n c i p l e s s p e c i f i c a l l y r e l a t e d t o Indonesian n u t r i t i o n problems, such as v i t a m i n A d e f i c i e n c y and young c h i l d feeding. Dominos, c a r d games, and board games convey t h e many messages. The q u a l i t y o f p r o d u c t i o n was h igh , and r e c e p t i o n has been e n t h u s i a s t i c .

334. ISRAEL, R.; LAMPTEY, P., eds. N u t r i t i o n T r a i n i n g Manual Catalogue f o r Hea l th Pro fess iona ls , T r a i n e r s and F i e l d Workers i n Developing Countr ies. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Serv ice , Educat ion Development Center, 1982. I O & .

T h i s cata logue p r o f i l e s 116 textbooks, i n s t r u c t i o n a l guides, c u r r i c u l u m models, and course o u t l i n e s r e l a t e d t o n u t r i t i o n i n deve lop ing c o u n t r i e s . M a t e r i a l s were screened f o r q u a l i t y , con ten t , and g e n e r a l i z a b i l i t y , and are presented b y ca tegor ies , i n c l u d i n g r e h a b i l i t a t i o n , a p p r o p r i a t e technology, and assessment and s u r v e i l l a n c e . Each p r o f i l e descr ibes contents , audience, language, and access. Tables summari ze t h e audience, geographic a p p l i c a t i o n , and language(s) o f each m a t e r i a l .

335. JAMAICA. Breas t feed ing K i t . K ingston, Caribbean Food and N u t r i t i o n I n s t i t u t e .

T h i s k i t p rov ides a complete package t o t r a i n and equip p r o f e s s i o n a l s i n t h e promot ion and suppor t o f b r e a s t feeding. A s e t o f 141 s l i d e s shows how t o m o t i v a t e and t o p r o v i d e p r a c t i c a l advice, i n c l u d i n g t i p s on weaning. The package a l s o i n c l u d e s an audiocasset te , t e a c h i n g no tes and guide, f o u r f a c t sheets, a p o s t e r , a b o o k l e t f o r mothers, and a p o s t c a r d f o r e v a l u a t i o n and f o r o r d e r i n g more cop ies o f t h e suppor t m a t e r i a l s .

336. JAMA I C A. Eat R igh t Campaign. Kingston, M i n i s t r y of Heal th .

T h i s campaign was developed t o address genera l and c h i l d - r e l a t e d concerns. Much emphasis i s p laced on a color-coded food group ing system. M a t e r i a l s rang ing from f l i p c h a r t s and p o s t e r s t o take-home pamphlets and c h i l d r e n ' s c o l o r i n g books use a c o n s i s t e n t s t y l e and s e t o f messages t h a t r e i n f o r c e each o ther .

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337. KENYA. Breas t feed ing I n f o r m a t i o n Group Campaign. N a i r o b i .

The m a t e r i a l s produced b y t h i s group a r e d i r e c t e d t o b o t h mothers and m e d i c a l personnel ; some address f a t h e r s d i r e c t l y , p o i n t i n g o u t t h a t t h e i r suppor t i s needed and o f f e r i n g s p e c i f i c t i p s on how t h e y can help. M a t e r i a l s f o r women are aimed a t b o t h t h e pregnant mother 's concerns and those o f b r e a s t feed ing women.

338. KENYA. Macho ya Kenya ( R u r a l B l indness Prevent ion P r o j e c t ) . Bethesda, Maryland, I n t e r n a t i o n a l Eye Foundat ion.

T h i s p r o j e c t focused on t h e many causes o f b l indness , i n c l u d i n g i n f e c t i o u s d iseases and i n j u r i e s . Some s e c t i o n s a l s o address t h e need fo r s u f f i c i e n t v i t a m i n A t o p revent v i s i o n problems. A c h i l d r e n ' s magazine w i t h s t o r i e s and games, pos ters , r a d i o spots , a s l i d e s e r i e s , and a gu ide f o r h e a l t h workers p r o v i d e d the media f o r t h i s r u r a l campaign. I n f o r m a l assessment found e n t h u s i a s t i c p a r t i c i p a t i o n i n t h e recommended a c t i v i t i e s , such as f a i r s and demonstrat ions.

339. KING, M.H. ; KING, F.M. ; MORLEY, D.L. : BURGESS, N u t r i t i o n f o r Developing Count r ies . London, Oxford 23%.

H. J.L. ; BURGESS, A.P. U n i v e r s i t y Press, 1980.

T h i s book may be used i n s e l f - t e a c h i n g o r as t h e b a s i s o f a n u t r i t i o n course f o r h e a l t h workers, midwives, a g r i c u l t u r a l a s s i t a n t s , o r school teachers. Each chapter p resents a s e c t i o n o f " t h i n g s t o do,'' p r o j e c t s f o r p a i r s o f s tudents t o conduct and present t h e i r f i n d i n g s t o t h e r e s t o f t h e c lass . The t e x t i s w r i t t e n i n a b a s i c vocabulary with thorough i n s t r u c t i o n s and i l l u s t r a t i o n s .

340. MORLEY, D.; WOODLAND, M. See How They Grow ( M o n i t o r i n g c h i l d growth f o r x r o p r i a t e h e a l t h care i n deve lop ing c o u n t r i e s ) . London, Macmil lan Press Ltd., 1979. 265p.

341. PAKISTAN. Peshawari S a l t Market ing. Islamabad, UNICEF Pakis tan

T h i s g o i t e r - p r e v e n t i o n campaign f o r t h e h i g h l a n d areas o f Pak is tan used a v a r i e t y o f media t o promote t h e use o f i o d i z e d s a l t . The packages themselves i n c l u d e d s t i c k e r s used t o i l l u s t r a t e a s t o r y book t h a t r e l a t e d a t r a d i t i o n a l t a l e o f a b r i d e who d i e s on her wedding eve, and whose g o i t r o u s s i s t e r i s a t f i r s t r e j e c t e d b y t h e groom. Other m a t e r i a l s i n c l u d e an i n f o r m a t i o n a l b o o k l e t f o r p r o f e s s i o n a l s , mob i les hung i n s t o r e s s e l l i n g i o d i z e d s a l t , h a n d b i l l s , banners, and calendars. The messages a lso emphasize t h e h y g i e n i c c o n d i t i o n s o f t h e s a l t and no te Koranic e x h o r t a t i o n s t o pursue good hea l th .

342. PARKINSON, S.; LAMBERT, J. The New South P a c i f i c Handbook o f N u t r i t i o n . Suva, F i j i , N a t i o n a l Food and N u t r i t i o n Committee, 1982. 92p.

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Al though e s p e c i a l l y designed f o r t h e South P a c i f i c r e g i o n , t h i s handbook i s a p r a c t i c a l re fe rence t h a t would be a good model f o r n u t r i t i o n educators develop ing m a t e r i a l s f o r o t h e r reg ions . S t r a i g h t f o r w a r d i l l u s t r a t i o n s and s imple language present p r i n c i p l e s o f food groups, n u t r i t i o n - r e l a t e d diseases, and awareness o f o p t i o n s i n t h e cho ice and use o f foods. The appendices p r o v i d e a read ing l i s t and an easy-to-read food va lue c h a r t .

343. PERU: Promoción de l o s Al imentos Indfgenos (Promot ion o f Ind igenous Foods). Lima, I n s t i t u o Nacional de N u t r i c i o n .

The Andean r e g i o n i s t h e source o f some h i g h l y n u t r i t i o u s foods, n e g l e c t e d i n favor o f imported o r non-nat ive foods. Th is campaign promoted t h e s t a t u s o f these foods t h r o u g h awareness o f t h e i r s u p e r i o r n u t r i t i v e va lue and t h e ease o f producing them. M a t e r i a l s i n c l u d e r e c i p e b o o k l e t s , a f i l m s t r i p , a b o o k l e t on u s i n g t h e foods f o r feeding young c h i l d r e n , and promot iona l pamphlets.

344. PHILIPPINES. P r i o r i t y N u t r i t i o n Messages: New D i r e c t i o n s f o r t h e P h i l i p p i n e s N u t r i t i o n Program. Makat i , Metro Mani la , N u t r i t i o n Center o f t h e P h i l i p p i n e s .

T h i s campaign f e a t u r e d a f l i p c h a r t f o r h e a l t h p r o f e s s i o n a l s which i n c l u d e d summaries o f a l l t h e major messages o f t h e campaign, r a n g i n g from g e n e r a l n u t r i t i o n guidance t o s p e c i f i c causes and remedies f o r v i t a m i n A d e f i c i e n c y .

345. PROFILING NUTRITION EDUCATION MATERIALS: AN INSTRUMENT WITH MANUAL. Oakland, C a l i f o r n i a , S o c i e t y f o r N u t r i t i o n Educat ion and Center f o r N u t r i t i o n Education, 1983. 14p.

The Soc ie ty f o r N u t r i t i o n Educat ion has produced t h i s t o o l f o r educators t o use i n s e l e c t i n g n u t r i t i o n educat ion m a t e r i a l s and resources. The i n s t r u m e n t i t s e l f c o n s i s t s o f a s e r i e s o f s imp le ques t ions f o r t h e e v a l u a t o r t o answer: f o r example, i s te rmino logy used c o r r e c t l y , and are e t h n i c groups d e p i c t e d w i t h o u t s tereotypes. Some o f t h e quest ions, such as t h e f i r s t example, r e q u i r e some n u t r i t i o n a l e x p e r t i s e , i n d i c a t i n g t h a t t h i s t o o l i s p r i n c i p a l l y o f use t o educators a l r e a d y f a m i l i a r w i t h n u t r i t i o n p r i n c i p l e s ; i t would n o t be o f use t o t h e average school teacher. The f i r s t s e c t i o n o f t h e document, " rev iewer 's manual ," p r o v i d e s g u i d e l i n e s f o r answering t h e ques t ions and e v a l u a t i n g t h e r e s u l t s . The format i s p a r t i c u l a r l y u s e f u l f o r p roduc ing a s e r i e s o f c o n s i s t e n t p r o f i l e s when t h e r e i s a v a r i e t y o f m a t e r i a l s o r rev iewers .

346. RITCHIE, J.A. S. Learn ing B e t t e r N u t r i t i o n : A Second Study o f Approaches and Techniques. Rome, FAO, 1979. 264p.

T h i s book examines t h e s o c i a l , economic, and t e c h n i c a l changes i n f l u e n c i n g n u t r i t i o n educat ion and t r a i n i n g programs. It presents a j u s t i f i c a t i o n o f t h e need f o r such educat ion; t h e background i n f o r m a t i o n on which t h e educat ion should be based; guidance f o r i t s p lann ing , suppor t , and e v a l u a t i o n ; and d e s c r i p t i o n s o f t h e e d u c a t i o n a l channels and methods t h a t seem t o show t h e g r e a t e s t promise.

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347. SOMMERS, P. Home Gardens: Handbook f o r Programme1 O f f i c e r s . New York, UNICEF, 1980. 59p.

T h i s manual p r o v i d e s t e c h n i c a l guidance f o r t r a i n e r s i n t h e development o f p o l i c i e s and programs t h a t promote home gardens. Economic c o n s i d e r a t i o n s , t e c h n i c a l gardening g u i d e l i n e s , and l i s t s o f m a t e r i a l s ' p r o v i d e a comprehensive gu ide t o e s t a b l i s h i n g and conduct ing a gardening p r o j e c t s u i t e d t o t h e needs o f t h e community. Appendices l i s t t r o p i c a l m a t e r i a l s t h a t can be used as mulch, o r as o rgan ic f e r t i l i z e r , and a t a b l e c o r r e l a t i n g s p e c i f i c vegetables t o v a r i o u s n u t r i e n t s .

348. SOMMER, A. F i e l d Guide t o t h e Detec t ion and C o n t r o l o f Xerophthalmia. Geneva, WHO, 1978. 47p.

T h i s manual p r o v i d e s p r a c t i c a l g u i d e l i n e s f o r c l i n i c i a n s , nurses, and p u b l i c h e a l t h o f f i c i a l s i n v o l v e d w i t h t h e d i a g n o s i s and p r e v e n t i o n o f v i t a m i n A d e f i c i e n c y . A case o f v i s i b l e eye s i g n s o f d e f i c i e n c y i s a medica l emergency, r e q u i r i n g t rea tment w i t h massive doses o f t h e v i tamin ; but long-term p r e v e n t i o n o f new o r r e c u r r i n g cases i d e a l l y l i e s i n p r o v i d i n g a d i e t w i t h adequate v i t a m i n A. Since i t i s a v a i l a b l e i n b r e a s t m i l k and from many common and cheap foods, such as green, l e a f y vegetables, even t h e v e r y poor can have adequate d i e t s i f t h e y are mot iva ted and aware o f t h e causes, consequences, and means o f p r e v e n t i n g t h i s d e f i c i e n c y . Thus, n u t r i t i o n educat ion should be used aga ins t v i tamin-A d e f i c i e n c y b l indness a t a l l l e v e l s : medica l personnel , f a m i l i e s o f v u l n e r a b l e c h i l d r e n , and p u b l i c o f f i c i a l s .

349. U.S. CENTERS FOR DISEASE CONTROL. Source Book f o r Hea l th Educat ion M a t e r i a l s and Community Resources. Washington, E, Centers f o r Disease Cont ro l , Center f o r Hea l th Promotion and Education, 1982.

350. U. S. DEPARïMENT OF AGRICULTURE. N u t r i t i o n Educat ion Resource Guide: An Annotated B i b l i o g r a p h y o f Educat ional M a t e r i a l s f o r t h e W I C and CSF Programs. Washington, D.C., USDA, Human N u t r i t i o n I n f o r m a t i o n Serv ice, 1982. 146p.

351. WERNER, D.; BCXIJER, B. He lp ing H e a l t h Workers Learn. Pa lo A l t o , C a l i f o r n i a , The Hesperian Foundation, 1982.

T h i s book i s about t r a i n i n g h e a l t h workers; i t i s n o t a s p e c i f i e d c u r r i c u l u m o r a l i s t o f t o p i c s t o be taught . Based on p r i n c i p l e s o f community p a r t i c i p a t i o n and awareness, i t o f f e r s a p r o f u s i o n o f p r a c t i c a l exerd ises and examples f o r educators t o use. The chapter on n u t r i t i o n guides t h e reader th rough an understanding o f t h e many p o s s i b l e causes o f m a l n u t r i t i o n , f rom i n a p p r o p r i a t e weaning foods t o oppress ive a g r i c u l t u r a l p o l i c i e s . Simple and p r a c t i c a l g u i d e l i n e s a r e prov ided f o r assessing community n u t r i t i o n s t a t u s , needs, and resources. The Road-to-Health c h a r t and t h e t h i n n e s s c h a r t a re expla ined, arm c i rcumference measurement techniques a r e descr ibed. A c h e c k l i s t o f ques t ions t o ask about t h e n u t r i t i o n o f t h e c o m u n i t y covers t h e many p o s s i b l e causes and l e a d s t o a n a l y s i s and a p p r o p r i a t e i n t e r v e n t i o n and community ac t ion . Examples o f a c t i v i t i e s range from i n s t r u c t i o n s f o r making ch i ld -we igh ing sca les t o a f o t o n o v e l a about t h e importance o f adequate food.

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352. WHO. A Manual f o r t h e Treatment o f Acute Diarrhoea. Geneva, D i a r r h o e a l Diseases C o n t r o l Program, WHO, 1980. 25p.

This b o o k l e t presents t h e t e c h n i c a l r a t i o n a l e and methodology f o r p r o v i d i n g o r a l r e h y d r a t i o n , i n s t e a d o f in t ravenous s o l u t i o n s . Packets o f premeasured o r a l r e h y d r a t i o n s a l t s a re a v a i l a b l e th rough WHO and UNICEF f o r t h e use o f h e a l t h workers; t h e y a r e s u p e r i o r t o homemade p r e p a r a t i o n s w i t h sugar and s a l t because t h e y a l s o c o n t a i n b i c a r b o n a t e ( t o c o r r e c t t h e b a s e - d e f i c i t a c i d o s i s ) and potassium t o r e p l a c e t h a t l o s t t h r o u g h d i a r r h e a .

353. WHO. Gu ide l ines f o r T r a i n i n g Community H e a l t h Workers i n N u t r i t i o n . Geneva, Swi tzer land, WHO, 1981, 153p. (WHO O f f s e t P u b l i c a t i o n No. 59) [ A l s o pub l ished i n French1

T h i s manual p resents lessons i n community needs assessment; m o n i t o r i n g c h i l d r e n ' s n u t r i t i o n a l s t a t u s ; materna l n u t r i t i o n ; i d e n t i f i c a t i o n , management, and p r e v e n t i o n o f n u t r i t i o n a l d e f i c i e n c i e s ; n u t r i t i o n and d i a r r h e a ; n u t r i t i o n and i n f e c t i o n ; and teach ing methods. S p e c i f i c a c t i v i t i e s and o b j e c t i v e s a r e of fered f o r each t o p i c , i n c l u d i n g problem-solv ing d iscuss ions , demonstrat ions, r o l e p l a y i n g , and p r a c t i c e t e a c h i n g exerc ises.

354. WHO. The Pr imary H e a l t h Worker: Working Guide; Gu ide l ines f o r Tra in ing ; Gu ide l ines f o r Adaptat ion. Revised ed. Geneva, Swi tzer land, World H e a l t h Organi zat ion, 1980. 346p.

355. ZAIRE. N u t r i t i o n . Kangu-Mayumbe, Bureau d'Etudes e t de Recherches pour l a Promotion de l a Santé.

T h i s p r o j e c t developed a n u t r i t i o n manual, a f lannelgraph, and a s e r i e s o f p i c t u r e s a v a i l a b l e i n d i f f e r e n t s izes . The p i c t u r e s may be used as a comprehensive n u t r i t i o n course, o r t o p i c a l s e c t i o n s may be used f o r t h e s p e c i a l needs o f s p e c i f i c groups, such as mothers o f young c h i l d r e n . Throughout, t h e i l l u s t r a t i o n s f e a t u r e a system o f t h r e e food groups and t h e f a m i l y as t h e c o n t e x t o f food p r e p a r a t i o n and consumption. The Bureau a l s o produces r e l a t e d n u t r i t i o n educat ion m a t e r i a l s , such as pamphlets, i n severa l languages.

356. ZAMBIA. N a t i o n a l N u t r i t i o n Educat ion Campaign. Lusaka, N a t i o n a l Food and N u t r i t i o n Commission.

T h i s campaign addressed Zambian m a l n u t r i t i o n problems by i n c r e a s i n g understanding o f t h e causes and p o s s i b l e remedies f o r m a l n u t r i t i o n , e s p e c i a l l y care i n t h e feeding o f young c h i l d r e n , t rea tment o f d i a r r h e a , and d e t e c t i n g m a l n u t r i t i o n b y r e g u l a r weighing. M a t e r i a l s f e a t u r e photographs c a r e f u l l y screened f o r understanding b y audiences n o t accustomed t o i n t e r p r e t i n g i l l u s t r a t i o n s on paper; t h e most comprehensible s t y l e was found t o be f u l l human f i g u r e s , w i t h any background removed. Poster s e r i e s i l l u s t r a t e p r i n c i p l e s o f r e c o g n i t i o n o f m a l n u t r i t i o n ; overconsumption o f a l c o h o l as a d r a i n on a f a m i l y ' s a b i l i t y t o a f f o r d adequate food; and t h e needs o f pregnant

women, i n c l u d i n g n o t o n l y t h e i r need f o r e x t r a food, but a l s o f o r decreased p h y s i c a l demands i n t h e i r work.

357. ZEITLIN, M. E. ; FORMACION, C. S. N u t r i t i o n I n t e r v e n t i o n i n Developing Countr ies, Study 2: N u t r i t i o n Education. Cambridge, Massachusetts, ~.

Oelgeschlager, Gunn and Hain Pub l ishers , Inc., 1981. 349p.

T h i s book, presented from t h e p e r s p e c t i v e o f t h e la rge-sca le p lanner , addresses methods f o r p lann ing , implement ing, and e v a l u a t i n g n u t r i t i o n educat ion programs. Target groups i n c l u d e mothers and c h i l d r e n , med ica l and a g r i c u l t u r a l p r o f e s s i o n a l s , p o l i t i c i a n s , p lanners, and heads o f m i n i s t r i e s , and commercial a d v e r t i s e r s . Each group i s d iscussed i n terms o f t h e a p p r o p r i a t e channels o f communications needed t o reach them. S t r a t e g i e s f o r g o a l - s e t t i n g and p r o b l e m s o l v i n g a r e presented. Great emphasis i s p laced on des ign ing a p p r o p r i a t e e d u c a t i o n a l messages; e v a l u a t i o n methods a r e discussed. The f i n a l s e c t i o n descr ibes a case s tudy, a P h i l i p p i n e p r o j e c t which used r a d i o f o r teach ing mothers t o e n r i c h t h e t r a d i t i o n a l weaning p o r r i d g e . The manual c o n t a i n s exp lanat ions o f common models o f knowledge, a t t i t u d e , behavior , and s t a t u s concepts; and t a b l e s , c h a r t s , and m r k s h e e t s , such as a form f o r t a k i n g 24-hour r e c a l l s o f i n f a n t s ' d i e t s .

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V I : E v a l u a t i o n

358. ANDRIEN, M. E v a l u a t i o n du Programme d'Educat ion N u t r i t i o n n e l l e du Centre H o s p i t a l i e r Régional de Bouaké. l 'Enseignement P r i m a i r e e t de 1 'Educat ion T e l e v i s u e l l e de Cote d ' I v o i r e e t L a b o r a t o i r e de Pedagogie Exper imentale de l ' u n i v e r s i t é de L iege, J u l y 1981.

S e r v i c e d ' E v a l u a t i o n d u Minis,tkre de

101p.

The p e d i a t r i c department o f t h i s I v o r y Coast h o s p i t a l has o f f e r e d n u t r i t i o n educat ion t o mothers o f malnour ished c h i l d r e n s ince 1975. The two-year fo rmal e v a l u a t i o n was based on s t u d i e s o f mothers o f 96 c h i l d r e n . Compared t o n o n - p a r t i c i p a n t s , mothers who had r e c e i v e d t h e n u t r i t i o n educat ion were more l i k e l y t o know what c o n s t i t u t e d a n u t r i t i o n a l l y wel l -balanced meal; t o prepare a s p e c i a l d i s h f o r t h e i r c h i l d r e n ; and t o g i v e t h e i r c h i l d r e n animal p r o t e i n foods. But most p a r t i c i p a n t s d i d n o t a t t r i b u t e t h e i r c h i l d r e n ' s i l l n e s s t o m a l n u t r i t i o n , and t h e y had cons iderab le d i f f i c u l t y i n c l a s s i f y i n g foods i n t o t h e t h r e e groups t a u g h t i n t h e program. The e v a l u a t i o n w i l l be ongoing and w i l l be used as a b a s i s f o r r e f i n i n g and improv ing t h e program.

359. AREAS NEEDING IMPROVEMENT I N THE ADULT EXPANDED FOOD AND NUTRITION EDUCATION PROGRAM. Washington D.C., Report t o t h e Secre tary o f A g r i c u l t u r e , U.S. General Account ing O f f i c e , 1980. 54p. (CED-80-138)

360. A FIELD GUIDE FOR EVALUATION OF NUTRITION EDUCATION: AN EXPERIMENTAL APPROACH TO DETERMINATION OF EFFECTS ON FOOD BEHAVIOR I N LESSER DEVELOPED COUNTRIES. A l l i s o n Park, Pennsylvania, Synec t ics Corpora t ion f o r U. S. Agency f o r I n t e r n a t i o n a l Development O f f i c e o f N u t r i t i o n , Techn ica l Ass is tance Bureau, 1975. 76p.

T h i s gu ide i s a p r o t o t y p e methodology f o r assess ing t h e e f f e c t i v e n e s s o f n u t r i t i o n programs i n improv ing t h e n u t r i t i o n - r e l a t e d behav io r o f p a r t i c i p a n t s . An e v a l u a t i o n methodology based on l i t e r a t u r e rev iews and exper t o p i n i o n was developed and e x p e r i m e n t a l l y a p p l i e d t o B r a z i l i a n programs u s i n g t h r e e approaches: person-to-person, group teaching, and mass media. Fur ther re f inements l e d t o t h i s guide, which presents t h e r e s u l t s o f t h e B r a z i l i a n t e s t and p r o v i d e s s p e c i f i c , g u i d e l i n e s on p lann ing , des ign ing , implementing, and a n a l y s i n g n u t r i t i o n educat ion programs.

361. BARNES-KALUNDA, S. Consul tant Report f o r Z a i r e (February 23 - March 17, 1982): E v a l u a t i o n o f t h e Mass Media Component o f A.I.D.'s N u t r i t i o n P lann ing P r o j e c t i n Za i re . Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Service, Educat ion Development Center, th rough subcont rac t t o Manoff I n t e r n a t i o n a l , Inc. , Washington, D. C., 1981. 30p.

Z a i r e ' s Centre N a t i o n a l de P l a n i f i c a t i o n de N u t r i t i o n Humaine (CEPLANUT) conducted a broad n u t r i t i o n i n t e r v e n t i o n p r o j e c t ; t h e mass media component was evaluated a f t e r two years o f opera t ion . T h i s r e p o r t p resents t h e methodology and f i n d i n g s o f t h e e v a l u a t i o n , which r e i n f o r c e d t h e importance o f good u n d e r l y i n g f i e l d research and c o o r d i n a t i o n among a d m i n i s t r a t i v e e n t i t i e s , and descr ibed t h e d i f f i c u l t i e s o f deve lop ing an e f f e c t i v e campaign i n v o l v i n g m u l t i p l e themes. The c o n s u l t a n t presents h e r observa t ions o f t h e

1 O0

e f f e c t i v e n e s s o f t h e program and prov ides a sample q u e s t i o n n a i r e t o be used w i t h p a r t i c i p a n t s i n t h e f i e l d i n v e s t i g a t i o n .

362. BRCMN, R.C.; BRCWN, J.E.; TEETER, R.A. Eva lua t ion o f a n u t r i t i o n c e n t e r program i n r u r a l A f r i c a . Journa l o f T r o p i c a l P e d i a t r i c s , vo l . 26, 1981, pp. 37-4 1.

T h i s program operated n u t r i t i o n c e n t e r s i n seven v i l l a g e s around Eulape, Zai re . Malnour ished c h i l d r e n 5 t o 24 months o ld , accompanied b y t h e i r mothers, spent 12 weeks i n t h e centers . c e n t e r s p rov ided a t r a i n e d a u x i l i a r y who prov ided n u t r i t i o n educat ion and superv ised food p r e p a r a t i o n . and 12 months l a t e r . a t tended t h e centers , p a r t i c i p a n t s showed l i t t l e advantage: boys' weight - for - age and we igh t - fo r -he igh t improved d u r i n g t h e i r s tays a t t h e centers , but t h e b e n e f i t s d i d n o t p e r s i s t ; g i r l s showed no advantage. The paper d iscusses p o s s i b l e reasons f o r t h i s l a c k o f impact.

F a m i l i e s p rov ided wood and foods; t h e

C h i l d r e n were evaluated upon d ischarge and n i n e Compared w i t h matched c o n t r o l c h i l d r e n who had n o t

363. BURGESS, A. E v a l u a t i o n o f N u t r i t i o n I n t e r v e n t i o n s : An Annotated B i b l i o g r a p h y and Review o f Methodologies and Resul ts. 2d ed. FAO Food and N u t r i t i o n Paper No. 24. Rome, I t a l y , Food and A g r i c u l t u r e Organ iza t ion o f t h e Un i ted Nat ions, 1982. 198p. b i b l .

T h i s r e p o r t c o n t a i n s over 110 i t e m s on e v a l u a t i o n methodology and 300 i t e m s d e s c r i b i n g t h e outcomes o f n u t r i t i o n i n t e r v e n t i o n s i n e v a l u a t i o n s tud ies . a d d i t i o n t o a summary o f t h e c o n t e n t , most r e f e r e n c e s a r e a l s o appra ised i n terms o f use fu lness , v a l i d i t y o f survey design, and a c c e p t a b i l i t y o f t h e conc lus ions . The most u s e f u l i t e m s are b o t h s t a r r e d and indexed i n t h r e e t a b l e s t h a t l i s t re ferences on e v a l u a t i o n methodologies accord ing t o t h e major t o p i c s covered and e v a l u a t i o n s t u d i e s and rev iews o f e v a l u a t i o n r e p o r t s o f p a r t i c u l a r i n t e r e s t accord ing t o s p e c i f i c types o f programs o r serv ices. i t e m s e i t h e r cover methodo log ica l aspects r e l e v a n t t o e v a l u a t i n g t h e n u t r i t i o n a l impact o f i n t e r v e n t i o n a c t i v i t i e s o r r e p o r t t h e n u t r i t i o n a l impact o f these i n t e r v e n t i o n s i n deve lop ing c o u n t r i e s .

I n

A l l

364. CLARK, N. ; MCCAFFERY, J. Demyst i f y ing Eva lua t ion . New York, World Education, 1979. 7%.

This guidebook p r o v i d e s d e t a i l e d i n s t r u c t i o n s f o r conduct ing a workshop on e v a l u a t i o n ; t h e in tended audience i s apparent ly agency-level personnel i n t e r e s t e d i n e v a l u a t i n g t h e e f f e c t i v e n e s s o f f i e l d programs. The p r e s e n t a t i o n i s based on a p r e l i m i n a r y workshop h e l d i n Kenya, i n c l u d i n g r e p r e s e n t a t i v e s o f World Educat ion p r o j e c t s i n Ghana and E t h i o p i a . The approach i s t o e v a l u a t i o n i n genera l , r a t h e r than n u t r i t i o n programs per se, but t h e conten t i s q u i t e g e n e r a l i z a b l e . The phases o f t h e seminar i n c l u d e d i n t r o d u c t i o n s t o experience-based l e a r n i n g , j u s t i f i c a t i o n f o r t h e need for e v a l u a t i o n , f i e l d work, a c t i o n and r e f l e c t i o n , and synthes is . The guide i s generously i l l u s t r a t e d and prov ides step-by-step i n s t r u c t i o n s f o r conduct ing t h e workshop.

101

365. CCOKE, T.M. Consu l tan t Report f o r C h i l e (June 23 - July 3. 1981 1: E v a l u a t i o n o f a Mass Media N u t r i t i o n Educat ion Program. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Service, Educat ion Development Center, t h r o u g h subcont rac t t o Manoff I n t e r n a t i o n a l , Inc. , Washington, D.C., 1981. 19p

T h i s r e p o r t p resents t h e c o n s u l t a n t ' s e v a l u a t i o n o f C h i l e ' s proposed b r e a s t feed ing promot ion mass media campaign. Conducted a t t h e b e g i n n i n g s tages o f t h e p r o j e c t ' s implementat ion, t h e e v a l u a t i o n i s an assessment o f t h e development s t r a t e g y o f t h e campaign, which was determined t o have been conducted c a r e f u l l y and thorough ly . The c o n s u l t a n t o f f e r s many s p e c i f i c suggest ions and comments r e g a r d i n g t h e messages and m a t e r i a l s about t o be used, such as t h e l a c k o f s p e c i f i c gu ides t o new b e h a v i o r s i n some o f t h e behavior-change messages. Such messages must n o t o n l y m o t i v a t e t o change an i n a p p r o p r i a t e behav io r ; t h e y must a l s o o f f e r an a p p r o p r i a t e new behav io r . The implementat ion and e v a l u a t i o n s t r a t e g i e s a r e a l s o examined, and f u r t h e r suggest ions o f f e r e d .

366. DEVADAS, R. P. ; S A R O J I N I , K. S. E v a l u a t i n g t h e impact o f n u t r i t i o d h e a l t h i n t e a r a t e d c u r r i c u l u m on t h e Drirnarv school c h i l d r e n and teachers i n s e l e c t e d - schools i n Coimbatore d i s t r i c t . I n d i a n Journa l of N u t r i t i o n and D i e t e t i c s , v o l . 15, 1978, pp. 295-301.

Teachers from 40 randomly s e l e c t e d schools i n Combinatore D i s t r i c t , I n d i a , were g i v e n a f ive-day course i n p r i n c i p l e s o f n u t r i t i o n and h e a l t h . They t h e n taught n u t r i t i o n i n t h e classrooms, i n t e g r a t e d i n t o t h e r e g u l a r c u r r i c u l u m . The course promoted t h e s e l e c t i o n , product ion, p r e p a r a t i o n , conserva t ion , and consumption o f a wel l -balanced d i e t . E v a l u a t i o n showed improved knowledge o f b o t h t h e teachers and t h e s tudents , d i f f e r i n g s i g n i f i c a n t l y f rom a c o n t r o l group. B e l i e f s and p r a c t i c e s a l s o improved; f o r example, t h e teachers had improved t h e l u n c h served a t t h e schools.

367. DEVADAS, R.P. ; S A R O J I N I , K.S. ; RAJAKUMARI, S. Impact o f n u t r i t i o n and h e a l t h educat ion on t h e growth and development o f p r imary school c h i l d r e n i n se lec ted areas o f Tamil Nadu, I n d i a . I n d i a n Journal of N u t r i t i o n and D i e t e t i c s , v o l . 18, no. 1, 1981, p. 1-8.

A b a s e l i n e survey o f t h e c u l t u r a l , s o c i a l , demographic, and economic s t a t u s o f 2,651 f a m i l i e s o f lower-c lass c h i l d r e n a t t e n d i n g 660 s c h o o l s i n Tami l Nadu (Kanyakumari, N i l g i r i s , and Combinatore d i s t r i c t s ) was used as t h e b a s i s o f a n u t r i t i o n educat ion program a t t h e elementary-school l e v e l . S p e c i a l f i ve-day courses were prov ided f o r a l l 3,600 teachers f rom t h e schools, and teachers were g i v e n s p e c i a l l y designed classroom m a t e r i a l s . E v a l u a t i o n a t t h e end o f t h e course and a f t e r 18 months o f implementat ion showed s i g n i f i c a n t r e s u l t s : teachers ' h o w l e d g e and n u t r i t i o n - r e l a t e d p r a c t i c e s improved d r a m a t i c a l l y , and t h e teachers were ab le t o i d e n t i f y and address n u t r i t i o n - r e l a t e d problems i n t h e i r s tudents . They implemented .the recommended c u r r i c u l u m and produced s i g n i f i c a n t improvements i n t h e i r s tudents ' n u t r i t i o n knowledge, p r a c t i c e s , and s t a t u s . A t a b l e d i s p l a y s t h e r a t e s o f decrease o f s e v e r a l n u t r i e n t d e f i c i e n c y s igns. The b e h a v i o r a l impact extended t o t h e c h i l d r e n ' s homes ; i n most homes, p r a c t i c e s improved i n cooking methods, i n i n c l u d i n g greens i n t h e d i e t , and i n garbage d i s p o s a l .

102

368. GREEN, educat ion. 155-1 61.

L.W. E v a l u a t i o n and measurement: Some d i l e m a s f o r h e a l t h American Journa l o f P u b l i c Heal th , vo l . 67, no, 2, 1977, pp.

The n a t u r e o f h e a l t h educat ion poses seven dilemmas discussed i n t h i s paper: (I) r i g o r o f exper imenta l des ign vs. s i g n i f i c a n c e o r program a d a p t a b i l i t y ; (2) i n t e r n a l v a l i d i t y o r t r u e e f f e c t i v e n e s s VS. e x t e r n a l v a l i d i t y o r f e a s i b i l i t y ; (3) exper imenta l vs. p lacebo e f f e c t s ; (4) e f f e c t i v e n e s s vs. economies o f sca le ; ( 5 ) r i s k vs. p a y o f f ; ( 6 ) measurement o f long-term vs. shor t - term outcomes ; and (7) t h r e s h h o l d vs. d i m i n i s h i n g r e t u r n l e v e l s o f expendi tures on educat ion. The d i s c u s s i o n p laces emphasis on t h e need t o develop a more complete da ta base aga ins t which t o s tandard ize measures ; r e p l i c a t i o n o f exper iments i n d i f f e r e n t s e t t i n g s ; and b e t t e r documentation, r e p o r t i n g , and d i f f u s i o n o f exper ience.

369. GUTHRIE, H.A.; SCHEER, J.C. V a l i d i t y o f a d i e t a r y score i n assessing n u t r i e n t i n t a k e . J o u r n a l o f t h e American D i e t e t i c Assoc ia t ion , v o l . 78, 1981, pp. 240-45.

370. HOORWEG, J.; MCDû'dELL, I. E v a l u a t i o n o f N u t r i t i o n Educat ion i n A f r i c a : C o m u n i t y Research i n Uganda, 1971 -1 972. The Hague, Nether lands, A f r i ka- Studiencentrum Communication No. 6. Moul ton Pub l ishers , 1979, 158p.

The major purpose o f t h i s sutdy was t o c o n t r i b u t e t o methods i n e v a l u a t i v e r e s e a r c h i n n u t r i t i o n i n t e r v e n t i o n programs. Conducted i n t h e i n p a t i e n t and o u t p a t i e n t departments o f a N u t r i t i o n R e h a b i l i t a t i o n Center (NRC) i n Kampala and an o u t p a t i e n t c l i n i c a t Lu tee te , t h e s t u d y admin is tered pre- and p o s t - t e s t s t o mothers r e c e i v i n g n u t r i t i o n educat ion. N u t r i t i o n knowledge and food pre ferences were improved, and more mothers c o u l d recognize s i g n s o f m a l n u t r i t i o n . I n r u r a l areas, t h e f a c t o r s most s t r o n g l y c o r r e l a t e d w i t h a c h i l d ' s r e c o v e r y were amount o f land , s i z e o f household, and h e l p r e c e i v e d b y t h e mother ; i n urban areas, t h e s t r o n g e s t c o r r e l a t i o n - a n e g a t i v e corre la t ion--was between r e c o v e r y and mother' s educat ion. Low c o r r e l a t i a n s between food resources and c h i l d r e n ' s d i e t s are a t t r i b u t e d t o methodo log ica l shortcomings (mothers ' inaccura te responses) . Throughout t h e r e p o r t , cons iderab le a t t e n t i o n i s g i v e n t o c o n s t r u c t i n g a p p r o p r i a t e measurement techniques.

371. HORNIK, R.C. A n approach t o e v a l u a t i o n f o r b r e a s t f e e d i n g campaigns. In : I s r a e l , R.C., ed., Using Communications t o Solve N u t r i t i o n Problems. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Service, Educat ion Development Center, i n press.

Few b r e a s t feed ing campaigns a r e evaluated; those t h a t a re u s u a l l y ask t h e ques t ion , " d i d i t work?" Such a narrow p e r s p e c t i v e on p r o j e c t e v a l u a t i o n i s l e s s l i k e l y t o b e successfu l than e v a l u a t i o n based on ques t ions designed t o g a i n i n f o r m a t i o n on how t h e program c o u l d improve i t s opera t ions . Choosing these quest ions, based on an understanding o f t h e p r o j e c t and t h e p o p u l a t i o n , and i n t e r p r e t i n g t h e r e s u l t s are key t o a p r o d u c t i v e and u s e f u l eva lua t ion . E v a l u a t i o n i n te rms o f p r o j e c t - o r i e n t e d concerns i s addressed, r a t h e r than broader , p o l i c y - o r i e n t e d eva lua t ion .

372. JACOBSON, H. N. N u t r i t i o n Eva lua t ion : Promises and Dangers. The U n i v e r s i t y o f Nor th Caro l ina , Occasional Paper Ser ies, v o l 2, no. 1, September 1979.

I n an e r a o f scarce resources and i n c r e a s i n g demands f o r a c c o u n t a b i l i t y , e v a l u a t i o n o f n u t r i t i o n programs o f a l l t y p e s i s becoming i n c r e a s i n g l y impor tan t . Problems a r i s e under two circumstances: when t h e goa ls and o b j e c t i v e s o f t h e program t o be evaluated a r e n o t c l e a r enough t o p rov ide guidance on t h e d e s i r e d outcomes, and when e v a l u a t i o n s a r e asked t o go beyond t h e s t a t e o f t h e a r t . The l a t t e r problem i s p a r t i c u l a r l y common i n n u t r i t i o n educat ion, and t h e p a r t i c u l a r danger here i s t h a t any f i n d i n g may w e l l be a f a l s e p o s i t i v e o r f a l s e n e g a t i v e r e s u l t . Th is paper d iscusses t e c h n i c a l development o f reasonable e x p e c t a t i o n s on t h e p a r t s o f program planners, t h e people served b y t h e programs, and t h e p r o v i d e r s o f serv ices .

373. JELLIFFE, D.B. ; JELLIFFE, E.F. P. Consul tant Report f o r B r a z i l (March 21-31, 1982 1: An Assessment o f t h e B r a z i l i a n N a t i o n a l Breast Feeding Promotion Campaign. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Service, Educat ion Development Center, 1982. 58p.

T h i s c o n s u l t a n t team was i n v i t e d b y t h e B r a z i l i a n N a t i o n a l I n s t i t u t e o f N u t r i t i o n (INAN) t o evaluate t h e n a t i o n a l n u t r i t i o n promot ion p r o j e c t as i t enetered i t s second phase. The r e p o r t p resents an i t i n e r a r y and t h e team's comments and recommendations f o r each o f t h e many components o f t h e campaign. A f i n a l s e c t i o n on e v a l u a t i o n cons iders n o t o n l y t h e development o f an e v a l u a t i o n s t r a t e g y f o r t h i s program, but t h e need f o r a g e n e r a l i z a b l e methodology f o r e v a l u a t i o n o f b r e a s t f e e d i n g promot ion programs i n genera l .

374. JELLIFFE, D.B.; JELLIFFE, E.F.P. Consul tant Report f o r B r a z i l ( J u l y 31 - August 14, 1983): A Follow-Up V i s i t t o Assess t h e Progress o f t h e N a t i o n a l Breas t feed ing Promot ion Program. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Service, Educat ion Development Center, 1983. 84p.

T h i s progress r e p o r t i n d i c a t e s t h a t t h e B r a z i l i a n p r o j e c t has accomplished an e f f e c t i v e and widespread b r e a s t f e e d i n g promot ion campaign, making use o f many mass media. T e l e v i s i o n a d v e r t i s i n g , newspaper columns, b o o k l e t s , photography contes ts , car toons, and l i t e r a c y - t r a i n i n g m a t e r i a l s were among t h e media used. Popular sent iments were e v i d e n t l y a f f e c t e d , as t h e r e was a l s o spontaneous advocacy o f b r e a s t f e e d i n g b y t e l e v i s i o n programs and s p o r t s f i g u r e s . Changing o f t h e genera l s o c i a l and med ica l a t t i t u d e s towards b r e a s t f e e d i n g seems t o have been accomplished; fo rmal e v a l u a t i o n w i l l commence i n 1984. Mothers' support groups, i n f o r m a t i o n d i s s e m i n a t i o n b y h e a l t h s e r v i c e s , suppor t f o r working women, and c o n t a c t s w i t h t h e i n f a n t food i n d u s t r y a r e a l s o components o f t h e campaign. The r e p o r t i s i l l u s t r a t e d with examples o f m a t e r i a l s and s c r i p t s used, i n c l u d i n g photographs o f t h e m a t e r i a l s i n use.

375.. KLEIN, R. E. ; READ, M. .S. ; RIECKEN, H.W. ; BROWN, J.A. ; PRADILLA, A. ; DAZA, C.H., eds. E v a l u a t i n g t h e Impact o f N u t r i t i o n and H e a l t h Programs. New York, Plenum Press, 1979. 462p.

104

Th is book presents papers f rom a conference t h a t focused on t h e need f o r impact measures o f h e a l t h and n u t r i t i o n programs, p a r t i c u l a r l y i n L a t i n America. N u t r i t i o n educat ion i s one o f many n u t r i t i o n i n t e r v e n t i o n s considered. One s e c t i o n d iscusses e d u c a t i o n a l achievement as an outcome o f n u t r i t i o n i n t e r v e n t i o n programs. The papers address t h e assessment o f s p e c i f i c outcomes o f i n t e r v e n t i o n s , implement ing and u s i n g e v a l u a t i o n s , and p r a c t i c e and problems o f impact eva lua t ion .

376. KûLBE, L. J. E v a l u a t i n g e f fec t i veness- - the problems o f b e h a v i o r a l c r i t e r i a . H e a l t h Educat ion, JanuaryIFebruary, 1979, pp. 12-1 6.

School-based h e a l t h educat ion faces unique problems, p a r t i c u l a r l y when asked t o produce changes i n behav io r r a t h e r than s imp le inc reases i n knowledge (as most school c u r r i c u l a ) . P a r t i c u l a r problems inc lude: (1 1 school h e a l t h educat ion i s p r i m a r i l y designed t o i n f l u e n c e h e a l t h r a t h e r than i l l n e s s o r s i c k - r o l e behaviors ; (2) i t a t tmepts t o i n f l u e n c e many d i f f e r e n t and u n r e l a t e d behav io rs ; ( 3 ) i t addresses f a i r l y l a r g e groups; ( 4 ) i t focuses o n l y upon y o u t h f u l populat ions; (5) h e a l t h - r e l a t e d behav io rs a r e d i f f i c u l t t o observe; (6 ) the causa l r e l a t i o n s h i p between school-based educat ion and any observed b e h a v i o r a l change i s d i f f i c u l t t o e s t a b l i s h ; (7) p u b l i c school teachers g e n e r a l l y a r e n o t t r a i n e d i n e v a l u a t i o n methodology o r theory ; ( 8 ) t h e y a r e q u i t e p r o p e r l y th rea tened by t h e adopt ion o f b e h a v i o r a l c r i t e r i a t o i n d i c a t e program e f fec t i veness ; (9 1 de termin ing whether programs a r e e f f e c t i v e i n changing behavior m i g h t be l e s s impor tan t than e v a l u a t i n g why such programs a r e o r a r e n o t e f f e c t i v e ; (10) teachers a r e n o t t r a i n e d i n behav io r 1 change t h e o r y o r p r a c t i c e ; (11) i f school h e a l t h educat ion i s t o be evalua ed on b e h a v i o r a l c r i t e r a , e d u c a t i o n a l techniques should move from a decis ion-making focus ( i n which s tudents s e l e c t f rom a l t e r n a t i v e behav io rs ) t o p e r s asion- communication approaches; and ( 1 2 ) a l l t h e problems mentioned above a r e f e l t more s h a r p l y a t t h e elementary l e v e l . t 377. LEVINE, R.R.; MCCHESNEY, A.S.; BRUSH, M.K. n u t r i t i o n educat ion. J o u r n a l o f N u t r i t i o n Educat ion, v o l , 11, 1979, p. 124.

An assessment o f h i g h school

378. MANOFF, R.K. Consu l tan t Report f o r B r a z i l Volume II (March 21-31. 1982): An Assessment o f t h e Communications Component o f t h e B r a z i l i a n N a t i o n a l Breast Feeding Program. Newton, Massachusetts, I n t e r n a t i o n a l N u t r i t i o n Communication Serv ice, Educat ion Development Center, through subcont rac t to Manoff I n t e r n a t i o n a l , Inc. , Washington, D.C., 1982. 42p.

T h i s r e p o r t o u t l i n e s t h e i n n o v a t i v e communications s t r a t e g y used b y t h e B r a z i l i a n n a t i o n a l b r e a s t feed ing program (see a l s o J e l l i f f e and J e l l i f f e , above). t h a t address a l l o f t h e many p l a y e r s i n the promot ion o f b r e a s t l feeding; among these a r e n o t o n l y t h e mothers themselves but a l s o t h e i r f a m i l i e s , h e a l t h personnel , h o s p i t a l s , food and o t h e r i n d u s t r i e s , government o f f i c i a l s , and t h e community a t l a r g e . Appendices present t h e t e x t s o f addresses d e l i v e r e d t o t h e program's n a t i o n a l work ing group t o o u t l i n e t h e p r i n c i p l e s o f design, implementat ion, and e v a l u a t i o n o f mass media programs.

Th is a c t i o n - o r i e n t e d program i n c l u d e s c a r e f u l l y develoqed components

105

379. MCKENZIE, J.D. ; MUMFORD, P. The e v a l u a t i o n o f n u t r i t i o n educat ion programmes: A r e v i e w o f t h e present s i t u a t i o n . World Review o f N u t r i t i o n and D i e t e t i c s , v o l . 5, 1965, pp. 21-31.

Th is paper p resents a r e v i e w o f t h e s t a t u s o f n u t r i t i o n educat ion e v a l u a t i o n i n t h e Un i ted States. Most n u t r i t i o n educat ion programs were found t o r e l y s imply on t r a n s m i s s i o n o f i n f o r m a t i o n and d i d n o t conduct e v a l u a t i o n s , assuming t h a t t h e i r audience, w i t h s u f f i c i e n t income and r e s p e c t f o r s c i e n t i f i c knowledge, would take a c t i o n on t h e i n f o r m a t i o n . E v a l u a t i o n was a lso neg lec ted because i t llcomes a t t h e end o f a programme" and demands s p e c i a l e f f o r t s and resources. The au thor reviews t h e few eva lua ted programs, i n c l u d i n g e v a l u a t i o n s w i t h "negat ive r e s u l t s f 1 as w e l l as p o s i t i v e . The au thor concludes t h a t success o r f a i l u r e i s determined b y t h e methods used, t h e p e r s o n a l i t i e s invo lved, and t h e p r e v a i l i n g c i rcunstances. She c a l l s fo r c l o s e r coopera t ion between n u t r i t i o n p r o f e s s i o n a l s and those i n t h e s o c i a l sciences.

380. REPORT ON NUTRITION CONCEPTS EVALUATION STUDY. Ottawa, Canada, Department o f N a t i o n a l Hea l th and Welfare, 1979. 62p.

381. SAHN, D.; PESTRONK, R. A Review o f Issues i n N u t r i t i o n Program Eva lua t ion . A I D Program E v a l u a t i o n D iscuss ion Paper No. 10. Chevy Chase, Maryland, A I D /DIHF/AR DA, 1981. 22Op.

382. SCHURCH, B., ed. E v a l u a t i o n o f N u t r i t i o n Educat ion i n T h i r d Wor ld Communities. Bern, S t u t t g a r t , Vienna, Hans Huber Pub l ishers , 1982. 235p.

Without eva lua t ion , we s h a l l never know where we stand and w i l l n o t know whether any i n t e r v e n t i o n o r type o f i n t e r v e n t i o n has been wor thwh i le . T h i s workshop c o l l e c t e d papers on t o p i c s promot ing t h e development o f a p p r o p r i a t e m o t i v a t i o n s and methodologies i n t h e e v a l u a t i o n o f n u t r i t i o n educat ion programs. Topics inc luded: i n t e g r a t i n g e v a l u a t i o n i n t o programming; assessment o f knowledge, a t t i t u d e s , and behavior ; v a l i d i t y o f d i e t a r y survey methods ; food composi t ion tab les ; choosing i n d i c a t o r s o f n u t r i t i o n a l s t a t u s ; assessing the p r e v e n t i v e impact o f n u t r i t i o n educat ion; impact e v a l u a t i o n ; whether c o n t r o l o f non-treatment v a r i a b l e s i s necessary; c o s t e v a l u a t i o n ; and t h e genera l i z a b i l i t y o f ev a l ua t i o n p r o t o c o 1 s.

383. ST. PIERRE, R.G. ; REZMOVIC, V. An overv iew o f t h e n a t i o n a l N u t r i t i o n Education and T r a i n i n g Program eva lua t ion . Journal o f N u t r i t i o n Educat ion, v o l . 14, no. 2, 1982, pp. 61-66.

The U.S. n a t i o n a l N u t r i t i o n Educat ion and T r a i n i n g Program (NETP) was funded t o p rov ide n u t r i t i o n educat ion t o school c h i l d r e n , t h e i r teachers, and food s e r v i c e personnel ; and t o p r o v i d e . f o r t h e development o f n u t r i t i o n educat ion m a t e r i a l s . A p r e l i m i n a r y e v a l u a t i o n a f t e r two years o f o p e r a t i o n found t h a t the program was meet ing i t s i n i t i a l o b j e c t i v e s : programs were o p e r a t i n g i n n e a r l y a l l s t a t e s ; funds were b e i n g used as in tended, f o c u s i n g on l o c a l r a t h e r than la rge-sca le development; programs were addressing t h e problems i d e n t i f i e d i n s t a t e - l e v e l needs assessments. Both c e n t r a l i z e d ( s t a t e - l e v e l c u r r i c u l a )

106

and d e c e n t r a l i z e d ( m u l t i p l e o r genera l i zed c u r r i c u l a ) were found t o have had l a r g e p o s i t i v e in f luences on c h i l d r e n ' s n u t r i t i o n - r e l a t e d knowledge. was some w i l l i n g n e s s t o t r y new foods ( a major a t t i t u d e change) and some p o s i t i v e e f f e c t on food preferences and other a t t i t u d e s , but these e f f e c t s were n o t as s t r o n g as t h e e f f e c t s on knowledge. T h i s a r t i c l e presents t h e des ign and implementat ion o f t h e e v a l u a t i o n i n d e t a i l .

There

384. TRAGLER, A. T. ; BHATT, S. S. ; FERNANDEZ, A. Assessment o f h e a l t h educat ion i n n u t r i t i o n . Journal o f T r o p i c a l P e d i a t r i c s , vo l . 27, 1981, pp. 221-223.

Mothers o f 200 c h i l d r e n under one year o l d rece ived n u t r i t i o n educat ion t h r o u g h t h e p e d i a t r i c department o f a genera l h o s p i t a l i n Bombay, I n d i a . P e d i a t r i c s o c i a l workers and cooks gave p r e s e n t a t i o n s i n c l u d i n g the importance o f b r e a s t feeding, e a r l y i n t r o d u c t i o n o f semi-so l id foods, f requent s m a l l meals, c h e a p l y a v a i l a b l e n u t r i t i o u s foods, and hygiene. F l i p c h a r t s and o ther a i d s were used. A q u e s t i o n n a i r e a t t h e end o f t h e sess ion i n d i c a t e d t h a t 40% o f t h e mothers had f u l l y understood t h e p r e s e n t a t i o n , 32% asked ques t ions and needed f u r t h e r exp lanat ions , and 28% d i d n o t understand what had been presented.

107

Geographic Index

Note: Numbers r e f e r t o e n t r i e s , n o t page numbers.

AFRICA, 62, 66, 84, 124.

Burundi , 62.

Cameroon, 49, 62, 164, 173, 180.

C e n t r a l A f r i c a n Repub l i c , 62.

Congo, 94, 224, 225.

Egypt, 164.

E t h i o p i a , 194, 364.

Gabon, 220.

Gambia, 164.

Ghana, 95, 164, 201, 219, 364.

I v o r y Coast, 62, 358.

Kenya, 164, 188, 213, 214, 215, 216, 337, 338, 364.

Lesotho, 164, 219.

L i b e r i a , 164.

Madagascar, 53.

M a l i , 62, 164.

M a u r i t a n i a , 62, 202.

Morocco, 94, 164, 208, 212.

Namibia, 209.

N i g e r , 62.

N i g e r i a , 33, 134, 152, 176, 178, 194, 201, 221.

Rwanda, 62.

Senegal, 140, 164, 226, 227.

S i e r r a Leone, 33, 201, 202, 217.

South A f r i c a , 211.

108

Sudan, 53, 164, 201, 206, 207.

Tanzania, 76, 122, 164.

T u n i s i a , 62, 97, 190, 192, 218.

Uganda, 370.

Z a i r e , 62, 164, 194, 210, 223, 355, 361, 362.

Zambia, 222, 356.

ASIA, NEAR EAST, AND PACIFIC, 37, 45, 78, 124, 164, 245, 254, 342.

A u s t r a l i a , 57, 162.

Bangladesh, 78, 94, 164, 190, 248.

Burma, 164.

China, 244.

I n d i a , 33, 56, 70, 109, 115, 130, 164, 170, 183, 193, 194, 201, 228, 229, 230, 231, 233, 234, 235, 242, 243, 247, 249, 250, 329, 366, 367, 384.

I ndones ia , 87, 94, 158, 160, 164, 188, 240, 241, 251, 252, 291, 312, 326, 328, 330, 331, 332, 333.

I r a n , 256.

I s r a e l , 122, 203.

Jordan, 164, 190.

Korea, Rep. o f , 33, 253.

Ma lays ia , 78.

Nepal , 164.

Oman, 201.

Pak is tan , 164, 341.

Papua New Guinea, 78, 164, 239.

P h i l i p p i n e s , 34, 78, 105, 122, 139, 148, 164, 168, 184, 187 245, 246, 251, 255, 257, 344, 357.

S r i Lanka, 164, 238.

Tha i land, 78, 164, 188, 232.

V i e t Nam, 20.

194, 203, 237

Yemen Arab Rep., 164.

EUROPE, 16, 61, 264, 266.

Belgium, 5.

Cyprus, 202.

Denmark, 57.

F i n l a n d , 16.

France, 5, 9, 60, 74, 181, 258, 259-

Germany, Fed. Rep. of, 5, 16.

Hungary, 194.

I r e l a n d , 5.

I t a l y , 5, 162.

Luxemburg, 5, 266.

Ne the r lands , 27, 122, 153.

Norway, 16.

Sweden, 16, 194.

S w i t z e r l a n d , 16, 261.

U n i t e d Kingdom, 5, 33, 79, 122, 131, 201, 202, 262, 263, 265=

Yugoslav ia , 16.

LATIN AMERICA AND CARIBBEAN, I, 124, 128, 132, 136, 165, 287, 288, 375.

Barbados, 132.

B e l i z e , 273.

B o l i v i a , 94, 164, 313.

B r a z i l , 73, 94, 135, 146, 149, 271, 280, 283, 286, 295, 314, 360, 373, 374, 378.

C h i l e , 13, 194, 270, 275, 316, 365.

Costa Rica, 164.

Dominica, 294.

110

Dominican Republ ic , 164, 201, 274, 276, 277.

Ecuador, 164, 321.

Guadeloupe, 269.

Guatemala, 33, 142, 164, 190, 194, 268, 272, 281, 291 , 324, 325.

H a i t i , 164, 267, 282, 292, 293.

Honduras, 164.

Jamaica, 33, 164, 202, 284, 290, 335, 336.

Panama, 164.

Peru, 164, 190, 343.

T r i n i d a d and Tobago, 279.

NORTH AMERICA

Canada, 26, 29, 104, 117, 166, 195, 302, 311, 320, 380.

Mexico, 33, 101.

U n i t e d S ta tes , 6, I O , 18, 65, 85, 108, 201, 141, 144, 150, 157, 167, 185, 201, 202, 203, 296, 297, 298, 299, 300, 301, 303, 305, 306, 307, 308, 309, 310, 359, 379, 383.

111

T o p i c a l I ndex

- Note: Numbers r e f e r t o e n t r i e s , n o t page numbers.

A d v e r t i s i n g , 21, 25, 90, 94, 105, 152, 191, 232, 278, 304.

A g r i c u l t u r e , 19, 30, 39, 78, 123, 142, 145, 146, 165, 211, 213, 228, 322, 332, 343, 351, 357.

Anthropometry, 49, 144, 169, 214, 351.

A t t i t u d e , 36, 46, 65, 108, 116, 132, 148, 156, 160, 168, 170, 171, 172, 179, 183, 186, 192, 218, 219, 223, 246, 255, 268, 288, 313, 317, 357, 3709 382, 383.

Behavior m o d i f i c a t i o n , 75, 82, 298.

B e l i e f s , 80, 94, 109, 147, 152, 157, 161, 164, 166, 172, 176, 178, 179, 180, 189, 190, 193, 213, 248, 327, 331, 366.

B i b l i o g r a p h i e s , 41, 61, 110, 111, 154, 164, 167, 200, 320, 323, 334, 349, 350, 363.

B iochemis t ry , 144, 169.

B o t t l e feeding, 44, 152, 172, 194, 232, 239, 278, 279.

Breast feed ing , 3, 13, 26, 44, 132, 133, 134, 135, 145, 161, 169, 172, 173, 183, 194, 204, 206, 207, 217, 232, 234, 235, 236, 237, 248, 263, 270, 278, 279, 280, 284, 289, 290, 309, 313, 314, 316, 317, 318, 321, 323, 326, 335, 336, 337, 348, 365, 371, 373, 374, 378, 384.

Ca lo r ies , 142, 158, 193, 199, 241, 331.

Campaigns, 62, 80, 105, 139, 204, 218, 223, 239, 252, 257, 258, 279, 292, 313, 314, 316, 317, 318, 319, 320, 327, 329, 332, 333, 336, 337, 338, 341, 343, 344, 361, 371, 373, 374.

CARE, 224.

CFNI (Caribbean Food and N u t r i t i o n I n s t i t u t e ) , 23, 128, 335.

C l i n i c s , see H e a l t h care.

Col lege, 32, 64, 148, 210, 203, 322.

Communications, 22, 86, 93, 94, 107, 138, 217, 218, 241, 254, 268, 329, 357.

112

Community, 8, 34, 73, 87, 95, 102, 109, 115, 122, 123, 159, 179, 180, 213, 222, 223, 228, 238, 241, 252, 255, 268, 271, 274, 276, 277, 284, 288, 291, 311, 312, 315, 328, 329, 332, 351, 353, 378, 382.

Conferences, 46, 54, 62, 81, 122, 375.

CRS ( C a t h o l i c R e l i e f S e r v i c e s ) , 212.

C u l t u r e , 39, 59, 77, 84, 189, 217, 226, 227, 367.

Day care , see Pre-school.

D ia r rhea , 204, 277, 313, 318, 319, 321, 324, 325, 329, 352, 353, 356.

Doc tors , 26, 81, 122, 147, 166, 172, 218, 232, 233, 321, 325.

Economics, 39, 85, 123, 131, 142, 165, 211, 214, 226, 279, 285, 312, 346, 367.

E lementary schools , 27, 83, 108, 148, 181, 186, 197, 201, 202, 228, 231, 252, 258, 305, 366, 367, 376.

E v a l u a t i o n , 5, 8, 29, 65, 66, 80, 89, 94, 108, 122, 124, 128, 130, 139, 159, 160, 210, 217, 218, 223, 224, 225, 227, 229, 231, 240, 241, 247, 252, 253, 254, 268, 270, 273, 276, 277, 279, 284, 292, 311, 312, 315, 331, 335, 345, 346, 351, 357-384.

Face- to- face educat ion , 55, 93, 115, 138, 360.

F a m i l y p lann ing , 3, 142, 194, 213, 250, 253, 284, 294, 312-

FAO, 23, 154, 322, 346, 363.

F e r t i l i t y , 142, 194.

Food groups and guides, 59, 63, 99, 100, 116, 158, 213, 258, 308, 311, 324, 336, 342, 355, 358, 369.

F r e i r e , Paulo, 73, 98, 123, 124, 288.

Games, 24, 68, 118, 137, 258, 330, 333, 338.

Gardens, 165, 202, 211, 213, 231, 267, 332, 347.

G o i t e r , 313, 321, 341.

H e a l t h care , 194, 204, 208, 210, 214, 218, 219, 220, 222, 229, 230, 233, 234, 236, 237, 250, 257, 263, 264, 275, 279, 285, 294, 319, 374.

Hea l th workers, 12, 26, 95, 122, 152, 159, 170, 180, 199, 230, 232, 233, 258, 264, 268, 274, 276, 277, 280, 281, 284, 290, 294, 312, 315, 325, 327, 331, 335, 337, 338, 339, 344, 348, 351, 352, 353, 354, 357, 378.

Helen K e l l e r I n t e r n a t i o n a l , 87.

High school, see Secondary schools.

INCAP ( I n s t i t u t o de N u t r i c i o n de Centro America y Panama), 23.

Income, 162, 168, 184, 191, 212, 222, 228, 257, 316.

I n f a n t s , 25, 171, 172, 180, 181, 188, 236, 237, 253, 257, 258, 263, 278, 2839 294, 357.

I n f o r m a l education, 15, 36, 39, 123, 135.

IUNS ( I n t e r n a t i o n a l Union o f N u t r i t i o n Science) , 33, 76, 198.

Knowledge, 24, 39, 55, 56, 108, 116, 132, 147, 148, 152, 157, 160, 161, 168, 170, 172, 174, 177, 186, 187, 192, 193, 195, 212, 213, 214, 215, 218, 219, 220, 223, 231, 235, 239, 241, 246, 247, 248, 249, 251, 253, 255, 257, 279, 305, 322, 331, 357, 358, 366, 367, 370, 376, 379, 382, 383.

L a c t a t i o n , see Breas t feeding.

L e g i s l a t i o n , 25, 44, 134, 135.

L i t e r a c y , 56, 70, 142, 170, 316, 374.

M a l n u t r i t i o n , 34, 45, 70, 76, 115, 121, 124, 130, 142, 145, 161, 165, 168, 173, 176, 182, 193, 199, 210, 211, 212, 213, 220, 221, 222, 231, 239, 247, 248, 249, 250, 267, 270, 271, 275, 282, 284, 285, 293, 321, 351, 353, 356, 358, 362, 370.

Mass media, 19, 21, 22, 31, 55, 83, 90, 93, 102, 106, 116, 124, 128, 130, 132, 134, 148, 163, 184, 208, 218, 223, 224, 225, 234, 239, 241, 254, 257, 268, 273, 279, 284, 323, 360, 361, 365, 374, 378.

Medica l care, see Hea l th care.

M ig ra t i on , 101, 145, 146.

Nurses, 74, 147, 214, 270, 272, 290, 298, 348.

114

Obesi ty , 82, 153, 163, 171, 264, 298, 3100

O r a l r e h y d r a t i o n , see Diarrhea.

Parents, 51, 52, 118, 252, 298, 308.

P a r t i c i p a t o r y educat ion, 109, 291, 330.

Phys ic ians , see Doctors.

P iaget , 63, 64.

Pregnancy, 161, 217, 234, 235, 253, 255, 258, 270, 275, 279, 280, 284, 290, 299, 300, 307, 325, 337, 356-

Preschool , 108, 118, 149, 157, 168, 170, 222, 229, 238, 253, 271, 295, 302, 304, 312.

P r o t e i n , 158, 199, 217, 241, 331, 358.

Psychology, 46, 48, 77, 79, 85, 138.

Radio, 22, 24, 55, 66, 78, 102, 127, 130, 139, 184, 218, 223, 225, 239, 241, 246, 252, 254, 257, 279, 292, 311, 313, 314, 318, 319, 321, 338, 357-

S a n i t a t i o n , 24, 136, 250, 321, 325, 367.

Save t h e C h i l d r e n Federat ion, 238, 291, 324, 330.

Schools, see Col leges, Elementary schools, Secondary schools.

Secondary schools, 27, 108, 131, 150, 197, 201, 300, 322, 377.

S o c i a l Market ing, 21, 31, 80, 109, 240.

Socioeconomics, 49, 59, 76, 121, 161, 162, 189, 190, 193, 194, 211, 223, 227, 257, 346, 367.

Sociology, 46, 138.

31 3,

7,

Supplementary feed i n g , 174, 183, 194, 206, 207, 208, 210, 212, 215, 229, 2349 235, 237, 238, 241, 242, 247, 250, 271, 285, 286, 289, 295, 296, 307, 312.

Taboos, see B e l i e f s .

Teachers, 17, 24, 96, 88, 108, 157, 186, 203, 212, 231, 256, 268, 298, 308, 339, 366, 367, 376, 383-

T e l e v i s i o n , 22, 57, 90, 130, 223, 301, 304, 311, 314, 316, 3Z19 374*

115

T r a i n i n g , 13, 23, 29, 34, 42, 81, 95, 101, 104, 122, 124, 128, 132, 135, 148, 202, 203, 205, 206, 207, 213, 231, 232, 235, 238, 241, 250, 256, 258, 272, 273, 291, 315, 317, 326, 332, 339, 346, 347, 351, 353, 354, 366, 367.

Unesco, 33, 37, 39, 40, 45, 118, 201, 202, 203.

UNICEF, 118, 204, 208, 347, 352.

Urban, 2, 145, 222, 230, 235, 236, 267, 314, 317, 370.

U.S.A.I.D. (U.S. Agency f o r I n t e r n a t i o n a l Development), 93 164, 212, 218, 219, 361.

Values, see A t t i t u d e s .

115, 127 139,

V i tamins , 13, 87, 91, 158, 172, 174, 229, 251, 252, 256, 290, 292, 302, 329, 333, 338, 344, 347, 348-

Weaning, 39, 134, 152, 160, 199, 208, 214, 240, 242, 248, 249, 253, 263, 267, 284, 289, 294, 313, 319, 321, 323, 325, 327, 329, 335, 351, 357-

Weight, 34, 43, 82, 159, 163, 214, 229, 233, 237, 241, 247, 249, 250, 257, 264, 293, 300, 305, 328, 362.

W.H.O. (Wor ld H e a l t h O r g a n i z a t i o n ) , 25, 44, 95, 132, 133, 134, 135, 194, 205, 264, 348, 352, 353, 354.

Women, 3, 56, 115, 134, 142, 183, 187, 217, 228, 250, 268.

Workshops, 124, 130, 134, 135, 166, 225, 235, 254, 274, 276, 277, 281, 311, 315, 326, 364.

Nutrition education: the state of the art review and analysis...

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