An Investigation of Nutrition Knowledge, Beliefs and Dietary Intake of Women in a Poor Community as a Basis for Nutrition Education

A descriptive and exploratory design was employed to investigate nutrition knowledge, beliefs and dietary intake in poor women, using the health belief model, as a basis for developing a culturally relevant nutrition education program. Women from four housing developments in a metropolitan southern city were studied.

Twenty-four judges in nutrition, health education, poor populations of color, and communication were utilized to establish content, cultural and linguistic validity of the knowledge and beliefs instruments. Statistical analysis showed sufficient reliability: knowledge test - .88 (KR-21) and beliefs scale - .90 (Cronbach's alpha). Alpha reliabilities for beliefs subscales, except seriousness (.49), were also acceptable (.56 to .81). The instrument was pilot-tested twice in the population and revised.

A non-representative sample of 100 women was obtained from a sampling frame of inhabited units in the four developments. Participation criteria were: being age 18 years or older, current development residency, and primary food caretaker. The sample was predominately African-American (81%), single (53%), below age 45 (72%), high school graduates (45%), and homemakers (43%).

Personal or group interviews were conducted by the researcher and three trained resident interviewers on: 1) nutrition knowledge, related to the Dietary Guidelines and Objectives for the Nation; 2) nutrition beliefs, as measured through the six original constructs of the HBM; 3) dietary intake status and behaviors; and 4) other relevant information.

Results showed below average nutrition knowledge (69.5%), especially regarding diet-disease linkages. Strong positive perceptions existed for susceptibility, seriousness, benefits, and motivation constructs. However, many barriers to nutritional adequacy were reported, namely: lack of transportation, religious beliefs, and lack of trust in health authorities. A positive moderate correlation existed between nutrition knowledge and beliefs (.53). Subjects showed below average to average intake for the five food groups and water, and a mixture of positive and negative dietary patterns regarding current nutritional recommendations. All of the nutrition-related disorders were reported, with teeth problems, obesity, hypertension, diabetes, and heart disease being most prevalent. Subjects exhibited strong misperceptions about personal obesity.

The housing development population was identified as a typical hard-to-reach population, with unique characteristics and perceptions to be considered during program development. Several obstacles encountered forced major methodological adjustments at various points throughout the study.