Browsing by Author "Kalyoncu, Z. Begum"
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Article Citation Count: 3Communities for Healthy Living (CHL) A Community-based Intervention to Prevent Obesity in Low-Income Preschool Children: Process Evaluation Protocol(Bmc, 2020) Atasoy, Zeynep Begüm Kalyoncu; Aftosmes-Tobio, Alyssa; Gavarkovs, Adam; Kitos, Nicole; Figueroa, Roger; Kalyoncu, Z. Begum; Davison, Kirsten K.; Nutrition and DieteticsBackgroundProcess evaluation can illuminate barriers and facilitators to intervention implementation as well as the drivers of intervention outcomes. However, few obesity intervention studies have documented process evaluation methods and results. Community-based participatory research (CBPR) requires that process evaluation methods be developed to (a) prioritize community members' power to adapt the program to local needs over strict adherence to intervention protocols, (b) share process evaluation data with implementers to maximize benefit to participants, and (c) ensure partner organizations are not overburdened. Co-designed with low-income parents using CBPR, Communities for Healthy Living (CHL) is a family-centered intervention implemented within Head Start to prevent childhood obesity and promote family well-being. We are currently undertaking a randomized controlled trial to test the effectiveness of CHL in 23 Head Start centers in the greater Boston area. In this protocol paper, we outline an embedded process evaluation designed to monitor intervention adherence and adaptation, support ongoing quality improvement, and examine contextual factors that may moderate intervention implementation and/or effectiveness.MethodsThis mixed methods process evaluation was developed using the Perez et al. framework for evaluating adaptive interventions and is reported following guidelines outlined by Grant et al. Trained research assistants will conduct structured observations of intervention sessions. Intervention facilitators and recipients, along with Head Start staff, will complete surveys and semi-structured interviews. De-identified data for all eligible children and families will be extracted from Head Start administrative records. Qualitative data will be analyzed thematically. Quantitative and qualitative data will be integrated using triangulation methods to assess intervention adherence, monitor adaptations, and identify moderators of intervention implementation and effectiveness.DiscussionA diverse set of quantitative and qualitative data sources are employed to fully characterize CHL implementation. Simultaneously, CHL's process evaluation will provide a case study on strategies to address the challenges of process evaluation for CBPR interventions. Results from this process evaluation will help to explain variation in intervention implementation and outcomes across Head Start programs, support CHL sustainability and future scale-up, and provide guidance for future complex interventions developed using CBPR.Trial registrationClinicalTrials.gov, NCT03334669. Registered on October 10, 2017Article Citation Count: 1Culinary acculturation assessment inventory (CAAI): Construction and validation in first generation immigrant consumers in Turkey(Elsevier Sci Ltd, 2021) Atasoy, Zeynep Begüm Kalyoncu; Demir, Ahmet U.; Ayaz, Aylin; Nutrition and DieteticsThe effect of immigration upon immigrants' choice of food should be captured not only with dietary intake, but also through assessing culturally-based culinary exposures. This approach would advance dietary acculturation research towards culinary acculturation. For this purpose, Culinary Acculturation Assessment Inventory (CAAI) is developed, using visual items. Validity and reliability of CAAI relating to the Turkish Cuisine were determined in a group of first-generation immigrants. Recommended scale development methods were employed. The initial version, including 40 items across two domains of dietary intake and culinary exposures was administered to 256 participants (162 immigrants from 53 countries, 94 Turkish participants). Exploratory factor analyses were performed to identify dietary and culinary practice patterns. Final version of CAAI included 37 items, comprising five factors in dietary domain as basic, meat-heavy, starch-heavy, and accessory foods patterns (Cronbach's alpha: 0.834), and one factor in cuisine-related practices domain (Cronbach's alpha: 0.732). Construct validity was investigated by Multiple Analysis of Covariance (MANCOVA) comparing CAAI factor scores between the immigrant and Turkish participants. Among immigrants, comparisons were made according to acculturation proxies, while accounting for potential covariates. Factor scores that differed significantly between the immigrants and Turkish people (basic and cuisine-related practices patterns) also differed significantly among immigrants with high vs. low fluency in Turkish. In conclusion, CAAI is a reliable and valid measure of culinary acculturation of immigrant population. This novel instrument and its short version can be adapted and used in other countries to capture the culinary acculturation of their immigrants.