Transcript Overview of the CNF & its Applications

Development and pilot testing
of an instrument to assess
nutrition messages on four
micronutrients in Canadian
magazines
Lindsay Zalot, BASc
Dietetic Intern
The Ottawa Hospital – Civic Campus
Outline
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Introduction
Rationale and Objective
Methods
Results
Discussion
Implications and Conclusions
Acknowledgements
References
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Introduction
 Health Canada provides credible information to the public
while striving to prevent and reduce risks to individual health
and promote healthier lifestyles. (Health Canada, 2007)
 Recent changes in Canadian nutrition policies may be
reflected in the media.
 Women have specific nutritional needs and vulnerabilities
and, as such, are at unique risk for various nutrition-related
diseases and conditions that affect the duration and quality
of their lives.
 Intakes of calcium, vitamin D, iron and folate are marginal
(Garriguet, 2004)
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Introduction continued
 Tracking Nutrition Trends VI data showed that 76% of
respondents reported that they received their nutrition
information from print media. (Canadian Council of Food and Nutrition, 2006)
 Magazines are a primary source of nutrition information for
72% of Canadian women. (Hassan et al., 2007)
 Women perceive conflicting dietary information as one of the
barriers hindering their ability to meet dietary
recommendations. (French et al., 2005)
 There have been some Canadian studies conducted on
messages women receive from the print media.
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Nutrition and Media Messages
▪ Korinis et al (1998) examined calcium and weight loss
information in American teen-focused verses women’s
magazines over two 4-year periods and discovered that
messages related to calcium was primarily offered to
women past their best opportunity to affect bone mass.
▪ Tassan, Marchessault and Campbell (2007) compared
the frequency of calcium and body weight messages in
Chatelaine and Flare magazines and concluded that
opportunities existed to provide improved calcium and
osteoporosis coverage for women at a prime age to
increase their bone density.
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Rationale and Objective
 A study that develops and tests a tool for examining
the quantity and accuracy of nutrition messages geared
towards women of reproductive age needs to be
conducted.
 The objective of this research project was to develop
and pilot test a coding instrument that utilized a
content analysis methodology, to assess the quantity,
types and accuracy of messages related to calcium,
vitamin D, iron and folate, for use in a larger Health
Canada (HC) study.
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Content Analysis
 Content Analysis is a research technique that
systematically examines the frequencies and
meanings of linguistic elements by using a set of
qualitative and quantitative methods to collect and
analyze data from print communication. (Pratt & Pratt,
1995; Kondracki et al., 2002)
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Process of Content Analysis
Developing a research objective
Making conceptualization decisions
Deciding on operationalization measures and coding schemes
Determining the scope of the sample
Training coders and revising coding materials
Process of coding
Determining agreement between coders
Communicating the results
(Neuendorf, 2002)
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Sample
Three Magazines: Canadian Living, Chatelaine
and Homemakers (n=16 issues)
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Sample continued
 For the pilot study, our sub-sample of magazine issues
(n=16) was an approximate 10% of all issues
published within our sampling time frame (20032007).
 Issues were randomly chosen using a random number
generator and then coded and analyzed.
 Nutrition, food and health messages regarding four
micronutrients: calcium, vitamin D, iron and folate.
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Instrument Development
 Two instruments were created for our study: the
coding sheet and the codebook, based on other
validated instruments. (Barr, 1989; Guillen & Barr, 1994)
 The coding sheet was the electronic data collection
tool (Excel spreadsheet) used for each magazine
issue.
 The codebook was the set of rules that guided our
decisions for inclusion and exclusion of criteria.
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Coding the Messages
 Messages in the magazine issues were coded.
 A Message was defined as “the piece of written text or
the image that was coded that pertained to one of the
four micronutrients of interest, calcium, vitamin D, iron,
or folate, in five message formats: advertisement,
editorial, image, article, or letter to the editor. The
length of the Message ranged from part of a sentence
to multiple sentences.”
 Messages included nutrient content claims, general
statements on the physiological function of the
nutrients, and nutrient analyses found in recipes.
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Coding continued
 An advertisement, editorial, image, article, or
letter to the editor was considered to contain a
‘message’ if it contained at least one of the 22 preselected criteria chosen for inclusion on the coding
sheets, which were operationally defined in the
codebook.
 Criteria that were included had to reflect the
objective (i.e., quantity, types and accuracy of
messages related to the 4 micronutrients of
interest) for the pilot test.
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Coding continued
 Important criteria included:
 Total number of messages
 Number of messages related to each
micronutrient
 What the nutrient was presented in relation to
(e.g., food, nutritional supplements, nutrient
analysis, the physiological function of a nutrient,
or non-dietary uses of the nutrient)
 Evaluation for congruence to Canadian nutrition
policy, and if each message was congruent
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Coding Procedures
 Two coders: Dr. Marcia Cooper and myself.
 Training sessions allowed coders to develop and
revise coding rules and definitions included in
codebook and code sheet.
 The goal was to have high intercoder reliability, as
defined by agreement, in coding messages the
same way.
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Coding Procedures continued
 Coding of the 16 magazine was conducted independently
by the two coders during a period of 7 weeks in March and
April, 2008.
 Data were directly entered into electronic code sheets and
results of selected elements were tallied for further
analysis.
 Due to the timeline of the research project, 12 out of the
16 coded magazine issues (4 Chatelaine, 3 Canadian
Living and 5 Homemakers issues) were analyzed for
agreement between coders.
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Coding Procedures continued
 To determine agreement, both coders’ coding sheets
were compared to see if the same messages were
identified, and how each message was coded for each
element.
 To resolve coding discrepancies, the primary source of
information (i.e., the actual magazine issue) was
consulted to view the message itself.
 Only 8 of the 22 criteria collected on the code sheets
were further analyzed for this project, with the
remaining criteria to be assessed in the future.
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The number of total messages regarding calcium, vitamin
D, iron and folate in the 12 magazine issues analyzed
Magazine
Coded
# of total
Messages
Number of Messages relating to
micronutrients:
Ca
Vit D
Fe
Folate
Chatelaine
(n=4)
100
86
21
40
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Canadian
Living (n=3)
179
147
10
132
128
Homemakers
(n=5)
99
67
9
67
68
Total (n=12
issues)
378
300
40
239
220
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Percentage agreement between coders on number of messages
Magazine
Coded
Actual #
of
Messages
# of
Messages
Coded by
MC
# of
Messages
Coded by
LZ
%
Agreement
Chatelaine
(n=4)
100
98
88
83
Canadian
Living (n=3)
179
170
169
86
Homemakers
(n=5)
99
88
98
85
Total (n=12)
378
356
355
n/a
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Discussion
 This instrument development and pilot testing study
highlighted new information and exposed unique
challenges to overcome before conducting the
larger Health Canada study.
 The coding sheet will be modified to incorporate the
coders’ feedback on how well it captured the
information the coders were trying to obtain.
 With 22 elements, the tool was too long
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Implications for the Larger
Health Canada Study
 Next important step for the tools: to undergo validation.
 “When properly applied, content analysis methods are
both reliable and valid.” (Kondracki et al., 2002)
 Intercoder and intracoder reliability will need to be further
determined for the pilot study results before the actual
study occurs.
 To ensure consistent training, a strategy will be developed
that will take a prospective coder through coding different
messages for the various micronutrients in varying
message formats.
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Conclusion
 Content analysis is a detail-oriented methodology
that was carefully applied to gain new knowledge
in creating a instruments to measure the quantity,
accuracy and types of messages in Canadian
women’s magazines.
 The goal of content analysis is to be objective so
that real messages are captured and subsequently
coded accurately.
 Print media is an important source of nutrition
information for women and it is important to know
what messages women receive.
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Acknowledgements
 Dr. Marcia Cooper, Health
Canada – a supporter, mentor,
helper, decision-maker
 Dr. Laurie Wadsworth, St.
Francis Xavier University–
reviewed the coding instrument
and was the peer reviewer for
my paper
 The donors who contributed
their magazines
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Selected References
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Health Canada. About mission, values, activities; 2007 [cited 2008 June 17].
Available from: http://www.hc-sc.gc.ca/ahc-asc/activit/aboutapropos/index_e.html
Garriguet D. Statistics Canada. Overview of Canadians’ eating habits 2004. Ottawa:
Health Statistics Division; 2006. Catalogue no. 82-620-MIE — No. 2.
Canadian Council of Food and Nutrition. Tracking nutrition trends VI; 2006 [cited
2007 18 Oct]. Available from: http://www.ccfn.ca/pdfs/TNT_VI_Report__2006.pdf
Hassan T, Marchessault G, Campbell M. Messages about calcium and weight in
Canadian women’s magazines. Can J Diet Pract Res 2007;68(2):103-106.
French MR, Moore K, Vernace-Inserra F, Hawker GA. Factors That Influence:
Adherence to Calcium Recommendations. Can J Diet Pract Res 2005;66(1):25-29.
Pratt CA, Pratt CB. Comparative content analysis of food and nutrition
advertisements in Ebony, Essence, and Ladies’ Home Journal. J Nutr Educ
1995:27:11-17.
Kondracki NL, Wellman NS, Amundson DR. Content analysis: review of methods
and their application in nutrition education. J Nutr Educ Behav 2002;34:224-230.
Neuendorf KA. The Content Analysis Guidebook. Thousand Oaks, CA: Sage; 2002
Barr SI. Nutrition in food advertising: content analysis of a Canadian women’s
magazine, 1928-1986. J Nutr Ed 1989;21:64-72.
Guillen EO, Barr SI. Nutrition, dieting and fitness magazines in a magazine for
adolescent women, 1970-1990. J Adolesc Health 1994;15:464-472.
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THANK YOU!
Thanks for your attention!
I will be pleased to answer any
questions you may have.
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