Glenda P Azana | University of the Philippines Los Baños (original) (raw)

Papers by Glenda P Azana

The Philippine journal of science, Apr 26, 2021

The project aimed to reduce the prevalence of malnutrition among 6-35-mo-old children, and to det... more The project aimed to reduce the prevalence of malnutrition among 6-35-mo-old children, and to determine the implementation of intervention strategy through process evaluation in a disaster area affected by super typhoon "Yolanda". The effects of the intervention on the nutritional status and food intake of children-participants, as well as the nutrition knowledge of their mothers and caregivers in disaster-stricken areas, were determined. The project covered 344 underweight and normal weight-forage infants and young children 6-35-moold in four barangays each in Jaro, Leyte and Basey, Samar, Philippines. The planning, organizing, implementation, monitoring, and process evaluation phases of implementing a nutrition intervention were documented. Weights and heights/lengths of children and food intake were taken before and after the intervention. The children-participants were fed for 4 mo with complementary foods, while their mothers/caregivers were taught about health and nutrition concepts. A significant increase in the mean weight and height/length of childrenparticipants after 120 feeding days and the improvement in the energy and protein intakes of the children were observed. However, these increases had no significant impact on the overall nutritional status of children living in a disaster area. Likewise, a significant increase in the mean knowledge scores of their mothers/caregivers on breastfeeding and food safety at endline (p < 0.001) was noted. The implementation was closely monitored following some guidelines and its feasibility in a disaster situation. The intervention strategy provided an option of doing nutritional assessment and implementing a food-based and education intervention for mother and child during the rehabilitation phase of a disaster.

Nutrition Research and Practice, 2022

BACKGROUND/OBJECTIVES: Filipino children aged 6-10 yrs are consuming poor quantities and quality ... more BACKGROUND/OBJECTIVES: Filipino children aged 6-10 yrs are consuming poor quantities and quality of food based on the 2013 Philippine National Nutrition Survey. During these years healthy eating habits must be formed through family influence. Within this background, a complete package of nutrition intervention-feeding and nutrition classes, was pilot tested in selected schools to determine 1) changes in nutrition attitude and behavior and 2) food intake of schoolchildren after the intervention. SUBJECTS/METHODS: A quasi-experimental design was used in the study. School children aged 7-9 yrs enrolled in selected Philippine public elementary schools and their mothers/ caregivers were the study participants. Profile and socio-demographic data were collected from each participant at baseline. The nutrition behavior and food intake of children were determined using the modified Child and Diet Evaluation Tool (CADET) and the 24-h food recall form, respectively. Data were analyzed using Stata version 15. RESULTS: No significant differences in characteristics were found among the 339 childmother pairs in the 4 study groups. The modified CADET recorded improved mean attitude scores of children ranging from 22 to 24 points at endline in the group receiving both lunch feeding and nutrition education classes (group 3). The perceived better behavior of children was reported by their mothers in terms of increased intake of milk and vegetables and decreased consumption of sugar. These improvements were supported by the actual food intake of children obtained from the 24-h food recall. CONCLUSIONS: Family involvement, particularly of mothers/caregivers, appeared to be an important factor in shaping the children's eating behavior. An intervention package with lunch feeding and nutrition classes resulted in a substantial improvement in children's behavior and actual food intake with increased levels of vegetables and milk while lowering sugar consumption. The adoption of the intervention package in public elementary schools should therefore be pursued.

Nutrition Research and Practice, 2022

BACKGROUND/OBJECTIVES: Filipino children aged 6-10 yrs are consuming poor quantities and quality ... more BACKGROUND/OBJECTIVES: Filipino children aged 6-10 yrs are consuming poor quantities and quality of food based on the 2013 Philippine National Nutrition Survey. During these years healthy eating habits must be formed through family influence. Within this background, a complete package of nutrition intervention-feeding and nutrition classes, was pilot tested in selected schools to determine 1) changes in nutrition attitude and behavior and 2) food intake of schoolchildren after the intervention. SUBJECTS/METHODS: A quasi-experimental design was used in the study. School children aged 7-9 yrs enrolled in selected Philippine public elementary schools and their mothers/ caregivers were the study participants. Profile and socio-demographic data were collected from each participant at baseline. The nutrition behavior and food intake of children were determined using the modified Child and Diet Evaluation Tool (CADET) and the 24-h food recall form, respectively. Data were analyzed using Stata version 15. RESULTS: No significant differences in characteristics were found among the 339 childmother pairs in the 4 study groups. The modified CADET recorded improved mean attitude scores of children ranging from 22 to 24 points at endline in the group receiving both lunch feeding and nutrition education classes (group 3). The perceived better behavior of children was reported by their mothers in terms of increased intake of milk and vegetables and decreased consumption of sugar. These improvements were supported by the actual food intake of children obtained from the 24-h food recall. CONCLUSIONS: Family involvement, particularly of mothers/caregivers, appeared to be an important factor in shaping the children's eating behavior. An intervention package with lunch feeding and nutrition classes resulted in a substantial improvement in children's behavior and actual food intake with increased levels of vegetables and milk while lowering sugar consumption. The adoption of the intervention package in public elementary schools should therefore be pursued.

Nutrition and Health, 2020

Background: Nutrition interventions during the early years of a child’s life are anchored on the ... more Background: Nutrition interventions during the early years of a child’s life are anchored on the need to provide good nutrition and proper health care to optimize their growth potential as adults. In the Philippines, undernutrition is a persistent problem among 0–10 year old Filipino children. In this age group, children consume a diet poor in quantity and quality. Aim: This study aimed to assess the effects of a school-lunch and nutrition education intervention among schoolchildren in terms of attaining good nutrition. Method: Using a quasi-experimental design, children aged 7–9 years from public elementary schools in the province of Laguna, Philippines were categorized into three intervention groups and one non-intervention group. Anthropometric measurements; nutrition knowledge, attitude and behavior; and food intake among children and households were collected at baseline and endline periods. SPSS for Windows version 16 and Stata version 15 were utilized for data analysis. Resul...

Journal of Nutrition Education and Behavior, 2018

Objective: We explored quality of implementation during a pilot evaluation in spring 2017, using ... more Objective: We explored quality of implementation during a pilot evaluation in spring 2017, using a multiprong approach: principles-based fidelity, attendance, and participant reaction: interest, relevance, comfort level, and satisfaction. Description: We conducted live observation of a subset of sessions with a checklist of "core concepts". Facilitators answered questions regarding participant engagement and understanding of concepts presented. Participants completed a session evaluation that assessed understanding of core concepts presented (knowledge), and facilitator rapport. We aimed to assess adherence but also other site-specific nuances associated with learning and key outcomes. Evaluation: Of the 13 participating families (fathers), most attended six sessions. In total, parents completed 109 after-session (one-page) evaluation forms. Most (90%) indicated class sessions were somewhat or very useful, somewhat or very interesting, and that participants felt comfortable sharing opinions. Most (94%) of their responses rated facilitators as supportive and as having addressed participants' needs and interests. Conclusions and Implications: This process evaluation findings illustrate quality implementation assessment. Overall facilitators had high levels of facilitation skills. The principle-based fidelity addressed the necessity, not only to capture adherence, but also whether the program has been able to achieve the desired results. It also provided insight to implementation that allows for adaptability to "real life" situations without loss of effectiveness. However, it called for a highly-skilled evaluator and developing the indicators of that can be broadly used in community settings. Funding: USDA.

World Nutrition, 2019

Background: Malnutrition among Filipino children persists; underscoring the value of nutritional ... more Background: Malnutrition among Filipino children persists; underscoring the value of nutritional assessment procedures. In the Philippines, this is carried out at the local level in its annual Operation Timbang [weigh] (OPT or OPT Plus). Local government unit officials observed higher malnutrition prevalence rates in nutrition survey reports of the Department of Science and Technology’s Food and Nutrition Research Institute (DOST-FNRI) compared with its OPT. A revisit of the OPT provided evidence on the comparability of the two data sets and sources of variance analyzed. Objectives: 1) describe municipal level assessment of OPT in 10 barangays of Abra de Ilog municipality; 2) identify facilitating and hindering factors in OPT; and 3) compare OPT results with DOST-FNRI local nutrition survey in Abra de Ilog and identify potential sources of variance therefrom. Methods: Primary data were collected using focus group discussions and key informant interviews. Height and weight data were...

Acta Horticulturae, 2017

The prevalence of iron deficiency anemia (IDA) and vitamin A deficiency (VAD) remain at a signifi... more The prevalence of iron deficiency anemia (IDA) and vitamin A deficiency (VAD) remain at a significant public health level in the Philippines as shown by National Nutrition Surveys conducted by the FNRI-DOST. While riboflavin and folic acid deficiencies among schoolchildren could also be areas of concern, nutritional assessment of these vitamins are lacking. In this study, Moringa oleifera, locally known as Malunggay, was considered as a possible solution to these problems because of its high nutritional content. The study was conducted in two public elementary schools in Muntinlupa City where 121 underweight children aged 8-10 years old were divided into control (n=60) and experimental (n=61) groups. The control group was fed with snack foods (arrozcaldo, ginataang mais, macaroni soup, pancit canton and polvoron) during recess while the experimental group was fed with the same snack foods wherein three grams Malunggay leaf powder (MLP) was added. Height and weight, food intake and hemoglobin, serum ferritin, vitamin A, riboflavin and folic acid were measured before and after the 120-day feeding period. Results showed that the consumption of the snack foods significantly increased the nutrient intakes of the children. Greatest increase was recorded for vitamin A intake of the children given 3 g MLP. Endline vitamin A intake exceeded the requirement for vitamin A. Increase in height and weight between the groups were not different. Increase in hemoglobin levels was greater among children who consumed snack foods with MLP while increase in serum vitamin A levels was observed in both groups. A significant increase in serum folic acid was recorded in the experimental group. In conclusion, regular consumption of Malunggay leaves may help alleviate certain micronutrient deficiencies such as IDA, VAD and folic acid deficiency.

Forum 2015 Abstracts, 2015

Introduction: Measuring hunger and food insecurity has always been a challenge given the various ... more Introduction: Measuring hunger and food insecurity has always been a challenge given the various tools available to provide estimates both at the macro (sufficiency in staple stock) and micro (household food security) levels. In the Philippines, estimates of food insecurity have been provided by the Food and Nutrition Research Institute (FNRI) starting 2001 using an adaptation of the Radimer/Cornell (1992) measures of hunger and food insecurity. The tool has been found to be reliable using the 2003 data extracted from the sixth National Nutrition Survey (NNS), Food Security module but was recommended for further exploratory factor analysis to test for efficiency of items. Methods: This study assessed the construct validity of the adapted Radimer/Cornell instrument for measuring household food insecurity using principal component analysis with varimax rotation based on the 2003 NNS data. Results: The results revealed the prevalence of food insecurity was higher at the mother's level (33.7%) compared to the child (21.0%), indicative of "managed process" or coping with food insecurity at the households. "Altered eating" emerged (factor 1) at the individual level of food insecurity, while "anxiety over quantity and quality of food" was (factor 2) at the household level, that explained 44.0% and 23.2% of the total variance, respectively. Thus, a high cumulative variance (67.2%) was generated for these two factors, implying sufficient variance was obtained to justify the derivation of these two factors from the dataset. Conclusion: The food security items in the adapted Radimer/Cornell instrument contained valid indicators for assessing food insecurity in Filipino households.

Journal of Nutrition Education and Behavior, 2015

Journal of Primary Care & Community Health, 2020

Aims: Undernutrition among 0 to 5 years old children remains a public health problem in the Phili... more Aims: Undernutrition among 0 to 5 years old children remains a public health problem in the Philippines. This process evaluation study documented and examined the implementation of an intervention strategy for young children. Methods: Complementary feeding of 6-month to 2-year-old children was implemented for 120 days by the municipalities of Plaridel and Pulilan in Bulacan, Philippines utilizing local-based food made of rice and mung bean along with nutrition education classes among mothers/caregivers using the developed nutrition modules. A total of 121 mother-/caregiver-child pairs were the program participants of the intervention. Pre-post design were used in the analysis of quantitative data. Qualitative data were encoded verbatim manually using emerging themes. Key informant interviews among community workers and municipal officials and focus group discussions among mothers/caregivers and community workers were conducted to gather the needed data. Results: The municipalities a...

European Journal of Nutrition & Food Safety, 2015

ABSTRACT

Journal of Nutrition Education and Behavior, 2015

The Philippine journal of science, Apr 26, 2021

The project aimed to reduce the prevalence of malnutrition among 6-35-mo-old children, and to det... more The project aimed to reduce the prevalence of malnutrition among 6-35-mo-old children, and to determine the implementation of intervention strategy through process evaluation in a disaster area affected by super typhoon "Yolanda". The effects of the intervention on the nutritional status and food intake of children-participants, as well as the nutrition knowledge of their mothers and caregivers in disaster-stricken areas, were determined. The project covered 344 underweight and normal weight-forage infants and young children 6-35-moold in four barangays each in Jaro, Leyte and Basey, Samar, Philippines. The planning, organizing, implementation, monitoring, and process evaluation phases of implementing a nutrition intervention were documented. Weights and heights/lengths of children and food intake were taken before and after the intervention. The children-participants were fed for 4 mo with complementary foods, while their mothers/caregivers were taught about health and nutrition concepts. A significant increase in the mean weight and height/length of childrenparticipants after 120 feeding days and the improvement in the energy and protein intakes of the children were observed. However, these increases had no significant impact on the overall nutritional status of children living in a disaster area. Likewise, a significant increase in the mean knowledge scores of their mothers/caregivers on breastfeeding and food safety at endline (p < 0.001) was noted. The implementation was closely monitored following some guidelines and its feasibility in a disaster situation. The intervention strategy provided an option of doing nutritional assessment and implementing a food-based and education intervention for mother and child during the rehabilitation phase of a disaster.

Nutrition Research and Practice, 2022

BACKGROUND/OBJECTIVES: Filipino children aged 6-10 yrs are consuming poor quantities and quality ... more BACKGROUND/OBJECTIVES: Filipino children aged 6-10 yrs are consuming poor quantities and quality of food based on the 2013 Philippine National Nutrition Survey. During these years healthy eating habits must be formed through family influence. Within this background, a complete package of nutrition intervention-feeding and nutrition classes, was pilot tested in selected schools to determine 1) changes in nutrition attitude and behavior and 2) food intake of schoolchildren after the intervention. SUBJECTS/METHODS: A quasi-experimental design was used in the study. School children aged 7-9 yrs enrolled in selected Philippine public elementary schools and their mothers/ caregivers were the study participants. Profile and socio-demographic data were collected from each participant at baseline. The nutrition behavior and food intake of children were determined using the modified Child and Diet Evaluation Tool (CADET) and the 24-h food recall form, respectively. Data were analyzed using Stata version 15. RESULTS: No significant differences in characteristics were found among the 339 childmother pairs in the 4 study groups. The modified CADET recorded improved mean attitude scores of children ranging from 22 to 24 points at endline in the group receiving both lunch feeding and nutrition education classes (group 3). The perceived better behavior of children was reported by their mothers in terms of increased intake of milk and vegetables and decreased consumption of sugar. These improvements were supported by the actual food intake of children obtained from the 24-h food recall. CONCLUSIONS: Family involvement, particularly of mothers/caregivers, appeared to be an important factor in shaping the children's eating behavior. An intervention package with lunch feeding and nutrition classes resulted in a substantial improvement in children's behavior and actual food intake with increased levels of vegetables and milk while lowering sugar consumption. The adoption of the intervention package in public elementary schools should therefore be pursued.

Nutrition Research and Practice, 2022

BACKGROUND/OBJECTIVES: Filipino children aged 6-10 yrs are consuming poor quantities and quality ... more BACKGROUND/OBJECTIVES: Filipino children aged 6-10 yrs are consuming poor quantities and quality of food based on the 2013 Philippine National Nutrition Survey. During these years healthy eating habits must be formed through family influence. Within this background, a complete package of nutrition intervention-feeding and nutrition classes, was pilot tested in selected schools to determine 1) changes in nutrition attitude and behavior and 2) food intake of schoolchildren after the intervention. SUBJECTS/METHODS: A quasi-experimental design was used in the study. School children aged 7-9 yrs enrolled in selected Philippine public elementary schools and their mothers/ caregivers were the study participants. Profile and socio-demographic data were collected from each participant at baseline. The nutrition behavior and food intake of children were determined using the modified Child and Diet Evaluation Tool (CADET) and the 24-h food recall form, respectively. Data were analyzed using Stata version 15. RESULTS: No significant differences in characteristics were found among the 339 childmother pairs in the 4 study groups. The modified CADET recorded improved mean attitude scores of children ranging from 22 to 24 points at endline in the group receiving both lunch feeding and nutrition education classes (group 3). The perceived better behavior of children was reported by their mothers in terms of increased intake of milk and vegetables and decreased consumption of sugar. These improvements were supported by the actual food intake of children obtained from the 24-h food recall. CONCLUSIONS: Family involvement, particularly of mothers/caregivers, appeared to be an important factor in shaping the children's eating behavior. An intervention package with lunch feeding and nutrition classes resulted in a substantial improvement in children's behavior and actual food intake with increased levels of vegetables and milk while lowering sugar consumption. The adoption of the intervention package in public elementary schools should therefore be pursued.

Nutrition and Health, 2020

Background: Nutrition interventions during the early years of a child’s life are anchored on the ... more Background: Nutrition interventions during the early years of a child’s life are anchored on the need to provide good nutrition and proper health care to optimize their growth potential as adults. In the Philippines, undernutrition is a persistent problem among 0–10 year old Filipino children. In this age group, children consume a diet poor in quantity and quality. Aim: This study aimed to assess the effects of a school-lunch and nutrition education intervention among schoolchildren in terms of attaining good nutrition. Method: Using a quasi-experimental design, children aged 7–9 years from public elementary schools in the province of Laguna, Philippines were categorized into three intervention groups and one non-intervention group. Anthropometric measurements; nutrition knowledge, attitude and behavior; and food intake among children and households were collected at baseline and endline periods. SPSS for Windows version 16 and Stata version 15 were utilized for data analysis. Resul...

Journal of Nutrition Education and Behavior, 2018

Objective: We explored quality of implementation during a pilot evaluation in spring 2017, using ... more Objective: We explored quality of implementation during a pilot evaluation in spring 2017, using a multiprong approach: principles-based fidelity, attendance, and participant reaction: interest, relevance, comfort level, and satisfaction. Description: We conducted live observation of a subset of sessions with a checklist of "core concepts". Facilitators answered questions regarding participant engagement and understanding of concepts presented. Participants completed a session evaluation that assessed understanding of core concepts presented (knowledge), and facilitator rapport. We aimed to assess adherence but also other site-specific nuances associated with learning and key outcomes. Evaluation: Of the 13 participating families (fathers), most attended six sessions. In total, parents completed 109 after-session (one-page) evaluation forms. Most (90%) indicated class sessions were somewhat or very useful, somewhat or very interesting, and that participants felt comfortable sharing opinions. Most (94%) of their responses rated facilitators as supportive and as having addressed participants' needs and interests. Conclusions and Implications: This process evaluation findings illustrate quality implementation assessment. Overall facilitators had high levels of facilitation skills. The principle-based fidelity addressed the necessity, not only to capture adherence, but also whether the program has been able to achieve the desired results. It also provided insight to implementation that allows for adaptability to "real life" situations without loss of effectiveness. However, it called for a highly-skilled evaluator and developing the indicators of that can be broadly used in community settings. Funding: USDA.

World Nutrition, 2019

Background: Malnutrition among Filipino children persists; underscoring the value of nutritional ... more Background: Malnutrition among Filipino children persists; underscoring the value of nutritional assessment procedures. In the Philippines, this is carried out at the local level in its annual Operation Timbang [weigh] (OPT or OPT Plus). Local government unit officials observed higher malnutrition prevalence rates in nutrition survey reports of the Department of Science and Technology’s Food and Nutrition Research Institute (DOST-FNRI) compared with its OPT. A revisit of the OPT provided evidence on the comparability of the two data sets and sources of variance analyzed. Objectives: 1) describe municipal level assessment of OPT in 10 barangays of Abra de Ilog municipality; 2) identify facilitating and hindering factors in OPT; and 3) compare OPT results with DOST-FNRI local nutrition survey in Abra de Ilog and identify potential sources of variance therefrom. Methods: Primary data were collected using focus group discussions and key informant interviews. Height and weight data were...

Acta Horticulturae, 2017

The prevalence of iron deficiency anemia (IDA) and vitamin A deficiency (VAD) remain at a signifi... more The prevalence of iron deficiency anemia (IDA) and vitamin A deficiency (VAD) remain at a significant public health level in the Philippines as shown by National Nutrition Surveys conducted by the FNRI-DOST. While riboflavin and folic acid deficiencies among schoolchildren could also be areas of concern, nutritional assessment of these vitamins are lacking. In this study, Moringa oleifera, locally known as Malunggay, was considered as a possible solution to these problems because of its high nutritional content. The study was conducted in two public elementary schools in Muntinlupa City where 121 underweight children aged 8-10 years old were divided into control (n=60) and experimental (n=61) groups. The control group was fed with snack foods (arrozcaldo, ginataang mais, macaroni soup, pancit canton and polvoron) during recess while the experimental group was fed with the same snack foods wherein three grams Malunggay leaf powder (MLP) was added. Height and weight, food intake and hemoglobin, serum ferritin, vitamin A, riboflavin and folic acid were measured before and after the 120-day feeding period. Results showed that the consumption of the snack foods significantly increased the nutrient intakes of the children. Greatest increase was recorded for vitamin A intake of the children given 3 g MLP. Endline vitamin A intake exceeded the requirement for vitamin A. Increase in height and weight between the groups were not different. Increase in hemoglobin levels was greater among children who consumed snack foods with MLP while increase in serum vitamin A levels was observed in both groups. A significant increase in serum folic acid was recorded in the experimental group. In conclusion, regular consumption of Malunggay leaves may help alleviate certain micronutrient deficiencies such as IDA, VAD and folic acid deficiency.

Forum 2015 Abstracts, 2015

Introduction: Measuring hunger and food insecurity has always been a challenge given the various ... more Introduction: Measuring hunger and food insecurity has always been a challenge given the various tools available to provide estimates both at the macro (sufficiency in staple stock) and micro (household food security) levels. In the Philippines, estimates of food insecurity have been provided by the Food and Nutrition Research Institute (FNRI) starting 2001 using an adaptation of the Radimer/Cornell (1992) measures of hunger and food insecurity. The tool has been found to be reliable using the 2003 data extracted from the sixth National Nutrition Survey (NNS), Food Security module but was recommended for further exploratory factor analysis to test for efficiency of items. Methods: This study assessed the construct validity of the adapted Radimer/Cornell instrument for measuring household food insecurity using principal component analysis with varimax rotation based on the 2003 NNS data. Results: The results revealed the prevalence of food insecurity was higher at the mother's level (33.7%) compared to the child (21.0%), indicative of "managed process" or coping with food insecurity at the households. "Altered eating" emerged (factor 1) at the individual level of food insecurity, while "anxiety over quantity and quality of food" was (factor 2) at the household level, that explained 44.0% and 23.2% of the total variance, respectively. Thus, a high cumulative variance (67.2%) was generated for these two factors, implying sufficient variance was obtained to justify the derivation of these two factors from the dataset. Conclusion: The food security items in the adapted Radimer/Cornell instrument contained valid indicators for assessing food insecurity in Filipino households.

Journal of Nutrition Education and Behavior, 2015

Journal of Primary Care & Community Health, 2020

Aims: Undernutrition among 0 to 5 years old children remains a public health problem in the Phili... more Aims: Undernutrition among 0 to 5 years old children remains a public health problem in the Philippines. This process evaluation study documented and examined the implementation of an intervention strategy for young children. Methods: Complementary feeding of 6-month to 2-year-old children was implemented for 120 days by the municipalities of Plaridel and Pulilan in Bulacan, Philippines utilizing local-based food made of rice and mung bean along with nutrition education classes among mothers/caregivers using the developed nutrition modules. A total of 121 mother-/caregiver-child pairs were the program participants of the intervention. Pre-post design were used in the analysis of quantitative data. Qualitative data were encoded verbatim manually using emerging themes. Key informant interviews among community workers and municipal officials and focus group discussions among mothers/caregivers and community workers were conducted to gather the needed data. Results: The municipalities a...

European Journal of Nutrition & Food Safety, 2015

ABSTRACT

Journal of Nutrition Education and Behavior, 2015