S124 Poster Abstracts Journal of Nutrition Education and Behavior  Volume 51, Number 7S, 2019
P202 (continued)
time (ST) from elementary to middle school among children
and whether there are disparities by sex and weight status.
Study Design, Settings, Participants: Lower-income
children who participated in the FLEX Study during
grades 4 and 5 were re-recruited into this supplementary
prospective cohort study, FLEX+ during middle school
(grade 6).
Measurable Outcome/Analysis: Demographic data
were collected via parent questionnaire. Child assess-
ments included height, weight, and 7-day accelerome-
try (Actigraph GT3X+) in 4th, 5th, and 6th grade. The
association between grade and changes in sMVPA and
ST were examined using mixed effects models adjusting
for sex, race, BMI status, free/reduced price lunch eligi-
bility (FPRL), and mean weekly ambient temperature.
Individual-level clustering was adjusted for as a random
intercept. Interactions were tested to examine dispar-
ities by sex and BMI status.
Results: Eighty eight children (grade 4: 9.2 § 0.5 years,
42% male, 38% non-white, 39% FRPL, 33% overweight/
obese, sMVPA = 19.9 § 8.5 min/day) had valid accelerome-
ter wear-time (> 3 days, >10 hrs/day). There was a decline
in children meeting the 30-minute sMVPA recommenda-
tion from grades 4 to 6 (14.8%, 7.5%, and 3.5%, respec-
tively; P < .05); however, the decline in sMVPA was not
significant (P > .05). Notably, the change in ST reflects an
increase in grade 5 (b = 16.5 mins/day; 95% CI: 8.4, 24.6;
P < .001) and grade 6 (b = 61.7 mins/day; 95% CI: 46.4,
77.0; P < .001) compared to grade 4. There were no signifi-
cant effects of sex or BMI status on changes in sMVPA or
ST (P > .05).
Conclusion: Policies and programs that promote move-
ment time during school hours are urgently needed to
counteract the steep increase in sedentary behaviors that
occur in middle school.
Funding: NIH.
Written Oral and Social Media Communication
P203 Breaking the Vicious Cycle of Health
Literacy and Related Health Outcomes: A
Systematic Review
Sarah Sprayberry, MS, Texas Tech University; Mary Murimi,
PhD, LDN, RD, mary.murimi@ttu.edu, Texas Tech
University, P.O. Box 41270, Lubbock, TX 79409; Ana
Florencia Moyeda-Carabaza, MS, Texas Tech University;
Hyunjung Lee, BS, Texas Tech University; Bong Nguyen, MS,
Texas Tech University
Background: The goal to address health literacy issues
and in turn improve health related outcomes has
increased; however, evidence-based studies divulging the
aspects that strengthen health literacy interventions in
underserved populations is limited.
Objective: The purpose of this systematic review is to
determine the factors that contribute to efficacy of health
literacy interventions based on studies that were pub-
lished between 2012 and 2018.
Study Design, Settings, Participants: Following the
PRISMA guidelines, relevant studies were obtained through
Medline, PubMed, Science Direct, and Scopus databases.
Five authors screened and determined the quality of the
studies using the Grading of Recommendations Assess-
ment, Development, and Evaluation (GRADE) system and
extracted the data from the articles.
Measurable Outcome/Analysis: A total of ten studies
were reviewed.
Results: Factors identified as important contributors to
efficacy of health literacy interventions included: compre-
hensive baseline assessment, tailoring messages based on
the assessment, distinguishing health knowledge versus
health literacy, applying recommended strategies for
health literacy and affording adequate duration and dos-
age for the intervention.
Conclusions: Based on this review, studies that were suc-
cessful in achieving their health literacy goals conducted
comprehensive baseline interventions, utilized the results
of the assessment to inform the intervention, and
employed best practices for health literacy beyond the use
of plain language. Most importantly, they allocated ade-
quate dosage and duration as a commitment to change the
desired behaviour.
Funding: None.
P204 Comparing Website Data From Food
Newsletter Subscribers with General “Organic”
Search Traffic Data
Lisa Franzen-Castle, PhD, MS, RD, lfranzen2@unl.edu,
University of Nebraska-Lincoln, 110 Ruth Leverton Hall,
Lincoln, NE 68583; Kayla Colgrove, MS, RDN, ACSM-CPT,
University of Nebraska-Lincoln; Cami Wells, MS, RD,
University of Nebraska-Lincoln; Alice Henneman, MS, RDN,
University of Nebraska-Lincoln
Objective: Assess demographic differences for a food
website between online newsletter subscribers and general
organic website visitors. “Organic” traffic arrives at a web-
site through search engines vs. referring channels.
Use of Theory or Research: In-person programing is
limited and the Internet has become a significant source for
disseminating information, making it important to evaluate
potential differences in users. Ninety-eight percent of ages
18-65+ use the Internet (Pew Research Center, 2018).
Target Audience: Adult food newsletter subscribers and
organic website visitors interested in consumer food-
related issues.
Program Description: The University’s food website
connects all Extension food-related areas on one “umbrella”
website. Email newsletters are one part of the website.
Evaluation Methods: To assess online newsletter sub-
scribers, a survey was distributed during 2018. Survey
completion incentive was entry into a random gift card
drawing. Google Analytics was used to assess 2018 organic
website traffic.
Results: The website had more than 1.6 million users.
Google Analytics showed over 80% of visitors found the
website through an organic search. The newsletter sub-
Continued on page S125
Journal of Nutrition Education and Behavior  Volume 51, Number 7S, 2019
P204 (continued)
scribers survey (21% return rate; n = 992) indicated only
20% of respondents found the website through an organic
search; other methods included electronic mailing list
announcement (14%), professional conferences (13%),
forward from email (13%), other (13%), and co-worker
(11%). Though both data sets showed a website visitor age
span of 18-65+ years, the highest percent of organic visi-
tors was 25-34-years-old (30%) while 70% of newsletter
subscribers fell into the 40-69-year-old range. Most sub-
scribers (94%) were female compared to 65% of general
visitors. Similar topics of interest for both groups were:
food safety, storage, and cooking.
Conclusions: Data highlighted how using additional
venues to promote website materials, such as newsletters,
should be used beyond only placing content online.
Newsletters may appeal to a more specific age and gender
than organic search traffic. Though general topic interest
may be similar, newsletter surveys helped tease out more
specific interests.
Funding: None.
P205 Detox Tea Advertising on Social Media:
Examining the Content of Popular Detox Tea
Brands on Instagram
Kendra Auguste, MA, MPH, kauguste@ufl.edu, University of
Florida, 2000 Weimer Hall, PO Box 118400, Gainesville,
FL 32611; Amanda Bradshaw, MS, University of Florida;
Alexis Bajalia, BS, University of Florida; Debbie Treise, PhD,
University of Florida; Summer Shelton, MA, University of
Florida; Matthew Cretul, MA, University of Florida;
Montserrat Carrera Seoane, MA, University of Florida
Background: Social media has emerged as a major
influence on consumer health and behavior (Korda and
Itani 2013). With more than a third of all U.S. adults
using the social networking site Instagram (Pew
Research Center 2017), food and dietary supplement
marketing may be effective in building consumer aware-
ness and furthermore influencing attitudes towards
advertised products. Advertisements for detox tea prod-
ucts in particular are widely prevalent on social media,
with celebrity endorsements being the most notable.
However, little is known of what information detox tea
brands include in marketing messages on the popular
social networking site, Instagram.
Objective: The purpose of this study was to analyze the
content of detox tea advertisements on Instagram in order
to understand how detox teas are being portrayed in social
media.
Study Design, Settings, Participants: A qualitative
content analysis explored how 11 detox tea brands adver-
tised their products on Instagram. The use of health
claims and nutrient claims in posts were also recorded.
Detox tea brand posts were selected for analysis during
Thanksgiving weekend of 2017. Previous research has
shown that people are more health conscious during the
holidays as body weight significantly increases (and is
retained throughout the year) due to increased dietary
Poster Abstracts S125
intake during this time. A total of 220 posts were coded
by researchers.
Measurable Outcome/Analysis: Coding and identifi-
cation of themes was conducted using the constant com-
parative method.
Results: Findings suggested structure-function claims
were the most frequently used. Qualitative content analy-
sis revealed five overarching themes in the content of
detox tea posts on Instagram including advertising and
promotion of products, two-way dialogue with the brand,
brand connections, health and fitness and finally, social
sharing.
Conclusion: Exploring the content of these supplement
advertisements provides insight on useful strategies for
increasing brand engagement on social media. Addition-
ally, analysis of this content supports research suggesting
a connection between exposure to social media content
and influencing consumer behavior.
Funding: None.
P206 I Tweet, You Tweet, We All Tweet About
Listeria in Ice Cream
Lori Greene, MS, LD, RDN, lgreene@ches.ua.edu, University
of Alabama, 504 University Blvd, Tuscaloosa, AL 35487;
Hyoungkoo Khang, PhD, University of Alabama
Background: Forty-eight million Americans are affected
by foodborne illnesses each year with over 3,000 deaths
attributed to these illnesses indicating the need for accu-
rate and timely communication of outbreaks and recalls.
Objective: To compare the frame of messages and source
of tweets on Twitter from the Blue Bell Creameries listeria
outbreak after the initial announcement of the food-
borne illness outbreak in March 2015 and after the
announcement of the recall of all Blue Bell products in
April 2015.
Study Design, Settings, Participants: Tweets were
gathered from ForSight and Crimson Hexagon using the key
words “blue bell” and “listeria” or “recall.” Systematic ran-
dom sampling was performed to analyze approximately 20%
of tweets with the final sample size of 443 tweets from March
13-17, 2015 and 2,223 tweets from April 20-24, 2015.
Measurable Outcome/Analysis: A quantitative con-
tent analysis was performed to determine the source of
the message, frame of the message, message sentiment,
and use of web link in message. The Chi square statistical
test was used to determine if there were any significant dif-
ferences between the date ranges. A qualitative content
analysis was performed in NVIVO to determine the most
frequent words found in the tweets.
Results: A significant difference was found between the
two date ranges between the frames of the tweets [x2 (6,
N = 2,666) = 46.315, P < .001], the source of the tweets [x2
(5, N = 2,666) = 49.154, P < .001], the message sentiment
[x2 (5, N = 2,666) = 47.189, P < .001], and the use of a web
link in the tweets [x2 (2, N = 2,666) = 17.508, P < .001].
The frequent words used in the tweets from March 13-17,
2015 were linked, deaths, outbreak, products, and three.
The frequent words used in the tweets from April 20-24,
Continued on page S126