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Nutrition Research Proposals Samples For Students
27 samples of this type
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Good Example Of Does Lack Of Nutritional Education Contribute To Preterm Birth Rates In African Research Proposal
Free research question research proposal sample, should sports nutrition superstore expand its capacity to produce fresh salads, granola, and other healthy options in the smoothie bar.
Rationale Sports Nutrition Superstore is located in Newport Beach, California. It is locally owned and operated, so there is no corporate headquarters for the business. Currently, the company focuses mostly on selling athletic supplements; however, in recent months, the smoothie bar has become very popular in the store (Yelp, Sports Nutrition Superstore). The growing desire for healthy food options in the California beach culture may present this company with a unique opportunity to provide another potential healthy choice for a market desiring healthy food options (Johnston).
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<Insert Name> <Insert Submission Date> <Insert Chairperson Name>
Research Proposal On Reasons For Healthy Diet: Beauty, Mental Health, Treatment, Lifestyle
Good example of research proposal on research objectives 6, literature review.
Summary The literature review covers the challenge faced by McDonalds in the increasing opposition to marketing its products to children and having an image for producing unhealthy foods. The research objective is to find solutions for the company to implement so that it can change this perception about the company and reduce opposition to its business practices.
Section 1: Summary of Business Problem and Research Objectives 2 Section 2: Literature Search and Review 2 Analysis of the Literature Review 5 Section 3: Research Objectives and Methodology 6
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Child obesity is rising around the world. Obesity is being observed at a younger age of children than in the past. There are many factors that have led to this trend. This paper seeks to examine one of these factors; parents’ connection to child obesity. It seeks to establish whether there is a substantive relationship and if it is there, to what extent does it cause obesity in children. The paper uses various data collection methods and analysis techniques to cover the issue.
Keywords: Child Obesity, Parents, BMI
Direct Practice Improvement Project Prospectus Research Proposal Sample
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Healthier Vending Machines Research Proposals Examples
Fresh Healthy Vending is a vending machine enterprise headquartered in San Diego, California (Callaghan et al, 2010). It was founded in 2010. The company is the leading healthy vending franchisor in the United States. It specializes in healthier alternatives to traditional vending machines which habitually offer junk foods products and beverages. Fresh Healthy Vending also boasts of 250 active franchises in over 44 states. The company has sold and delivered close to 3500 vending machines in the United States.
the Date Research Proposal
Change for a better future, nurse coaches and weight loss research proposal examples.
Use of Health Coaching tools and techniques to work with middle aged women at the weight loss boot camp and nutritional counseling center, to achieve positive and permanent weight loss results.
Problem and Solution
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The proposal research aims at determining whether plants grow well in water or soil, when carried out practical through setting up an experiment. The information obtained from this experiment will help gardeners have knowledge on how to grow their plants healthier, taller and faster.
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College Students’ Healthy Nutrition Research Proposal
People’s choices for foods and other nutrition-related practices are influenced by a variety of determinants with tremendous consequences for nutrition. Understanding consumer behaviour helps nutrition specialists to deliver effective nutrition intervention programs. Existing literature suggests that many students purchase foods outside school’s meal programs, mostly snacks and sweetened beverages with high calories and low nutritional value (Hales, 2010; Koplan et al., 2005). Economic determinants influence food choices among students, especially the price of food and convenience (Hales, 2010; Li, 2011). A research study by Cullen et al. (2000) demonstrated that many children eat out and are allowed to eat what they want. Among these children, parental influence on the menu choice occurs only when cost is an issue (Cullen et al., 2000). In a related study by Pokin et al. (2005), it was reported that food expenditure patterns for high priced products significantly reduces the number of fruits servings, vegetables and dairy products consumed by students suggesting that costly foods influence student’s choices.
Student’s choice of healthy foods for consumption appears to be determined by nutrition and health influences. In a study to investigate the effect that nutritional education has on a consumer’s diet, Shakkour (2008) demonstrated that nutritional education could help people improve the quality of eating behaviors. This suggests that wellness policies in schools and other school-based activities aimed at promoting positive dietary behavior could help solve the problem of overweight students and reduce the risk of obesity. However, dietary choices and physical activity behaviors among adolescents and children are influenced by familial factors, societal factors, the media and other settings (Gay, 2006; Martin and Oakley, 2008). According to the Center for Disease Control and Prevention (2011), schools provide supportive environment for students to learn and practice healthy behaviors such as the choice of healthy foods and physical activity.
Current literature shows that healthy diets are unaffordable and cost is a major barrier for students in accessing healthy foods (Rivas and Flores, 2011). In a systematic demand analysis for unhealthy and healthy food, Zheng and Zhen (2010) reported little evidence that substitution between healthy and unhealthy food could be induced by relative price changes. Such findings are consistent with arguments by Rivas and Flores (2011) that increasing taxes on unhealthy food items could raise their relative prices and result to positive change in eating behaviors. Rivas and Flores (2011) asserted that cash incentives may be the most effective approach in reducing the consumption of unhealthy foods. Further, Champlin and Henderson (1998) argued that the eating behaviors of teens reflect their living environment and health status, implying that cost impacts on the choice of healthy foods.
This study will examine health and nutrition behaviors of college students in order to gain deeper understanding of the factors that influence food consumption particularly, among the university students. The main research question would be; “How does knowledge about nutrition and health influence university students to choose foods for consumption?”
This study will test the following hypothesis
- Hy.1- costly foods influence student’s choices.
- Hy.2- nutrition and health influence students to choose healthy foods for consumption.
- Hy.3- cost impact on choice of unhealthy foods.
Research Methods and techniques
Quantitative research method will be applied using cross-sectional study research design that will gather data within a single period. The data will be used to examine whether nutrition and health knowledge influences the food intake behavior of the university students (Miere et al., 2007). The nutritional model will be applied to guide the collection of data and nutritional behaviors of the participants (Sakamaki et al., 2005).
Since cross-sectional study design is less costly and quick, it is feasible for this study (Kolodinsky et al., 2007). In addition, the information gathered will be analyzed quickly and easily to give a snapshot characteristic of the population (Panagiotakos et al., 2007). Comparing the students’ dietary behavior can be easily done at once using this study method (Irazusta et al., 2006). Nevertheless, this study design only provides a snapshot of the population being studied. Therefore, only some generalizations will be drawn from the data gathered (Young & Fors, 2001).
Participants and sampling
In this study, all universities students are deemed viable when carrying out the research (Spyckerelle et al., 1992). From the total number of university students, just thirty students will be selected via appropriate sampling method that will give a true population representation and a valid data (Lee & Loke, 2005). For the main study, the proposed sample size will comprise 15 female participants between the age of 18 and 25, and 15 gentlemen between the aged between 19 and 27 (Wardle et al., 2004).
Due to time and cost constraints, a selective sampling will be used to choose the thirty students (Schweyer & Le-Corre, 1994). Although random sampling is quick and convenient method for selecting the participants, the researcher is free to select the participants who are accessible and representative of the population (Mikolajczyk et al., 2009). The disadvantage of selective sampling is that it may be biased in case the sample does not represent the whole population (Osler & Heitmann, 1996).
Data for this study will be acquired from primary sources (Roddam et al., 2005). The relevant primary data will be gathered via questionnaires (Hagman et al., 1986). A comprehensive exploration instrument is assumed to have been developed and satisfactorily tested prior to embarking on this actual research study (Von-Bothmer & Fridlund, 2005). Therefore, thirty questionnaires that examine the students’ nutritional behavior will be used (appendix 1).
The questionnaire will take the students roughly between 15 and 21 minutes to complete. The advantage of the questionnaires is that the potential data will be gathered within the shortest time possible (Spyckerelle et al., 1992). Conversely, the disadvantage is that the students would not be willing to provide the information or may be giving untrue information particularly, in situations they feel that they would not benefit from the study (Kim et al., 2003).
Before embarking on the research study, all the application requirements that the research committee needs will be completed (Brunt et al., 2008). In addition, all the participants will be provided with information concerning their freedom of participation based on the stated standards (Anderson et al., 1994). A letter of introduction from the university specifying and explaining the study and the standard methods will also be provided. The letter will provide an assurance of secrecy to their information (Baric et al., 2003). Moreover, information sheet guiding and describing the study will be provided (Bull, 1992). The participants will be made aware that they can withdraw their involvement without any consequence (Brevard & Ricketts, 1996). Lastly, the research participants will be provided with letters of consent.
An approval for participation in this research study will be sought from the responsible authorities (El-Ansari et al., 2007). However, measures will be put in place during and after the research study has been conducted to help protect the respondents and any other subjects from harms (Bas et al., 2005). Finally, the information acquired from the study participants will be securely stored and protected whereas study finding reports will not divulge the participants’ identification (Kafatos et al., 2000).
Anderson, AS, Macintyre, S & West, P 1994, “Dietary patterns among adolescents in the west of Scotland”, Br J Nutr , vol.71 no.1, pp. 111-122.
Baric, CI, Satalic, Z, & Lukesic, Z 2003, “Nutritive value of meals, dietary habits and nutritive status in Croatian university students according to gender”, International J ournal of Food Science Nutrition , vol. 54 no. 6, pp.473-484.
Bas, M, Altan, T, Dincer, D, Aran, E, Kaya, HG & Yuksek, O 2005, “Determination of dietary habits as a risk factor of cardiovascular heart disease in Turkish adolescents”, Eur J Nutr , vol.44 no.3, pp.174-182.
Brevard, PB & Ricketts, CD 1996, “Residence of college students affects dietary intake, physical activity, and serum lipid levels”, J Am Diet Assoc , vol.96 no.4, pp.35-38.
Brunt, A, Rhee, Y & Zhong, L 2008, “Differences in dietary patterns among college students according to body mass index”, J Am Coll Health , vol.56 no.9, pp.629-634.
Bull, NL 1992, “Dietary habits, food consumption, and nutrient intake during adolescence”, J Adolesc Health, vol.13 no.1, pp. 384-388.
Center for Disease Control and Prevention (CDC) 2011, School health guidelines to promote healthy eating and physical activity , Web.
Champlin, S & Henderson, A 1998, Promoting teen health; linking schools, health organizations, and community , SAGE, New York.
Cullen, W, Baranowski, T, Rittenberry, L & Olveira, N 2000, “Social-environmental influences on children’s diets: results from focus group with African-Euro-and Mexican-American children and their parents”, Health Education Research, vol. 15 no.5, pp.581-590.
El-Ansari, W, Maxwell, AE, Mikolajczyk, RT, Stock, C, Naydenova, V & Kramer, A 2007, “Promoting public health: benefits and challenges of a European wide research consortium on student health”, Cent Eur J Public Health , vol.15 no.6, p.58-65.
Gay, K 2006, Am I fat? The obesity issue for teens: Enslow Publishers, Inc., New York.
Hagman, U, Bruce, A, Persson, LA, Samuelson, G & Sjolin, S 1986, “Food habits and nutrient intake in childhood in relation to health and socio-economic conditions. Irazusta, A, Gil, S, Ruiz, F, Gondra, J, Jauregi, A, Irazusta, J & Gil, J 2006, “Exercise, physical fitness, and dietary habits of first-year female nursing students”, Biol Res Nurs , vol.7 no.2, pp. 175-186.
Hales, D 2010, An invitation to health: choosing to change , Cengage Learning, New York.
Kafatos, A, Verhagen, H, Moschandreas, J, Apostolaki, I & Van-Westerop, JJ 2000, “Mediterranean diet of Crete: foods and nutrient content”, J Am Diet Assoc , vol.100 no.8, pp.1487-1493.
Kim, S, Haines, PS, Siega-Riz, AM & Popkin, BM 2003, “The diet quality index-international (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States”, J Nutr , vol.133 no.1, pp.3476-3484.
Kolodinsky, J, Harvey-Berino, JR, Berlin, L, Johnson, RK & Reynolds TW 2007, “Knowledge of current dietary guidelines and food choice by college students: better eaters have higher knowledge of dietary guidance”, Journal of American Diet Association , vol.107 no.12, pp.1409-1413.
Koplan, J, Liverman, C & Kraak, V 2005, Preventing childhood obesity: Health in the balance , National Academies Press, New York.
Lee, RL & Loke, AJ 2005, “Health-promoting behaviors and psychosocial well-being of university students in Hong Kong”, Public Health Nurs , vol.22 no.1, pp. 209-220.
Li, L 2011, “Factors influencing student’s food choices when shopping for food”, International Journal of Business and Management, vol. 6 no.1, pp. 165-186.
Martin, J & Oakley, C 2008, Managing child nutrition programs: leadership for excellence, Jones & Bartlett Learning, New York.
Miere, D, Filip, L, Indrei, LL, Soriano, JM, Molto, JC & Manes, J 2007, “Nutritional assessment of the students from two European university centers”, Rev Med Chir Soc Med Nat Iasi, vol.111 no.6, pp.270-275.
Mikolajczyk, RT, El-Ansari, W & Maxwell, AE 2009, “Food consumption frequency and perceived stress and depressive symptoms among students in three European countries”, Nutr J, vol.8 no.3, pp. 27-32.
Osler, M & Heitmann, BL 1996, “The validity of a short food frequency questionnaire and its ability to measure changes in food intake: a longitudinal study”, Int J Epidemiol , vol.25 no.4, pp. 1023-1029.
Panagiotakos, D, Sitara, M, Pitsavos, C & Stefanadis, C 2007, “Estimating the 10-year risk of cardiovascular disease and its economic consequences, by the level of adherence to the Mediterranean diet: the ATTICA study”, J Med Food, vol.10 no.4, pp. 239-243.
Pokin, B, Duffey, K & Gordon-Larsen, P 2005, “Environmental influences on food choice, physical activity and energy balance”, Physiology & Behavior, vol. 86 no. 12, pp.603-613.
Rivas, J. & Flores, M 2011, Cash incentives and unhealthy food consumption , Web.
Sakamaki, R, Amamoto, R, Mochida, Y, Shinfuku, N & Toyama, K 2005, “A comparative study of food habits and body shape perception of university students in Japan and Korea”, Nutr J , vol.4 no.1, pp. 31.
Schweyer, FX & Le Corre, N 1994, “L’alimentation au quotidien chez les e’tudiants”, Pre’venir , vol.26 no.6, pp.87-92.
Shakkour, E 2008, The relationship between nutritional knowledge and application , Web.
Spyckerelle, Y, Herbeth, B & Deschamps, JP 1992, “Dietary behaviour of an adolescent French male population”, J Hum Nutr Diet , vol.5 no.3, pp. 161-168.
Von Bothmer, MI & Fridlund, B 2005, “Gender differences in health habits and in motivation for a healthy lifestyle among Swedish university students”, Nurs Health Sci , vol.7 no.1, pp.107-118.
Wardle, J, Haase, AM, Steptoe, A, Nillapun, M, Jonwutiwes, K & Bellisle, F 2004, “Gender differences in food choice: the contribution of health beliefs and dieting”, Ann Behav Med , vol.27 no.2, pp.107-116.
Young, EM & Fors, SW 2001, “Factors related to the eating habits of students in grades 9–12”, J Sch Health , vol.71 no.2, pp.483-488.
Zheng, X & Zhen, C 2010, Healthy food, unhealthy food and obesity , Web.
Introduction: This survey questionnaire will help to evaluate the university student’s choice of food they choose to buy and/or eat and the factors that influences it. This questionnaire has two sections the Personal Information and Survey Proper. Please spare time in answering the survey form. Your personal data’s and answers will be kept as confidential. The information that gathered will be used for academic purposes.
- Personal Information (Please put your answers on the space provided)
- Name: _______________________ ( Optional )
- Gender: ___
- Education Level : ___________
- Marital Status : ___________
- Citizenship : ___________
- Weight: ___________
- Height: ___________
- Weekly Allowance : ________
Please check the appropriate box
- Buying food at your university canteen/ cafeteria?
- Are you bringing your own food/ snacks at your school?
Write your answers
- How many times in a week do you visit your school campus canteen/ cafeteria? __________
- When was the last time you visited school campus canteen/ cafeteria? _______
- What is your favorite food and drink that you usually buy at the school campus canteen/ cafeteria? __________________________________
(Note: Before proceeding to 2 nd part of this survey form Please do complete 1st part questions).
Survey Proper (Please check the appropriate box)
- Check the box with your appropriate answers
- Write your answers on the space provided
- Which do you prefer buying food at the school premises or buying outside the school, and then write the food you usually buy:___________________________________________________________________
- Write your insights about nutritious and healthy foods and ways on having it without costing you too much:________________________________________________________________________________________________________
- Check the box of your appropriate answer;
- Do you suffer some illness in eating unhealthy foods?
- Are you aware that the food you consume will affect your health?
- Chicago (A-D)
- Chicago (N-B)
IvyPanda. (2022, June 22). College Students' Healthy Nutrition Research. https://ivypanda.com/essays/healthy-nutrition-research-proposal-of-college-students/
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- How to Write a Research Proposal | Examples & Templates
How to Write a Research Proposal | Examples & Templates
Published on October 12, 2022 by Shona McCombes and Tegan George. Revised on November 21, 2023.
A research proposal describes what you will investigate, why it’s important, and how you will conduct your research.
The format of a research proposal varies between fields, but most proposals will contain at least these elements:
- Research design
While the sections may vary, the overall objective is always the same. A research proposal serves as a blueprint and guide for your research plan, helping you get organized and feel confident in the path forward you choose to take.
Table of contents
Research proposal purpose, research proposal examples, research design and methods, contribution to knowledge, research schedule, other interesting articles, frequently asked questions about research proposals.
Academics often have to write research proposals to get funding for their projects. As a student, you might have to write a research proposal as part of a grad school application , or prior to starting your thesis or dissertation .
In addition to helping you figure out what your research can look like, a proposal can also serve to demonstrate why your project is worth pursuing to a funder, educational institution, or supervisor.
Research proposal length
The length of a research proposal can vary quite a bit. A bachelor’s or master’s thesis proposal can be just a few pages, while proposals for PhD dissertations or research funding are usually much longer and more detailed. Your supervisor can help you determine the best length for your work.
One trick to get started is to think of your proposal’s structure as a shorter version of your thesis or dissertation , only without the results , conclusion and discussion sections.
Download our research proposal template
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Writing a research proposal can be quite challenging, but a good starting point could be to look at some examples. We’ve included a few for you below.
- Example research proposal #1: “A Conceptual Framework for Scheduling Constraint Management”
- Example research proposal #2: “Medical Students as Mediators of Change in Tobacco Use”
Like your dissertation or thesis, the proposal will usually have a title page that includes:
- The proposed title of your project
- Your supervisor’s name
- Your institution and department
The first part of your proposal is the initial pitch for your project. Make sure it succinctly explains what you want to do and why.
Your introduction should:
- Introduce your topic
- Give necessary background and context
- Outline your problem statement and research questions
To guide your introduction , include information about:
- Who could have an interest in the topic (e.g., scientists, policymakers)
- How much is already known about the topic
- What is missing from this current knowledge
- What new insights your research will contribute
- Why you believe this research is worth doing
As you get started, it’s important to demonstrate that you’re familiar with the most important research on your topic. A strong literature review shows your reader that your project has a solid foundation in existing knowledge or theory. It also shows that you’re not simply repeating what other people have already done or said, but rather using existing research as a jumping-off point for your own.
In this section, share exactly how your project will contribute to ongoing conversations in the field by:
- Comparing and contrasting the main theories, methods, and debates
- Examining the strengths and weaknesses of different approaches
- Explaining how will you build on, challenge, or synthesize prior scholarship
Following the literature review, restate your main objectives . This brings the focus back to your own project. Next, your research design or methodology section will describe your overall approach, and the practical steps you will take to answer your research questions.
To finish your proposal on a strong note, explore the potential implications of your research for your field. Emphasize again what you aim to contribute and why it matters.
For example, your results might have implications for:
- Improving best practices
- Informing policymaking decisions
- Strengthening a theory or model
- Challenging popular or scientific beliefs
- Creating a basis for future research
Last but not least, your research proposal must include correct citations for every source you have used, compiled in a reference list . To create citations quickly and easily, you can use our free APA citation generator .
Some institutions or funders require a detailed timeline of the project, asking you to forecast what you will do at each stage and how long it may take. While not always required, be sure to check the requirements of your project.
Here’s an example schedule to help you get started. You can also download a template at the button below.
Download our research schedule template
If you are applying for research funding, chances are you will have to include a detailed budget. This shows your estimates of how much each part of your project will cost.
Make sure to check what type of costs the funding body will agree to cover. For each item, include:
- Cost : exactly how much money do you need?
- Justification : why is this cost necessary to complete the research?
- Source : how did you calculate the amount?
To determine your budget, think about:
- Travel costs : do you need to go somewhere to collect your data? How will you get there, and how much time will you need? What will you do there (e.g., interviews, archival research)?
- Materials : do you need access to any tools or technologies?
- Help : do you need to hire any research assistants for the project? What will they do, and how much will you pay them?
If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.
- Sampling methods
- Simple random sampling
- Stratified sampling
- Cluster sampling
- Likert scales
- Null hypothesis
- Statistical power
- Probability distribution
- Effect size
- Poisson distribution
- Optimism bias
- Cognitive bias
- Implicit bias
- Hawthorne effect
- Anchoring bias
- Explicit bias
Once you’ve decided on your research objectives , you need to explain them in your paper, at the end of your problem statement .
Keep your research objectives clear and concise, and use appropriate verbs to accurately convey the work that you will carry out for each one.
I will compare …
A research aim is a broad statement indicating the general purpose of your research project. It should appear in your introduction at the end of your problem statement , before your research objectives.
Research objectives are more specific than your research aim. They indicate the specific ways you’ll address the overarching aim.
A PhD, which is short for philosophiae doctor (doctor of philosophy in Latin), is the highest university degree that can be obtained. In a PhD, students spend 3–5 years writing a dissertation , which aims to make a significant, original contribution to current knowledge.
A PhD is intended to prepare students for a career as a researcher, whether that be in academia, the public sector, or the private sector.
A master’s is a 1- or 2-year graduate degree that can prepare you for a variety of careers.
All master’s involve graduate-level coursework. Some are research-intensive and intend to prepare students for further study in a PhD; these usually require their students to write a master’s thesis . Others focus on professional training for a specific career.
Critical thinking refers to the ability to evaluate information and to be aware of biases or assumptions, including your own.
Like information literacy , it involves evaluating arguments, identifying and solving problems in an objective and systematic way, and clearly communicating your ideas.
The best way to remember the difference between a research plan and a research proposal is that they have fundamentally different audiences. A research plan helps you, the researcher, organize your thoughts. On the other hand, a dissertation proposal or research proposal aims to convince others (e.g., a supervisor, a funding body, or a dissertation committee) that your research topic is relevant and worthy of being conducted.
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A THESIS PROPOSAL ON NUTRITIONAL STATUS OF 5 TO 10 YEARS CHILDREN OF NAMJE, VEDETAR VDC OF DHANKUTA DISTRICT
Nepal demographic health survey reported that 41% of children under five years were stunted, 11% wasted and 29% underweight. Several factors were noted to contribute towards malnutrition-for example, socio-economic factors, mother's literacy, acute illnesses, age of the child (Sah N, Determinants of child malnutrition in Nepal). Social problems such as poverty, skewed land distribution and food insecurity are some of the underlying factors which cause malnutrition. World Health Organization (WHO) data from 2011 report the prevalence of moderate and severe malnutrition to be 29.8% and 8.5% respectively, among boys under five in Nepal. Moderate and severe stunning among Nepali boys who are under five were reported to be 41.3% and 16.8% respectively, and that among girls were 39.5% and 15.8% respectively.
Advanced Journal of Graduate Research
Journal of Nutritional Health & Food Science
Dr. Tulsi R A M Bhandari
IOSR Journal of Nursing and Health Science
In developing countries malnutrition is one of the major public health problems among children. Normal growth is dependent on adequate nutrition and encompasses major transformations from birth to adulthood. Socio-economic status and behaviors of family members, environmental factors are other determinants of nutritional status of children. This research was conducted to assess the factors associated with nutritional status of children in Allahabad District of Uttar Pradesh. This was a community based Cross-sectional study. It was conducted in Allahabad district. A totalsample of three hundred ninety one children were selected using random sampling technique. Data was collected using a pre tested schedule. More than half of the children (74.79 % in Jasra Block and 67.53 % in Chakka Block) aged 6- 24 months were malnourished according to Gomez Classification . Most of the mothers were illiterate. Majority of the children were found stunted according to Waterlow?s classification. More than the half the children (57.75%) were underweight who were born by mother less than 18 years of age where as 75% were underweight born by mother aged above 35 years of age. More than half of the children were found underweight and Nearly 2/3rd of the children were found stunted. To get better nutritional status of children, greater emphasis should be given to under five years children with community based awareness programs to mother and care givers.
International Journal Of Community Medicine And Public Health
Background: Proper nutrition is crucial for healthy living. According to Nepal multi-indicator cluster survey 2019, prevalence of stunting, wasting and underweight were 31.5%, 12% and 24.3% respectively. The prevalence of under nutrition is higher in Karnali Province than other Provinces of Nepal. This study is conducted to assess the factors affecting the nutritional status of under five years’ children in Rara Chhayanath municipality, Mugu district.Methods: A community based cross sectional study was conducted in Rara Chhayanath municipality, Mugu district of Nepal which was purposively selected. Three wards were selected for collection of data. Verbal informed consent was taken from the mothers of the under five children and approval was taken from Little Buddha College of Health Science and Municipality. Bivariate analysis was performed to identify the factors associated with nutrition status of children. Results: In the study, prevalence of stunting and wasting were high as com...
Journal of Nepal Paediatric Society
Introduction: Undernutrition is a major health problem in developing countries which may have adverse effects on growth and development of an individual. The objectives of this study were to assess the prevalence and grades of malnutrition in children below 60 months of age, attending outpatient department at Gandaki Medical College teaching hospital.Materials and Methods: A prospective study was conducted among 556 children below 60 months of age from August to December 2013. Weight and length/height were measured using standard technique and were plotted on WHO centiles curves and severity determined based on WHO classification. The prevalence of underweight, stunting and wasting were determined by anthropometry.Results: Based on WHO classification, out of 556 children, 20.2% were underweight, 34% were stunted and 15.1% were wasted respectively. Of them, severe underweight were 4.7%, severe stunted were 14.1% and severe wasted were 7.2% respectively.Conclusion: A high prevalence o...
International Journal of Community Medicine and Public Health
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Nutrition Research Proposal
What state is best to start an LLC: California or Washington?
What state is best to raise a family: North Carolina or Ohio?
What state is better: New York or Maryland?
What state is better: Washington or Michigan?
What state is better: New Jersey or Virginia?
A nutrition research proposal is a document laying down the request of nutrition for a valid organization which deals with nutrition researches. It focuses on the major principles of a food company on the basis of which the researcher conducts the research and lays down the credibility of his findings for the benefit of the company.
Sample Nutrition Research Proposal
Name of the Organization: Just a Minute Noodles
Name of the food product: Flour Noodles
Name of the owner: Mr. Denmark Volvo
Proposal given to: Walton Cox, Nutritionist, Geometrics Health World
Product rating: 8/10
Date of proposal: 5 th June, 2011
Company ranking: 30 th in the international arena
Ingredients used in the product:
- Monosodium Glutamate
- Food additives
- Taste enhancer
- Natural flavours
Requirements of the research: We want to carry out a nutrition research to rate the harmfulness and beneficial aspects of the product. A thorough study of the ingredients must be conducted to throw light on all the positive and negative outcomes of using the product and to check for an alternative substance that would provide for greater benefits. The research must give a clear indication of the facts related to the health of the consumer. The research findings must highlight the four main following areas:
Health: How much restriction of the product’s intake is required for patients with heart diseases?
Pregnancy: Till which trimester an expecting woman is free to consume the product and why?
Age: Which age group of people should abstain from this product?
Demerits: What are the harms caused by regular consumption of the product?
Proposal acceptance valid till: 5 th July 2011
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Challenges in conducting clinical nutrition research
Connie m. weaver.
C.M. Weaver is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA. J.W. Miller is with the Department of Nutritional Sciences, Rutgers University, New Brunswick, New Jersey, USA.
Joshua W. Miller
Clinical nutrition research has played a pivotal role in establishing causality between diet or nutrient intake and health outcome measures and in the determination of dietary requirements and levels of supplementation to achieve specific outcomes. Because the studies are performed with humans, clinical nutrition research can be readily translated into public health messages. However, there are many challenges and considerations unique to the field, such as the baseline nutritional status of study participants, defining appropriate control groups, effective blinding of participants and investigators, the evolving ethics of randomized control trials, and a tension in a priori decisions regarding inclusion of nutritionally vulnerable participants versus representative samples of general populations. Regulatory approvals that place increasing burdens on the ability of investigators to carry out and complete research protocols have grown dramatically in recent years. There is much room for improved efficiency in the approval and reporting processes aimed at protecting volunteers and providing transparency to the public. Decreased redundancy would have a direct benefit to clinical nutrition research and investigators. Despite these challenges, the information to be gained and the rewards of clinical nutrition research remain high.
Clinical nutrition research involves the study of the effects of dietary interventions on one or more biological or health-related endpoints in human participants. Such research is foundational to providing evidence for dietary guidance and public health messaging. Experimental dietary modifications may include several components of a diet, often involving changes in whole food dietary patterns and, consequently, changes in multiple macronutrients and micronutrients simultaneously. A prime example is the Dietary Approaches for Stopping Hypertension (DASH) diet, which has been shown to reduce blood pressure in adults. 1 Increasing understanding of the influence of dietary patterns on health is a focus of the most recent iteration of the Dietary Guidelines for Americans (2015–20). 2 Alternatively, experimental dietary modifications may focus on the addition or subtraction of a single nutrient to the diet. Good examples are the randomized controlled trials (RCTs) that showed periconceptual folic acid supplements reduce the incidence of neural tube defects, which led to the now widespread practice of folic acid fortification around the world. 3 Clinical nutrition studies have historically been key to determining nutrient requirements. This is especially true for micronutrients, where a single nutrient can be manipulated while other potential dietary confounders are held constant. For example, the level of calcium intake shown to optimize calcium accretion in adolescence 4 is used as the recommended dietary allowance for calcium for adults. 4
Basic principles for designing, managing, and conducting clinical research studies are available in the literature. 5 The goal of this perspective paper is to overview some of the newer and specific challenges associated with conducting clinical nutrition research. Hopefully, shared experiences can help new researchers to the field be better prepared to navigate the obstacles.
SPECIAL ISSUES WITH DIET/NUTRIENTS AS THE INTERVENTION
The gold standard for clinical research is the double-blind RCT. Randomized controlled trials provide interventions that reduce confounding and allow causation to be inferred. In clinical nutrition studies, the whole diet can be controlled, as in metabolic balance studies, or just a nutrient or bioactive compound can be withheld or provided as a supplement with an otherwise self-selected diet. Randomized controlled trials for single micronutrients or bioactive ingredients are much easier to accomplish than macronutrient, whole food, or dietary pattern studies. The more complex the design of menus; the procurement, storage, and transfer of the intervention to the participant; and the participant’s ability to handle receipt of the intervention, including storage, preparation, and protocol compliance, can be daunting. Even when a study is conducted at a clinical research site, there are logistical challenges, such as parking availability, the number of subjects that can be accommodated at a given time, storage concerns, and so forth. Moreover, it is difficult, if not impossible, to blind participants to the forms of whole foods or macronutrients that make up their study meals. In contrast, micronutrients or other bioactive compounds may be provided in the form of pills that are identical in appearance to placebo, thus allowing for true blinding, similar to pharmaceutical drug trials. However, there are important differences between diet/nutrient RCTs and drug RCTs that greatly influence the design and conduct of such trials as well as their interpretation.
Challenges with nutrition interventions that are not found in drug trials are summarized in Table 1 . For compliance with a dietary pattern or macronutrient feeding study, the diet or food has to be well tolerated; there is also a higher bar for the dietary intervention to be appealing than for drugs meant to treat a specific health problem where motivation to participate and comply with study protocols may be higher due to the immediacy of the condition (eg, cancer, heart disease, Alzheimer’s disease). A food or diet must be accepted by a wide range of tastes and cultural preferences in most studies. Furthermore, unlike with drugs, the whole diet may shift when the aim is to study 1 dietary component. This is especially true for macronutrients (ie, protein, fat, and carbohydrates). When 1 is manipulated, so is another. This begs the question: Was the response due to increased protein or fat, for example, or to a decrease in the displaced macronutrients? And this assumes that the alterations in macronutrients are made while maintaining equal overall caloric intake. Alternatively, a specific macronutrient may be altered without changing intake of other macronutrients, but this imposes the confounding factor that overall caloric intake has been changed. Moreover, proteins, fats, and carbohydrates are general categories of nutrients with subcategories that may have very different dietary and metabolic properties. For example, when designing a low-fat experimental diet to be compared with a high-fat diet, what are the forms and distribution of fats (saturated, monounsaturated, polyunsaturated) that will be used in each diet? In addition, when changing whole foods in a diet, it is very difficult to maintain equal intakes of micronutrients and bioactive compounds because the levels of these substances can vary dramatically within different foods.
Study design considerations for clinical nutrition research
Another confounding factor is that the background intake and status of a nutrient of interest can greatly influence the response being studied. In drug trials, unlike in nutrition trials, there is an absence of the drug at baseline. This is almost never true for nutrient studies, thus requiring consideration of the baseline status of the nutrient in question in the study population. Our current ability to assess usual intake of a nutrient, much less a bioactive constituent, is poor, 6 , 7 and only some nutrients have a good biochemical status indicator (eg, a blood or urinary analyte). Moreover, if the baseline level of the intervention substance is already adequate, little change in outcome can be expected. Many nutrients have threshold intakes—that is, the enzyme, carrier, or receptor becomes saturated. The majority of studies do not consider the starting status of participants being recruited or even assess intake or status at the start of the study. On the other hand, recruiting only those with an intake level below a certain threshold or those most at risk for the outcome being measured limits the generalizability of findings. In addition, withholding a nutrient in an RCT from individuals known to be low or deficient in that nutrient may create an ethical dilemma.
As with many drugs, the form a nutrient or bioactive food component takes, the matrix that it is in, and the dose can influence its bioavailability. For example, synthetic folic acid is more bioavailable than natural folates found in foods, 8 and the bioavailability of vitamin B 12 varies among natural food sources 9 and decreases with increasing dose due to physiological limits on absorption. 10 Processing of food can render the compound of interest more or less bioavailable through exposure to temperature, change in pH, exposure to other constituents, and so on. Some nutrients share the same transporters and compete for absorption (eg, zinc and copper), whereas absorption of some nutrients may be affected by other dietary constituents (eg, the chelation of minerals such as magnesium, calcium, zinc, and iron by phytates).
Of special interest for dietary guidance are acute effects that may differ from chronic exposure. For example, whey proteins enhance calcium absorption acutely but not when they are consumed chronically. 11 Similarly, vitamin C enhances iron absorption acutely but not chronically. 12 Consumption of supposedly bioactive ingredients purified from whole food can also have unexpected results. One of the most famous examples is from the Alpha-Tocepherol, Beta Carotene Cancer Prevention Study. 13 Fruits and vegetables have long been associated with reduced risk of lung and other cancers. But when >29 000 Finnish male smokers were given rather high doses of alpha-tocopherol (50 mg/d) and beta carotene (20 mg/d) alone or together for 5–8 years, a higher incidence of lung cancer occurred in men who received beta carotene than in those who did not. This finding suggests that the presumption of benefit or lack of potential harm, which is often ascribed to vitamins, may not apply to all individuals. This may be particularly true for individuals with initiated cancers, where specific nutrients or dietary patterns may promote progression. This phenomenon of “feeding” initiated cancers may underlie the findings of the Alpha-Tocepherol, Beta Carotene Study, as well as the controversial finding that colorectal cancers might have been temporarily promoted in the United States and Canada after initiation of government-mandated folic acid fortification policies. 14 , 15
What is an ethical control? The concept of using standard of care as the control in medicine has become adopted in dietary supplement studies. In osteoporosis research, the typical control group receives calcium and vitamin D supplements rather than a placebo. Is this appropriate for nutrition research? Classic depletion/repletion studies were a staple of nutrition research in previous decades, and they revealed much of our fundamental knowledge about the metabolic and physiologic effects of nutrient deficiencies. However, deliberately depleting participants in a nutrient to the point of harm—or even to the point of biochemical impairment without overt clinical or physiological consequence—is now typically considered unacceptable. In recent years, institutional review boards (IRBs) have extended this ethical concept to RCTs in which deficiency is not being induced by the study protocol per se but a portion or all of the study population is low or deficient in a specific nutrient at baseline based on their own selected dietary patterns or other circumstances. It could be argued that there is value to understanding the effectiveness of an intervention in people in their natural condition, and to their credit, IRBs often allow study of subjects whose usual intakes, diet patterns, or nutrient status are insufficient. However, in some cases, IRBs have concluded that because those conducting the trial are aware that some or all of the study sample has low or deficient status, it is unethical to conduct a placebo-controlled trial because a portion of the participants will, by receiving placebo, go untreated for their deficiency. Continuing with this line of reasoning could lead to the conclusion that, because nutritional deficiencies are known to exist all over the world, nutritional research should not be performed at all and that researchers should, instead, dedicate their time to finding deficient individuals and repleting them.
Of course, it is not being suggested that individuals in current or imminent danger from nutritional deficiencies be denied intervention. Rather, it is being pointed out that part of the problem may be semantic and of the research community’s own making. Individuals tend to be labeled “deficient” if they have a blood level of a nutrient below a specific cutoff value. However, often these individuals have no overt, clinical signs of deficiency and, therefore, may more accurately be considered to have “low” or “suboptimal” status. For these individuals, it may be ethical to deny treatment (ie, by including them in a placebo group) based on the concept of “equipoise.”
Equipoise, in medicine, refers to the uncertainty around whether a treatment will be effective. 16 , 17 With appropriate consideration of risks and benefits, the principle of equipoise may be used to justify a particular placebo-controlled intervention study. Consider the experience of 1 of the present authors (J.W.M.): He was part of a research team that had found, as others had reported in the literature, that a particular patient population had low circulating levels of a particular nutrient but no overt clinical signs or symptoms directly ascribable to the “deficiency.” The research team submitted a proposal to the National Institutes of Health (NIH) to perform an RCT in this patient population to determine whether supplements of the nutrient might be beneficial. A reviewer of the proposal commented that the study was unethical because treatment would be withheld from deficient individuals. In rebuttal, it was argued that disallowing the RCTs meant that it would never be known whether supplements of the nutrient would be beneficial, and without credible RCTs, medical practice (which did not include supplements of the nutrient in these patients) would not be changed. Therefore, by the principle of equipoise and the state of the evidence known at the time, it was argued that it would be unethical not to perform the study because there was a chance that patients might benefit in the future. This argument was successful, and the study was funded.
Making successful ethical arguments in favor of nutritional research strategies and protocols is essential to the future of nutrition and health. In particular, it must be recognized that, as knowledge accumulates, nutritional recommendations change over time. An example comes from clinical bone research. Supplementation with calcium and vitamin D is considered standard of care, and it has been the practice to include these supplements across groups in bone research studies, including the placebo group. Thus, knowledge of the efficacy of diet and drugs on bone outcome measures without calcium and vitamin D supplements is lacking. However, recent questions surrounding the safety of these supplements, have led to a decline in sales. Researchers must, therefore, be able to carry out nutrition research on bone outcomes and other topics using strategies and protocols that are both ethical and can improve understanding in ways that allow for evidence-based decisions for health care to be made.
Another issue with nutrition research is the lack of ability to intervene for a sufficient length of time to investigate chronic disease outcomes. An inherent limitation is that funding periods are typically ≤5 years. Obesity and chronic diseases of most concern today (eg, cancer, vascular disease, neurodegenerative disease, osteoporosis) have long latency progressions. Partly because it is difficult to have intellectual property around diet or dietary components, there is much less funding available to support long-term nutrition studies compared with drug trials. It is also more feasible for volunteers to take a drug daily than to change their diet for a prolonged period of time. Providing a prescribed diet for a study is labor intensive and operationally difficult for a lengthy period. To illustrate, an ongoing study involves 4 diets (ie, DASH-high sodium, DASH-low sodium, usual-high sodium, and usual-low sodium) at 5 energy levels for 20 different menu preparations for >500 adolescents for 25 days each. Blood pressure and serum lipid changes can be monitored in this time frame but not disease outcomes.
Blinding, which is a study design element to reduce bias, is difficult to achieve with most nutrition studies. For example, with the aforementioned DASH/sodium dietary study, the kitchen staff involved in menu preparation has to know the intervention, and it is difficult to disguise from the participants a diet rich in fruits, vegetables, and dairy from one low in these foods or whether the food is salty or not. Nevertheless, some principles encompassed in the philosophy of blinding can be applied. For example, staff collecting primary outcome measures can be blinded to the intervention, and interventions can be coded so that statisticians analyzing the data are unaware of intervention assignment.
Deciding on a study population is also a challenge, especially with limited funding. There is a tension between achieving generalizable findings and sufficient power to determine an effect. Because of the typically small effects of diet on physiologic responses and the long latency of effects of diet on disease outcomes, there is strong motivation to select a homogeneous, narrow population to reduce the sample size required to see an effect. Selection of a group most likely to be responsive (inadequate nutrient status, high-risk population, etc) and a homogeneous population to reduce variance (narrow age range, same life stage, same sex, same ethnicity, etc) is more likely to produce a positive outcome. However, it comes at a cost for the generalizability of results, which is important for establishing public health guidelines. Seldom are nutrition RCTs sufficiently funded to recruit enough volunteers to represent a population and also include enough volunteers in the subpopulation that is likely to have an outcome during response the time of the trial. A more recent concern is defining a healthy population, considering that more than half of American adults have at least 1 chronic condition.
The tension between generalizability and effect may be decided by impact goals. For public health messaging, generalizability is critical because the target audience is the masses. With an increasing interest in personalized nutrition, identifying subgroups or individuals who can benefit from an intervention becomes the larger goal.
With the increased ability to process complex data, nutrition research is expanding the outcomes being considered from single pathways or tissues to multiple outcomes, be they beneficial or harmful. For example, the gut, with its microbiome, is being viewed as an organ that actively participates in processing and synthesizing nutrients together with the host to impact health. Bone is being considered in conjunction with muscle and adipose tissue in new ways.
There is also concern about the possible harmful consequences of dietary supplements or fortification programs designed to fill gaps between nutrient intake levels compared with requirements. A current debate is over folic acid. In the United States, it was mandated that wheat flour be fortified with folic acid by 1998; subsequently, the incidence of neural tube defects decreased dramatically between 1998 and 2004, by 19%–32%, justifying the mandate because it achieved its intended purpose of reaching women of childbearing age, who comprised the vulnerable subgroup. 18 , 19 However, concern over an associated increased risk of cancer, especially colorectal cancer, with folic acid fortification and folic acid supplement use has caused some to question the practice for the entire population. 14 , 15 , 20 Moreover, there is increasing, although circumstantial, evidence that an imbalance of low vitamin B 12 status with high folate status can have negative effects on development, 21 cognition in older adults, 22–24 and response to B 12 supplementation. 25 Nevertheless, >80 countries have adopted mandatory folic acid fortification of at least 1 cereal grain ( http://www.ffinetwork.org/index.html ).
Overall, fortification of foods is declining. Demand for unfortified ready-to-eat cereals is concerning because consumption of such cereals could widen the nutrient gap between intake levels and recommendations, especially for children and the elderly. Fortified ready-to-eat cereals are a major source of vitamin B 12 in a bioavailable form for the elderly, and fortification in general helps most Americans meet recommendations. 26 However, concern over safety and lack of benefit of dietary supplements, including calcium, vitamin D, vitamin E, and multivitamins, has received a great deal of media attention.
COPING WITH BIAS
Scientists routinely have to navigate bias, both that of others and their own. Important examples of the former include the biases of reviewers of grant applications and manuscripts, as well as public and professional perceptions. External assumptions of bias can be particularly acute when the research is funded by industry, which has become a growing issue as federal funding declines and industry funding is sought to fill the void and maintain research programs. Biases and misinformation in the media, especially in opposition to industry-supported research, can be particularly strong and widespread. Examples of individual bias include the desire for respect and recognition among peers, the academic imperative to “publish or perish,” a personal history of supporting a specific position, personal passions, ideologies or philosophies, religious or ethical orientations, nationality, ethnicity, and financial conflicts of interest.
In addition, nutrition scientists encounter some unique biases. At a basic level, there is no agreement about the best approach to study the role of nutrition in health and disease. Basic scientists prioritize finding a molecular mechanism for what a nutrient does or how nutrient status influences molecular machinery. Without that, they are not convinced of the phenomenon. Critics of this approach disagree. What is learned from in vitro studies may not represent the human condition and may very well be an artifact of the manipulated environment. Animal models provide the distinct advantage of allowing long-term controlled diet designs with disease outcomes. However, no animal model is a completely satisfactory model of a human disease. Randomized controlled trials in humans are relevant, allow causal inference, and minimize confounding but typically suffer from poor compliance, are of inadequate duration to have disease outcome measures, and are criticized for being artificial compared with the human experience. Epidemiology attempts to find relations in the context of usual behavior and, thus, may fulfill the desire to study steady-state phenomena. On the other hand, results are associational and not causal. Teasing out the role of 1 nutrient or food or a diet pattern from the milieu of confounders is a daunting task. Moreover, the methodologies to capture what individuals eat remains crude. Each line of evidence provides insights, but none are perfect or ideal in nutrition research.
Biases arise even within each approach to studying nutrition. When reviewing a report of an RCT, evaluating compliance with the intervention is subject to one’s experience. If the paper reports 100% compliance, a reviewer could be concerned about coercion. For example, if the study was conducted in an African village that required approval of the village chief, the culture may be that everyone follows the chief’s decision. Similar differences in cultural perceptions exist for subject reimbursements. Some cultures find reimbursements coercive, and others find them ethical to offset subject burden. Some international IRBs will not review applications with budgets below some set amount, which could be viewed as inappropriate to the purpose of an IRB by others.
Each study environment has its own unique circumstances to be considered. For example, in the United States, controlled feeding studies in adolescents have been conducted at summer research camps; eleven such camps have investigated calcium metabolism (eg, Jackman et al. 27 ). Going away to camp is a well-accepted American experience, but the concept is met with curiosity and sometimes skepticism outside the United States. Summer camp environments alter the concept of subject burden. Many measurements can be taken over time compared with what is feasible in a study visit to a clinic where each added measurement adds to the length of the visit. Time is rarely a consideration at a camp, where the challenge is to fill time with activities that are enjoyable to the participants.
All types of research can contribute to our understanding of nutrients and health. Knowledge of whether there is an effect, at what dose and for whom the effect occurs, the mechanism involved, and whether the effect can feasibly be translated into practice are all needed. It is prudent to weigh all evidence and evaluate it critically. 28
EXPANSION OF REGULATORY APPROVALS
The growth in regulatory approvals required for clinical nutrition research in the last 3 decades has made research daunting, especially for junior scientists who can ill afford the months to years that may be required to get a study launched ( Box 1 ). It is a worthwhile endeavor to streamline the cumbersome approval process for conducting human research to stimulate this valued type of research contribution. Without clinical trials, there can be no updated systematic reviews for evidence to set guidelines.
Box 1 Regulatory approvals and processes for clinical nutrition research
- Institutional review board training, approvals, and reporting
- Good clinical practice training
- Clinical trials registries
- Sponsor audits and progress reports
- Conflict-of-interest training and reporting
- Data sharing plans
- Data safety and monitoring plans and reports
- Investigative new drug applications or requests for exemptions
- Isotopic tracer approvals and protocols
Approval from an IRB to begin a research study involving human subjects has been required for many years. As institutional programs around IRBs have grown, the amount of effort required by investigators to annually update IRB approvals and to apply for and receive permission for slight modifications to the recruitment process or study design has multiplied. This effort is compounded when >1 institution is engaged in the research, and the approval of >1 IRB is required. Attempts are being made for reciprocity across IRBs, but there is still much room for improved efficiency.
For some trials, an additional oversight burden is placed on investigators when sponsors provide monitoring of the study. All oversight reports, including monitor assessments, data safety reports, and reports from data safety and monitoring boards, must be provided to the IRB. Although the goal of a single oversight entity is laudable, the research enterprise has grown so complex that today there is no such entity. The multiplicity of reviews is a threat to efficient and effective protection of subjects.
Human subject protection training for investigators and key research personnel came into vogue in the early 2000s. The burden for institutions to prepare and deliver these trainings resulted in the development of the Collaborative Institutional Training Initiative in 2000. The content has significantly expanded over the years and now encompasses a series of 14 different trainings, with various parts and subparts. Each research institution establishes which members of the research team require training, which series are required, and which modules within a series are required, making the demonstration of compliance with training requirements problematic when >1 institution is engaged or when researchers change institutional affiliations.
Nevertheless, the IRB is a salient safeguard for subject protection. Streamlining the process should be imperative across all sectors. It is important that new investigators build substantial time for training and IRB approval into protocols in the development stage.
In 1997, the US Congress passed a law (the Food and Drug Administration Modernization Act) requiring registration of clinical trials. In 2000, NIH launched a publically available clinical trial registry, ClinicalTrials.gov. The requirements for its use have continued to expand, such that in 2005 the International Committee of Medical Journal Editors began requiring trial registration as a condition of publication. In 2006 the World Health Organization stated that all clinical trials should be registered, and in 2007 the World Health Organization launched the International Clinical Trials Registry Platform. Also in 2007 Congress passed the Food and Drug Administration Amendments Act, expanding the requirements for submission to ClinicalTrials.gov and imposing civil monetary penalties for noncompliance. In 2015, NIH modified the definition of “clinical trial,” again expanding the net to bring more studies into these registries. Beginning in 2017, all investigators who design, oversee, manage, or conduct clinical trials will be required to complete online training in good clinical practice. Clinical trial grants submitted to NIH will need to include plans for registering the trial in ClinicalTrials.gov.
This evolution directly impacts investigators. As an example, top journals such as the New England Journal of Medicine, JAMA , and the American Journal of Clinical Nutrition deny manuscript submission for studies not registered, but when registration must occur is a question of concern. In this shifting environment, it is noted that registration was initially required prior to manuscript submission, but now registration is required by NIH and journals prior to recruitment of volunteers. In addition, editors check the registration sites to make sure the manuscripts represent the a priori primary aims of the study; if not, the author(s) must declare that a finding is being reported that was not initially a primary aim.
At this point, there are multiple levels of oversight and reporting requirements for research whose aim is to improve the health and welfare of people. To ensure that there is objectivity in this research, financial conflicts of interest must be declared at several levels (eg, to the university when a grant or renewal is submitted, to the journal when submitting a manuscript, to some journals when reviewing a manuscript, and to the audience when presenting research in a public venue). Training on conflicts of interest is another professional requirement for investigators. Conflict-of-interest training is not unique to clinical research and is required for many professions, such as law. Disclosing financial conflicts of interest is important for transparency to garner trust from the public. 29 While there is no evidence that redundancy in conflict-of-interest training has improved the quality of the science produced or protected human subjects, the training does involve significant financial and human resources. And worse, even with transparency, some people have a bias that privately funded research yields only results that are favorable to the funder's interests.
Looking ahead, data sharing for clinical research is now expected from federal sponsors, but mechanisms for sharing data are not publically available yet. In some areas of science (eg, DNA sequence sharing, Genbank), public databases are valuable. The approaches that have been used, including online supplementary information with journal articles and authors’ personal webpages, are unsatisfactory. Libraries will likely help with solutions in the near future.
INVESTIGATIVE NEW DRUGS
In September 2013, a guidance document for clinical investigators, sponsors, and IRBs was released by the US Food and Drug Administration (FDA) to determine whether human research studies can be conducted without an investigative new drug (IND) application. 30 In effect, researchers working on food and nutrition intervention studies with health outcomes beyond nutritional deficiencies were expected to apply to the FDA to determine whether they were exempt from requiring an IND. The process was managed the same as for drugs, and the application process was unclear, even as to whom the inquiry should be directed. The Center for Food Safety and Nutrition, for example, has no staff to review IND applications. This non–legally binding guidance led many industry sponsors to take their clinical research overseas to avoid delays in conducting domestic research. In addition, it left industry in a regulatory dilemma; if a company were to file an IND to perform a clinical trial, would the product be considered a food or a drug? In the latter case, both extensive monetary investment and approval processes would be required. The ruling compromised clinical nutrition research in the United States, especially research on bioactive foods and ingredients, and stalled productivity of untenured faculty, thus endangering the food research structure of the country.
In response to a national protest in the form of letters to the FDA signed by >70 nutrition and food science administrators and professional societies, the FDA issued a notice of stay (for parts of the guidelines), which was published in the Federal Register on October 30, 2015 (80 FR66907). Investigative new drug regulations [21 CFS 312.2(b)] state that clinical investigations of a biologic product lawfully marketed in the United States are exempt from IND application requirements if they meet the 5 designated criteria outlined in Box 2 . Still, NIH will not allow self-interpretation if these requirements are met. Thus, if the research is sponsored by NIH, investigators must apply for exempt status for an IND.
Box 2 Criteria for exemption from filing an investigative new drug application for clinical investigations of a biologic product
All 5 of the following criteria must be met for a clinical investigation of a biologic product to be exempt from requirements for an investigative new drug application:
- The investigation is not intended to be reported to the FDA as a well-controlled study in support of a new indication for use, nor intended to be used to support any other significant change in the labeling for the drug.
- The investigation is not intended to support a significant change in the advertising for a prescription drug product.
- The investigation does not involve a change in route of administration, dosage level, or patient population, or other factor that significantly increases the risk (or decreases the acceptability of risk) with use of the drug product.
- The investigation is conducted in compliance with the requirements for institutional review (21 CFS 56) and informed consent (21 CFS 50).
- The investigation is conducted in compliance with the requirements of 21 CFS 312.7 (ie, the drug may not be represented as safe or effective, nor may it be commercially distributed) for the purposes for which it is under investigation.
USE OF ISOTOPIC TRACERS
Use of radioactive isotopic tracers also requires an IND application if the tracers are used in basic research for immediate therapeutic, diagnostic, or similar purposes or otherwise to determine the safety and efficacy of the product. Exemptions may be allowed if these conditions do not apply (21 CFS 361). However, use of radioisotopes in humans must be approved by a Radioactive Drug Research Committee that is composed of and approved by the FDA. Stable isotopes typically do not require an IND application.
Intravenous isotope preparation requires sterile techniques and standard pharmaceutical compounding protocols. Careful documentation, including source and lot of all chemicals used, aliquot scheme, and pyrogenicity, and sterility testing are necessary for stored preparations. FDA regulation USP 797 covers some of the materials, but there are no specific regulations for stable isotopes in humans.
Clinical nutrition researchers encounter many hurdles, including difficulties with recruiting volunteers, navigating a complex maze of approvals, and coping with myriad biases. Special scientific issues involved with clinical nutrition research include study designs that increase or decrease the status of a nutrient, food, or bioactive agent but often do not compare presence with absence of the compound (as is typical in drug trials); ethical issues regarding withholding of a nutrient from participants who are low or deficient in that nutrient; study populations that may already be sufficient in the compound of interest and, thus, may not show benefit of supplementation; interventions that are difficult to blind to both the subjects and the investigators; and a tension between studying subgroups most likely to respond versus recruiting a representative and, therefore, generalizable sample. Nevertheless, clinical nutrition research is an essential endeavor that provides the evidence base underlying dietary requirements and public health messages. Despite its intricacies, clinical nutrition research can have a profound impact, both to individuals and populations, thus justifying the effort.
Funding/support. C.M.W. is supported by a grant from the National Heart, Lung, and Blood Institute (U01 HL117835).
Declaration of interest. The authors declare no conflicts of interest relevant to the content of this article.
17 Research Proposal Examples
A research proposal systematically and transparently outlines a proposed research project.
The purpose of a research proposal is to demonstrate a project’s viability and the researcher’s preparedness to conduct an academic study. It serves as a roadmap for the researcher.
The process holds value both externally (for accountability purposes and often as a requirement for a grant application) and intrinsic value (for helping the researcher to clarify the mechanics, purpose, and potential signficance of the study).
Key sections of a research proposal include: the title, abstract, introduction, literature review, research design and methods, timeline, budget, outcomes and implications, references, and appendix. Each is briefly explained below.
Watch my Guide: How to Write a Research Proposal
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Research Proposal Sample Structure
Title: The title should present a concise and descriptive statement that clearly conveys the core idea of the research projects. Make it as specific as possible. The reader should immediately be able to grasp the core idea of the intended research project. Often, the title is left too vague and does not help give an understanding of what exactly the study looks at.
Abstract: Abstracts are usually around 250-300 words and provide an overview of what is to follow – including the research problem , objectives, methods, expected outcomes, and significance of the study. Use it as a roadmap and ensure that, if the abstract is the only thing someone reads, they’ll get a good fly-by of what will be discussed in the peice.
Introduction: Introductions are all about contextualization. They often set the background information with a statement of the problem. At the end of the introduction, the reader should understand what the rationale for the study truly is. I like to see the research questions or hypotheses included in the introduction and I like to get a good understanding of what the significance of the research will be. It’s often easiest to write the introduction last
Literature Review: The literature review dives deep into the existing literature on the topic, demosntrating your thorough understanding of the existing literature including themes, strengths, weaknesses, and gaps in the literature. It serves both to demonstrate your knowledge of the field and, to demonstrate how the proposed study will fit alongside the literature on the topic. A good literature review concludes by clearly demonstrating how your research will contribute something new and innovative to the conversation in the literature.
Research Design and Methods: This section needs to clearly demonstrate how the data will be gathered and analyzed in a systematic and academically sound manner. Here, you need to demonstrate that the conclusions of your research will be both valid and reliable. Common points discussed in the research design and methods section include highlighting the research paradigm, methodologies, intended population or sample to be studied, data collection techniques, and data analysis procedures . Toward the end of this section, you are encouraged to also address ethical considerations and limitations of the research process , but also to explain why you chose your research design and how you are mitigating the identified risks and limitations.
Timeline: Provide an outline of the anticipated timeline for the study. Break it down into its various stages (including data collection, data analysis, and report writing). The goal of this section is firstly to establish a reasonable breakdown of steps for you to follow and secondly to demonstrate to the assessors that your project is practicable and feasible.
Budget: Estimate the costs associated with the research project and include evidence for your estimations. Typical costs include staffing costs, equipment, travel, and data collection tools. When applying for a scholarship, the budget should demonstrate that you are being responsible with your expensive and that your funding application is reasonable.
Expected Outcomes and Implications: A discussion of the anticipated findings or results of the research, as well as the potential contributions to the existing knowledge, theory, or practice in the field. This section should also address the potential impact of the research on relevant stakeholders and any broader implications for policy or practice.
References: A complete list of all the sources cited in the research proposal, formatted according to the required citation style. This demonstrates the researcher’s familiarity with the relevant literature and ensures proper attribution of ideas and information.
Appendices (if applicable): Any additional materials, such as questionnaires, interview guides, or consent forms, that provide further information or support for the research proposal. These materials should be included as appendices at the end of the document.
Research Proposal Examples
Research proposals often extend anywhere between 2,000 and 15,000 words in length. The following snippets are samples designed to briefly demonstrate what might be discussed in each section.
1. Education Studies Research Proposals
See some real sample pieces:
- Assessment of the perceptions of teachers towards a new grading system
- Does ICT use in secondary classrooms help or hinder student learning?
- Digital technologies in focus project
- Urban Middle School Teachers’ Experiences of the Implementation of
- Restorative Justice Practices
- Experiences of students of color in service learning
Consider this hypothetical education research proposal:
The Impact of Game-Based Learning on Student Engagement and Academic Performance in Middle School Mathematics
Abstract: The proposed study will explore multiplayer game-based learning techniques in middle school mathematics curricula and their effects on student engagement. The study aims to contribute to the current literature on game-based learning by examining the effects of multiplayer gaming in learning.
Introduction: Digital game-based learning has long been shunned within mathematics education for fears that it may distract students or lower the academic integrity of the classrooms. However, there is emerging evidence that digital games in math have emerging benefits not only for engagement but also academic skill development. Contributing to this discourse, this study seeks to explore the potential benefits of multiplayer digital game-based learning by examining its impact on middle school students’ engagement and academic performance in a mathematics class.
Literature Review: The literature review has identified gaps in the current knowledge, namely, while game-based learning has been extensively explored, the role of multiplayer games in supporting learning has not been studied.
Research Design and Methods: This study will employ a mixed-methods research design based upon action research in the classroom. A quasi-experimental pre-test/post-test control group design will first be used to compare the academic performance and engagement of middle school students exposed to game-based learning techniques with those in a control group receiving instruction without the aid of technology. Students will also be observed and interviewed in regard to the effect of communication and collaboration during gameplay on their learning.
Timeline: The study will take place across the second term of the school year with a pre-test taking place on the first day of the term and the post-test taking place on Wednesday in Week 10.
Budget: The key budgetary requirements will be the technologies required, including the subscription cost for the identified games and computers.
Expected Outcomes and Implications: It is expected that the findings will contribute to the current literature on game-based learning and inform educational practices, providing educators and policymakers with insights into how to better support student achievement in mathematics.
2. Psychology Research Proposals
See some real examples:
- A situational analysis of shared leadership in a self-managing team
- The effect of musical preference on running performance
- Relationship between self-esteem and disordered eating amongst adolescent females
Consider this hypothetical psychology research proposal:
The Effects of Mindfulness-Based Interventions on Stress Reduction in College Students
Abstract: This research proposal examines the impact of mindfulness-based interventions on stress reduction among college students, using a pre-test/post-test experimental design with both quantitative and qualitative data collection methods .
Introduction: College students face heightened stress levels during exam weeks. This can affect both mental health and test performance. This study explores the potential benefits of mindfulness-based interventions such as meditation as a way to mediate stress levels in the weeks leading up to exam time.
Literature Review: Existing research on mindfulness-based meditation has shown the ability for mindfulness to increase metacognition, decrease anxiety levels, and decrease stress. Existing literature has looked at workplace, high school and general college-level applications. This study will contribute to the corpus of literature by exploring the effects of mindfulness directly in the context of exam weeks.
Research Design and Methods: Participants ( n= 234 ) will be randomly assigned to either an experimental group, receiving 5 days per week of 10-minute mindfulness-based interventions, or a control group, receiving no intervention. Data will be collected through self-report questionnaires, measuring stress levels, semi-structured interviews exploring participants’ experiences, and students’ test scores.
Timeline: The study will begin three weeks before the students’ exam week and conclude after each student’s final exam. Data collection will occur at the beginning (pre-test of self-reported stress levels) and end (post-test) of the three weeks.
Expected Outcomes and Implications: The study aims to provide evidence supporting the effectiveness of mindfulness-based interventions in reducing stress among college students in the lead up to exams, with potential implications for mental health support and stress management programs on college campuses.
3. Sociology Research Proposals
- Understanding emerging social movements: A case study of ‘Jersey in Transition’
- The interaction of health, education and employment in Western China
- Can we preserve lower-income affordable neighbourhoods in the face of rising costs?
Consider this hypothetical sociology research proposal:
The Impact of Social Media Usage on Interpersonal Relationships among Young Adults
Abstract: This research proposal investigates the effects of social media usage on interpersonal relationships among young adults, using a longitudinal mixed-methods approach with ongoing semi-structured interviews to collect qualitative data.
Introduction: Social media platforms have become a key medium for the development of interpersonal relationships, particularly for young adults. This study examines the potential positive and negative effects of social media usage on young adults’ relationships and development over time.
Literature Review: A preliminary review of relevant literature has demonstrated that social media usage is central to development of a personal identity and relationships with others with similar subcultural interests. However, it has also been accompanied by data on mental health deline and deteriorating off-screen relationships. The literature is to-date lacking important longitudinal data on these topics.
Research Design and Methods: Participants ( n = 454 ) will be young adults aged 18-24. Ongoing self-report surveys will assess participants’ social media usage, relationship satisfaction, and communication patterns. A subset of participants will be selected for longitudinal in-depth interviews starting at age 18 and continuing for 5 years.
Timeline: The study will be conducted over a period of five years, including recruitment, data collection, analysis, and report writing.
Expected Outcomes and Implications: This study aims to provide insights into the complex relationship between social media usage and interpersonal relationships among young adults, potentially informing social policies and mental health support related to social media use.
4. Nursing Research Proposals
- Does Orthopaedic Pre-assessment clinic prepare the patient for admission to hospital?
- Nurses’ perceptions and experiences of providing psychological care to burns patients
- Registered psychiatric nurse’s practice with mentally ill parents and their children
Consider this hypothetical nursing research proposal:
The Influence of Nurse-Patient Communication on Patient Satisfaction and Health Outcomes following Emergency Cesarians
Abstract: This research will examines the impact of effective nurse-patient communication on patient satisfaction and health outcomes for women following c-sections, utilizing a mixed-methods approach with patient surveys and semi-structured interviews.
Introduction: It has long been known that effective communication between nurses and patients is crucial for quality care. However, additional complications arise following emergency c-sections due to the interaction between new mother’s changing roles and recovery from surgery.
Literature Review: A review of the literature demonstrates the importance of nurse-patient communication, its impact on patient satisfaction, and potential links to health outcomes. However, communication between nurses and new mothers is less examined, and the specific experiences of those who have given birth via emergency c-section are to date unexamined.
Research Design and Methods: Participants will be patients in a hospital setting who have recently had an emergency c-section. A self-report survey will assess their satisfaction with nurse-patient communication and perceived health outcomes. A subset of participants will be selected for in-depth interviews to explore their experiences and perceptions of the communication with their nurses.
Timeline: The study will be conducted over a period of six months, including rolling recruitment, data collection, analysis, and report writing within the hospital.
Expected Outcomes and Implications: This study aims to provide evidence for the significance of nurse-patient communication in supporting new mothers who have had an emergency c-section. Recommendations will be presented for supporting nurses and midwives in improving outcomes for new mothers who had complications during birth.
5. Social Work Research Proposals
- Experiences of negotiating employment and caring responsibilities of fathers post-divorce
- Exploring kinship care in the north region of British Columbia
Consider this hypothetical social work research proposal:
The Role of a Family-Centered Intervention in Preventing Homelessness Among At-Risk Youthin a working-class town in Northern England
Abstract: This research proposal investigates the effectiveness of a family-centered intervention provided by a local council area in preventing homelessness among at-risk youth. This case study will use a mixed-methods approach with program evaluation data and semi-structured interviews to collect quantitative and qualitative data .
Introduction: Homelessness among youth remains a significant social issue. This study aims to assess the effectiveness of family-centered interventions in addressing this problem and identify factors that contribute to successful prevention strategies.
Literature Review: A review of the literature has demonstrated several key factors contributing to youth homelessness including lack of parental support, lack of social support, and low levels of family involvement. It also demonstrates the important role of family-centered interventions in addressing this issue. Drawing on current evidence, this study explores the effectiveness of one such intervention in preventing homelessness among at-risk youth in a working-class town in Northern England.
Research Design and Methods: The study will evaluate a new family-centered intervention program targeting at-risk youth and their families. Quantitative data on program outcomes, including housing stability and family functioning, will be collected through program records and evaluation reports. Semi-structured interviews with program staff, participants, and relevant stakeholders will provide qualitative insights into the factors contributing to program success or failure.
Timeline: The study will be conducted over a period of six months, including recruitment, data collection, analysis, and report writing.
Budget: Expenses include access to program evaluation data, interview materials, data analysis software, and any related travel costs for in-person interviews.
Expected Outcomes and Implications: This study aims to provide evidence for the effectiveness of family-centered interventions in preventing youth homelessness, potentially informing the expansion of or necessary changes to social work practices in Northern England.
Research Proposal Template
Get your Detailed Template for Writing your Research Proposal Here (With AI Prompts!)
This is a template for a 2500-word research proposal. You may find it difficult to squeeze everything into this wordcount, but it’s a common wordcount for Honors and MA-level dissertations.
Your research proposal is where you really get going with your study. I’d strongly recommend working closely with your teacher in developing a research proposal that’s consistent with the requirements and culture of your institution, as in my experience it varies considerably. The above template is from my own courses that walk students through research proposals in a British School of Education.
Chris Drew (PhD)
Dr. Chris Drew is the founder of the Helpful Professor. He holds a PhD in education and has published over 20 articles in scholarly journals. He is the former editor of the Journal of Learning Development in Higher Education. [Image Descriptor: Photo of Chris]
- Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 50 Durable Goods Examples
- Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 100 Consumer Goods Examples
- Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 30 Globalization Pros and Cons
- Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 17 Adversity Examples (And How to Overcome Them)
8 thoughts on “17 Research Proposal Examples”
Very excellent research proposals
Dear Sir, I need some help to write an educational research proposal. Thank you.
Hi Levi, use the site search bar to ask a question and I’ll likely have a guide already written for your specific question. Thanks for reading!
very good research proposal
Thank you so much sir! ❤️
Very helpful 👌
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UKnowledge > Martin-Gatton College of Agriculture, Food and Environment > Dietetics and Human Nutrition > Theses & Dissertations
Theses and Dissertations--Nutrition and Food Systems
Theses/dissertations from 2024 2024.
Increased Social Support and Maintained Weight Loss Among Post Metabolic and Bariatric Surgery Patients Following a Support and Nutrition-Based Program , Sydney Mae McIntosh
Theses/Dissertations from 2023 2023
MILK THISTLE SUPPLEMENTATION AND EXERCISE TO INFLUENCE BILIRUBIN AND BODY WEIGHT OUTCOMES , Don Arthur Matutina
IDEAL BODY WEIGHT AND BODY FAT PERCENTAGE PREDICT RELATIVE ENERGY DEFICIENCY IN SPORT (RED-S) SCORES IN COLLEGIATE ATHLETES , Emily Norman
EXAMINING THE UTILITY OF A KENTUCKY FCS COOPERATIVE EXTENSION CURRICULUM ON COMMUNITY MEMBERS’ HEALTHY AND SUSTAINABLE DIET-RELATED BEHAVIORS , Catharine Pickford
SEX DIFFERENCES IN CARDIOMETABOLIC RISK FACTORS IN YOUTH WITH OBESITY , Lucrecia Valdez
DEVELOPMENT OF A COMMUNITY-BASED PLAN FOR AN EFFECTIVE BEHAVIORAL INTERVENTION TO REDUCE CHILDHOOD OBESITY IN A RURAL APPALACHIAN COMMUNITY , Jennifer Stacy Wells
Theses/Dissertations from 2022 2022
Maximal Strength Training Increases Metabolic Energy Expenditure in Sedentary Adults Classified as Obese , Robert E. Anderson III
FAMILY AND CONSUMER SCIENCES EXTENSION AGENTS PERCEPTION OF A SUSTAINABLE EATING CURRICULUM FOR KENTUCKIANS , Lindley Barker
“It’s just part of our hospitality:” Examination of cultural factors that may inform future initiatives to improve health outcomes in a rural Appalachian community , Lauren Cassidy Batey
Farmers’ Market Incentive Program as an Intervention for Improving Behavior Regarding Fruit and Vegetable Consumption in Children and Adolescents , Madison Blades
PILOT STUDY: THE ROLE OF ONLINE GROCERY SHOPPING IN MEAL PLANNING & PREPARTION: UTILIZING TEXT MESSAGE BASED BEHAVIORAL NUDGES , Brittany Nikole Cox
Nutritional Status in Critical Care of COVID-19 Patients , Dolph Lewis Davis III
THE EFFECT ON INCORPORATING FRESH FRUITS AND VEGETABLES INTO AN EMERGENCY FOOD BOX PROGRAM IN RURAL APPALACHIA KENTUCKY , Zixuan Li
ATTENTIONAL BIAS, INHIBITORY CONTROL, AND FOOD REINFORCEMENT AS MECHANISMS PROMOTING EATING BEHAVIOR AFTER EXERCISE , Kylie F. L. McFee
EXAMINING MOTIVATIONS AND BARRIERS FOR ONLINE GROCERY SHOPPING AMONG URBAN AND RURAL POPULATIONS OF KENTUCKY, NORTH CAROLINA, AND MARYLAND , J.B. Pitts
Leveraging Community Health Workers’ Expertise in the Community to Address Food Insecurity in Appalachia , Alexis Kimbro Scott
Theses/Dissertations from 2021 2021
PROCURING PRODUCE IN A RURAL, APPALACHIAN COUNTY: A THEMATIC ANALYSIS OF COMMUNITY MEMBER EXPERIENCES , Caroline Blincoe
In-store Marketing Campaign to Promote the Purchase of Healthy Foods and Beverages at Convenience Stores in Rural Kentucky , Brynnan Nicole Jacobs Dunaway
EXPLORING THE RELATIONSHIPS BETWEEN CULTURAL VALUES AND DIET PATTERNS AMONG MEXICAN AND CUBAN IMMIGRANTS IN KENTUCKY , Nasreen Omran
Assessing Self-Perceived Nutrition-Related Lifestyle Behaviors and Knowledge of University Music Students Following a Targeted Presentation , Gretchen Trumbo
Theses/Dissertations from 2020 2020
Evaluation of Kentucky Grown Soft Red Winter Wheat with Sensory Evaluation for Bread-making Capabilities and Quality , Asa Conkwright III
CARDIAC EFFECTS OF OBESITY DURING PREGNANCY IN C57BL/6J MICE , Kayla Lynn Dudick
Examining Cultural Influences on Dietary Behaviors among Mexican Americans with Low Acculturation , Austyn Erickson
Energy Compensation with Exercise is not Dependent on Dose , H. Michael Hays
AN EDUCATIONAL PILOT INTERVENTION TO INCREASE ENVIRONMENTAL HEALTH LITERACY AMONG RURAL KENTUCKY YOUTH ATTENDING SUMMER CAMP , Ashley Rose Mattingly
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