Food literacy is a set of interrelated knowledge, skills, and behaviors required to plan and manage, select, prepare, and eat food, which can be measured by the "Cooking and Food Provisioning Action Scale" (CAFPAS). This study aimed to validate the French translation of the CAFPAS and to explore the association between food literacy and diet quality. The French translation of the CAFPAS was completed within the NutriQuebec project, a web-based cohort in Quebec, Canada. Cronbach's alpha was used to evaluate the internal consistency of the scale. Associations between the total CAFPAS score and sociodemographic variables were explored to assess the construct validity of the scale. Diet quality was assessed with the Healthy Eating Food Index-2019 (HEFI-2019) and its association with food literacy was analysed. A total of 1204 participants (87.8 % women) were included. Cronbach's alpha values were equal to or higher than 0.85 for the total CAFPAS score and its three subscales. The total CAFPAS score was significantly associated with age (p < 0.0001), household annual income (p = 0.0076), and gender (p = 0.0014), with women showing a higher level of food literacy than men. The total CAFPAS score was positively but weakly correlated with the total HEFI-2019 score (r = 0.12; p = 0.0001). Globally, the French translation of the CAFPAS appeared to be a valid and reliable scale to assess food literacy in French-speaking adults in Canada.

Public health research faces challenges in recruiting socio-economically disadvantaged groups. This study evaluated whether machine learning (ML) algorithms developed using data from a general population could predict indices of diet quality among a socio-economically disadvantaged group. Data from 5367 adults (77·5 % females) in the NutriQuébec project and on 122 variables potentially associated with dietary intakes were used. Dietary intakes were measured using a web-based 24-h recall. Participants were categorised by fifths of a deprivation score based on income, education and material and social deprivation. Participants in the first four fifths formed the general NutriQuébec sample (n 4180) and those above the fifth quintile formed the high deprivation sample (n 1187). Three indices of diet quality defined as 'high' or 'low' were used: vegetable and fruit consumption (VFC, ≥ 5·0 reference amounts (RA)/d), 'other foods' consumption, meaning, foods not recommended in Canada's Food Guide 2019 (OFC, > 5·0 RA/d) and overall diet quality measured using the Healthy Eating Food Index-2019 (HEFI-2019, > 48·9 points). The algorithms developed and tested in the general NutriQuébec sample predicted high VFC, OFC and HEFI-2019 with accuracies of 0·60 (95 % CI 0·58, 0·62), 0·58 (95 % CI 0·56, 0·60) and 0·61 (95 % CI 0·59, 0·63), respectively. In the high deprivation sample, the algorithms predicted the diet quality indices with comparable accuracies (VFC, 0·69, 95 % CI 0·67, 0·71; OFC, 0·56, 95 % CI 0·54, 0·58; HEFI-2019, 0·66, 95 % CI 0·65, 0·67). ML algorithms trained to predict three diet quality indices in the general NutriQuébec sample were applicable to a high deprivation group.

Although socioeconomic status is known to influence dietary intakes, effects are variable and population-specific. This cross-sectional study aimed to document dietary intakes and overall diet quality according to indicators of socioeconomic status in adults of the province of Québec, Canada. Dietary intake data from 24 h dietary recalls in 6334 adults recruited online as well as through community organizations in the NutriQuébec project were used. Overall diet quality was assessed using the Healthy Eating Food Index (HEFI)-2019. Usual intake distributions and thresholds of vegetables and fruits (V&F), sodium, and sugary drinks were estimated using the National Cancer Institute method. The sample was calibrated for sex, age, and area of residence. Overall, 36.1% (95% CI 34.2-38.1) of adults in Québec consumed ≥5 servings of V&F/day, 17.6% (95% CI 15.2-19.9) had sodium intakes ≤ 2300 mg/day and 32.1% (95% CI 22.9-41.3) consumed the equivalent of ≤1 serving of sugary drink/week. Individuals with lower household income, lower individual educational attainment, living in materially deprived areas and living in food insecure households had lower HEFI-2019 scores and lower usual intakes of V&F. Individuals with lower educational attainment and living in food insecure households had also higher daily intakes of sugary drinks. Sodium intake did not differ across socioeconomic groups. Overall, these data indicate that most individuals in the province of Québec do not meet current targets for healthy eating and that diet inequities remain a major public health challenge in Québec.

Consumption of locally produced foods is generally perceived as being part of a healthy dietary pattern. Accordingly, in 2020, the provincial government of Québec (Canada) promoted the purchase of local foods for economic and health benefits. The present cross-sectional study aimed to document the association between the behavior of local food procurement and overall diet quality in a sample of adults from the province of Québec. Data were collected in a sample of 834 adults (86.6

BackgroundEvidence-based practice (EBP) is described as the integration of the following 3 main dimensions in health professionals' decision making: best currently available research evidence, professional expertise, and patient's values and circumstances. Barriers to EBP at an individual level have been assessed using questionnaires. Knowing which EBP dimensions are actually explored in these questionnaires is essential to promote EBP and its adoption.ObjectiveThe aim of this review was to identify and describe questionnaires that have been used among dietitians to evaluate knowledge, skills, attitudes, and/or behaviors related to EBP, and to perform a content analysis of these, drawn on the EBP dimensions explored.MethodsQuestionnaires were identified through a systematic review in MEDLINE, Embase and the Cumulative Index to Nursing and Allied Health Literature (last search was November 2022). Eligibility criteria were studies using, evaluating, or developing questionnaires meant to evaluate knowledge, skills, attitudes, and/or behaviors related to EBP among dietitians. The content analysis was conducted to identify the EBP dimensions explored (ie, research evidence, professional expertise, and/or patient's values and circumstances). Questionnaire items were categorized as follows: 1 sole EBP dimension, a combination of dimensions, or no identifiable dimension.ResultsThirty reports (25 studies) were included. The analysis of the 847 items extracted from the 25 questionnaires used showed that the main EBP dimension explored was the integration of research evidence into decision making, found in 75% of items, solely or in combination with another dimension. Professional expertise was explored in 18% of the items, patient's values and circumstances were found in 3%, and the combination of these 3 dimensions was found in <1%.ConclusionsThe important imbalance of explored EBP dimensions in the questionnaires used may lead to a partial and misleading evaluation that prevents efficient strategies to foster EBP. There is an important need to develop more integrative and accurate evaluations of EBP targeting dietitians to promote and develop high-quality dietetics practice.

Objective Sleep is part of a healthy lifestyle and in adults with diabetes, inadequate sleep is associated with risks of developing complications. The objective was to compare beliefs about healthy sleep habits (HSHs) in adults with versus without diabetes based on the Reasoned Action Approach. Methods A total of 56 adults with and 98 without diabetes answered open-ended questions regarding their beliefs about: avoiding screen use in bed; having a regular sleep schedule; or avoiding caffeine, alcohol, and cigarettes before bedtime. A qualitative content analysis was used to identify the most important beliefs, similarities, and differences between both groups. Results Both groups reported that adopting HSHs could improve sleep. Having a regular sleep schedule was perceived to facilitate diabetes management in adults with diabetes. Negative consequences specific to adopting each HSH were identified in both groups. Adopting HSHs was associated with mainly negative emotions (e.g., stress, anxiety, fear) in both groups. Avoiding screen use in bed was associated with anxiety of not knowing blood glucose levels at night in adults with diabetes. Partners, parents, and friends were considered the most important individuals who would approve of adopting HSHs, but they were often perceived as unlikely to adopt HSHs themselves in both groups. Adults with diabetes perceived more barriers to adopting HSHs. Facilitating factors for both groups included removing triggers of unhealthy sleep habits, behavior substitution, using reminders, time management, and social support. Discussion These beliefs can guide the development of behavioral sleep interventions, including interventions specifically for adults with diabetes.

While there is evidence that the early lockdown due to COVID-19 pandemic may have had small positive impacts on several populations' dietary habits, the longer term effects remain largely unknown. The aim of this study was to document changes in diet quality over the two years of the COVID-19 pandemic in adults from the Province of Québec, Canada. We hypothesized that diet quality remained unchanged since the onset of the pandemic. Data are from the NutriQuébec project, a web-based cohort destined to study temporal changes in dietary habits among adults in the Province of Quebec, Canada. We retained 1922 participants (85% female, mean age 50.4 ± 15.4 years) who completed questionnaires before March 12, 2020 including validated web-based 24-h dietary recalls. Among those, 918 completed the questionnaires during the first pandemic year (March 2020- February 2021) and 572 recompleted the questionnaires during the second year (March 2021-February 2022). The study outcome was temporal changes in diet quality measured by the newly developed Healthy Eating Food Index (HEFI-2019), which measures adherence to the recommendations on healthy food choices in the 2019 Canadian Food Guide (CFG), on a scale of 80 points. Temporal changes in HEFI-2019 score were assessed using mixed models adjusted for sex, age, census metropolitan area, marital status, education, occupation, smoking and social and material deprivation index. The mean pre-pandemic HEFI-2019 score in this cohort was 47.3/80 points (95%CI 45.9 to 48.7). There was no change in the mean HEFI-2019 score during the first year of the pandemic (+0.1 point, 95% CI −0.5 to 0.7) but a small reduction during year 2 (−1.2 points, 95% CI −1.9 to −0.5). The reduction in the HEFI-2019 score at year 2 compared with the pre-pandemic values was mostly seen in September 2021 (−1.4 points vs. September 2019; 95%CI −2.4 to −0.3) and February 2022 (−1.5 point vs. February 2020; 95%CI −2.2 to −0.2). Contrary to our hypothesis, diet quality in this longitudinal cohort study of adult men and women has slightly deteriorated during the second year of COVID-19. These results are specific to the NutriQuébec sample. The longer-term impact of the pandemic on diet quality needs to be confirmed in other longitudinal cohorts. Ministère de la santé et des services sociaux du Québec.

In this study, we identify existing interactive knowledge translation tools that could help patients and health-care professionals to prevent diabetes complications in the Canadian context. We conducted an environmental scan in collaboration with researchers and 4 patient partners across Canada. We conducted searches among the research team members, their networks and Twitter, and through searches in databases and Google. To be included, interactive knowledge translation tools had to meet the following criteria: used to prevent diabetes complications; used in a real-life setting; used any instructional method or material; had relevance in the Canadian context, written in English or French; developed and/or published by experts in diabetes complications or by a recognized organization; created in 2013 or after; and accessibility online or on paper. Two reviewers independently screened each record for selection and extracted the following data: authorship, objective(s), patients' characteristics, type of diabetes complications targeted, type of knowledge users targeted and tool characteristics. We used simple descriptive statistics to summarize our results. Thirty-one of the 1,700 potentially eligible interactive knowledge translation tools were included in the scan. Tool formats included personal notebook, interactive case study, risk assessment tool, clinical pathway, decision support tool, knowledge quiz and checklist. Diabetes complications targeted by the tools included foot-related neuropathy, cardiovascular diseases, mental disorders and distress and any complications related to diabetes and kidney disease. Our results inform Canadian stakeholders interested in the prevention of diabetes complications to avoid unnecessary duplication, identify gaps in knowledge and support implementation of these tools in clinical and patients' decision-making.

Background The impact that the coronavirus disease 2019 (COVID-19)–related early lockdown has had on dietary habits of the population and on food insecurity is unknown. Objective The aim of this study was to document the change in diet quality and in food insecurity observed during the COVID-19–related early lockdown. We hypothesized that the lockdown was associated with a deterioration in overall diet quality and an increase in food insecurity. Methods Data are from a COVID-19 subsample of NutriQuébec, a web-based cohort destined to study temporal changes in dietary habits among adults in Quebec, Canada. Participants completed questionnaires before (between June 2019 and February 2020) and during (April to May 2020) early lockdown, including a validated web-based 24-h recall (n = 853) and a questionnaire on food security (n = 922). Primary study outcomes were temporal changes in diet quality measured by the Healthy Eating Index (HEI)–2015 and in the prevalence of food insecurity. Results There was a small increase in the HEI-2015 during the COVID-19 early lockdown compared with baseline (+1.1 points; 95% CI: 0.6, 1.5), mostly due to small improvements in the intakes of whole grains, greens and beans, refined grains, total vegetables, total dairy, seafood and plant proteins, added sugar, and total protein subscores of the HEI-2015. Exploratory analyses suggested that individuals aged 18–29 y (+3.6 points; 95% CI: 2.4, 4.7), participants with lower education (+1.9 points; 95% CI: 1.3, 2.6), or with obesity (+3.8 points; 95% CI: 2.7, 4.8) showed particularly important increases in the HEI-2015. The prevalence of food insecurity was reduced from 3.8% at baseline to 1.0% during the early lockdown (prevalence ratio = 0.27; 95% CI: 0.08, 0.94). Conclusions Contrary to our hypotheses, diet quality has slightly improved and prevalence of food insecurity was reduced in this sample of adults from Quebec during the COVID-19–related early lockdown. These results may be generalizable only to relatively healthy populations.

The global food system is facing multiple problems, including rising food insecurity, degrading environments, and an increased incidence of diet-related chronic diseases. International organizations are thus calling for a transition toward territorialized food systems to alleviate some of these challenges. Yet, limited evidence supporting the benefits of territorialized food systems is available. Our objective was to summarize the current body of literature on territorialized food systems and their impacts on human health, food security, and the environment using a rapid review methodology. Articles were retrieved from three databases and analyzed using keywords and inclusion criteria corresponding to territorialized food systems, environment, human health, and food security. Six relevant publications were identified. While this limited evidence suggests that territorialized food systems may have positive effects on all three dimensions, data are not consistent across publications. For example, territorialized food systems may contribute to improved diet quality, provide agroecosystem services, and contribute to food security. However, food produced within these food systems may have a higher carbon footprint and be less available than industrially produced food. This rapid review also highlights the siloed nature of the current research on territorialized food systems and emphasizes the need for more holistic and interdisciplinary research.

AbstractObjective:A randomised controlled trial found no evidence of an impact of a blog written by a registered dietitian (RD) on vegetables and fruit and milk and alternatives (e.g. soya-based beverages, yogurt and cheese) consumption – two food groups included in the 2007 version of the Canadian Food Guide – in mothers and their children compared with a control condition. To investigate these null findings, the current study explored participants’ perceptions of engagement with the blog and its influence on their dietary behaviours.Design:Mixed methods process evaluation using a post-intervention satisfaction questionnaire and a content analysis of mothers’ comments on the blog (n 213 comments).Setting:French-speaking adult mothers living in Quebec City, Quebec, Canada (n 26; response rate = 61·9 % of the total sample randomised to exposure to the blog).Results:Most mothers (n 20/26; 76·9 %) perceived the blog useful to improve their dietary habits – with the most appreciated blog features being nutritional information and healthy recipes and interactions with fellow participants and the RD. Mothers reported several facilitators (e.g. meal planning and involving children in household food activities) and few barriers (e.g. lack of time and children’s food preferences) to maternal and child consumption of vegetables and fruit and milk and alternatives. Lack of time was the principal reported barrier affecting blog engagement.Conclusions:The findings from the current study suggest that blogs written by an RD may be an acceptable format of intervention delivery among mothers, but may not alleviate all the barriers to healthy eating and engagement in a dietary intervention.

Abstract Background Social media represent cost-effective platforms to advance the dissemination and uptake of health research to improve population health. However, there is limited evidence available to support researchers overcome methodological challenges related to recruitment and retention of participants in studies using social media for delivering behavior change interventions. This study aims to describe the recruitment and the retention strategies used in a randomized controlled trial (RCT) that evaluated a blog-delivered healthy eating intervention among mothers of preschoolers and school-aged children. Methods Eighty-four adult mothers of children aged between two and 12 years old living in Quebec City, Quebec, Canada, were recruited between October 2015 and February 2017 using traditional methods (e.g. institutional email lists, flyers, newspapers, and word of mouth) and Facebook advertisements. Retention rates were calculated at the end of the 6-month intervention and at a 12-month follow-up assessment. Sociodemographic characteristics, Internet use behaviors and retention rates of mothers recruited through traditional methods and Facebook were compared using Wilcoxon-Mann-Whitney tests and Fisher exact tests. Results Of the 196 mothers who responded to the recruitment call, 87 (44.4%) were eligible and 84 (42.9%) were randomized to the trial, representing a recruitment success of 76.4% (84/110) from the planned sample size target. Among those, a minority (3.6%) were recruited using Facebook. Those mothers presented similar sociodemographic characteristics to those recruited using traditional methods. Retention rates were 73.8% and 66.7% at 6 and 12 months, respectively, with similar rates between mothers recruited using Facebook and traditional methods. Various challenges associated with population retention were highlighted with lack of time being mothers’ main reason for withdrawing from the study. Conclusions The methodological challenges experienced during the conduct of the blog-delivered healthy eating intervention allowed to draw upon several lessons regarding the recruitment process and the retention of mothers of preschoolers and school-aged children to inform future social media-delivered research. Recommendations for future research include exploring mothers’ perceptions and preferences to tailor social media recruitment, ensure that interventions are delivered to them using social media platforms that are already integrated into their routine, and are providing remote outcome assessments to increase participant retention. Trial registration Clinical Trial Protocol NCT03156803. Registered on 17 May 2017, retrospectively registered.

In the context of low consumption of vegetables and fruits and milk and alternatives among Canadian mothers and children, novel strategies are needed to improve maternal and child nutrition. This study evaluated the long-term effects of an evidence-informed healthy eating blog on dietary intakes and food-related behaviours of mothers and their child. The study presents a secondary outcome analysis of a randomised controlled trial in which 84 mothers (mean age of 37.6 +/- 6.7 years) of 2- to 12-year-old children living in Quebec City, Canada, were randomly assigned to a dietary intervention delivered through a healthy eating blog written by a registered dietitian (RD;n= 42) or a control group (n= 42) during a period of 6 months. Dietary intakes, maternal eating behaviours, food parenting practices, and body weight were measured at baseline, 3 months, at the end of the intervention (6 months), and 6-month post-intervention (12 months). Differences between groups were assessed with mixed linear models. Globally, this study found no evidence of long-term differences in mean dietary intakes in mothers exposed to the blog and their children as well as other food-related outcomes and body weight compared with the control condition. Potential predictors of adherence to dietary recommendations in mothers and children (e.g., involvement of children in household food activities) were identified. In conclusion, a healthy eating blog written by an RD did not result in evidence of any long-term differences in dietary intakes and food-related behaviours in mothers and their children compared with the control condition.

Introduction The epidemic of non-communicable diseases including cardiovascular diseases and type 2 diabetes is attributable in large part to unhealthy eating and physical inactivity. In the fall of 2016, the Québec government launched its first-ever Government Health Prevention Policy (Politique gouvernementale de prévention en santé (PGPS)) to influence factors that lead to improved health status and quality of life as well as reduced social inequalities in health in the population of Québec. NutriQuébec is a web-based prospective open cohort study whose primary aim is to provide essential data for the evaluation of the PGPS on the Québec population’s eating and other lifestyle behaviours over time. Methods and analysis Over a first phase of 3 years, NutriQuébec will enrol 20 000 adults living in the province of Québec in Canada through a multimedia campaign designed to reach different segments of the population, including subgroups with lower socioeconomic status. Participants will be invited to complete on a web platform nine core questionnaires on a yearly basis. Questionnaires will assess several dimensions related to lifestyle, including eating and physical activity behaviours, as well as a large number of personal characteristics and global health status. Temporal trends in eating and lifestyle behaviours will be analysed in relation to the implementation of the PGPS to provide essential data for its evaluation at a population level. Data analyses will use sociodemographic weights to adjust responses of participants to achieve, so far as is possible, representativeness of the adult Québec population. Ethics and dissemination Université Laval Research Ethics Board approved the NutriQuébec project. Data analysis, presentations in conferences and publication of manuscripts are scheduled to start in 2020. Trial registration number NCT04140071.

Background Prospective cohort studies may support public health efforts in reducing health inequalities. However, individuals with a low socioeconomic status (SES) are generally underrepresented in health research. This study aimed to examine the intention and determinants of intention of individuals with a low SES towards participation in a Web-based prospective project on nutrition and health (NutriQuébec) in order to develop recruitment and retention strategies. Methods A cross-sectional survey based on the Theory of planned behaviour was conducted in the Province of Québec, Canada. Low SES individuals (high school or less and annual household income < $55,000 CAN) were recruited through a Web panel of a polling firm to assess intention, attitude, subjective norm and perceived behavioural control (PBC) towards participation in the NutriQuébec project. Linear regression and logistic regression analyses were conducted. Results Mean age of respondents (184 women, 141 men) was 57.6 y (SD = 13.6). Attitude ( ß = 0.54, 95%CI: 0.41–0.68) and PBC ( ß = 0.50, 95%CI: 0.37–0.63) were significantly associated with intention. Participants who agreed that participating in the study would contribute to an improvement in 1) collective health (odds ratio [OR] = 2.15, 95%CI: 1.27–3.64) and in 2) one’s lifestyle habits (OR = 1.70, 95%CI: 1.04–2.78) were more likely to express positive intention compared to participants who did not agree with these statements. Participants who agreed to participate in the study even 1) in the absence of a financial incentive (OR = 1.43, 95%CI: 1.04–1.99) and even 2) if the completion of questionnaires took up to two hours (OR = 1.78, 95%CI: 1.27–2.48) were also more likely to express high intention. Receiving a personalized brief health assessment (OR = 1.61, 95%CI: 1.13–2.30) and the use of simple questions in the questionnaires (OR = 1.54, 95%CI: 1.05–2.25) were facilitating factors associated with high intention. Participants believing that participation would be too time-consuming were less likely to have positive intention (OR = 0.57, 95%CI: 0.43–0.75). Conclusions The development of a positive attitude and a high PBC towards participation in the NutriQuébec project will be necessary to obtain representative data of low SES adults.

BACKGROUND NutriQuébec is a Web-based prospective study on the relationship between diet and health as well as the impact of food-related health policies in the adult population of Québec, Canada. Recruitment and retention of individuals with a low socioeconomic status (SES) in such a study are known to be challenging, yet critical for achieving representativeness of the entire population. OBJECTIVE This study aimed to identify the behavioral, normative, and control beliefs of individuals with a low SES regarding participation in the NutriQuébec project and to identify their preferences regarding recruitment methods. METHODS A total of four focus groups were conducted in community centers located in low-income areas of Québec City, Canada. On the basis of the theory of planned behavior, participants’ beliefs associated with attitude, subjective norm, and perceived behavioral control regarding hypothetical participation in the NutriQuébec project were identified. Focus groups were recorded, transcribed, and coded by two analysts. RESULTS Participants (16 men and 12 women) were aged between 28 and 72 years, and a majority of the participants had an annual household income of Can $19,999 or less. The main perceived advantages of participating in the NutriQuébec project were contributing to improved collective health and supporting research. The only disadvantage identified was the risk of having to fill out too many questionnaires. Participants could not, in general, identify persons from their entourage who would approve or disapprove their participation in the study. The main facilitators identified were obtaining a brief health assessment and the ability to complete questionnaires in a way that is not Web-based. The main barrier was the lack of internet access. The preferred means of recruitment were through social media, television, and community centers. CONCLUSIONS These results provide insightful information regarding the best methods and messages to use in order to recruit and retain individuals with a low SES in a population-based prospective study on lifestyle and health on the internet.

BACKGROUND:Although social media such as blogs are still considered innovative communication technologies, some registered dietitians (RDs) are using them to promote healthy eating; however, evidence regarding the effects of healthy eating blogs on users' diet is lacking.OBJECTIVE:This study evaluated the effects of an evidence-informed healthy eating blog written by an RD on dietary intakes, with a focus on vegetables and fruit and milk and alternatives consumption, and food-related behaviors of Canadian mothers.DESIGN:This study was a parallel, randomized, controlled trial.PARTICIPANTS/SETTING:Data were collected from 84 French-speaking adult mothers of children aged between 2 and 12 years living in Quebec City, Quebec, Canada, who were recruited between October 2015 and February 2017 using institutional e-mail lists, flyers, newspapers, social media advertisements, and word of mouth.INTERVENTION:The intervention was exclusively delivered through an evidence-informed healthy eating blog-integrating theory-based intervention methods to improve diet quality by increasing vegetables and fruit and milk and alternatives consumption in mothers-for 6 months at a dose of one new post written by an RD each week. Mothers could engage with the RD and fellow participants by posting comments on the blog.MAIN OUTCOME MEASURES:Main outcomes were daily intakes of vegetables and fruit and milk and alternatives. Outcome assessments were performed at baseline, 3 months, and at the end of the 6-month intervention.STATISTICAL ANALYSIS:Differences between the groups were examined using mixed linear models.RESULTS:At 6 months, no significant difference was observed between groups for intakes of vegetables and fruit (P=0.923), milk and alternatives (P=0.271), or food-related behaviors and body weight (P=0.180).CONCLUSIONS:A healthy eating blog, at a dose of 1 post per week, had no effects on dietary intakes, food-related behaviors, and body weight of mothers after 6 months. Methodologic issues are discussed to inform future health behavior research using blogs to promote healthy eating.

Background Healthy eating blogs are knowledge translation tools used by nutrition and dietetics practitioners for helping people improve their health behaviors and food choices. Objective Our aim was to explore women's perceptions of the usefulness and ease of use of healthy eating blog (HEB) characteristics that might increase potential users' intention to use them as tools to improve their dietary habits. Design We conducted qualitative research using semi-structured individual interviews. Participants Thirty-three women (mean age of 44 years; range=27 to 61 years) living in the Quebec City, Canada, metropolitan area were studied. Intervention Four existing HEBs, written by French-Canadian registered dietitians (RDs) whose main objective was the promotion of a healthy diet, were explored by women during individual interviews. A standardized open-ended interview questionnaire based on the Technology Acceptance Model was used to identify women's perceptions about characteristics of type of blog content delivery, RD blogger's delivery of information, blog layout, and blog design. Main outcome measures Women's perceptions toward the contribution of HEB characteristics to the usefulness and ease of use of those tools to improve their dietary habits were measured. Analyses performed Interviews were audiorecorded, transcribed verbatim, coded, and analyzed through an inductive content analysis using NVivo software. Results The most useful characteristics of type of blog content delivery identified by women were recipes, hyperlinks, and references. Among characteristics of RD blogger's delivery of information, most women reported that interaction between blog readers and the RD blogger created a sense of proximity and of connection that was helpful for improving their dietary behaviors. Women's perceptions toward various characteristics of blog layout and design were also discussed. Conclusions Incorporating specific characteristics when designing HEBs should be considered by RDs and future research to promote the use of those tools to support dietary behavior change efforts of internet users.