Progress 09/01/00 to 08/31/03
Outputs
In the first phase, information related to how low income African American mothers make decisions about incorporating fruits and vegetables into the diets for themselves and their children was collected in the context where these decisions are made. Information was gathered by observation and interview from 10-18 women in each of the 5 stages of readiness to change intake of fruits or vegetables in the grocery store as they shopped for a significant quantity of groceries, and in their home as they prepared a family meal. Verbalizations as part of a "think loud" protocol were recorded in the grocery store and at home from a total of 70 women. Data were analyzed using qualitative data analysis procedures. In the second phase, think aloud data collected in the first phase were used to generate survey items related to pros and cons to change, self-efficacy, processes of change used, and frequency of practices related to providing fruits and vegetables to children. The
survey was pretested to establish acceptable internal consistency. Women were recruited according to stage of change prior to completing the survey. Survey data collection was completed after a 9-month period of time with data collected from 41 women in the precontemplation stage and 80-120 women per stage for the remaining 4 stages (total number of respondents = 434). Analysis of variance showed that there were no socio-demographic differences by stage of change. Those in the later stages consumed about 10 servings of fruits and vegetables per day compared to about 3 per day for those in earlier stages. Pro scores, self-efficacy scores, and the use of 7 of 10 of both the experiential and behavioral processes of change increased as stage advanced. Principal components analysis identified 5 factors from the decisional balance scale, 3 of which were related to stage of change including health benefits and characteristics that facilitate preparation and planning. The reported frequency
of most practices used by mothers to provide fruits and vegetables to children was positively associated with authoritative parenting index responses, stage of change, and self-efficacy with the strongest correlations observed with self-efficacy. These practices involved preparation and feeding strategies, modeling, and making foods available and accessible. Stage of change, pro scores, and self-efficacy scores were also associated with authoritative parenting index responses. The current study offers a different perspective compared to other studies involving fruit and vegetable consumption and stage of change in African American adults because all constructs of the Transtheoretical Model were applied, a staging mechanism that was thought to be more accurate was used, and subjects were classified prior to recruitment into the study. The findings of this study confirmed the expected pattern of relationships between the constructs of the Transtheoretical Model and stage of change for
fruit and vegetable consumption for low-income African American mothers and the potential application for future intervention programs.
Impacts
The results of this study will be used to develop educational materials for use in counseling of African American mothers of young children to modify their eating patterns and practices related to provision of fruits and vegetables to their children. In regard to self-efficacy, future intervention efforts for those in earlier stages should incorporate education and development of skills to increase consumption outside of the home environment and when busy and emphasize the health benefits of changing behavior, as well as improving preparation and planning strategies. Helping women in the earlier stages overcome barriers and improve self-efficacy for increasing their own fruit and vegetable intake may also increase the frequency with which they engage in practices to provide fruits and vegetables to their children. For example, mothers with higher intakes in the later stages have fruits and vegetables available to them, which is likely to improve their availability for
children in the home. Parent education should also focus on practices reflective of an authoritative or positive parenting style regarding fruit and vegetable intake.
Publications
- Henry, H., Reicks, M., Smith, C., Reimer, K., Atwell, J., Thomas, R. 2003. Identification of factors affecting purchasing and preparation of fruit and vegetables by stage of change for low-income African American mothers using the think aloud method. J. Am. Diet. Assoc. In press.
- Reicks, M., Smith, C., Henry, H., Reimer, K., Atwell, J., Thomas, R. 2003. Use of the think aloud method to examine fruit and vegetable purchasing behaviors among African American low-income women. J. Nutr. Educ. Behav. 35:154-160.
- Chase, K., Reicks, M., Smith, C., Henry, H., Reimer, K. 2003. Factors influencing purchase of bread and cereals by low-income African American women and implications for whole grain education. J. Am. Diet. Assoc. 103:501-504.
- Henry, H., Atwell, J., Reicks, M., Reimer, K., Smith, C., Thomas, R. 2002. Determinants of fruit and vegetable consumption in low-income African American mothers according to stage of change. Soc Nutr Educ Annual Meeting Abstract, St. Paul, MN.
- Reimer, K., Atwell, J., Henry, H., Reicks, M., Smith, C., Thomas, R. 2002. Child-feeding strategies relating to fruits and vegetables according to stage of change in African American women. Soc Nutr Educ Annual Meeting Abstract, St. Paul, MN.
- Henry, H., Reimer, K., Smith, C., Reicks, M. 2003. The relationship between low-income African American mothers' stage of change, parenting style, and frequency of practices to provide fruits and vegetables to children. Submitted to Health Educ. Res. August 2003.
- Reicks, M., Atwell, J., Henry, H., Reimer, K., Smith, C., Thomas, R. 2002. Use of the think aloud method to examine fruit and vegetable purchasing behaviors among African American low-income women. Soc Nutr Educ Annual Meeting Abstract, St. Paul, MN.
- Smith, C., Atwell, J., Henry, H., Reimer, K., Reicks, M., Thomas, R. 2002. Examination of meal preparation behavior among low-income African American mothers using the think aloud method. Soc Nutr Educ Annual Meeting, St. Paul, MN.
- Reimer, K., Smith, C., Reicks, M., Henry, H., Thomas, R., Atwell, J. 2003. Child-feeding strategies in African American Women according to stages of change for fruit and vegetable consumption. Submitted to Publ. Health Nutr. February 2003.
- Henry, H., Reimer, K., Smith, C., Reicks, M. 2003. The relationship between components of the Transtheoretical Model and fruit and vegetable intake in low-income African American mothers. Submitted to Am. J. Health Promot. September 2003.
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