Progress 10/01/01 to 09/30/06
Outputs
Objective 1: Qualitatively assess the preferred delivery method, as well as the acceptability of stage tailored newsletters in young adults in diverse populations. Magazine, newsletters, and individualized computer-generated letter reports were designed and field tested in year 1 with young adults. 246 individuals were interviewed individually or in focus groups, with proceedings audiotaped, transcribed and analyzed in NE. Information to improve the appearance and wording of the print materials were used by RI to revise a series of colorful theory-based newsletters and an F&V Connection magazine. Methods for distributing training materials, manuals and newsletters to stakeholders were determined. Some of these educational materials and training manuals have also been placed on the Food Stamp Nutrition Connection's database. Objective 2: Develop a sustained, 6-month stage-tailored intervention for young adults designed to increase consumption of vegetables and fruits
tailored for diverse populations of young adults. Work groups were formed for instrument development (OR, ME), preparation of mailed educational print materials (Lead: RI, NE, OR), standardization of protocols for subject recruitment (NY, AL, ME, SD), training and procedures for the educational phone call component of the intervention (NE, KS, RI), and for planning and management of data analysis (KS, ME, MI, WI). Extension partners contributed to development and testing of many of these recruitment and assessment materials, and refinement of the educational materials. Electronic files for educational materials were revised to reflect 2005 Dietary Guidelines and distributed via CD to each participating state. Objective 3: Test the efficacy of the intervention compared to a non-treatment control and compare the efficacy across diverse populations. Testing intervention efficacy began in 2003 and was completed in 2004. In the IFAFS funded states, NC219 research and Extension partners
collectively recruited 2042 low income young adults, determined their fruit and vegetable stage of change, administered consent procedures, and implemented the study protocol. The intervention group received stage-tailored newsletters, individualized progress reports and educational phone calls with a focus on improving fruit and vegetable intakes. The intervention was completed by 1255 subjects (61% completion). SD was not part of the IFAFS funding and therefore, contributed by testing the materials in a college age population. 437 college students were recruited, determined their fruit and vegetable stage of change, administered consent procedures, and implemented study protocol. The intervention group received stage-tailored newsletters, one motivational interview, and an individualized tailored email over a 4-month period. 72% completed the intervention with fruit and vegetable consumption increasing significantly more for the intervention group than the control group. Manuscript
is published.
Impacts
Educational materials targeting young adults in different stages of readiness to increase fruit and vegetable consumption have been developed and tested and found to be effective. The stage-based newsletters increased fruit and vegetable consumption in the 18-24 year old limited-income audience and 18-24 year old college student. The written materials tested in the intervention have been distributed to each principle investigator to use in their state nutrition education programs. A website with the stage-based materials has been developed and is maintained by University of Wisconsin-Madison and is available for use by the investigators. The work of this research group is being continued through a recently approved Multi-State Research Project NC-1028: Promoting healthful eating to prevent excessive weight gain in young adults, 2006-2011
Publications
- Richards, A., Kattelmann, K., Ren, C. Motivating 18 to 24 year olds to increase their fruit and vegetable consumption. J. Am. Dietetic Assoc. 2006;106:1405-1411.
- Nitzke S, Kritsch K, Boeckner L, Greene G, Hoerr S, Horacek T, Kattelmann K, Lohse B, Oakland MJ, Phillips B, White A. A stage-based intervention increases fruit and vegetable intakes of low-income young adults. In review: accepted with revisions, 2006, Am J Health Promot
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Progress 01/01/05 to 12/31/05
Outputs
The goal of this multi-state project is to develop and test an effective, cost-effective intervention to increase fruit and vegetable consumption of 18-24 year old young adults. The primary objectives of the project are to 1) to increase fruit and vegetable intakes of young adults and 2) to determine the effectiveness of stage-tailored interventions modalities on the Transtheoretical Model (TTM or Stages of Change). SD participated in the refinement of stage-based newsletters and instrument development. Partnerships were developed with Extension Educators for recruitment of over 2000 low-income participants ages 18-24 years old from 9 different states. Participants were randomized to intervention or control group. Assessment of fruit and vegetable intake, stage of change for fruit and vegetable intake, self-efficacy, and decisional balance were measured at baseline and 12 months later at completion for both groups. The intervention group received a series of 4
stage-based newsletters and two educational telephone calls from Extension Educators. The study is completed and principal investigators are in the process of analyzing the data and preparing manuscripts. SD is in the process of analyzing whether in-person contact or by telephone the better avenue of recruitment of the low-income 18-24 year old. Additionally, SD measured the efficacy of the intervention on over 400 18-24 year college students. The intervention increased fruit and vegetable consumption by 1 serving/day. SD is one of the principal investigators for the funded NRI-Integrated grant Web-based Behavior Change for Obesity Prevention of Young Adults which started January 2005. The objective of this project is to develop a web-based program for the prevention of weight gain in the 18-24 year old college population. SD is one of the states developing the intervention materials. SD also participated in writing the NC219 renewal proposal.
Impacts
Educational materials targeting young adults in different stages of readiness to increase fruit and vegetable consumption have been developed and tested and found to be effective. The stage-based newsletters increased fruit and vegetable consumption in the 18-24 year old limited-income audience. The written materials tested in the intervention have been distributed to each principle investigator to use in their state nutrition education programs. A website with the stage-based materials has been developed and is maintained by University of Wisconsin-Madison and is available for use by the investigators.
Publications
- Rasmussen, D. & Kattelmann, K. 2005. Practitioner perception of training for failure to thrive. Thesis.
- Park A, Nitzke S, Kritsch K, Greene G, White A, Doong J, Hoerr S, Boeckner L, Kattelmann K, Lohse B, Betts N, Oakland MJ. 2005. Development of an interactive, stage-based web site aimed to increase fruit and vegetable intake among 18 to 24 year olds. Society for Nutrition Education Annual Conference, Orlando, FL. Journal of Nutrition Education and Behavior 2005:S75-S76.
- Park, A.L., Nitzke, S.A., Kritsch, K.R., Lohse, B.A., Kattelmann, K.K., Boeckner, L.S., White, A.A., Oakland, M.J., Hoerr, S.L. 2005. Fruit and Vegetable Express: An interactive, stage-tailored web program designed to increase fruit and vegetable intake among 18-24 year olds. Journal of the American Dietetic Association 2005:A-11.
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Progress 01/01/04 to 12/31/04
Outputs
The goal of this multi-state project is to develop and test an effective, cost-effective intervention to increase fruit and vegetable consumption of 18-24 year old young adults. The primary objectives of the project are to 1) to increase fruit and vegetable intakes of young adults and 2) to determine the effectiveness of stage-tailored interventions modalities on the Transtheoretical Model (TTM or Stages of Change). South Dakota participated in the refinement of stage-based newsletters and instrument development. Partnerships were developed with Extension Educators for recruitment of over 2000 low-income participants ages 18-24 years old from 9 different states. Participants were randomized to intervention or control group. Assessment of fruit and vegetable intake, stage of change for fruit and vegetable intake, self-efficacy, and decisional balance were measured at baseline and 12 months later at completion for both groups. The intervention group received a series of
4 stage-based newsletters and two educational telephone calls from Extension Educators. The study is completed and principal investigators are in the process of analyzing the data. South Dakota is in the process of analyzing whether in-person contact or by telephone the better avenue of recruitment of the low-income 18-24 year old. Additionally, South Dakota measured the efficacy of the intervention on over 400 18-24 year college students. The intervention increased fruit and vegetable consumption by 1 serving/day. South Dakota assisted in the submission of NRI-Integrated grant Web-based Behavior Change for Obesity Prevention of Young Adults which was funded to start January 2005.
Impacts
Qualitative data and quantitative assessments of stage-tailored intervention will improve the effectiveness of future theory-based interventions to promote nutritional health and prevention of obesity via increase fruit and vegetable intake.
Publications
- Leek, V. J. 2005. Best method to recruit 18-24 year old low-income, M.S. Thesis.
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Progress 01/01/03 to 12/31/03
Outputs
The objective of this study was to test the effectiveness of an intervention using stage-based newsletters with a motivational interview session to increase fruit and vegetable consumption of young adults. 437 college students between the ages of 18 to 24 were enrolled, stratified on stage-of-change (SOC) for fruit and vegetable consumption, and randomized to control or intervention group. Participants were excluded if they did not sign the informed consent form, declared major of nutrition, lack of telephone and email access. 72% completed the study. Both control and intervention were measured at baseline and completion for SOC and fruit and vegetable consumption. SOC was measured using an algorithm that based stage assignment upon whether or not the individual consumed more or less than 5 servings of fruits and vegetables per day. Participants were considered as pre-contemplation (no intention of changing in the next 6 months), contemplation (thinking of changing in
the next 6 months), preparation (planning to change in the next 30 days), action (have changed behavior to meet a specific criterion) and maintenance (behavior has been sustained for six months) depending upon their response to the fruit and vegetable algorithm. Fruit and vegetable intake was measured using a 26-item food frequency questionnaire (FFQ) and a 1-item question that queried how many servings fruits and vegetables they usually consumed per day. The FFQ asked how often the individual had eaten specific fruits and vegetables in the last year. The questionnaire included 12 fruit items and 14 vegetable items with How Often? and How Much? quantifiers. The participants in the intervention group received 4-stage based fruit and vegetable newsletters via mail (1/month), a motivational interview, and email follow-up. During the motivational interview participants identified barriers to fruit and vegetable consumption and possible solutions. E-mail follow-up was individually tailored
and a nutrition website was available to participants. Results were analyzed using and included the following tests: PROC GLM, PROC NPAR1WAY, Kruskal-Wallis, and Chi squared. The intervention group significantly increased fruit and vegetable by 0.88 servings/day (1-item question, p=0.043) and 0.63 servings/day (FFQ, p less than 0.0001) servings per day than control group. The use of stage-based newsletters with 1 motivational interview and email follow-up is effective in increasing the fruit and vegetable consumption of young adults.
Impacts
Fruit and vegetable consumption was increased by approximately one serving per day in 18-24 year old college students during a 4 month intervention that used a series of newsletters tailored to stage of change and a motivational interview.
Publications
- No publications reported this period
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