NC219: Using Stage Based Interventions to Increase Fruit and Vegetable Intake in Young Adults

(Multistate Research Project)

Status: Inactive/Terminating

Project Menu

SAES-422 Reports

Annual/Termination Reports:

[01/29/2003] [02/20/2004] [05/01/2005] [10/13/2005] [11/07/2006]

Date of Annual Report: 01/29/2003

Report Information

Annual Meeting Dates: 07/24/2002 - 07/26/2002
Period the Report Covers: 10/01/2001 - 10/01/2002

Participants

Jamie Ruud University of Nebraska;
Tonya Horacek Syracuse University;
Adrienne White University of Maine;
Nancy Betts University of Nebraska;
Geoffrey Greene University of Rhode Island;
Kendra Kattelmann South Dakota State University;
Linda Boeckner, - University of Nebraska;
Susan Nitzke University of Wisconsin;
Sharon Hoerr Michigan State University;
Barbara Lohse Knous Kansas State University;
Bea Phillips Tuskegee University;
Mary Jane Oakland Iowa State University;
Dennis Saviano Administrative Advisor Purdue University;
Susan Welsh - USDA

Brief Summary of Minutes

The members of NC 219 held their annual meeting in St. Paul, Minnesota for three days prior to the beginning of the annual meeting of the Society of Nutrition Education. The meeting began with reports from Dean Savaiano about multi-state research groups and Susan Walsh from the USDA perspective. Both of them talked about new and upcoming opportunities for programming and research in the area of health/nutrition behaviors. These reports were followed by state reports from each participating institution.

There are two-funded projects related to NC 219. Nancy Betts reported on NRI, and Susan Nitzke, reported on IFAFS progress to date. Details of these reports are included within the section on progress of work and principal accomplishments related to the NC 219 objectives.

On the second day of the meeting, the Extension partners, associated and funded through the IFAFS grant, joined the group for the next day and a half working together to accomplish the work for beginning the intervention in early, 2003.

Accomplishments

This report covers the first year of renewal for NC219, Using Stage Based Interventions to Increase Fruit and Vegetable Intake in Young Adults, October 1, 2001 through September 30, 2006, (writing team: RI lead, KS, ME, WI), and the first year activities for two grants: 1) USDA/NRICGP Using Stages of Change to increase fruit and vegetable intake, $400,000, September 1, 2001 through September 30, 2004, (NE lead, AL, KS, IA, MI, ME, NY, OR, RI, SD, WI) and 2) USDA/IFAFS A Staged-Based Intervention to Increase Fruit and Vegetable Intakes of Young Adults, $2,000,000, October 1, 2001 through September 30, 2005, (WI, lead, AL, KS, IA, MI, ME, NE, NY, OR, RI). A bridging subcommittee integrated the activities of the three projects, NC219, NRI, and IFAFS (KS, NE, ME, RI, WI). Objective 1: Qualitatively assess the preferred delivery method, as well as the acceptability stage tailored newslettes in young adults in diverse populations. A great deal of work was accomplished during this year to design print materials a magazine, newsletters, and individualized computer-generated letter reports that are appropriate and communicate effectively for the intended study group of young adults. A guidebook and videotape demonstrating interviewing techniques for use with focus groups and individual interviews were developed by NE. Using this standardized method focus groups and indepth interviews were conducted with 246 subjects in AL, IA, KS, ME, MI, NE, NY, OR, RI, SD, and WI. These sessions were audiotaped in the individual states, transcribed using qualitative analysis software and analyzed in NE. The common wording patterns have guided wording for instruments, and the subjects gave us much feed back to improve the look, feel, and wording for the print interventions (stage-based magazine and newsletters). Based on this qualitative research, RI has developed and revised 20 color newsletters for fruits and 20 color newsletter for vegetables for use in the intervention. 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. The term economically disadvantaged was operationalized to provide the following screening criteria for subjects in the study: subject recruited through a verifiable program serving limited income, or if subject or family live in subsidized housing, receive aid to dependent children, temporary assistance for needy families, free/reduced price school lunch, or Food Stamps/elctronic benefits card, eligible for earned income credit or not required to file income taxes, participate in WIC, Medicaid, Welfare to Work, or a personal income less than $16,000/yr. In addition a recruitment committee led by NY, AL, and ME developed a recruiting manual to be used in all states to standardize procedures for recruiting and enrolling subjects. Materials developed include screening survey form to use in person or by telephone, electronic and print templates for recording subjects and recruiting sites, posters for attracting subjects that could be individualized with phone numbers for each state. Instrument Development committee led by OR and ME starting with instruments developed through earlier research in NC219 were adapted to meet the time limits for each assessment phone call to the subjects from WI survey research center. Modifying the Food Frequency Questionnaire for fruits and vegetables validated in earlier NC219 research from a pencil and paper to telephone administered instrument was accomplished. Timed comparisons were made between the NIH/NCI SCAN instrument and the NC219 FFQ. The Educational Phone Calls committee headed by NE, RI, and KS designed a training manual and stage-based scripts for guiding the two intervention educational phone calls which each subject will receive. The Mailed Materials subcommittee headed by RI and OR worked with the final revisions of newsletters and computer generated stage-based letters that will be received by each subject. The Data Generation and Analysis Committee headed by KS, ME, MI, and WI worked to develop guiding principles and the main hypotheses for the IFAFS project which implements this second NC219 objective. Reports were made by all of these working committees for total group input and revision. Objective 3: Test the efficacy of the intervention compared to a non-treatment control and compare the efficacy across diverse populations. Preparation of intervention materials, data collection instruments, and subject and data tracking forms, training manuals for recruitors and educators were all prepared during 2002 for implementation in early 2003. Other related work: A Latino interest subcommittee was formed of KS, WI, NE, IA, RI, SD to gather information that might be helpful in applying for funding to extend this stage-based TTM work for dietary change within the Latino communities. A questionnaire was developed for use with key informants and interviews were conducted in three states: WI, KS, and IA. The Latino population in these states was primarily from Mexico, followed by Guatemala, Costa Rica, and Puerto Rico, with smaller numbers from South America. One of the key observations was that few of the adults read English because most Mexican immigrants have only a primary school education before beginning to work. Therefore, educational strategies involving mainly a print basis will have limited use and effectiveness. WORK PLANNED FOR NEXT YEAR: The Stage Based intervention with young adults will begin in early 2003. Instrument development will continue to produce a finalized data-gathering instrument for research project. Manuals and materials for educators who will be recruiting and making educational phone calls will be completed for training in the states in early 2003. Electronic templates for communicating subject information after recruitment will be completed. And, all intervention materials will be completed for use in the project. This is the year when all of the development work of this year will go live in the intervention project.

Publications

Refereed papers Ma, J., Betts, N.M., Horacek, T., Georgious, B., White, A., Nitzke, S. 2002. The importance of decisional balance and self-efficacy in relation to stages of change for fruit and vegetable intakes by young adults. Am. J. Health Promot., 16: 157-166. Horacek, T., White, A., Betts, N., Hoerr, S., Georgious, C., Nitzke, S., Ma, J., Greene, G. 2002. Self-efficacy, perceived benefits and weight satisfaction discrimination among Stages of Change for fruit and vegetable intakes for young men and women. J. Am. Diet. Assoc. 102: 1466-1470. Hoerr, S.L., Bokram, R., Lugo, B., Bivins, T., Keast, D.R. Risk for disordered eating among college students relates to gender and ethnicity. Journal of the American College of Nutrition. 2002. 21(3): 1-8. Rossi, S.R., Greene, G.W., Rossi, J.S., Plummer, B.A., Benisovich, S.V., Keller, S., Velicer, W.F., Redding, C.A., Prochaska, J.O., Pallonen, U.E., Meier, K.S. (2001). Validation of decisional balance and temptations measures for dietary fat reduction in a large school-based population of adolescents. Eating Behaviors, 2, 1-18. Jones, H., Ruggiero, L., Edwards, L., Vallis, T.M., Rossi, S., Rossi, J.S., Greene, G., Kelly, K., Prochaska, J.O., & Zinman, B. (2001). Diabetes Stages of Change (DiSC): Evaluation methodology for a new approach to diabetes management. Canadian Journal of Diabetes Care, 25, 97107. In Press Horacek, R., Greene, G., Georgiou, C., White, A., Ma, J. Comparison of three methods for assessing fruit, vegetalbe and grain stages of change for young adults. Topics in Clin Nutr. Ma, J., Bett, N., Horacek, T., Georgiou, C., White, A., Nitzke, S., Swanson, M. Assessing stages of change for fruit and vegetable intake in young adults: A combination of traditional staging algorithms and food frequency questionnaires. Health Educ Res: Theory and Practice. Clark, PG, Nigg, CR, Greene, G, Riebe, D, Saunders, SD (in press). The study of exercise and nutrition in older Rhode Islanders (SENIOR): Translating theory into research. Health Education Research. Horacek T, White A, Betts N, Hoerr S, Georgiou C, Nitzke S, Ma J, Greene G. (in press) Self-efficacy, perceived benefits and weight satisfaction discriminate among Stages of Change for fruit and vegetable intake for young men and women. Journal of the American Dietetic Association. Riebe D, Greene G, Ruggiero L, Stillwell K, Blissmer B, Nigg C, Caldwell M. (in press) Evaluation of a healthy-lifestyle approach to weight management Evaluation of a Healthy-Lifestyle Approach to Weight Management. Preventive Medicine. Cynthia A. Padula, C, Rossi, S, Nigg, C, Lees, F, Fey-Yensan, N, Greene, G, Clark, P (in press) Using Focus Groups for Instrument Development: Application of the Transtheoretical Model to Fruit and Vegetable Behaviors of Older Adults. Journal of Nutrition in the Elderly. In Print Abstracts Lee, S.Y., Hoerr, S.L., Schiffman, R., Fitzgerald, H. Poor mother-toddler interaction predicts poor dietary quality in limited income mothers. World Association for Infant Mental Health‘s 8th Congress, Amsterdam, 2002 Omar, M., Hoerr, S.L., Coleman, G. Perceptions and reality mothers feeding toddlers. Society for Nutrition Education, Minneapolis, MN 2002. Lee, S.Y., Hoerr, S.L., Schiffman, R., Fitzgerald, H.E. Dietary quality and beverage consumption of mothers and toddlers in low indome families. Am. Diet. Assoc. Annual Meeting, Philadelphia, PA, 2002. Knous, B.L., Oakland, M.J. Satter, E., Wooden, J., Barrett, E. Construct validation of 16-item survey to assess eating competence. Society for Nutrition Education, Minneapolis, MN. 2002. Greene, G., Riebe, D., Ruggiero, L., Caldwell, M., & Blissmer, B, (2002, April). A home-based, healthy lifestyle weight management program. Annals of Behavioral Medicine, 24 (supplement), S112 (Abstract). Prochaska, J.O., Velicer, W.F., Rossi, J.S., Redding, C.A., Greene, G.W., Rossi, S.R., Sun, X., Fava, J.L., Laforge, R., & Plummer, B. (2002, April) Impact of simultaneous stage-matched expert systems for multiple behaviors in a population of parents. Annals of Behavioral Medicine, 24 (supplement), S192 (Abstract). Redding, C.A., Prochaska, J.O., Goldstein, M., Velicer, W.F., Rossi, J.S., Sun, X., Rakowski, W., Rossi, S.R., Greene, G.W., DePue, J., Fava, J., Laforge, R., & Ehrlich, B (2002, April). Efficacy of stage-matched expert systems in primary care patients to decrease smoking, dietary fat, sun exposure and relapse from mammography. Annals of Behavioral Medicine, 24 (supplement), S192 (Abstract). Rossi, J.S., Ruggiero, L., Rossi, S., Greene, G., Prochaska, J., Edwards, L., Vallis, M., Jones, H., Zinman, B., Chung, R., & Shikuma, N. (2002). Effectiveness of stage-based multiple behavior interventions for diabetes management in two randomized clinical trials. Annals of Behavioral Medicine, 24 (supplement), S192 (Abstract). Ruggiero, L., Edwards, L., Greene, G., Jones, H., Prochaska, J., Rossi, J., Rossi, S., Vallis, M., Zinman, B. (2002, June) The Relation between Blood Glucose Self-Testing and Glycemic Control: Diabetes Stages of Change (DiSC) Study. American Diabetes association 62nd Scientific Sessions, San Francisco, CA. Greene, G., L., Edwards, L., Jones, H., Prochaska, J., Rossi, J., Rossi, Ruggiero, L., S., Vallis, M., Zinman, B. (2002, June) Dietary Fat Reduction in Overweight Persons: Diabetes Stages of Change (DiSC) Study. American Diabetes association 62nd Scientific Sessions, San Francisco, CA. Vallis, M, L., Edwards, L., Greene, G., Jones, H., Prochaska, J., Rossi, J., Rossi, S., Ruggiero, L., Zinman, B. (2002, June) Improving Quality of Life Using Readiness To Change Interventions. American Diabetes association 62nd Scientific Sessions, San Francisco, CA. Jones, H., L., Edwards, L., Greene, G., Prochaska, J., Rossi, J., Rossi, Ruggiero, L., S., Vallis, M., Zinman, B. (2002, June) 3 behaviors: Diabetes Stages of Change (DiSC) Study. American Diabetes association 62nd Scientific Sessions, San Francisco, CA. Rossi, J.S., Ruggiero, L., Rossi, S., Greene, G., Prochaska, J., Edwards, L., Vallis, M., Jones, H., Zinman, B., Chung, R., & Shikuma, N. Effectiveness of stage-tailored multiple behavior interventions for diabetes management in two randomized clinical trials. In S. S. Johnson (Chair), Innovations in Trantheortical Model Research: Multiple Behavior Change Interventions. Symposium, 1st annual meeting of the International Society of Behavioral Nutrition and Physical Activity, Seattle, WA. (2002, July). Greene, G., Peterson, K., Elliot, D., Domas, A., Toobert, D., Resnicow, K., Clark, P., Breger, R., Rossi, S., Williams, G., Nebeling, L. Behavioral Change Consortium dietary validation studies. Poster presentation, 1st annual meeting of the International Society of Behavioral Nutrition and Physical Activity, Seattle, WA. (2002, July). Nigg, C., Riebe, D., Greene, G., Clark, P., Rossi, J., Lees, F., Burbank, P., Owens, P., English, C. Garber, C., Fey-Yensan, N., Luisi, A., Padula, C. Dufresne, R., Rossi, S., Ruggiero, L., Jordan, P., Saunders, s., Stillwell, K., Greany, M., Prochaska, J. Mediators of behavior change: Comparing exercise with fruit and vegetable consumption. Paper presentation, 1st annual meeting of the International Society of Behavioral Nutrition and Physical Activity, Seattle, WA. (2002, July).

Impact Statements

Through our research, we are providing a rigorous application and evaluation of a theory-based model of behavior change to address a fundamental gap in our knowledge of how to effectively intervene to improve food choice behavior.
Increasing consumption of fruits and vegetables among young adults can result in both short- and long-term health benefits for themselves, as well as, for current and future children who may follow the health habits of their parents.
Producers could receive an economic benefit due to increased consumption of fruits and vegetables.

Date of Annual Report: 02/20/2004

Report Information

Annual Meeting Dates: 10/09/2003 - 10/11/2003
Period the Report Covers: 10/01/2002 - 10/01/2003

Participants

Nancy Betts, University of Nebraska, nbetts1@unl.edu;
Linda Boeckner, University of Nebraska, lboeckner1@unl.edu;
Constance Georgiou, Oregon State University, georgioc@orst.edu;
Geoffrey Greene, University of Rhode Island, GWG@URI.EDU;
Sharon Hoerr, Michigan State University, hoerrs@msu.edu;
Tanya Horacek, Syracuse University, thoracek@syr.edu;
Kendra Kattelmann, South Dakota State University,kendra_kattelmann@sdstate.edu;
Barbara Lohse, Kansas State University, lohse@oznet.ksu.edu;
Susan Nitzke, University of Wisconsin-Madison, nitzke@nutrisci.wisc.edu;
Karen Kritsch, University of Wisconsin-Madison, kkritsch@wisc.edu;
Mary Jane Oakland, Iowa State University, moakland@iastate.edu;
Beatrice Phillips, Tuskegee University, ghebwp@tusk.edu;
Dennis Savaiano, Purdue University, savaiano@cfs.purdue.edu;
Susan Welsh, USDA-CSREES, swelsh@csrees.usda.gov;
Adrienne White, University of Maine, aawhite@umenfa.maine.edu

Brief Summary of Minutes

NC219 serves as an umbrella for two federally-funded projects. These projects are underway. Based on the status of data collection, data management questions were resolved and initial plans for analysis, interpretation and dissemination were determined. The representatives determined general publication guidelines and procedures. Eight manuscripts regarding the previous two years of data collections and development of novel methodology are in various stages of completion. Initial discussions of additional manuscripts were held. Ways to disseminate products from the study (ie training video, manuals, newsletters) were discussed. Plans for a developing a new five-year project proposal (2006-2011) with an increased focus on combating obesity and increasing nutritional literacy and plans for seeking competitive funding were made.

Accomplishments

Objective 1, to qualitatively assess the preferred delivery method, as well as the acceptability of stage tailored newsletters in young adults in diverse populations, is completed. Manuscripts for scientific peer review are in process. Methods for distributing products of interest to stakeholders (training materials, manuals and newsletter) have been determined. Objective 2, to develop a sustained, 6-month stage-tailored intervention designed to increase consumption of vegetables and fruits tailored for diverse populations of young adults has been completed. Objective 3, to test the efficacy of the intervention compared to a non-treatment control and compare the efficacy across diverse population is underway. During 2003-2004, we will complete data collection and begin analysis. Data collection results from waves one and two from both funded studies will be ready for decisions on dissemination by the October 2004 meeting. The final wave of results for one of the funded studies should also be ready for examination and dissemination. The group will use preliminary results to shape the direction for a new multistate project.

Publications

Greene, G., Horacek,T. White, A., and Ma, J. 2003. Use of a diet interview method to define Stages of Change in young adults for fruit, vegetable and grain intake.Top.Clin.Nutr.18:35-44. Horacek,T., Greene, G., Georgiou, C., White, A., Ma, J. 2002. Comparison of three methods for assessing fruit, vegetable, and grain Stages of Change for young adults. Top. Clin. Nutr. 7(5): 36-61. Ma, J., Betts, N. M., Horacek, T., Georgiou, G., White, A. 2003. Assessing stages of change for fruit and vegetable intake in young adults: A combination of traditional staging algorithms and food frequency questionnaires. Health Educ Res: Theory Practice.18:101-113. Parham, E.S., White, A.A. 2003. Women and weight: A model-based perspective, in Nutritional Concerns of Women, 2nd ed, Klimis-Zacas, D, Ed., CRC Press, Boca Raton, 367-397. Ganji V, Hampl JS, Betts NM. Race, gender and age-specific differences in dietary micronutrient intakes of US children. International Journal of Food Science and Nutrition, 54:485-490, 2003. Chung SJ, Hoerr SL, Levine R, Song WO, Coleman G. Validity for classifying the stages of change among dietary assessment methods on eating fruits and vegetables for American College students. Korean Journal Community Nutrition. 2002. 4(3):143-150. Clark, P.G., Nigg, C.R., Greene, G., Riebe, D., Saunders, S.D., Burbank, P., Dufresne, R., English, C., Garber, C., Lees, F., Luisi, A., Owens, N., Padula, C., Prochaska, J., Rossi, J., Rossi, S., Ruggiero, L., Stillwell, K., Fey-Yensan, N. (2002). The Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR): Translating theory into research. Health Education Research. 17:552?561. Horacek T, White A, Betts N, Hoerr S, Georgiou C, Nitzke S, Ma J, Greene G. (2002). Self-efficacy, perceived benefits and weight satisfaction discriminate among Stages of Change for fruit and vegetable intake for young men and women. Journal of the American Dietetic Association. 102:1466-1470 Riebe D, Greene G, Ruggiero L, Stillwell K, Blissmer B, Nigg C, Caldwell M. (2003) Evaluation of a healthy-lifestyle approach to weight management. Preventive Medicine 36:45-54. Jones, H, Edwards, L., Vallis, M, Ruggiero, L., Rossi, S., Rossi, J., Greene, G., Prochaska, J., Zinman, B. (2003) Changes in diabetes self-care behaviors make a difference to glycemic control: the Diabetes Stages of Change (DISC) study. Diabetes Care. 26:732-737. Greene, G, Riebe, D, Ruggiero, L, Caldwell, M, Blissmer, B. (2003). A pilot home-based, healthy lifestyle weight management program. Topics in Clinical Nutrition. 18:135-141. Vallis, M., Ruggiero, L, Greene, G., Jones, H., Zinnman, B., Rossi, R., Edwards, L., Rossi, J., Prochaska, L. (2003). Stages of change for healthy eating in diabetes: Relationships to Demographic, eating related, health care utilization and psychosocial factors. Diabetes Care. 26:1468-1474. Padula, CA, Rossi, S, Nigg, C, Lees, F, Fey-Yensan, N, Greene, G, Clark, P (2003) Using Focus Groups for Instrument Development: Application of the Transtheoretical Model to Fruit and Vegetable Behaviors of Older Adults. Journal of Nutrition for the Elderly. 22:13-33. Greene, GW, Fey-Yensan, N, Padula, C, Rossi, S, Rossi, JS, Clark, PG (In Press). Differences in Psychosocial Variables by Stage of Change for Fruits and Vegetables in Older Adults. Journal of the American Dietetic Association. Prochaska J.O., Velicer WF, Rossi J.S., Redding C.A., Greene G.W., Rossi S.R., Sun X,, Fava J.L., Laforge R., & Plummer, B. (in press). Impact of simultaneous stage-matched expert systems for multiple behaviors in a population of parents. Health Psychology. Greene, GW. Stages of Change for Healthy Eating. American Dietetic Association. Philadelphia, PA October, 2002 J Am Dietet Assoc 102:9 Suppl 2 abstract). Greene, G., Fey-Yensan, N., Padula, C., Rossi, S. (2002) Differences in psychosocial variables by stage of change for fruits and vegetables in older adults. The Gerontologist; 42 (S):157 (Abstract). Blissmer, B., Riebe, D., Ruggiero, L., Greene, G., & Caldwell, M. 2 year changes in health-related quality of life: Effects of a 6-month clinical weight management program. Society for Behavioral Medicine, Salt Lake City, UT July 2003, (Abstract) Rossi, S., Rossi, J.S., Greene, G., Fey-Yensan, N., Padula, C., Nigg, C., Owens, N.J., & Clark, P. Development of a brief measure of self-efficacy for fruit and vegetable consumption in older adults. Society for Behavioral Medicine, Salt Lake City, UT July 2003, (Abstract) Rossi, S., Greene, G., Rossi, J.S., & Betts, N.M. Young adult fruit and vegetable self-efficacy measure. Society for Behavioral Medicine, Salt Lake City, UT July 2003, (Abstract) Greene, G. Self-Assessment of Servings of Fruits and Vegetables in Young Adults. 2nd Annual Meeting of the International Society of Behavioral Nutrition and Physical Activity, Quebec, CA. July 2003, (Abstract) Betts, N., Nitzke, S., Kritsch, K., Greene, G., Lohse Knous, B., Transforming young adult?s perceptions about eating fruits and vegetables into a stage-tailored intervention. SNE Conference Preceedings, 2003, 36(1). Gunnink S, Hoerr SL, Mannie K, Wellman A, Monroe J. Fruit, vegetable and dairy intake of collegiate varsity football players. SNE Conference Preceedings, 2003, 36(1) Frank S, Georgiou C, Ellis K. 2002. New BMI-for-age percentiles relate to blood pressure, diet and phppysical activity in preschoolers. J Am Dietet Assoc 102:9 Suppl 2 p. A-70. Koorndyk T, Georgiou C. 2002. Young adults‘‘‘‘ beliefs about and use of herbal supplements in relation to their dietary attitudes and behaviors. J Am Dietet Assoc 102:9 Suppl 2 p. A-50. Betts N, Nitzke S, Greene G. Identifying dietary processes of change using qualitative interview methods. Fourth International Interdisciplinary Conference, Advances in Qualitative Methods, Banff, Alberta, Canada, May 2, 2003 (Abstract) Shafer K, McCabe A, Condron E, Lohse Knous B, Satter E, Stotts J, Morcos S. Examining eating competence change in a general nutrition course reveals gender and food preparation issues. Society for Nutrition Education Annual Conference Proceedings 36(1):43;2003. Lohse B, Shafer K. Problem-based learning is effective for extension education about omega-3 fats. Society for Nutrition Education Annual Conference Proceedings 36(1):33;2003. Lohse B, Edens K, Hess MA. Grain-based foods portion size recall compared to portion photo selection. The FASEB Journal 17(4):A281;2003. Lohse B, Oakland MJ, Satter E, Wooden J, Barrett E. Characteristics of persons who under perceive consumption of three or more daily servings of vegetables. The FASEB Journal 17(4):A287;2003. Chang M, Nitzke S, Brown R, Baumann L. Development and validation of a self-efficacy measure for dietary fat intake behaviors in low-income women. Society of Behavioral Medicine, Salt Lake City, UT, March 20, 2003. Nitzke S, Chang M, Baumann L. Usefulness of a diet habit questionnaire in low-income young mothers. SNE Conference Preceedings, 2003, 36 (1), 24. Hague A, White A. Negative Attitudes of Obesity: A Web-based Intervention to Effect Change. SNE Conference Preceedings, 2003, 36 (1), 24.

Impact Statements

Date of Annual Report: 05/01/2005

Report Information

Annual Meeting Dates: 02/22/2005 - 02/27/2005
Period the Report Covers: 10/01/2003 - 03/01/2005

Participants

Participants Attachment:

Attachment

Brief Summary of Minutes

Minutes Attachment:

Attachment

Accomplishments

NC 219 has four main objectives. This year objective3 was targeted: To determine the effectiveness of stage-tailored intervention modalities by testing the efficacy of the intervention compared to a non-treated control across diverse low-income populations [of 18-24 year olds]. NC219 participants collectively recruited 2042 low income young adults, staged their fruit and vegetable intakes, randomized them to control and intervention groups, then proceded with the study protocol to meet the project goals. For the intervention group this included sending stage-tailored newsletters, individualized progress reports, and making educational phone calls. More specific procedures are delineated in the Journal of Extension publication listed in the publication section. 1255 subjects completed the study, data analyses are underway and interpretation of findings are forthcoming as noted in the meeting minutes. Activities in the coming year will include completion of data analysis, manuscript development, and addressing the Objective 4 of NC219: To extend findings to a specific set of recommendations for community-based practitioners.

Publications

Ruud, J.S., Betts, N.M., Kritsch, K, Nitzke, S., Lohse, B., Boeckner, L. Acceptability of stage-tailored newsletters about fruits and vegetables by young adults. Journal of the American Dietetic Association. (In Press) Greene, GW, Fey-Yensan, N, Padula, C, Rossi, S, Rossi, JS, Clark, PG (2004). Differences in Psychosocial Variables by Stage of Change for Fruits and Vegetables in Older Adults. Journal of the American Dietetic Association. 104:1236-1243. Nitzke, S., Kritsch, K., Lohse, B., Horacek, T., White, A., Greene, G., Georgiou, C., Betts, N., Boeckner, L. (2004). Extension and research professionals join forces to address a critical nutrition issue. Journal of Extension 42(5):1-7. Accessed at: http://www.joe.org/joe/2004october/iw1.shtml. The F&V Connection to feeling good and looking hot. The Initiative for Future Agriculture and Food Systems (IFAFS) Multi-state Research Team. Supported by the USDA grant to Iowa State University, Kansas State University, University of Maine, Michigan State University, University of Nebraska, Oregon State University, University of Rhode Island, South Dakota State University, Syracuse University, Tuskegee University and the University of Wisconsin-Madison. URI NFS Department 2003. Shafer KJ, Lohse B, Carbone ET. Cognitive interviewing in nutrition education: Development of a user manual for Native Americans. Journal of Nutrition Education 36 (Suppl 1):S51; 2004. Stotts J, Lohse B, Shafer K, Boeckner J, Kritsch K, Nitzke S. Educational telephone calls in a stage-of-change tailored intervention serve a dual purpose as an intervention and in-progress quality measure. The FASEB Journal 18(5):A847;2004. Leek, V. Jan 2005 Best method to recruit 18-24 year old low-income, thesis. South Dakota State University. Deana Novembrino: Differences between perceived intake and measured intake of fruits and vegetables in college aged students. May 2004. University of Rhode Island. Doctoral Dissertation. Shafer, Kimberly. January 7, 2005. A Descriptive Study of Native American Young Adults' Cognitive Reactions to Components of a Stage-Based Nutrition Education Intervention about Fruits and Vegetables. Kansas State University.

Impact Statements

Nutrition educators will be able to provide more effective programs to promote nutrition-related lifestyle behaviors.

Date of Annual Report: 10/13/2005

Report Information

Annual Meeting Dates: 09/15/2005 - 09/17/2005
Period the Report Covers: 10/01/2004 - 10/01/2005

Participants

Participants:
Tanya Horacek, Syracuse University, thoracek@syr.edu
Sarah Dayton , Syracuse University, sfdayton@syr.edu
Barbara Lohse, The Pennsylvania State University, lohseb@psu.edu
Mary Jane Oakland, Iowa State University, moakland@iastate.edu
Onekia Esters, Iowa State University
Kendra Kattlemann, South Dakota State University, kendra.kattelmann@sdstate.edu
Geoff Greene, University of Rhode Island,
Susan Welsh, USDA-CREES, swelsh@csrees.usda.gov
Linda Boeckner, University of Nebraska, LBoeckner1@unl.edu
Adrienne White, University of Maine, aawhite@umenfa.maine.edu
Beatrice Phillips, Tuskegee University, ghebwp@tuskegee.edu
Susan Nitske, University of Wisconsin-Madison, nitzke@nutrisci.wisc.edu
Sharon Hoerr, Michigan State University, hoerrs@msu.edu
Seon Young Lee, Michigan State University, leeseu15@msu.edu

Brief Summary of Minutes

NC219 serves as an umbrella for three federally-funded projects. Two of the projects are now completed with data analyses and manuscript preparation in process by the group. The group worked on a preparing a manuscript describing the main outcomes from one of the major funded projects. Additional manuscripts from the federally funded projects were presented and discussed by they main author of each manuscript. Dissemination of products from the study were discussed and implemented. University of Wisconsin has developed an interactive website with the materials. University of Nebraska updated the magazine and provided copies of via CD to each participant. The representatives worked on implementation plans for the third project. The proposal for the five-year renewal of NC219 was completed.

Accomplishments

Objective 1, to qualitatively assess the preferred delivery method, as well as, the acceptability of stage tailored newsletters in young adults in diverse populations, is completed. Manuscripts for scientific review have been completed and submitted for publication. Materials have been distributed to via CD to major participants for use in individual states. Website with training materials has been established by University of Wisconsin. Objective 2, to develop a sustained, 6-month stage-tailored intervention designed to increase consumption of vegetables and fruits tailored for diverse populations of young adults has been completed and educational materials have been distributed via CD to each major participant to use in nutrition education to young adult audiences. Objective 3, to test the efficacy of the intervention compared to a non-treatment control and compare the efficacy across diverse populations, has been completed. Manuscripts are being prepared for dissemination of results.

Publications

Ruud, J.S., Betts, N.M., Kritsch, K, Nitzke, S., Lohse, B., Boeckner, L. (In press). Acceptability of stage-tailored newsletters about fruits and vegetables by young adults. Journal of the American Dietetic Association. Park A, Nitzke S, Kritsch K, Greene G, White A, Doong J, Hoerr S, Boeckner L, Kattelmann K, Lohse B, Betts N, Oakland MJ. 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. 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. Esters, O, Oakland, MJ, Nitzke, S, Kritsch, K, Boeckner, L, Lohse, B, Greene,G. Educational telephone calls as a tool by extension paraprofessionals to change dietary behavior in low-income young adults. JNEB 37 (Suppl. 1):S32, 2005. Coleman G, Horodynski M, Contreras D, Hoerr SL. (2005) Nutrition Education Aimed at Toddlers. J Nutr Educ Behav. 37(2):96-97. Hoerr SL, Utech A, Ruth E. (2005) Child Control of Food Choices in Head Start Families. J Nutr Educ Behav. 37(4):185-190. Henry M, Hoerr SL. Horodynski M, Lee SY. Mothers poor diet quality signals risk for her toddler. Society for Nutrition Education, Orlando, FL, 2005. Shafer KJ, Lohse B. Use of Cognitive Interview Techniques in the Development of Fruit and Vegetable Nutrition Education for American Indian Young Adults Aged 18-24 Years. Submitted to Journal of Healthcare for the Poor and Underserved, (in review). Shafer KJ, Lohse BA. How to Conduct a Cognitive Interview, A Nutrition Education Example. Cooperative State Education, Research and Extension Service. http://www.csrees.usda.gov/nea/food/pdfs/cog_interview.pdf; 2005 Lohse B, Shafer K. Culturally sensitive fruit and vegetable nutrition education for American Indian young adults. Journal of Nutrition Education and Behavior 37 (Suppl 1) S33; 2005. Lohse B, Shafer KJ, Theory-driven n-3 polyunsaturated fatty acid education delivered by written correspondence and problem-based approaches. Nutrition Research. (In Press). Lohse B, Stotts, JL, Priebe J. Survey of herbal usage by Kansas and Wisconsin WIC participants reveals moderate, appropriate usage and identifies herbal education needs. Journal of the American Dietetic Association (accepted for publication). Gromis J, Stotts J, Lohse B. Reach and Behavioral Impact of Nutrition Education Newsletters. Journal of Nutrition Education and Behavior 37 (Suppl 1) S70; 2005. Lohse B, Nelson T, Shunk J, Gromis J, Poorbaugh R. Reach and impact of radio-driven campaign to increase food stamp program participant attendance at farmers market events. The FASEB Journal 19(4):A459; 2005. Oakland, MJ, Mao, J, Yuxia, M. Effects of urban residence on nutrition transition in low-income young adults migrating from rural areas in Hebei, China. JNEB 37 (Suppl. 1):S60, 2005. Hague A, White A. 2005. Web-Based Intervention for Changing Attitudes of Obesity among Current and Future Teachers. Journal of Nutrition Education and Behavior. 37:58-66. Chang, MW, Baumann LC, Nitzke S, Brown R. Predictors of fat intake behavior differ between normal weight and obese WIC mothers. American Journal of Health Promotion 2005;19(4):269 Nitzke S, Kritsch K, Lohse B, Horacek T, White A, Greene G, Georgiou C, Betts N, Boeckner L. Extension and research professionals join forces to address a critical nutrition issue. Journal of Extension [On-line], 2004;42(5). Available at: http://www.joe.org/joe/2004october/iw1.shtml. White AA, Nitzke S, Peterson K. Viewpoint: Are soft drinks getting a bum rap? We dont think so. Journal of Nutrition Education and Behavior 2004;36:266-271. Chang MW, Nitzke S, Baumann, Brown R. Predictors of fat intake behavior in obese WIC mothers. Society of Behavioral Medicine Annual Meeting and Scientific Sessions, Boston MA, April 2005. Chang MW, Nitzke S. Baumann L, Brown R. Should the DHQ be used with WIC mothers? and How do WIC mothers interpret items on the DHQ? Two posters at the Society for Nutrition Education Annual Conference, Orlando, FL, July 2005. Esters O, Oakland MJ, Nitzke S, Kritsch L, Boeckner L, Lohse B and Greene G. Educational telephone calls as a tool by extension professionals to change dietary behavior in low-income young adults. (Presentation at SNE 2005 Annual Conference in Orlando, Florida, July 26, 2005) Journal of Nutrition Education and Behavior 2005:S30. Rasmussen, D., Kattelmann, K. (2005) Practitioner perception of nutrition education in medical curriculum for diagnosis of failure to thrive in infants and children. J. Developmental and Behavioral Pediatrics submitted August 14, 2005. Kattelmann, K., Mary, H., Russell, M., Charney, P., Stokes, M., & Compher, C. (2005) Preliminary evidence for a medical nutrition therapy (MNT) protocol: enteral feedings of the critically ill. Submitted and in review to J. Amer. Dietetics Assoc. Hise, M., Kattelmann, K., Parkhurst, M. (2005) Evidence-based clinical practice: dispelling the myths. Nutrition in Clinical Practice. 20:294-302. Richards, A., Kattelmann, K., Ren, C. (2005) Motivating 18 to 24 year olds to increase their fruit and vegetable consumption. Submitted to J. Am. Dietetic Assoc and is in review. Invited presentations: Extension Nutrition Aides Participate in Research to Increase Fruit and Vegetable Intakes of Young Adults. Nutrition, Food and Physical Activity Symposium. Cooperative Extension Symposium. Wells Conference Center, April 27, 2005. Research Applications of the Transtheoretical Model to Change Food-Related Behaviors. Maine Nutrition Council Quarterly Meeting. University of Maine, May 18, 2005 Food and Society Meeting. National Roundtable Discussion on Obesity and Youth. Best Practices Applying the Transtheoretical Model in a Fruit and Vegetable Intervention for Low Income Young Adults. NASULGC and USDA/CSREES. Washington, DC. July 19-20, 2005.

Impact Statements

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.
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.

Date of Annual Report: 11/07/2006

Report Information

Annual Meeting Dates: 09/28/2006 - 09/30/2006
Period the Report Covers: 10/01/2001 - 09/01/2006

Participants

Attendees: Thursday, September 28-30
1. Beatrice Phillips, Tuskegee, Alabama
2. Barbara Lohse, Pennsylvania State University
3. Megumi Murashima, Michigan State University, grad student
4. Seung-yeon Lee, Michigan State University, post doc
5. Adrienne White, University of Maine
6. Kendra Kattelmann, South Dakota State University
7. Linda Boeckner, University of Nebraska
8. Susan Welsh, CSREES, USDA
9. Sarah Dayton, NY Syracuse NY
10. Tanya Horacek, Syracuse NY
11. Geoff Greene, University of Rhode Island
12. Tanda Kidd, Kansas State University

Thursday, September 28, 2006 Attendees: Tanya Horacek NY; Sarah Dayton NY; Maria Erdman NY; Susan Welsh CSREES; Linda Boeckner NE; Kendra Kattelmann SD; Adrienne White ME; Seung yeon Lee MI; Megumi Murashima MI; Bea Phillips AL; Sharon Hoerr MI; Geoff Greene RI; Tanda Kidd KS

Brief Summary of Minutes

9/28/2006
NC219 Annual Meeting
September 28-30, 2006
Fayetteville, NY Host: Syracuse University

1. Introductions and State Reports; AL, PA, ME, SD, WI, NE, CSREES, NY, RI, MI
CSREES Report.
o An agency wide review was held this year. There were 14 portfolio reviews. Some panelists involved were Laura Sims; Margery Caldwell; Larry Jones; Tammy Bray; Judy Wilson; Roger Clemens, Susan Nitzke (IPA);
o Welsh will do several CSREES department-wide reviews this year.
o National program leaders have been assigned to states, not areas of expertise. Welsh has OH and WV.
o Welsh is the liaison to the nutrition department chairs who will meet in WDC November 13-15. A goal is to establish more research between food science and human nutrition, e.g., bioactive food components.
Other topics include:
§ Tailoring functional foods to promote energy balance.
§ Linda Myers will talk about the new DRI process.
§ NASs ranking of FS & HN nutrition doctoral programs.
§ ADA will discuss the new MS required for dietetics.
§ Possibility of new credentialing program for community nutrition from SNE.
§ Initiate discussion on integrated programs between nutrition and sports medicine
" The USDA budget hasnt passed yet; funding levels are about the same as in former years.
o The Farm Bill specifically mentions obesity. NC1028-Promtoing healthful eating to prevent excessive weight gain in young adults is one of two Multi state research funded projects addressing obesity.
o The federal administration is still interested in making formula funding (HATCH) more competitive with investigators submitting proposals to be reviewed nationally.
" CSREES is interested in working with NASLGUC to identify model campuses for healthy living, especially to reduce obesity.
" The NRI was just released with section on obesity 31.5. Proposals are due June 5th. Panels will have expertise on physical activity, economics, and human development, as well as in human nutrition.
" There will be a session at EB, 2007 Obesity prevention: integrating research and outreach to consumers. The Nutrition Education RIS recommended this program. It is intended to attract researchers with NRI funding for integrated projects.
" Cindy Tuttle is the new nutrition person at CSREES and Director of Nutrition Family/Consumer Sciences.

2. PRECEDE-PROCEED 4 hr workshop. Tanya Horacek & Maria Erdman.
" Green & Krueter. (4th ed) Health Program Planning: an Educational and Ecological Approach. McGraw Hill, 2005.
" This is a planning model incorporating aspects from several disciplines and behavioral theories. It is a rigorous, iterative application of all four types of evaluation (formative, process, outcome, impact) throughout that involves the community participants at each step and addresses policy and environmental factors as well as individual qualities.
" The first step of social diagnosis incorporates assessment of the target groups values, attitudes, lifestyle, etc.
" Advantage and limitations of this model are that it features the differences between groups, rather than suppressing differences as does a national level intervention that would use one standardized evaluation form, for example.

3. IFAFS Sprouts (subprojects) update
" Progress on projects were reviewed.
" Research partners worked in small groups on IFAFS manuscripts in process.

Friday, September 29, 2006
1. Subcommittees worked on Webhealth projects and IFAFS manuscripts.

2. Webhealth conference call. Attendees:
§ Adrienne reported that the online survey has been completed and four focus groups were completed last week for Lesson Exercise #1.
§ Sue Schembre reported that one student went to the wrong lesson. This problem can be avoided in the future by being sure that students type in the full correct address.

A. Adrienne reported for Brian Rahill about updating the Web design and timing for when the lessons will be pilot tested.
§ SD starts a focus group next week.
§ The second lesson is set for October 16th and was ready by Sept 29th. Comments must be returned by October 6th.
§ Each state should get an outside person to provide an outside review; there is a short time line for this.
§ Lessons 1 and10 will need to be pilot tested informally, but not through the focus group procedures.
§ Suzanne Shoff and Sue Schembre offered technical assistance to review the lessons.

B. Sarah Dayton reported on the systematic approach to incorporate instructional and motivational design models into the curriculum process. She will evaluate the entire curriculum for both internal and external consistency with objectives. This is a two step process: 1) technical-immediate; 2) Sarahs lesson evaluation-in November.
" Technical changes will likely be those that can be incorporated in October.
" Each lesson will be evaluated using Sarahs lesson evaluation model (incorporating the Dick and Carey model and the ARCs model). This comprehensive assessment tests for lesson consistency as well as ability to motivate the audience.
" Volunteers to do this were SD, NY, WI, MI, AL, RI. Sarah will be the organizer of this assessment.

C. Barbara reported for the instrument committee (Suzanne, Kendra, Barb).
1. Instruments to be used this fall:
" For this set of focus groups, we have the 12-item GHQ-12 Quality of life, BMSLSS instruments to be able to control for other life stressors.
" Two other items: course credit load, work load outside of school
" F/V intake 2 item self assessment; perceived F/V goal.
" Self assessed physical activity from myPyramid.
2. Sue Schembre reported on the training DVD for the step test.
" There are four measuresHeight, weight, waist circumference, step test.
" There also needs to be written instructions and a paper reporting form for these test.
" All states need to use a wall mounted stadiometer and a digital or balance beam scale for the anthropometric measurements.
" Suzanne Shoff will send the reporting form to Sue Schembre.
3. Barb reminded us that states wishing to collect additional data must submit a SPIDER and the instruments for prior approval.
§ Barb will do cheek swabs for a genetic marker test in her states pilot for 25 subjects.
§ Michigan wants to do parenting style (and possibly feeding style).
§ Adrienne pointed out that the incentive for the pilot test was only $20, so additional measures must be limited to only one.
4. Other points related to instruments.
" The directions to subjects must provide the time for measurements, proper attire, to arrive fasted, etc.
" The step test is from Queens College and Deb Reibe will send us the reference on its validity and reliability to predict VO2Max.
" Students will be able to see their results on the website. There needs to be some explanatory text. Each states IRB will need to approve this.
" Each state should also include a paper IRB form when the physical assessment is done. Susan Shoff will modify the on-line consent form for the pen and paper form used in the intervention.

5. Recruitment (Linda) Committee reported that states should send names recruitment coordinators to her by October 15.
" By November15, each state should have made connections on campus for the recruitment process. IRB approval will be necessary for this recruitment and assessment.
" Linda will resend the recruitment manuals.

D. Tanya led the discussion on SPIDERS and asked each state to discuss theirs.
Directions to the minutes on the web are: http://www.nutritionlearning.com/minutes/ username:webhealth; password: webhealth
All manuscripts and theses or dissertations must go through this process. Each PI should communicate directly with Tanya regarding joining a spider.
§ Barb discussed her spiders
a. Cheek swabs for genotype testing. N=25 mostly for the lab techs time ~$2500. PPARS.
b. Examination to see if the 4 eating competence lessons are applicable to FSNEP audience and funding. Barb will need additional copies of these 4 lessons.
c. Examination of the eating competence outcome status of this group in the focus group data and how it relates to the other data collected.
§ Megumi and Sharon discussed the idea related to childs parenting style and health status of young adults.
§ Adrienne reported on her use of online focus groups with young adults
§ Geoff reported on 2 manuscripts related to the fall focus 2005 groups. We will need apportion investigators to various papers to avoid too many authors on one paper
a. Seung yeon reported on one paper about body image and body acceptance, eating and regulation.
b. Molly has a paper on the barriers and benefits to maintaining healthy weight.
§ Sue Schembre will restructure the TFEQ and examine predictive validity with weight change. Her instrument development will result in a new instrument.
§ Sarahs spider was reprised on curriculum evaluation.

E. Adrienne updated the schedule for the spring pilot testing that states should modify based on their semester schedule.
" Jan 16-26 recruitment and assessment
" Jan 29-Apr 20 intervention
" Apr 23-24 post assessment

F. Next Web Health conference call October 10, 2pm EST, 1pm CST.
207-581-3555.

3. NC 1028 and IFAFS conference call Sept. 29, 2006 1-3pm
Attendees: Tanda Kidd; Adrienne White; Sharon Hoerr; Beatrice Phillips; Linda Boeckner; Sarah Colby; Tanya Horaeck; Susan Nitzke; Geoff Greene; Kendra Kattelmann; Steve Hertzler until 2:20; Nancy Betts for Janice Hermann until 2:20
Absent: Kim Shafer; Janice Hermann.
New NC1028 members:
Steve Hertzler hertzler@iastate.edu Iowa state
Sarah Colby scolby@gfhnrc.ars.usda.gov ARS
Janet Hermann (not yet signed up) Oklahoma State
Kimberly Schafer (not yet signed up) USDA, Grand Forks

A. NC1028 Leadership
" Tanda Kidd (Kansas) Secretary from 2006-07. (Sarah Colby ARS/USDA volunteered to serve for 2007-2008.)
Bea Phillips (Tuskegee) Chair for 2006-07

B. Annual Meeting: NC1028 and NRI: June 5-7, 2007 at URI, Spring Pine, RI.

C. Timeline (NC1028)
" Tanya reprised a brief overview of the PRECEDE-PROCEED Model to be used in NC1028 intervention. Discussion ensued on processes for involving key players on each campus as participants in the process (establishing relationships). Linda will e-mail reading materials on PRECEDE-PROCEED to those members on the phone call, but who missed the workshop the previous day.
" Sarah Colby is holding focus groups with students on her campus dealing with barriers to weight management. Adrienne will send WebHealth focus group questions to Sarah.
" Linda Boeckner led a discussion of the first year objectives of the NC1028 proposal.
1. Enhance participatory research skills: Sarah Colby, Tanya and Sharon. Sharon & Tanya will attend the Evaluating Nutrition Education and Health Promotion Conference, October 14-15 in Houston.
2. Establishing partnerships with outreach educators and young adult populations. Each state will do this on our own campuses. Geoff and Seung-Yeon will develop a reporting form to identify how we are doing each period.
3. Initiate epidemiology literature review: Sarah Colby; Susan Nitzke; Adrienne White; Maria Erdman will organize this.
4. Develop grant proposal due June 5th to NRI. Tanda, Linda, Kendra will comprise the writing team. Each state will address college students and some might reach out to other target groups. An NRI goal might be a model for creating healthy living on campus to prevent obesity. They will begin by reformatting the approved NC1028 proposal into the NRI proposal framework.

D. Conference Calls- will be every two months.
First date: November 16 at 3:00 ET/ 2:00 CT / 1:00 MT
Alternate date: November 20 at 9:00 ET/ 8:00 CT / 7:00 MT.
Bea Phillips will set up this first conference call.
The agenda is to schedule the remaining phone conferences.
Susan Nitzke will check into transferring the IFAFS website into the NC1028 website.
Username: grantme Password: 3wishes

E. Ordering IFAFS materials. Susan Nitzke
" " Susan ordered a printing of 10,000 copies of the F & V Connection, available to states.
" " FV Express Bites WILL SOON BE available in Spanish as well as English.
" " All the newsletters will be printed in English and two in Spanish. All THE UPDATED FILES WILL SOON BE available online.
" An order form was sent to all the NC219 group members. Orders received by next week will be shipped free. AFTER THAT, A WAY TO COVER SHIPPING EXPENSES WILL HAVE TO BE IDENTIFIED.
" IFAFS distribution committee: Susan, Geoff, Barb, Linda

F. Reports
" Linda Boeckner has a 5 year report for NC219.
" Susan Nitzke must do a 5 year IFAFS report.
" Kendra recommended checking with NIMMS to check the reporting formats.
" We should be sure to indicate that there are additional publications in process and list the specific topics.
" The list of NC219 publications was reviewed.
o Under related publications there will be two subheadings: NRI & NC1028
o There are a high number of publications listed with collaborative authorship among NC 219 members.

Meeting adjourned 5pm

Submitted by
Sharon L Hoerr and Beatrice Phillips

Accomplishments

Accomplishments Objective 1: Qualitatively assess the preferred delivery method, as well as the acceptability of stage tailored newsletters in young adults in diverse populations. Print materials (magazine, newsletters, individualized computer-generated letter reports) were designed and field tested in year one of the project, with young adults in each of the participating states. A specialized guidebook and videotape demonstrating interview techniques was used to standardize collection of qualitative data for this phase of the research . 246 individuals were interviewed individually or in focus groups, with proceedings audiotaped, transcribed and analyzed in Nebraska. 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 these materials (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 Connections database of reviewed and recommended materials. Manuscripts for scientific peer review were prepared, submitted, and published. 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 (Lead: OR, ME), preparation of mailed educational print materials (Lead: RI, NE, OR), standardization of protocols for subject recruitment (Lead: NY, AL, ME, SD), training and procedures for the educational phone call component of the intervention (Lead: NE, KS, RI), and for planning and management of data analysis (Lead: (KS, ME, MI, WI). Materials developed included: screening survey form, recruiting manual and posters, electronic and print templates for subject records, educational phone call procedures manual and stage-based scripts. Instruments developed in previous NC219 research were revised, tested and adapted to meet the telephone time limits for each assessment phone call conducted by WI survey research center. Extension partners contributed to development and testing of many of these recruitment and assessment materials, and refinement of the educational materials. Manuscript about the extension-research partnership was prepared, submitted and published. 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. 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). Manuscript about the intervention outcomes is currently under review. Impacts In the IFAFS-funded research, follow-up interviews 6 months after the 6-month intervention period showed that positive results were achieved and maintained. Participants in the experimental group had higher intakes of fruit and vegetables than controls (perceived daily intakes of 4.90 vs. 4.60 servings per day, F=3.49, p<0.05 and 4.31 vs. 3.92 servings/day via 5-A-Day Screener, F=4.78, p<0.01) and greater progression to action or maintenance stages (66% progress in fruit for intervention vs. 55% progress in fruit for controls; 47% vs. 32% progress for vegetables, p=0.0080 and 0.0001, respectively). Education and supervision of graduate students have been an integral part of the NC219 activity. Graduate students have assisted in all aspects of the integrated projects that have been part of the NC219 multi-state project, have presented their work at national professional conferences, conducted ancillary data collection/analysis and, thus, gained professional experience to enhance their skills and expertise. The work of this group has been extended via Extension systems in the cooperating states. Printed educational materials have been made available to each state in the project, and inservice education on Transtheoretical Model for Behavior Change (Stages of Change) for Extension personnel has been conducted. A web-based educational tool, using the content of the stage-based newsletters and magazine and the adapted assessment instruments, was developed and evaluated for delivery to young adult audiences through the Web (F and V Express Bites, http://www.nutrisci.wisc.edu/fav/). Implications for the use of educational phone calls to support educational delivery leading to eating behavior changes have been identified. Plans to share that information via peer-reviewed research publication are in progress. The majority of work of this group was supported by a USDA IFAFS grant that was awarded in 2001 through 2005 with a no-cost extension until August 2006. A National Research Initiative grant funded a second project with young adults, using stage-based newsletters to enhance fruit and vegetable intake. In 2005, a National Research Initiative Integrated Projects grant was received to support additional work with young adults related to weight management and healthy food and physical activity choices. These additional funding sources are: 2001-2005 A Stage-Based Intervention to Increase Fruit and Vegetable Intakes of Young Adults. USDA/IFAFS. Susan Nitzke, Principal Investigator with subcontracts to each of the states in the Multi-State Research Project. Total Award: $2 million. 2001-2005 Using the Stages of Change Model to Increase Fruit and Vegetable Intake. USDA/NRI. Nancy Betts, Principal Investigator. Total Award: $400,000. 2005-2009 Behavior Modification for Obesity Prevention in Young Adults. USDA/NRI Integrated Project. Geoffrey Greene, Principal Investigator with subcontracts to ME, NY, AL, MI, WI, SD, PA. Total Award: $1,127,707. 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. The NC219 project team was successful in developing theory-based education strategies for low-income young adults between the ages of 18-24. However, the researchers discovered that young adults were more likely to drop from the intervention study if they had very low incomes (< $800 per month), were of ethnic minority status and/or were parents. The new multi-state project will use principles of community based participatory research to further increase relevance and accessibility of nutrition education programs, and reduce the attrition found within harder-to-reach segments of young adult audiences.

Publications

NC-219 Using Stages of Change Model to promote consumption of grains, vegetables and fruits by young adults NC219 Refereed Publications 2001 Ma J, Betts NM, Horacek T. (2001). Measuring stage of change for assessing readiness to increase fruit and vegetable intake. Am J Health Promot. 16(2):88-97. Shafer, KJ, Knous, BL. (2001). A Longitudinal Study of Cognitive and Affective Behavior in a Didactic Program in Dietetics: Implications for Dietetics Education. J Am Diet Assoc. 101:1051-1054. 2002 Chung SJ, Hoerr SL, Levine R, Song WO, Coleman G. (2002). Validity for classifying the stages of change among dietary assessment methods on eating fruits and vegetables for American college students. Kor J Comm Nutr. 4(3): 143-150. Horacek T, Greene G, Georgiou C, White A, Ma J. (2002). Comparison of three methods for assessing fruit, vegetable, and grain Stages of Change for young adults. Top Clin Nutr. 17(5): 36- 61. Horacek T, White A, Betts N, Hoerr S, Georgiou C, Nitzke S, Ma J, Greene G. (2002). Stage of change for fruit and vegetable intake. Nutr Res Newsl. 21(11):7-11. Horacek T, White A, Greene G, Betts NM, Hoerr S, Georgiou C, Nitzke S, Ma J. (2002). Decisional balance, self-efficacy and weight satisfaction discriminate stages of change for fruit and vegetable intakes among young men and women. J Am Diet Assoc. 102:1466-1470. Ma J, Betts NM, Horacek T, Georgiou C, White A, Nitzke S. (2002). The importance of decisional balance and self-efficacy in relation to stages of change for fruit and vegetable intakes by young adults. Am J Health Promot. 16:157-166. 2003 Greene G, Horacek T, White A, Ma J. (2003). Use of a diet interview method to define Stages of Change in young adults for fruit, vegetable and grain intake. Top Clin Nutr 18(1): 32-41. Ma J, Betts NM, Horacek T, Georgiou C, White A. (2003). Assessing stages of change for fruit and vegetable intake in young adults: A combination of traditional staging algorithms and food frequency questionnaires. Health Educ Res. 18:224-236. 2004 Nitzke, S. N., K.R. Kritsch, B. Lohse, T. Horacek, A. White, G. Greene, C. Georgiou, N. Betts, L. Boeckner. (2004). Extension and research professionals join forces to address a critical nutrition issue. J. Extens. 42(5):1-7, Accessible at: wwwjoe.org/joe/2004october/iwl.shtmi 2005 Chung SJ, Hoerr SL. (2005). Predictors of fruit and vegetable intakes in young adults by gender. Nutr Res. 25(5):413-513. Ruud JS, Betts NM, Kritsch K, Nitzke S, Lohse B, Boecker L. (2005). Acceptability of stage-tailored newsletters about fruits and vegetables by young adults. J Am Diet Assoc. 105:174-178. 2006 Richards A, Kattelmann K, Rem C. (2006). Motivating 18 to 24 year olds to increase their fruit and vegetable consumption. J Am Diet Assoc. 106:1405-1411. Chung SJ, Hoerr SL, Coleman G, Levine R. (In press, 2006) Processes underlying young women's decisions to eat fruits and vegetables. Br J Nutr Diet. 19(4). Nitzke S, Kritsch K, Boeckner L, Greene G, Hoerr S, Horacek T, Kattelmann K, Lohse B, Oakland MJ, Phillips B, White A. (In review: accepted with revisions, 2006). A stage-based intervention increases fruit and vegetable intakes of low-income young adults. Am J Health Promot.

Impact Statements

In the IFAFS-funded research, follow-up interviews 6 months after the 6-month intervention period showed that positive results were achieved and maintained. Participants in the experimental group had higher intakes of fruit and vegetables than controls (perceived daily intakes of 4.90 vs. 4.60 servings per day, F=3.49, p<0.05 and 4.31 vs. 3.92 servings/day via 5-A-Day Screener, F=4.78, p<0.01) and greater progression to action or maintenance stages (66% progress in fruit for intervention vs. 55% progress in fruit for controls; 47% vs. 32% progress for vegetables, p=0.0080 and 0.0001, respectively).
The work of this group has been extended via Extension systems in the cooperating states. Printed educational materials have been made available to each state in the project, and inservice education on Transtheoretical Model for Behavior Change (Stages of Change) for Extension personnel has been conducted. A web-based educational tool, using the content of the stage-based newsletters and magazine and the adapted assessment instruments, was developed and evaluated for delivery to young adult audiences through the Web (F and V Express Bites, http://www.nutrisci.wisc.edu/fav/). Implications for the use of educational phone calls to support educational delivery leading to eating behavior changes have been identified.