SAES-422 Multistate Research Activity Accomplishments Report
Sections
Status: Approved
Basic Information
- Project No. and Title: NC219 : Using Stage Based Interventions to Increase Fruit and Vegetable Intake in Young Adults
- Period Covered: 10/01/2001 to 10/01/2002
- Date of Report: 01/29/2003
- Annual Meeting Dates: 07/24/2002 to 07/26/2002
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
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
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.
Impacts
- 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.
Publications
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).