Sage Journals: Discover world-class research

Abstract

Purpose.

To examine the efficacy of an intervention based on the transtheoretical model (TTM) for increasing fruit and vegetable consumption among economically disadvantaged African-American adolescents.

Design.

Pretest-posttest quasi-experimental study.

Setting.

Youth services agencies located in New York, New Jersey, and Pennsylvania. Agencies were assigned to computer intervention (CIN) and nonintervention control study arms.

Subjects.

A total of 507 African-American adolescents ages 11 to 14 years.

Intervention.

Youths in the CIN arm completed four 30-minute intervention sessions tailored on TTM stages and processes of change.

Measures.

Self-reported fruit and vegetable consumption and stages, pros, cons, and self-efficacy for consumption.

Analysis.

Intervention effects were examined with analysis of covariance models that were controlled for demographic variables and baseline measures of each outcome. Chi-square analyses were used to examine between-arm differences in youths' stage progressions.

Results.

After adjustment by covariates, pros (p < .025) and fruit and vegetable consumption (p < .001) varied significantly with study arm. Youths in the CIN arm had higher pro scores and fruit and vegetable consumption than controls. More youths in the CIN arm than in the control arm progressed to later stages and maintained recommended intake levels (p < .05).

Conclusions.

A TTM-based intervention can increase fruit and vegetable intake and effect positive changes in TTM variables related to intake among economically disadvantaged African-American adolescents.

Keywords

Fruit and vegetable consumption Transtheoretical Model African-Americans Adolescents Dietary Intervention Prevention Research Manuscript format: research Research purpose: intervention testing Study design: quasi-experimental Outcome measure: cognitive behavioral Setting: local community Health focus: nutrition Strategy: education skill building/behavior change Target population: youth Target population circumstances: geographic location race/ethnicity

Get full access to this article

View all access options for this article.

References

Van Duyn

MAS

Pivonka

Overview of the health benefits of fruit and vegetable consumption for the dietetics professional: Selected literature. J Am Diet Assoc. 2000;100:1511–1521.

Krebs-Smith

Cook

Subar

, Fruit and vegetable intakes of children and adolescents in the United States. Arch Pediatr Adolesc Med. 1996;150:81–86.

American Cancer Society. Cancer facts and figures for African Americans 2005–2006. Available at: http://www.cancer.org/downloads/STT/CAFF2005AACorrPWSecured.pdf Accessed May 26, 2006.

National Cancer Institute. Age-adjusted incidence rates and 95% confidence intervals: SEER 13 registries for 1998–2002. Available at: http://www.seer.cancer.gov. Accessed May 20, 2005.

Prochaska

Velicer

. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12:38–48.

Greene

Rossi

, Dietary applications of the stages of change model. J Am Diet Assoc. 1999;99:673–678.

Prochaska

Velicer

Rossi

, Stages of change and decisional balance for 12 problem behaviors. Health Psychol. 1994;13:39–46.

Horowitz

Applying the transtheoretical model to pregnancy and STD prevention: A review of the literature. Am J Health Promot. 2003;17:304–328.

Spencer

Pagell

Hallion

Adams

. Applying the transtheoretical model to tobacco cessation and prevention: A review of the literature. Am J Health Promot. 2003;17:7–71.

10.

Greene

Fey-Yensan

Padula

, Differences in psychosocial variables by stage of change for fruits and vegetables in older adults. J Am Diet Assoc. 2004;104:1236–1243.

11.

Henry

Reimer

Smith

Reicks

Associations of decisional balance, processes of change, and self-efficacy with stages of change for increased fruit and vegetable intake among low-income African-American mothers. J Am Diet Assoc. 2006;106:841–849.

12.

Brug

Glanz

Kok

The relationship between self-efficacy, attitudes, intake compared to others, consumption, and stages of change related to fruit and vegetables. Am J Health Promot. 1997;12:25–30.

13.

Betts

Horacek

, 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. 2002;16:157–166.

14.

Campbell

Symons

Demark-Wahnefried

, Stages of change and psychosocial correlates of fruit and vegetable consumption among rural African-American church members. Am J Health Promot. 1998;12:185–191.

15.

Ling

AMC

Horwath

Defining and measuring stages of change for dietary behaviors: Readiness to meet fruit, vegetable, and grain guidelines among Chinese Singaporeans. J Am Diet Assoc. 2000;100:898–904.

16.

Van Duyn

Heimendinger

Russek-Cohen

, Use of the transtheoretical model of change to successfully predict fruit and vegetable consumption. J Nutr Educ. 1998;30:371–380.

17.

de Oliveira

MCF

Anderson

Auld

Kendall

Validation of a tool to measure processes of change for fruit and vegetable consumption among male college students. J Nutr Educ Behav. 2005;37: 2–11.

18.

Campbell

Motsinger

Ingram

, The North Carolina Black Churches United for Better Health Project: Intervention and process evaluation. Health Educ Behav. 2000;27:241–253.

19.

Havas

Anliker

Damron

, Final results of the Maryland WIC 5–A-Day promotion program. Am J Public Health. 1998;88:1161–1166.

20.

Resnicow

Jackson

Wang

, A motivational interviewing intervention to increase fruit and vegetable intake through Black churches: Results of the Eat for Life trial. Am J Public Health. 2001;91:1686–1693.

21.

Di Noia

Schinke

Prochaska

Contento

. Application of the transtheoretical model to fruit and vegetable consumption among economically disadvantaged African-American adolescents: Preliminary findings. Am J Health Promot. 2006;20:342–348.

22.

US Census Bureau. American fact finder [database]. Available at: http://factfinder.census.gov. Accessed June 21, 2006.

23.

Cancer Prevention Research Center. Stages of change (5 A Day). Available at: http://www1.od.nih.gov/behaviorchange/measures/PDF/5daystg.pdf. Accessed June 5, 2005.

24.

Ammerman

Lindquist

Lohr

Hersey

The efficacy of behavioral interventions to modify dietary fat and fruit and vegetable intake: A review of the evidence. Prev Med. 2002;35:25–41.

25.

Frenn

Malin

Brown

, Changing the tide: An internet/video exercise and low-fat diet intervention with middle-school students. Appl Nurs Res. 2005;18:13–21.

26.

Frenn

Malin

Bansal

. Stage-based interventions for low-fat diet with middle school students. J Pediatr Nurs. 2003;18:36–45.

Computer-Mediated Intervention Tailored on Transtheoretical Model Stages and Processes of Change Increases Fruit and Vegetable Consumption among Urban African-American Adolescents

Abstract

Purpose.

Design.

Setting.

Subjects.

Intervention.

Measures.

Analysis.

Results.

Conclusions.

Keywords

Get full access to this article

References