A motivational interviewing intervention to increase fruit and vegetable intake through Black churches: results of the Eat for Life trial.

OBJECTIVES This study reports on Eat for Life, a multicomponent intervention to increase fruit and vegetable consumption among African Americans that was delivered through Black churches. METHODS Fourteen churches were randomly assigned to 3 treatment conditions: (1) comparison, (2) self-help intervention with 1 telephone cue call, and (3) self-help with 1 cue call and 3 counseling calls. The telephone counseling in group 3 was based on motivational interviewing. The primary outcome, assessed at baseline and 1-year follow-up, was fruit and vegetable intake as assessed by 3 food frequency questionnaires. RESULTS Change in fruit and vegetable intake was significantly greater in the motivational interviewing group than in the comparison and self-help groups. The net difference between the motivational interviewing and comparison groups was 1.38, 1.03, and 1.21 servings of fruits and vegetables per day for the 2-item, 7-item, and 36-item food frequency questionnaires, respectively. The net difference between the motivational interviewing and self-help groups was 1.14, 1.10, and 0.97 servings for the 2-item, 7-item, and 36-item food frequency questionnaires, respectively. CONCLUSIONS Motivational interviewing appears to be a promising strategy for modifying dietary behavior, and Black churches are an excellent setting to implement and evaluate health promotion programs.

[1]  T. Baranowski,et al.  Dietary change through African American churches: baseline results and program description of the eat for life trial. , 2000, Journal of cancer education : the official journal of the American Association for Cancer Education.

[2]  D M Murray,et al.  A Monte Carlo Study of Alternative Responses To Intraclass Correlation in Community Trials , 1996, Evaluation review.

[3]  Frank Treiber,et al.  Evaluation of a Brief Telephone Questionnaire to Estimate Fruit and Vegetable Consumption in Diverse Study Populations , 1993, Epidemiology.

[4]  R. Heidel,et al.  Healthy People 2000: national health promotion and disease prevention objectives (excerpts). US Public Health Service. , 1991, Journal of allied health.

[5]  D. Becker,et al.  Synthesis of Findings and Issues from Religious ..Based Cardiovascular Disease Prevention Trials , 1997 .

[6]  A. Kristal,et al.  Patterns of dietary behavior associated with selecting diets low in fat: reliability and validity of a behavioral approach to dietary assessment. , 1990, Journal of the American Dietetic Association.

[7]  B. H. Patterson,et al.  Fruit and vegetables in the American diet: data from the NHANES II survey. , 1990, American journal of public health.

[8]  T. Baranowski,et al.  Validation of three food frequency questionnaires and 24-hour recalls with serum carotenoid levels in a sample of African-American adults. , 2000, American journal of epidemiology.

[9]  J Heimendinger,et al.  5 A Day for better health--nine community research projects to increase fruit and vegetable consumption. , 1995, Public health reports.

[10]  C. Rand,et al.  Heart, body, and soul: a church-based smoking-cessation program for Urban African Americans. , 1993, Preventive medicine.

[11]  Stephen Rollnick,et al.  Health Behavior Change: A Guide for Practitioners , 1999 .

[12]  J. Flack,et al.  A church-based cholesterol education program. , 1990, Public health reports.

[13]  K. Glanz,et al.  Development and validation of measures of psychosocial factors influencing fat- and fiber-related dietary behavior. , 1993, Preventive medicine.

[14]  Stephen B. Thomas,et al.  The characteristics of northern black churches with community health outreach programs. , 1994, American journal of public health.

[15]  W. Miller,et al.  Motivational Interviewing: Preparing People to Change Addictive Behavior , 1991 .

[16]  C. Rogers.  Carl Rogers on the development of the person-centered approach. , 1986 .

[17]  E W Gunter,et al.  An evaluation of a food frequency questionnaire for assessing dietary intake of specific carotenoids and vitamin E among low-income black women. , 1991, American journal of epidemiology.

[18]  David M. Murray,et al.  Design and Analysis of Group- Randomized Trials , 1998 .

[19]  M. Bachmann,et al.  Motivational consulting versus brief advice for smokers in general practice: a randomized trial , 1999 .

[20]  S. Foerster,et al.  California's "5 a day--for better health!" campaign: an innovative population-based effort to effect large-scale dietary change. , 1995, American journal of preventive medicine.

[21]  W. Miller,et al.  What is Motivational Interviewing? , 1995, Behavioural and Cognitive Psychotherapy.

[22]  W. Miller.  Motivational interviewing: research, practice, and puzzles. , 1996, Addictive behaviors.

[23]  R. Klesges,et al.  Measuring short-term dietary intake: development and testing of a 1-week food frequency questionnaire. , 1991, Journal of the American Dietetic Association.

[24]  T. Byers,et al.  Fruit and vegetable intake among adults in 16 states: results of a brief telephone survey. , 1995, American journal of public health.

[25]  M. Symons,et al.  Fruit and vegetable consumption and prevention of cancer: the Black Churches United for Better Health project. , 1999, American journal of public health.

[26]  J. Charleston,et al.  Lose weight and win: a church-based weight loss program for blood pressure control among black women. , 1992, Patient education and counseling.

[27]  B. H. Patterson,et al.  Food choices of whites, blacks, and Hispanics: data from the 1987 National Health Interview Survey. , 1995, Nutrition and cancer.

[28]  S. Caudill,et al.  Retinol, alpha-tocopherol, lutein/zeaxanthin, beta-cryptoxanthin, lycopene, alpha-carotene, trans-beta-carotene, and four retinyl esters in serum determined simultaneously by reversed-phase HPLC with multiwavelength detection. , 1994, Clinical chemistry.

[29]  M. Nichaman,et al.  Development of a food frequency instrument: ethnic differences in food sources. , 1989, Nutrition and cancer.

[30]  G Block,et al.  Validation of a self-administered diet history questionnaire using multiple diet records. , 1990, Journal of clinical epidemiology.

[31]  T. Baranowski,et al.  5 a day for better health: a new research initiative. , 1994, Journal of the American Dietetic Association.

[32]  S. Rollnick,et al.  Helping smokers make decisions: the enhancement of brief intervention for general medical practice. , 1997, Patient education and counseling.

[33]  R. Hayes,et al.  A comparison of diets of blacks and whites in three areas of the United States. , 1993, Nutrition and cancer.

[34]  A F Subar,et al.  US adults' fruit and vegetable intakes, 1989 to 1991: a revised baseline for the Healthy People 2000 objective. , 1995, American journal of public health.

[35]  N. MacKinnon,et al.  Social Cognitive Theory as a Framework to Explain Intentions to Practice Healthy Eating Behaviors1 , 1993 .

[36]  J. Dorn,et al.  Exercise, occupational activity, and risk of endometrial cancer. , 1997, Annals of epidemiology.

[37]  T. Patterson,et al.  The development of self-efficacy scales for healthrelated diet and exercise behaviors , 1988 .