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.

5 A Day for better health--nine community research projects to increase fruit and vegetable consumption.

One of the national objectives in "Healthy People 2000" is for members of the public to increase their consumption of fruits and vegetables to five or more servings daily. The National Cancer Institute (NCI) began a nationwide campaign to achieve this objective in 1991. As part of this campaign, the NCI funded nine research studies in 1993. These projects are implementing and evaluating community-based programs designed to increase fruit and vegetable consumption among different segments of the population in Alabama, Arizona, Georgia, Louisiana, Maryland, Massachusetts, Minnesota, North Carolina, and Washington. The settings for these projects include the Special Supplement Food Program for Women, Infants, and Children (WIC Programs), churches, worksites, and schools. The projects are led by multidisciplinary teams and entail extensive collaboration among academic, governmental, private sector, and voluntary agencies within each State. The projects represent a model public health paradigm for conducting this type of research.

How children remember what they have eaten.

OBJECTIVES: To determine whether students could verbalize, within 1 1/2 hours, how they remembered items eaten at the school lunch; to determine whether the categories of self-reported retrieval mechanisms were similar for two interview styles, integrated and nonintegrated; and to determine the effect of the two interview style on the accuracy of reporting items eaten by comparing reports with direct observation. DESIGN: Two styles of dietary intake interviews were compared with observed intake in a school lunch setting. SETTING: Two elementary schools in Georgia. SUBJECTS/SAMPLES: Eighty-two of 106 fourth graders from four classes volunteered; 24 (six per class) were randomly selected and assigned to an interview style. Students interviewed using a nonintegrated style verbalized how they remembered after they had reported everything eaten. Students interviewed using an integrated style verbalized how they remembered at the same time they reported eating each item. Both interview styles included free report followed by prompted report. MAIN OUTCOME MEASURES: Reported retrieval mechanisms were coded into 13 categories. Five measures of performance (specific match rate, general match rate, intrusion rate, omission rate, and overall match rate) were calculated by interview style for free report and prompted report separately. STATISTICAL ANALYSES PERFORMED: We analyzed the effect of interview style on the number of students reaching 100% accuracy after prompting and on accuracy of reporting condiments using Fisher's exact test. RESULTS: Most students could articulate how they remembered items eaten. Reported retrieval mechanism categories were comparable for both interview styles. Visual imagery, usual practice, behavior chaining, and preference were the most commonly reported retrieval mechanisms. Accuracy of free reports did not differ by interview style; however, the nonintegrated interview style produced dietary self-reports with fewer condiment omissions during free report and higher accuracy after prompting. APPLICATIONS: Determining what retrieval mechanisms children commonly use for remembering items eaten may help researchers design cues to improve the accuracy of dietary self-reports. More accurate dietary self-reports could markedly affect the many types of research that use dietary assessment.

Height, infant-feeding practices and cardiovascular functioning among 3 or 4 year old children in three ethnic groups.

Barker recently hypothesized that factors affecting prenatal and infant growth are related to adult blood pressure and CVD mortality. Predictions from Barker's hypothesis in regard to infant feeding were tested among a sample of 3 or 4 year old children. The relationship of infant-feeding characteristics (duration of breast-feeding, times of introduction of high fat, high carbohydrate, high potassium foods and table salt) to indicators of cardiovascular functioning (resting blood pressures and heart rates, and heart rate response to graded activity) while controlling for anthropometric (height, sum of seven skinfolds, BMI) and demographic (ethnicity, gender, social status) characteristics revealed that infant-feeding practices were not related to CV functioning in the predicted directions among this sample of 3 or 4 year old children. Furthermore, the positive relationship between height and systolic blood pressure was inconsistent with the Barker hypothesis.