We know how to change the dietary habits of motivated individuals. The results of our past randomized intervention trials indicate that if people are ready and motivated to change dietary behaviors, the likelihood of success is very high. We know far less about how to change the dietary habits of individuals who are not yet motivated to attempt changes. We hypothesize that two finding from our own and others' research will increase motivation for dietary change: the relationship of social support to health behaviors, and the effects of messages specifically designed to motivate individuals to change. This proposal will rigorously test an intervention package, based on our previous experience, designed to change dietary practices (lowering fat, increasing fruit and vegetable consumption) among lower socioeconomic (SES) families in religious organizations. We selected religious organizations because of the important role they play in the lives of their members and because of the social and supportive messages that can be delivered by them. The intervention package will deliver social support and motivating messages, as well as materials and skill-building opportunities for dietary change. Forty religious organizations will be randomized to intervention or comparison status. The 18-month intervention package, based on a merger of Social Learning Theory and Trans-theoretical Model of Behavior Change, will consist of material adapted from interventions of proven efficacy that present strategies for changing current behavior, messages that influence motivations and beliefs, and organization-wide interventions that affect environmental variables. We will base evaluation upon a randomly selected cohort from each religious organization's mailing list. Dietary habits will be assessed at baseline and 6 and 18 months follow-up, using a modified version of the Fat and Fiber Behavior Questionnaire, with a subset selected to receive 24-hour recalls. The intervention process will be measured and used as a mediator of dietary change in all intervention organizations. The primary outcome will be the difference in change in fat scores between intervention and comparison religious organizations.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Community Prevention and Control Study Section (CPC)
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Agurs-Collins, Tanya
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Fred Hutchinson Cancer Research Center
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Bowen, Deborah J; Barrington, Wendy E; Beresford, Shirley A A (2015) Identifying the effects of environmental and policy change interventions on healthy eating. Annu Rev Public Health 36:289-306
Bowen, Deborah J; Beresford, Shirley A A; Christensen, Catherine L et al. (2009) Effects of a multilevel dietary intervention in religious organizations. Am J Health Promot 24:15-22
Hart Jr, Alton; Bowen, Deborah J; Christensen, Catherine L et al. (2009) Process evaluation results from the Eating for a Healthy Life study. Am J Health Promot 23:324-7
Hannon, Peggy A; Bowen, Deborah J; Christensen, Catherine L et al. (2008) Disseminating a successful dietary intervention to faith communities: feasibility of using staff contact and encouragement to increase uptake. J Nutr Educ Behav 40:175-80
Hart Jr, Alton; Bowen, Deborah J; Kuniyuki, Alan et al. (2007) The relationship between the social environment within religious organizations and intake of fat versus fruits and vegetables. Health Educ Behav 34:503-16
Hart Jr, Alton; Tinker, Lesley; Bowen, Deborah J et al. (2006) Correlates of fat intake behaviors in participants in the eating for a healthy life study. J Am Diet Assoc 106:1605-13
Christensen, Catherine L; Bowen, Deborah J; Hart Jr, Alton et al. (2005) Recruitment of religious organisations into a community-based health promotion programme. Health Soc Care Community 13:313-22
Bowen, Deborah J; Beresford, Shirley A A; Vu, Thuy et al. (2004) Baseline data and design for a randomized intervention study of dietary change in religious organizations. Prev Med 39:602-11
Hart Jr, Alton; Tinker, Lesley Fels; Bowen, Deborah J et al. (2004) Is religious orientation associated with fat and fruit/vegetable intake? J Am Diet Assoc 104:1292-6
Hart Jr, Alton; Bowen, Deborah J (2004) The feasibility of partnering with African-American barbershops to provide prostate cancer education. Ethn Dis 14:269-73

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