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.
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