This study will develop a dietary change program for African American parents that promotes adherence to NCI dietary guidelines and is implemented through Parent As Teachers (PAT), a national parent education program. This program will encourage parents to model healthy eating to their children. The dietary change program will build upon two recognized strengths of African American families; kin networks and external social support networks. The primary evaluation outcomes will be to: reduce dietary fat intake to an average of 30 percent of energy or less; increase fiber containing foods in the diets of parents to five or more daily servings of vegetables (including beans and peas) and fruits in parents. The impact of the program on intermediate outcomes will be measured by changes in dietary patterns that describe behavioral components associated with lowering fat in the diet, nutrition related knowledge, and attitudes. The investigators will train parent educators to implement the dietary change program through PAT curriculum and evaluate the impact of the training on the parent educators. Parent educators will be trained to teach parents diet-related skills through a variety of materials (nutrition workbook, newsletters), and across settings (home visits and group meetings)which promote social support (parent-kin involvement). A quasi-experimental, nested cohort design will be used to evaluate the impact of the program on 1440 African American parents for 12 PAT sites located throughout St. Louis city and county. Process evaluation will include assessment of: session content of five individual home visits, the distribution of newsletters, parent and extended kin participation and session content of five group meetings, and parent perspective of satisfaction with the program. The program will be delivered through PAT, an agency well supported and enthusiastically accepted by African American parents as demonstrated by high participation rates of its clientele. A second strength is the potential to disseminate the curriculum developed for the proposed study on a national level through 1770 PAT-affiliated sites across 45 states.
