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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): The long-term goal of this research is to enhance the long- term maintenance of dietary behavior change, specifically the maintenance of increased fruit and vegetable consumption in the working population. This study is a randomized trial to evaluate the effectiveness of a new intervention, based on updated behavioral theories, to continue and maintain the behavior of increased fruit and vegetable (F&V) consumption, and to investigate the individual and worksite processes associated with sustaining and supporting that behavior. The intervention is designed to help the worksites adopt the 5 a Day activities as part of their overall operating procedures, in order to reinforce the maintenance of increased F&V consumption. It features state--of-the-art behavioral strategies at the worksite social environment, organizational and individual levels, to augment the long-term change in fruit and vegetable consumption and to build the capacity of the worksite to sustain 5 a Day activities. Members of the Employee Advisory Board (EAB) will be trained to be the main vehicle for the intervention. The project will help identify factors influencing the initiation and maintenance of behavior change at multiple levels. This project is important because only a limited number of community-based intervention studies have assessed the maintenance of behaviors more than two years after the research supported intervention has ended, and even fewer have actually intervened to sustain the program activities using a theoretical framework. The randomized controlled trial involves 20 current intervention worksites that will be randomized to maintenance intervention or control, and 20 current comparison worksites that will receive the intervention and then also be randomized to maintenance or control. The worksite is the experimental unit, and the primary outcome measure is change at the worksite level in servings of fruits and vegetables, assessed using independent cross-sectional samples of employees at two time points: the new baseline and 24-month follow-up. Biological markers of fruit and vegetable intake will also be assessed in a sub-sample of employees. Fruit and vegetables are important for good health, but the mean intake in the U.S. remains less than the five servings daily recommended by the National Cancer Institute. Worksites are good channels of dietary change and can be considered small communities where social environments can be changed to promote health. Indeed, both the original Seattle 5 a Day worksite program and preliminary results from the current Seattle 5 a Day worksite program successfully increased average daily consumption by employees of fruit and vegetables by about one third of a serving size.