REACHING RURAL RESIDENTS WITH NURTITION STRATEGIES

描述：解决农村、非裔美国人和 低收入美国人是美国癌症预防的重中之重。 这些人群的癌症死亡率往往高得不成比例。 与城市、高加索和高收入人群相比。一些高的 这些人群中的癌症死亡率可以通过改变食物来降低 美国人吃东西。具体地说，政府机构，包括国家 癌症研究所建议美国人至少摄入20克 每天摄入纤维，每天从脂肪摄入的卡路里不超过30%。 我们还远远没有达到这些目标，农村低收入者正在 尤其是在饮食计划和知识方面处于不利地位。 这些群体往往不太愿意改变他们的饮食，而且两者都需要 阅读水平适当的材料和做出改变的额外动力。 然而，我们的教育材料和技术在改变饮食方面 服务不足显然是不够的。 研究人员建议测试一种理论上有指导的干预方法 旨在减少脂肪和增加农村纤维消费的一揽子计划， 弗吉尼亚州南部低收入、低识字率的个人。这 干预将改编一本名为《帮助》的有效饮食改变手册 《你自己：健康饮食指南》给这些人群。个性化 饮食反馈和建议，以及私人医生的信件将 为改变饮食提供了额外的动力。 通过农村初级保健招募的1,050人 弗吉尼亚州南部的律师事务所将参与这项为期五年的研究。 受试者将被随机分配到干预和控制条件下。 将分发经修订的自助小册子和励志材料 在寄往病人家中的邮件中。所有干预信息都将 提供个人农村初级保健医生的签注。 研究参与者将在1点、6点和12点通过电话进行跟踪调查 月份间隔。饮食中脂肪和纤维行为的主要结果将是 使用脂肪和纤维行为问卷(FFB)进行测量。一项子研究 在干预中，参与者将测试三种不同的策略 根据先前的研究提出个性化的饮食反馈。这 项目将提供有关激励这种服务不足的新信息 人们对饮食变化的看法。合并后的战略将形成一个 自助干预方案，最大限度地有效地保留 低强度、低成本的长期理想品质。

DESCRIPTION: Addressing cancer among rural, African American, and low-income Americans is a high priority for cancer prevention in the U.S. Cancer mortality rates among these groups are often disproportionately high compared to urban, Caucasian, and high-income populations. Some of the high cancer mortality rates in these groups can be slowed by changing the foods Americans eat. Specifically, government agencies, including the National Cancer Institute, recommend that Americans consume at least 20 grams of fiber per day and no more than 30 percent of their daily calories from fat. We are far from reaching these goals, and rural, low-income individuals are especially disadvantaged when it comes to dietary programs and knowledge. These groups are often less ready to change their diets, and in need of both reading level appropriate material and extra motivation to make changes. Yet, our educational materials and techniques for changing diet in the underserved are clearly inadequate. The investigators propose testing a theoretically guided intervention package designed to decrease fat and increase fiber consumption in rural, low-income, low-literacy level individuals in southern Virginia. This intervention will adapt an effective dietary change booklet entitled "Help yourself: A Guide to Healthful Eating" to this population. Personalized dietary feedback and recommendations, and personal physician letters will be provided for additional motivation for dietary modification. One thousand and fifty individuals recruited through rural primary care practices in southern Virginia will participate in this five year study. Subjects will be randomly assigned to intervention and control conditions. The revised self-help booklets and motivational materials will be delivered in the mail to the home of patients. All intervention information will be provided with the personal rural primary care physician's endorsement. Study participants will be followed up by telephone at one, six, and twelve month intervals. Primary outcomes of dietary fat and fiber behavior will be measured using the Fat and Fiber Behavior Questionnaire (FFB). A sub-study in the intervention participants will test three different strategies for presenting personalized dietary feedback based on prior research. This project will provide new information on motivating this underserved population toward dietary change. The combined strategies will form a self-help intervention package that is maximally effective while retaining the long term, desirable qualities of low intensity and cost.