TAILORING NUTRITION EDUCATION FOR LOW INCOME AUDIENCES

描述(改编自申请者的摘要)：国家饮食指南 建议减少脂肪的总摄入量。需要更少的资源 昂贵和更有效的营养教育技术推广到 和不同的人口部分。电脑定制的营养教育， 它使消息个性化以满足个人的学习需求 是一种很有希望的方式来刺激人们做出健康的饮食改变，但是 有必要进行更多的研究。尤其缺乏的是低收入、低收入的研究 来自不同少数民族群体的识字观众。此外, 需要关于最具成本效益的渠道和方法的信息 提供量身定制的营养教育计划。建议的目的是 学习是为了开发适合文化和语言的量身定做 适合低文化人群的营养教育干预措施 并将这些干预措施作为随机对照试验的一部分进行测试 低收入门诊患者，包括西班牙裔，以确定哪些组成部分 在减少脂肪摄入方面是最具成本效益的。为期4年半的研究项目 是提议的。在01年，调查员将进行形成性评估 最终确定干预措施设计的技巧，其中包括英语和 西班牙语版本的励志/教学视频，书面定制 反馈工具包和电话咨询协议。为了测试这些干预措施， 我们将采用五组设计进行随机干预试验。 来自公共卫生诊所的讲英语和西班牙语的学员将 被招募参与其中。在诊所，他们将完成一项知情的 同意，基本人口学表格和你的餐盘进食模式 评估。这些信息将被扫描到数据库中。然后，符合条件的 患者将被要求进行基线电话干预，以收集 其他信息，即变革的阶段、障碍和促进者 调整干预措施所需的饮食改变、自我效能感等 完成膳食评估评价调查。然后，他们将被随机分配 进入5个实验条件之一。一组人将收到一份量身定做的 将营养包反馈为一份报告(ST)，另一份将收到此报告 信息在IO周期间(MT)以4个较小的分期付款方式邮寄。这个 MTI集团还将分四期收到量身定制的信息，但他们 将能够通过邮寄后续评估进行互动， “零售”他们在以后的分期付款中收到的信息。MTIP组 还将分四期接受量身定制的营养教育以及 同伴教育者打来的三个设定目标/解决问题的电话。他们会 在以后的分期付款中也可以接受“零售”教育。这四个人 干预组还将收到一段激励/教学视频。一个 第五个对照组将只收到非定制的书面材料。这个 这些干预措施的有效性将通过两种饮食方式进行比较 评估工具--一份饮食习惯问卷和两次24小时召回。在……里面 此外，调查人员将比较不同的成本 干预措施。

DESCRIPTION (Adapted from applicant's abstract): National dietary guidelines recommend a decrease in total fat consumption. There is a need for less expensive and more effective nutrition education techniques that reach large and varied segments of the population. Computer-tailored nutrition education, which personalizes messages to meet an individual's learning needs appears to be a promising way to stimulate people to make healthful dietary changes, but more research is necessary. Especially lacking are studies with low income, low literate audiences from various ethnic minority groups. In addition, information is needed on the most cost-effective channels and methods for delivering tailored nutrition education programs. The purpose of the proposed study is to develop culturally and linguistically appropriate tailored nutrition education interventions that are suitable for low literate audiences and to test these interventions as part of a randomized controlled trial with low income clinic patients, including Hispanics, to determine which components are most cost-effective in decreasing fat intake. A 4 1/2 year research project is proposed. In Year 01, the investigators will conduct formative evaluation techniques to finalize design of the interventions which include English and Spanish versions of motivational/instructional videos, written tailored feedback kits and telephone counseling protocols. To test these interventions, we will conduct a randomized intervention trial using a five group design. English and Spanish-speaking participants from public health clinics will be recruited to participate. At the clinic, they will complete an informed consent, basic demographics form and a Rate Your Plate eating pattern assessment. This information will be scanned into the database. Then, eligible patients will be called for a baseline telephone intervention to collect additional information, i.e. stage of change, barriers and facilitators for dietary change, self-efficacy, etc. needed for tailoring the intervention and complete dietary assessment evaluation surveys. They will then be randomized into one of 5 experimental conditions. One group will receive a tailored feedback nutrition kit as one report (ST), and another will receive this information mailed in 4 smaller installments over a IO- week period (MT). The MTI group will also receive tailored information in four installments, but they will be able to interact by mailing in follow-up assessments which can "retailor" the information they receive in later installments. The MTIP group will also receive tailored nutrition education in four installments as well as three goal-setting/problem-solving telephone calls by peer educators. They will also receive "retailored" education in later installments. These four intervention groups will also receive a motivational/ instructional video. A fifth comparison group will receive nontailored written materials only. The effectiveness of these interventions will be compared using two dietary assessment tools--a Food Habits Questionnaire and two 24 hour recalls. In addition, the investigators will compare the costs of the different interventions.