TAILORING NUTRITION EDUCATION FOR LOW INCOME AUDIENCES

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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.