Encouraging Young Adults to Make Effective Nutrition Choices: MENU Gen Y Study

描述(由申请人提供)：为了支持NIH改善人们健康和支持健康生活方式的目标，我们将进行一项随机试验，以评估一项针对年龄的网络干预措施，旨在改善年轻人(21-30岁)的饮食，因为他们正在进入更加独立的新生活阶段。我们研究的目标是利用吸引这一群体的相关特征，增加1980年或之后出生的年轻人，即“Y世代”(GenY)的水果和蔬菜(FV)的日摄入量。这个五年计划分两个阶段。在第一阶段，我们将使用焦点小组来确定针对GenY的需求和偏好的计划的关键干预要素，并将在我们修订我们经过测试的有效的基于互联网的干预(做出有效的营养选择或菜单，U19-CA079689)时，建立对干预的参与度。菜单研究旨在支持FV摄入量的增加，并完全依赖电子媒体(互联网和电子邮件)。在拟议的研究中，我们将修订菜单课程，应用针对年龄的和基于理论的方法来提高对GenY饮食行为变化的干预参与度和有效性。干预将使用三个心理社会特征，这些特征已经通过年龄组的经验检验：社会认知理论，自我决定理论(SDT)，特别关注社会营销理论(SMT)，它强调了解总体环境，以更好地塑造健康沟通。在开发我们的项目时，我们将应用发展心理学中关于GenY的知识，在我们的顾问的指导下，以及在我们的初步研究和第一阶段GenY焦点小组中收集的关于个人、环境和社会因素的形成性研究。焦点小组成员将在推出之前评估我们经过验证的菜单干预措施，以及我们修订后的针对年龄的交互式“菜单第一代”干预措施。在第二阶段，我们将评估Menu GenY干预的效果，包括通过电子邮件自我发起的个性化电子教练支持的附加值，作为定制在线干预的补充。具体地说，使用来自两个不同地区(底特律城市和宾夕法尼亚州农村)的1624名成年人的样本，并采用随机三臂设计，第二阶段的主要目标是：1)确定针对年龄的定制网络干预是否比没有年龄目标的非定制干预臂(控制臂)在改善FV的日常摄入量方面更有效；2)确定具有年龄目标和个性化电子教练支持的定制网络干预是否比对照更有效；3)确定以年龄为目标和电子咨询的量身定制的网络干预是否比单独以年龄为目标的量身定制的网络干预更有效。 与公共健康相关：越来越多的证据表明，生活方式的选择和不健康的饮食会增加健康风险，除非做出改变，否则年轻人的预期寿命将会下降。Menu Gen Y研究将调查和评估参与和支持年轻人改善饮食选择的方法，这些年轻人年龄在21岁到30岁之间，正在进入一个更独立的人生阶段。如果我们的干预成功，我们的目标是使用新的传播媒体并评估以年龄为目标的在线饮食行为改变计划，这将提供机会分享必要的战略，以接触到这些研究不足和脆弱的人群，帮助降低疾病风险，并最终建立持久的健康饮食习惯，以帮助下一代-他们的孩子。

DESCRIPTION (provided by applicant): In support of NIH goals to improve people's health and support a healthy lifestyle, we will conduct a randomized trial to evaluate an age-targeted web-based intervention designed to improve the diet of a young adults (ages 21-30) as they navigate a new life stage of greater independence. The goal of our study is to increase daily intake of fruits and vegetables (FV) for young adults born in or after 1980, known as "Generation Y" (GenY), using relevant features that appeal to this group. This five-year project has two phases. In the first phase, we will use focus groups to confirm planned, key intervention elements that target needs and preferences of GenY and will build engagement in the intervention, as we revise our tested, effective Internet- based intervention (Making Effective Nutrition Choices or MENU, U19-CA079689). The MENU study was designed to support an increase in FV intake, and relied solely on e-media (internet and email). In the proposed study we will revise the MENU curriculum, applying age-targeted and theory-based methods to improve intervention engagement and effectiveness for GenY dietary behavior change. The intervention will use three psychosocial features which have been subject to empirical examination by age group: Social Cognitive Theory, Self-Determination Theory (SDT), with special attention to Social Marketing Theory (SMT), which emphasizes understanding the total environment to better shape health communications. In developing our program, we will apply knowledge about GenY from developmental psychology, guided by our consultants and formative research on individual, environmental and societal factors collected in our preliminary studies and Phase I GenY focus groups. Focus group members will evaluate our validated MENU intervention, as well as our revised age-targeted, interactive "MENU GenY" intervention prior to launch. In the second phase, we will evaluate the efficacy of the MENU GenY interventions, including the added value of the self-initiated, personalized e-coaching support by email, as a supplement to the tailored online intervention. Specifically, using a sample of 1624 adults, ages 21 - 30 and from two geographically distinct regions (urban Detroit and rural Pennsylvania), and employing a randomized, three arm design, the primary aims of Phase II are to 1) determine if an age-targeted, tailored web-based intervention is more efficacious in improving daily intake of FV compared to an untailored intervention arm with no age targeting (control arm); 2) determine if a tailored web-based intervention with age targeting and personalized e-coaching support is more efficacious than the control; and 3) determine if the tailored web-based intervention with age targeting and e-counseling is more efficacious than a tailored web-based intervention with age targeting alone. PUBLIC HEALTH RELEVANCE: As growing evidence points to increased health risks due to lifestyle choices and unhealthy eating, young adults are facing a declining life expectancy unless changes are made. The MENU Gen Y study will investigate and evaluate ways to engage and support improved dietary choices for young adults, who, at ages 21 through 30, are navigating a more independent life stage. Should our intervention be successful, our aims to use new communication media and evaluate an age-targeted online dietary behavioral change program will provide the opportunity to share essential strategies to reach this under-studied and vulnerable population, help reduce disease risk, and ultimately build lasting healthy dietary habits to help the next generation - their children.