Translating a nutrition intervention thru WIC & Minority Health Promotion Centers

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DESCRIPTION (provided by the applicant): The purpose of the proposed research is to conduct translational research to study the process of disseminating a tailored nutrition intervention that has been shown to be efficacious in improving fruit and vegetable (FV) intake in diverse low income audiences as part of a NCI-funded efficacy study entitled Your Healthy Life/Su Vida Saludable (YHS/SVS). The proposed research will systematically study and characterize the process of successfully translating the YHL/SVS intervention into the established practice of two different types of sites: Minority Health Promotion Centers (MHPC) and WIC clinics in RI in partnership with the Rhode Island Department of Health (RIDH). The research will ascertain optimal diffusion strategies to enable this intervention program to be disseminated to similar settings throughout and beyond RI. Primary aims of the proposed research are: 1. To conduct formative research including focus groups and focused interviews with key stakeholders including the target audience, key RIDH officials, MHPC and WIC staff to inform adaptations of the content and format of the YHL/SVS intervention so that it meets the needs of these audiences/settings, and to inform the intervention and evaluation protocols and tools for the translational pilot; 2. To conduct a translational pilot with 20 sites (and their clients) to evaluate the process of dissemination including reach, adoption, implementation, fidelity, etc. using a variety of qualitative and quantitative evaluation measures; 3. To compile data from the translational pilot and use it to create a plan for disseminating the intervention throughout RI and into other states. Secondary aims will be to 1. To compare the effectiveness of the adapted YHL/SVS intervention to the effectiveness of a comparison intervention (traditional self help material) in terms of change in FV intake (and psychosocial mediators) of participants; 2. To compare the effect size achieved in the translational pilot study with the effect size achieved in the previous YHL/SVS randomized efficacy trial; and 3. To measure the public health impact of the adapted YHL/SVS intervention. The three year study will have three phases. Phase 1 in YO1 will include formative research with key stakeholders to inform adaptations of the content and format of the YHL/SVS intervention so that it meets the needs of these audiences/settings, to inform the plans for intervention implementation, and the evaluation methods, tools and measures so they meet the needs/priorities of the stakeholders. Phase II beginning in YO2 will be a translational pilot study with 6 MHPC and 14 WIC sites (half randomized to receive the tailored intervention and half randomized to receive the comparison intervention) and 1400 of their clients to study and evaluate the translation of the intervention. Phase III will be a continuation of the translation study with all sites receiving the tailored intervention. At the end of YO3, we will compile data from the translation research pilot study and use it to create a plan for disseminating the intervention throughout RI and into other states.