A Randomized Clinical Trial Evaluating Online Interventions to Improve Fruit and Vegetable Consumption
Open accessAbstract
Objectives. We assessed change in fruit and vegetable intake in a population-based sample, comparing an online untailored program (arm 1) with a tailored behavioral intervention (arm 2) and with a tailored behavioral intervention plus motivational interviewing–based counseling via e-mail (arm 3). Methods. We conducted a randomized controlled intervention trial, enrolling members aged 21 to 65 years from 5 health plans in Seattle, Washington; Denver, Colorado; Minneapolis, Minnesota; Detroit, Michigan; and Atlanta, Georgia. Participants reported fruit and vegetable intake at baseline and at 3, 6, and 12 months. We assessed mean change in fruit and vegetable servings per day at 12 months after baseline, using a validated self-report fruit and vegetable food frequency questionnaire. Results. Of 2540 trial participants, 80% were followed up at 12 months. Overall baseline mean fruit and vegetable intake was 4.4 servings per day. Average servings increased by more than 2 servings across all study arms (P < .001), with the greatest increase (+2.8 servings) among participants of arm 3 (P = .05, compared with control). Overall program satisfaction was high. Conclusions. This online nutritional intervention was well received, convenient, easy to disseminate, and associated with sustained dietary change. Such programs have promise as population-based dietary interventions.
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Logins were found to be positively associated with outcome in studies targeting food and vegetable consumption, physical activity, and weight management.
“Using the previously described rating system, logins were found to be positively associated with outcome in studies targeting food and vegetable consumption [32], physical activity [33-37], and weight management [38-40].”
From A Systematic Review of the Impact of Adherence on the Effectiveness of e-Therapies (2011) · cites this paper as [32]
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- Authors
- Alexander, G. L., McClure, J. B., Calvi, J. H., Divine, G. W., Stopponi, M. A., Rolnick, S. J., Heimendinger, J., Tolsma, D. D., Resnicow, K., Campbell, M. K., Strecher, V. J., Johnson, C. C., & for the MENU Choices Team
- Affiliations
- Kaiser Permanente (US)
- Gwen L. Alexander, George W. Divine, and Christine Cole Johnson are with the Department of Biostatistics and Research Epidemiology, Henry Ford Hospital and Health System, Detroit, MI. Jennifer B. McClure is with Group Health Research Institute, Seattle, WA. Josephine H. Calvi and Dennis D. Tolsma are with the Center for Health Research, Kaiser Permanente Georgia, Atlanta. Melanie A. Stopponi is with the Institute for Health Research, Kaiser Permanente Colorado, Denver. Sharon J. Rolnick is with...
- ORCID
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2010-02
- Volume
- 100
- Issue
- 2
- Pages
- 319-326
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC2804654
- OpenAlex
- W2099955616
- Cited by
- 131
- References
- 48
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 5 · 2023: 7 · 2022: 5 · 2021: 4 · 2020: 7 · 2019: 9 · 2018: 10 · 2017: 10 · 2016: 11 · 2015: 4 · 2014: 10 · 2013: 7 · 2012: 7
- FWCI
- 11.30
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- Funders
- National Cancer Institute (U19CA079689)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK056350)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- fruit and vegetable intake, motivational interviewing, email counseling, health insurance beneficiaries, program satisfaction
- MeSH terms
- Adult, Aged, Counseling, Feeding Behavior, Female, Fruit, Health Promotion, Humans, Interviews as Topic, Longitudinal Studies, Male, Middle Aged, Motivation, United States, Vegetables, Logistic Models, Statistics, Nonparametric, Internet, Electronic Mail, Consumer Health Information
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