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Erschienen in: Annals of Behavioral Medicine 1/2008

01.02.2008 | Original Article

Mediation of Adult Fruit and Vegetable Consumption in the National 5 A Day for Better Health Community Studies

verfasst von: Marci Kramish Campbell, Ph.D., M.P.H., R.D., Dale McLerran, M.S., Gabrielle Turner-McGrievy, M.S., R.D., Ziding Feng, M.D., Stephen Havas, M.D., M.P.H., M.S., Glorian Sorensen, Ph.D., M.P.H., David Buller, Ph.D., Shirley A. A. Beresford, Ph.D., Linda Nebeling, Ph.D., M.P.H., R.D., F.A.D.A.

Erschienen in: Annals of Behavioral Medicine | Ausgabe 1/2008

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Abstract

Background

The 5 A Day for Better Health community studies demonstrated in randomized trials the efficacy of population-based strategies to increase fruit and vegetable consumption in diverse geographic areas and settings.

Purpose

Mediation analysis can help to elucidate the theoretical basis of changing dietary habits. This is important for informing more powerful cancer prevention and control interventions to achieve broad public health impact.

Methods

Five sites that focused on adults were included in mediation analyses to determine whether theoretically derived constructs assessed at baseline and follow-up contributed to explaining change in fruit and vegetable (F&V) consumption. These variables were knowledge, self-efficacy, and autonomy/responsibility. Stage of change also was considered as a potential moderating variable.

Results

Self-efficacy and knowledge of the 5 A Day recommendation increased in those who received the interventions and were positively associated with higher F&V. Mediation of intervention effect was demonstrated for these variables. Autonomy/responsibility did not meet the criteria for mediation. There was no evidence of differential effect of mediators according to baseline stage.

Conclusions

The present study findings provide strong support for mediation of F&V consumption by two variables: self-efficacy and knowledge. The authors discuss the findings in relation to study limitations and future research directions.
Literatur
1.
Zurück zum Zitat Heimendinger J, Stables G, and Foerster S. The Scientific, Policy, and Theoretical Foundations for the National 5 A Day for Better Health Program. In 5 A Day for Better Health Program Monograph National Institute of Health. 2001, Chapter 1: 1. Heimendinger J, Stables G, and Foerster S. The Scientific, Policy, and Theoretical Foundations for the National 5 A Day for Better Health Program. In 5 A Day for Better Health Program Monograph National Institute of Health. 2001, Chapter 1: 1.
2.
Zurück zum Zitat HHS, USDA. Dietary Guidelines for Americans. 6th ed. Washington DC: US Government Printing Office; 2005 (January). HHS, USDA. Dietary Guidelines for Americans. 6th ed. Washington DC: US Government Printing Office; 2005 (January).
3.
Zurück zum Zitat Stables GJ, Subar AF, Patterson BH, et al. Changes in vegetable and fruit consumption and awareness among US adults: Results of the 1991 and 1997 5 A Day for Better Health Program surveys. J Am Diet Assoc. 2002; 102(6): 809–817.PubMedCrossRef Stables GJ, Subar AF, Patterson BH, et al. Changes in vegetable and fruit consumption and awareness among US adults: Results of the 1991 and 1997 5 A Day for Better Health Program surveys. J Am Diet Assoc. 2002; 102(6): 809–817.PubMedCrossRef
4.
Zurück zum Zitat Havas S, Heimendinger J, Damron D, et al. 5 A Day for better health—Nine community research projects to increase fruit and vegetable consumption. Public Health Reports. 1995; 110(1): 68–79.PubMed Havas S, Heimendinger J, Damron D, et al. 5 A Day for better health—Nine community research projects to increase fruit and vegetable consumption. Public Health Reports. 1995; 110(1): 68–79.PubMed
5.
Zurück zum Zitat Campbell MK, Demark-Wahnefreid W, Symons M, et al. Fruit and vegetable consumption and prevention of cancer: The Black Churches United for Better Health Project. Am J Public Health. 1999; 89(9): 1390–1396.PubMed Campbell MK, Demark-Wahnefreid W, Symons M, et al. Fruit and vegetable consumption and prevention of cancer: The Black Churches United for Better Health Project. Am J Public Health. 1999; 89(9): 1390–1396.PubMed
6.
Zurück zum Zitat Buller DB, Morrill C, Taren D, et al. Randomized trial testing the effect of peer education at increasing fruit and vegetable intake. J Natl Cancer Inst. 1999; 91(17): 1491–1500.PubMedCrossRef Buller DB, Morrill C, Taren D, et al. Randomized trial testing the effect of peer education at increasing fruit and vegetable intake. J Natl Cancer Inst. 1999; 91(17): 1491–1500.PubMedCrossRef
7.
Zurück zum Zitat Havas S, Anliker J, Damron D, et al. Final results of the Maryland WIC 5 A Day Promotion Program. Am J Public Health. 1998; 88(8): 1161–1167.PubMed Havas S, Anliker J, Damron D, et al. Final results of the Maryland WIC 5 A Day Promotion Program. Am J Public Health. 1998; 88(8): 1161–1167.PubMed
8.
Zurück zum Zitat Sorensen G, Hunt MK, Cohen N, et al. Worksite and family education for dietary change: The Treatwell 5 A Day Program. Health Educ Res. 1998; 13(4): 577–591.PubMedCrossRef Sorensen G, Hunt MK, Cohen N, et al. Worksite and family education for dietary change: The Treatwell 5 A Day Program. Health Educ Res. 1998; 13(4): 577–591.PubMedCrossRef
9.
Zurück zum Zitat Beresford SA, Thompson B, Feng Z, et al. Seattle 5 a day worksite program to increase fruit and vegetable consumption. Prev Med. 2001; 32(3): 230–238.PubMedCrossRef Beresford SA, Thompson B, Feng Z, et al. Seattle 5 a day worksite program to increase fruit and vegetable consumption. Prev Med. 2001; 32(3): 230–238.PubMedCrossRef
10.
Zurück zum Zitat Krebs-Smith S, Heimendinger J, Patterson BH, et al. Psychosocial factors associated with fruit and vegetable consumption. Am J Health Promot. 1995; 10(2): 98–104.PubMed Krebs-Smith S, Heimendinger J, Patterson BH, et al. Psychosocial factors associated with fruit and vegetable consumption. Am J Health Promot. 1995; 10(2): 98–104.PubMed
11.
Zurück zum Zitat Trudeau E, Kristal A, Li S, Patterson RE. Demographic and psychosocial predictors of fruit and vegetable intakes differ: Implications for dietary interventions. J Am Diet Assoc. 1998; 98(12): 1412–1417.PubMedCrossRef Trudeau E, Kristal A, Li S, Patterson RE. Demographic and psychosocial predictors of fruit and vegetable intakes differ: Implications for dietary interventions. J Am Diet Assoc. 1998; 98(12): 1412–1417.PubMedCrossRef
12.
Zurück zum Zitat Beresford SA, Curry SJ, Kristal AR, et al. A dietary intervention in primary care practice: The Eating Patterns Study. Am J Public Health. 1997; 87(4): 610–616.PubMed Beresford SA, Curry SJ, Kristal AR, et al. A dietary intervention in primary care practice: The Eating Patterns Study. Am J Public Health. 1997; 87(4): 610–616.PubMed
13.
Zurück zum Zitat Beresford S, Farmer E, Feingold L, et al. Evaluation of a self-help dietary intervention in a primary care setting. Am J Public Health. 1992; 82: 79–84.PubMedCrossRef Beresford S, Farmer E, Feingold L, et al. Evaluation of a self-help dietary intervention in a primary care setting. Am J Public Health. 1992; 82: 79–84.PubMedCrossRef
14.
Zurück zum Zitat Thompson FE, Kipnis V, Subar AF, et al. Evaluation of 2 brief instruments and a food-frequency questionnaire to estimate daily number of servings of fruit and vegetables. Am J Clin Nutr. 2000; 71(6): 1503–1510.PubMed Thompson FE, Kipnis V, Subar AF, et al. Evaluation of 2 brief instruments and a food-frequency questionnaire to estimate daily number of servings of fruit and vegetables. Am J Clin Nutr. 2000; 71(6): 1503–1510.PubMed
15.
Zurück zum Zitat Langenberg P, Ballesteros M, Feldman R, et al. Psychosocial factors and intervention-associated changes in those factors as correlates of change in fruit and vegetable consumption in the Maryland WIC 5 A Day Promotion Program. Annals Behav Med. 2000; 22(4): 307–315. Langenberg P, Ballesteros M, Feldman R, et al. Psychosocial factors and intervention-associated changes in those factors as correlates of change in fruit and vegetable consumption in the Maryland WIC 5 A Day Promotion Program. Annals Behav Med. 2000; 22(4): 307–315.
16.
Zurück zum Zitat Reynolds KD, Baranowski T, Bishop DB, et al. Patterns in child and adolescent consumption of fruit and vegetables: effects of gender and ethnicity across four sites. J Am Coll Nutr. 1999; 18(3): 248–254.PubMed Reynolds KD, Baranowski T, Bishop DB, et al. Patterns in child and adolescent consumption of fruit and vegetables: effects of gender and ethnicity across four sites. J Am Coll Nutr. 1999; 18(3): 248–254.PubMed
17.
Zurück zum Zitat Campbell MK, Symons M, Polhamus B, et al. Stages of change and psychosocial correlates of fruit and vegetable consumption among rural African American church members. Public Health Reports. 1998; 12(3): 185–191. Campbell MK, Symons M, Polhamus B, et al. Stages of change and psychosocial correlates of fruit and vegetable consumption among rural African American church members. Public Health Reports. 1998; 12(3): 185–191.
18.
Zurück zum Zitat Thompson B, Demark-Wahnefried W, Taylor G, et al. Baseline fruit and vegetable intake among adults in seven 5 A Day study centers located in diverse geographic areas. J Am Diet Assoc. 1999; 99(10): 1241–1248.PubMedCrossRef Thompson B, Demark-Wahnefried W, Taylor G, et al. Baseline fruit and vegetable intake among adults in seven 5 A Day study centers located in diverse geographic areas. J Am Diet Assoc. 1999; 99(10): 1241–1248.PubMedCrossRef
19.
Zurück zum Zitat Baranowski T, Klesges LM, Cullen KW, Himes JH. Measurement of outcomes, mediators, and moderators in behavioral obesity prevention research. Prev Med. 2004; 38(Suppl): S1–13.PubMedCrossRef Baranowski T, Klesges LM, Cullen KW, Himes JH. Measurement of outcomes, mediators, and moderators in behavioral obesity prevention research. Prev Med. 2004; 38(Suppl): S1–13.PubMedCrossRef
20.
Zurück zum Zitat Kraemer HC, Wilson GT, Fairburn CG, Agras WS. Mediators and moderators of treatment effects in randomized clinical trials. Arch Gen Psychiatry. 2002; 59(10): 877–83.PubMedCrossRef Kraemer HC, Wilson GT, Fairburn CG, Agras WS. Mediators and moderators of treatment effects in randomized clinical trials. Arch Gen Psychiatry. 2002; 59(10): 877–83.PubMedCrossRef
21.
Zurück zum Zitat Reynolds KD, Bishop DB, Chou CP, et al. Contrasting mediating variables in two 5 A Day nutrition intervention programs. Prev Med. 2004; 39(5): 882–893.PubMedCrossRef Reynolds KD, Bishop DB, Chou CP, et al. Contrasting mediating variables in two 5 A Day nutrition intervention programs. Prev Med. 2004; 39(5): 882–893.PubMedCrossRef
22.
Zurück zum Zitat Kristal AR, Glanz K, Tilley BC, Li S. Mediating factors in dietary change: Understanding the impact of a worksite nutrition intervention. Health Educ Behav. 2000; 27(1): 112–25.PubMedCrossRef Kristal AR, Glanz K, Tilley BC, Li S. Mediating factors in dietary change: Understanding the impact of a worksite nutrition intervention. Health Educ Behav. 2000; 27(1): 112–25.PubMedCrossRef
23.
Zurück zum Zitat Prochaska JO, DiClemente CC. Stages of change in the modification of problem behaviors. Prog Behav Modif. 1992; 28: 183–218.PubMed Prochaska JO, DiClemente CC. Stages of change in the modification of problem behaviors. Prog Behav Modif. 1992; 28: 183–218.PubMed
24.
Zurück zum Zitat Bandura A. Self Efficacy: The Exercise of Control. New York: Freeman; 1997. Bandura A. Self Efficacy: The Exercise of Control. New York: Freeman; 1997.
25.
Zurück zum Zitat Campbell MK, Reynolds KD, Havas S, et al. Stages of change for increasing fruit and vegetable consumption among adults and young adults participating in the national 5 A Day for Better Health community studies. Health Educ Behav. 1999; 26(4): 513–534.PubMedCrossRef Campbell MK, Reynolds KD, Havas S, et al. Stages of change for increasing fruit and vegetable consumption among adults and young adults participating in the national 5 A Day for Better Health community studies. Health Educ Behav. 1999; 26(4): 513–534.PubMedCrossRef
26.
Zurück zum Zitat Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Disord. 1986; 51(6): 1173–1182.CrossRef Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Disord. 1986; 51(6): 1173–1182.CrossRef
27.
Zurück zum Zitat MacKinnon DP, Lockwood CM, Hoffman JM, West SG, Sheets V. A comparison of methods to test mediation and other intervening variable effects. Psychol Methods. 2002; 7(1): 83–104.PubMedCrossRef MacKinnon DP, Lockwood CM, Hoffman JM, West SG, Sheets V. A comparison of methods to test mediation and other intervening variable effects. Psychol Methods. 2002; 7(1): 83–104.PubMedCrossRef
28.
Zurück zum Zitat Preacher K, Hayes A. SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behav Res Methods Instrum Comput. 2004; 36(4): 717–731.PubMed Preacher K, Hayes A. SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behav Res Methods Instrum Comput. 2004; 36(4): 717–731.PubMed
29.
Zurück zum Zitat Shrout PE, Bolger N. Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychol Methods. 2002; 7: 422–445.PubMedCrossRef Shrout PE, Bolger N. Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychol Methods. 2002; 7: 422–445.PubMedCrossRef
30.
Zurück zum Zitat Sobel ME. Asymptotic confidence intervals for indirect effects in structural equation models. In: Leinhardt S, ed. Sociological Methodology. Washington, DC: American Sociological Association; 1982: 290–312. Sobel ME. Asymptotic confidence intervals for indirect effects in structural equation models. In: Leinhardt S, ed. Sociological Methodology. Washington, DC: American Sociological Association; 1982: 290–312.
31.
Zurück zum Zitat Van Duyn MA, Kristal AR, Dodd K, et al. Association of awareness, intrapersonal and interpersonal factors, and stage of dietary change with fruit and vegetable consumption: a national survey. Am J Health Promot. 2001; 16(2): 69–78.PubMed Van Duyn MA, Kristal AR, Dodd K, et al. Association of awareness, intrapersonal and interpersonal factors, and stage of dietary change with fruit and vegetable consumption: a national survey. Am J Health Promot. 2001; 16(2): 69–78.PubMed
32.
Zurück zum Zitat Fuemeller B, Masse L, Yaroch A, et al. Psychosocial mediation of fruit and vegetable consumption in the Body and Soul effectiveness trial. Health Psychol. 2006; 25(4): 474–483.CrossRef Fuemeller B, Masse L, Yaroch A, et al. Psychosocial mediation of fruit and vegetable consumption in the Body and Soul effectiveness trial. Health Psychol. 2006; 25(4): 474–483.CrossRef
33.
Zurück zum Zitat Resnicow K, McCarty A, Baranowski T. Are precontemplators less likely to change their dietary behavior? A prospective analysis. Health Educ Res. 2003; 18(6): 693–705.PubMedCrossRef Resnicow K, McCarty A, Baranowski T. Are precontemplators less likely to change their dietary behavior? A prospective analysis. Health Educ Res. 2003; 18(6): 693–705.PubMedCrossRef
34.
Zurück zum Zitat Perry CL, Kelder SH, Murray D, Klepp K. Community-wide smoking prevention: Long term outcomes of the Minnesota Heart Health program and the Class of 1989 study. Am J Public Health. 1992; 82: 1210–1216.PubMedCrossRef Perry CL, Kelder SH, Murray D, Klepp K. Community-wide smoking prevention: Long term outcomes of the Minnesota Heart Health program and the Class of 1989 study. Am J Public Health. 1992; 82: 1210–1216.PubMedCrossRef
35.
Zurück zum Zitat Emmons KM, McBride CM, Puleo E, et al. Prevalence and predictors of multiple behavioral risk factors for colon cancer. Prev Med. 2005; 40(5): 527–534.PubMedCrossRef Emmons KM, McBride CM, Puleo E, et al. Prevalence and predictors of multiple behavioral risk factors for colon cancer. Prev Med. 2005; 40(5): 527–534.PubMedCrossRef
36.
Zurück zum Zitat Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004; 31(2): 143–163.PubMedCrossRef Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004; 31(2): 143–163.PubMedCrossRef
37.
Zurück zum Zitat Bandura A. Exercise of human agency through collective efficacy. Curr Dir Psychol Sci. 2000; 9: 75–78.CrossRef Bandura A. Exercise of human agency through collective efficacy. Curr Dir Psychol Sci. 2000; 9: 75–78.CrossRef
Metadaten
Titel
Mediation of Adult Fruit and Vegetable Consumption in the National 5 A Day for Better Health Community Studies
verfasst von
Marci Kramish Campbell, Ph.D., M.P.H., R.D.
Dale McLerran, M.S.
Gabrielle Turner-McGrievy, M.S., R.D.
Ziding Feng, M.D.
Stephen Havas, M.D., M.P.H., M.S.
Glorian Sorensen, Ph.D., M.P.H.
David Buller, Ph.D.
Shirley A. A. Beresford, Ph.D.
Linda Nebeling, Ph.D., M.P.H., R.D., F.A.D.A.
Publikationsdatum
01.02.2008
Verlag
Springer-Verlag
Erschienen in
Annals of Behavioral Medicine / Ausgabe 1/2008
Print ISSN: 0883-6612
Elektronische ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-007-9002-y

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