Pilot and Feasibility Test of an Implementation Intention Intervention to Improve Fruit and Vegetable Intake Among Women with Low Socioeconomic Status

Authors

Michele A. DeBiasse PhD, RDN, Boston University/College of Health & Rehabilitation Sciences: Sargent CollegeFollow
Deborah J. Bowen PhD, University of Washington, Seattle
Sherry L. Pagoto PhD, University of Massachusetts Medical School
Joseph M. Massaro PhD, Boston University School of Public Health
Nawfal Istfan MD, PhD, Boston University School of Medicine
Lisa M. Quintiliani PhD, RD, Boston University School of Medicine

Keywords

Implementation intentions; Fruit and vegetable intake; Low socioeconomic status; Theory of Planned Behavior; Public housing

Disciplines

Behavior and Behavior Mechanisms | Community Health and Preventive Medicine | Dietetics and Clinical Nutrition | Health Psychology | Public Health | Women's Health

Abstract

Fruit and vegetable intake (FVI), a modifiable risk factor for chronic diseases, is lower in low socioeconomic status (SES) populations. Implementation intentions (a specific type of planning that extends the Theory of Planned Behavior) has been studied to improve FVI, but not exclusively with low SES groups. Using mixed methods, we evaluated the feasibility, acceptability, and preliminary efficacy of an implementation intention intervention (versus a general plan) to increase FVI in women with low SES. For the pilot randomized controlled trial, demographics, body mass index, attitude, perceived behavioral control, goal intention strength, and FVI were measured at baseline and FVI again 1-month following the intervention. Feasibility data were collected for recruitment, randomization, retention, and assessment procedures and compared to predetermined targets. Semi-structured interview data was analyzed for emergent themes regarding acceptability of the trial. Preliminary efficacy of the intervention to improve FVI was analyzed descriptively. Feasibility targets were met for randomization (100% vs. ≥80% target), retention (93.5% vs. ≥70% target) and the assessment metrics missing data points (2% vs. ≤10% target) and days from intervention to follow up (mean=69.2, sd=42.6 vs.days). Targets for recruitment were not met with the exception of participants giving informed consent (100% vs. ≥70% target). Participants described the intervention as enjoyable and reported behavioral constructs outside of those measured as important to improve FVI. Limited efficacy analysis suggested that both groups increased their FVI (experimental: +0.17 servings per day, 95% CI: -0.85, 1.20; control: +0.50 servings per day, 95% CI: -0.56, 1.58). Further research which examines interventions based upon behavior change models to improve dietary health behaviors in marginalized groups is needed.

Recommended Citation

DeBiasse, Michele A. PhD, RDN; Bowen, Deborah J. PhD; Pagoto, Sherry L. PhD; Massaro, Joseph M. PhD; Istfan, Nawfal MD, PhD; and Quintiliani, Lisa M. PhD, RD (2017) "Pilot and Feasibility Test of an Implementation Intention Intervention to Improve Fruit and Vegetable Intake Among Women with Low Socioeconomic Status," Journal of Health Disparities Research and Practice: Vol. 10: Iss. 2, Article 10.
Available at: https://digitalscholarship.unlv.edu/jhdrp/vol10/iss2/10