This paper reports a pilot test of the feasibility of implementing an extension of the Expanded Food and Nutrition Education Program (EFNEP) home-based nutrition education intervention in order to maximize involvement of participants' naturally occurring social networks and to target cancer prevention eating patterns. Community residents served as hostesses of a two-session "Nutrition Home Party" and invited at least six family members/friends to attend the sessions, which were held in their homes. Paraprofessionals indigenous to the community facilitated the sessions. Nutrition education sessions were based on the Food Guide Pyramid and the Nutrition Facts label, with emphasis placed on encouraging participants to consume at least five servings of fruits and vegetables a day to reduce their risk of cancer. Preliminary experience with a home-based intervention model indicates that there is considerable potential for working through existing social networks to reach low-income populations.

PURPOSE:To explore similar patterns of fruit and vegetable consumption between health center employees and their spouses.DESIGN:Cross-sectional mailed survey assessing frequency of fruit and vegetable consumption, as well as demographics and knowledge, attitudes, access, and social support related to fruit and vegetable consumption.SETTING:Six Massachusetts health centers.SUBJECTS:Two hundred eleven health center employee/spouse pairs (422 individuals).MEASURES:The kappa statistic measured agreement in fruit and vegetable consumption between employees and spouses. The Spearman rho coefficient measured correlations for individual responses. Multiple Linear Regression Models examined variables that explained fruit and vegetable consumption level differences.RESULTS:Response rate was 59%. Mean fruit and vegetable daily intake was 4.68 and 4.30 servings for employees and spouses, respectively. Over 75% of employee and spouse estimates measuring fruit and vegetable consumption-related information, on average, were within one survey response category of each other. Knowledge, attitudes, and access indices were significantly correlated with fruit and vegetable consumption for both employees and spouses. The social support index was significantly correlated with fruit and vegetable consumption only for the spouses. Differences in knowledge, attitudes, and access indices between employees and spouses helped to explain different fruit and vegetable consumption levels. Nonresponse, selection, recall, and seasonal reporting biases may limit the findings' generalizability.CONCLUSIONS:The effectiveness of worksite nutrition interventions may be improved by involving family/household members.

Although there has been increasing attention to cancer prevention among low-income and minority populations, only a few nutrition interventions have addressed the special needs of people with low literacy skills. To determine the best provider and the most effective format for a nutrition intervention targeting patients with low Literacy skills, we conducted interviews with literacy experts and health care providers and focus groups with members of adult basic education classes. Thirty-five literacy experts and health-center-based physicians, nurses, and nutritionists in Boston, Mass, were interviewed. In addition, 50 volunteer clients from 4 Boston-based adult basic education programs participated in 6 focus groups. Results suggested that health care providers consider nutrition to be a fundamental health education topic, but that its successful inculcation in patients with limited literacy skills is hindered mostly by insufficient provider time. Almost all providers agreed that patients need to be referred to nutritionists for nutrition education. Although most providers and patients acknowledged that patients perceive physicians to be the authorities on health, patients with low literacy skills turned first to family members and friends for health information. These results suggest that effective nutrition interventions must build on patients' social networks; appear in a visually based, interactive format; and be culturally appropriate.

This article examines the relationship between reported social support and readiness to increase fruit and vegetable consumption, based on the Transtheoretical Stage of Change Model. Data were collected as part of the baseline assessments for a work site intervention study promoting increased consumption of fruits and vegetables. Among workers who did not live alone, household support was significantly higher for those of Hispanic and African American heritage than other groups, and was also higher among men, nonsmokers, and those living with adults compared to those living only with children. In multivariate analyses, coworker support was significantly associated with being in preparation compared to precontemplation/contemplation. Household support was not significantly related to readiness to change in multivariate analyses. The effectiveness of work site nutrition education interventions is likely to be enhanced by teaching participants to provide social support to coworkers and family members.