Research
Research and Professional Brief
A “Contract for Change” Increases Produce Consumption in Low-Income Women: A Pilot Study

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Abstract

This study determined whether a “Contract for Change” goal-setting exercise enhanced the effectiveness of the Expanded Food and Nutrition Education/Food Stamp Nutrition Education programs to increase produce consumption in low-income (<130% of poverty) women after 4 weeks. Thirty-eight participants were randomized in this three-group parallel arm study: (a) control group participants received life-skills lessons, (b) the education group received the Expanded Food and Nutrition Education/Food Stamp Nutrition Education “Food Guide Pyramid” lessons, and (c) the contract group also received the “Food Guide Pyramid” series and completed a “Contract for Change.” It was hypothesized that the contract group would have the greatest increases in advancement toward dietary change and produce consumption. Compared with controls, the contract group significantly moved toward acceptance of vegetable consumption (P≤.05). Compared with the education group, the contract group significantly increased fruit consumption. Results suggest that nutrition professionals can effectively use goal-setting to assist low-income populations with dietary change.

Section snippets

Methods

This intervention targeted English-speaking, low-income women (<130% of federal poverty level) who were potential recipients of University of California Cooperative Extension Expanded Food and Nutrition Education (EFNEP)/Food Stamp Nutrition Education (FSNEP) programs in seven California counties: San Joaquin, Solano, Sonoma, Mendocino, Santa Clara, Butte, and Calaveras. Counties were chosen to provide representation from both rural and urban areas. Women were eligible for the study if they

Results and Discussion

Three-hundred forty-five women were screened for this pilot study. From this cohort, 65 (19%) clients were enrolled, 38 (58%) completed surveys at the final time point, and 35 (54%) completed surveys at the follow-up time point. Due to dropouts, the treatment groups were greatly skewed. Five women (13%) completed the control lesson series, 14 (37%) completed the education lesson series, and 19 (50%) completed the contract lesson series. There were no significant differences between the three

Conclusions

Readiness to change and actual behavior change for produce intake can be demonstrated after brief interventions. The results of this pilot study show that goal-setting exercises can be an easy and effective means to increase the success of existing community-based education programs in low-income women. To this end, the California State EFNEP/FSNEP program has adopted the “Contract for Change” as a tool for county educators. It is recommended that future studies consider the limitations

K. Heneman is a post-doctoral researcher, A. Block-Joy and S. Zidenberg-Cherr are cooperative extension specialists, and F. M. Steinberg is an associate professor, Department of Nutrition, University of California

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    K. Heneman is a post-doctoral researcher, A. Block-Joy and S. Zidenberg-Cherr are cooperative extension specialists, and F. M. Steinberg is an associate professor, Department of Nutrition, University of California

    Davis. S. Donohue is an EFNEP advisor, Butte County

    L. Garcia is an FSNEP advisor, Sonoma County

    A. Martin is an FSNEP advisor, San Joaquin County

    D. Metz is an FSNEP advisor, Solano County

    D. Smith is an FSNEP advisor, Calaveras County

    E. West is an EFNEP advisor, Santa Clara County; all with the Cooperative Extension, University of California, Davis.

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