TUESDAY, OCTOBER 23

ORIGINAL CONTRIBUTIONS: EDUCATION AND BEHAVIOR STRATEGIES--THE PUBLIC

TITLE: DIFFERENTIAL LONG-TERM ADHERENCE TO A DIETARY INTERVENTION AMONG WOMEN PREVIOUSLY TREATED FOR BREAST CANCER AUTHORS: VA Newman, MS, RD, SW Flatt, MS, S Faerber, BS, JP Pierce, Phi), Cancer Prevention & Control Program, UCSD School of Medicine. LEARNING OUTCOME: To better understand long-term dietary behavior change by women participating in a telephone counseling intervention. ABSTRACT TEXT: An intensive protocol based on telephone counseling was used to encourage participants in an NCI,funded randomized trial to make a major change to their dietary pattern to assess the role of diet in cancer progression. The objective of this study was to identify different patterns of adherence among study participants with a goal to potential tailoring of the intervention in the future to improve cost-effectiveness. Subjects were the first 109 women in the intervention group who had completed baseline, 12-month, 24- or 36-month, and 48-month dietary assessments (average of four 24-hour recalls in a 3-week period). Daily dietary behavioral targets were: 5 vegetable sexvings (not including iceberg lettuce or white potatoes), 16 ounces of vegetable juice, 3 fiafit servings (not including fruit juices), 30 grams of fiber, and 15.20% energy form fat. The intervention led to a marked overall improvement in dietary pattern that was maintained through four years (13 <0.001). To further eharaeterize sub-gronps with different adherence patterns, we chose a two-stage density linkage cluster analysis using the SAS statistical program that divided the sample into four groups. Group 1 participants ( 10% of sample) were closer to the study dietary pattern at baseline, considerably overshot the study goals, and maintained their new diet through four years. Group 2 participants (32% of sample) also had a better than average dietary pattern at baseline, were able to achieve the study dietary pattern by 12 months, and to maintain it over the four year period. Group 3 participants (38% of sample) had a lower baseline dietary pattern, made considerable change, but did not quite achieve the flail study goals by 12 months, and were unable to completely maintain their initial change over four years. Group 4 participants (20% of sample) had the poorest baseline dietary pattern. While they improved their diet during the first 12 months, they were unable to get near the study behavioral goals, nor were they able to maintain these changes over the four years. However, their dietary pattern at four years was better than their baseline diet. This suggests that the intervention effort can be reduced with Group 1 participants and reallccated to Group 4 participants to maximize overall adherence.

TITLE: USING FORMATIVE RESEARCH TO DESIGN A BONE HEALTH CAMPAIGN FOR LOW-INCOME LATINAS

AUTHOR(S): E.J. Bell, M.S., R.D., C.D.E., California Project LEAN, Sacramento, CA; N.A. Marfinez, M.P.H., R.D., California Project LEAN, Sacramento, CA; L.M. Rodriguez, B.A., California Project LEAN, Sacramento, CA, M.C. Wang, Dr.P.H., R.D., University of California, B.erkeley, Berkeley, CA; L.J. McNicholas, Ph.D., R.D., C.G. Walter, B.A., California Project LEAN, Sacramento, CA, E.Takada, M.P.H.,California Project LEAN, Sacramento, CA

LEARNING OUTCOME: To identify strategies for promoting increased calcium consumption among low-income, Spanish-dominant Latino mothers and their school-aged children in California.

ABSTRACT TEXT: Every American woman has a one-in-two chance of suffering an osteoporosis-related fiacture. While the prevalence of osteoporosis in the United States is highest among non-Hispanic white women (21%), Latinas suffer from osteoporosis in significant numbers (16%). Funded by the U.S. Department of Agdcultare, this bone health grant was awarded to address California food stamp eligible mothers and their families. In California, Latinas comprise the largest segment (38%) of food stamp eligible recipients. Hispanic and non-Hispanic white women have the highest mean calcium intake nationally, yetstill fall below the recommended daily calcium level. Latinas consume the most milk (more than ¾ cup per day) when compared with other food-stamp eligible populations. The behavioral objective is to increase by one serving, the daily consumption of 1% milk for low-income, Spanish-dominant Latinas and their school-aged children. The design of this campaign was based on formative research, including primary and secondary research such as literature reviews, key informant interviews, focus groups, telephone surveys, and consumer intercept surveys. Based on the formative research and budget, this campaign utilized a paid Spanish-language radio, public relations, and grocery store campaign in two high-density Latino communities. One intervention site also had a promotora model, which utilized lay community health workers, recruited and trained to conduct educational group sessions. Pre- and post-campaign results were compared with two control sites in two high- density Latino communities. Preliminary evaluation findings will be shared.

TAILOR AND TARGET INTERVENTIONS IN FAITH TITLE: BASED COMMUNITY NUTRITION AND PHYSICAL

ACTIVITY PROGRAMS

AUTHOR(S):

E. G. Williams, PHD, RD, Charles R. Drew University of Medicine and Science, Los Angeles,CA

LEARNING OUTCOME: Describethe varied strategies utilized to impact the age, gender, and interest ministries in African American churches

ABSTRACT TEXT:The Progressive Health and Nutrition Network is one of fourteen faith based projects funded in 1998 by the California Nutrition Network for Healthy, Active Families of the California Department of Health Services. A call to action issued in response to findings from the 1997 California Dietary Practices Survey that 50% of African Americans ate fewer than 2 servings of fruits and vegetables each day, a level that sub- stantially increases the risk for multiple chronic diseases. The faith channel outreach has been lauded as an effective route to engage African Americans. Creative interventions were designed for the men, women, children, youth and young adult ministries. Nutrition activities were conducted at weekly seminars, Sunday School, Vacation Bible School, special church programs and health fairs, physical activities included an at home fitness program, walking clubs, praise dancing, karobics (karate and aerobics), and glory steppers. Recipes were tested prior to Wednesday night prayer meeting. Changes were documented in fruit and vegetable intake, exercise patterns, cooking practices and nutrition know- ledge.This model demonstrates that the entire congregation can be positively impacted with tailored and targeted nutrition and fitness interventions.

TITLE:

WINNER'S CIRCLE HEALTHY DINING PROGRAM

AUTHOR(S):

K. H. Shovelin~ MPH, RD, LDN, M B. Molloy, DrPI-I, MPH, RD, D. Yum, NC Prevention Partners

LEARNING OUTCOME: To describe a healthy dining program that is being successfully implemented in eating establishments across North Carolina including restaurants, worksites, schools, and cafeterias. ABSTRACT TEXT:

Curreat surveys show that families dine out frequently. Meals eaten out of the home are a critical source of nutrition and effort should be taken to make healthy choices. The Winner's Circle Healthy Dining Program aims to-create healthy eating environments across North Carolina, to create consistent, credible, and easily recognized nutritional guidance for consumers, and to increase consumer demand for healthy restaurant options. The Winner's Circle was launched in 2000 by collaborative agencies across the state. It has found positive reception among local health partners (health departments, hospitals and other agencies), restaurants, and consumers. It is voluntary and has no cost to the restaurant. Over half of the counties in North Carolina have been trained to implement the program. Implementation includes talkingto consumers about where they dine, rccmiting restaurants, providing menu screening and recipe analysis with criteria of low fat, low sodium, and accompanied by fruits, vegetables, and grains. This criterion was selected in accordance with most nutritional recommendations for adults. Once identified, items are marked by a single, consistent logo, a purple star with a gold fork. Local health partners actively promote the program to consumers to increase demand for healthy menu items. The combination of forming locally healthy restaurant partnerships, providing nutrition technical assistance to restaurants, and marketing healthy restaurants to consumers are key to creating healthy eating environments. This approach is a leading edge health promotion strategy aimed at improving dietary quality among Americans.

Journal of THE AMERICAN DIETETIC ASSOCIATION / A-89