TABLE 4.4 Summary of AHRQ Analyses of the Efficacy of Interventions to Modify Dietary Behavior Related to Cancer Risk: Fruit and Vegetable Intake

Outcome

Number of Studies

Median (range)

Median differences between intervention and control groups in percentage change in fruit and vegetable intake

Fruits and Vegetables (servings/day)

12

+16.6 (–3.7 to +60.9)

Fruits (servings/day)

9

+16.0 (0 to +73.4)

Vegetables (servings/day)

9

+5.7 (–17.2 to +153.2)

Median differences in percentage change in fruit and vegetable outcomes by intervention characteristics

Social Support Component

 

Yes

5

+17.3 (–3.7 to +18.6)

No

7

+15.9 (+6.9 to +60.9)

Interactions with Food

 

Yes

7

+14.9 (–3.7 to +60.9)

No

6

+16.8 (+6.9 to +31.8)

Goal Setting

 

Yes

5

+12.5 (–3.7 to +22.9)

No

7

+17.3 (+6.9 to +60.9)

 

SOURCE: AHRQ, 2001a.

mately 0.6 servings per day. The median difference for percent of energy from fat of –15.7 represents an estimated 7.3% reduction in percentage of calories from fat.

The majority of behavioral interventions to modify dietary patterns have been conducted within health care settings. The Diet Report reviewed 45 interventions conducted in health care settings, with most focused on persons at risk for chronic diseases (Agency for Healthcare Research and Quality, 2001a). The most frequently tested interventions used individualized counseling including self-monitoring, goal setting, and problem solving (Beresford et al., 1997; Chlebowski and Grosvenor, 1994; Simkin-Silverman et al., 1995), interactive recipe preparation (Boyd et al., 1996), or group sessions (Agurs-Collins et al., 1997; Coates et al., 1999; Lindholm et al., 1995; White et al., 1992). Two of the studies used computer or video components (Glasgow et al., 1996; Shannon et al., 1994). The intensities of the interventions ranged from 11 to 24 contacts, excluding the self-management or video interventions, in which contact was assumed to be ongoing. Follow-up contacts ranged from 3 months (Aubin et al., 1998) to 7 to 8 years (Boyd et al., 1996). Primarily on the basis of self-reported measures, these studies generally achieved positive results. All focused on fat consumption as the primary outcome of interest, whereas five also included



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