title: The Stanford Nutrition Action Program: a dietary fat intervention for low-literacy adults.
abstract: OBJECTIVE
  This study was undertaken to test the effectiveness of the Stanford Nutrition Action Program, an experimental trial to reduce dietary fat intake among low-literacy, low-income adults.
  
  
  METHODS
  Twenty-four paired adult education classes (351 participants, 85% women, mean age = 31 years) were randomly assigned to receive a newly developed dietary fat curriculum (the Stanford Nutrition Action Program) or an existing general nutrition curriculum. Food frequency and nutrition-related data, body mass index, and capillary blood cholesterol were collected at baseline and at two postintervention follow-ups.
  
  
  RESULTS
  The Stanford Nutrition Action Program classes showed significantly greater net improvements in nutrition knowledge (+7.7), attitudes (/0.2), and self-efficacy (-0.2) than the general nutrition classes; they also showed significantly greater reductions in the percentage of calories from total (-2.3%) and saturated (-0.9%) fat. There were no significant differences in body mass index or blood cholesterol. All positive intervention effects were maintained for 3 months postintervention.
  
  
  CONCLUSIONS
  The Stanford Nutrition Action Program curriculum, tailored to the cultural, economic, and learning needs of low-literacy, low-income adults, was significantly more effective in achieving fat-related nutritional changes than the general nutrition curriculum.
authors.affiliation: Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, Palo Alto, CA 94304-1825, USA.
authors.forename: B
authors.initials: B
authors.lastname: Howard-Pitney
authors.forename: M A
authors.initials: MA
authors.lastname: Winkleby
authors.forename: C L
authors.initials: CL
authors.lastname: Albright
authors.forename: B
authors.initials: B
authors.lastname: Bruce
authors.forename: S P
authors.initials: SP
authors.lastname: Fortmann
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003479:Curriculum; D018752:Diet, Fat-Restricted; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D052756:Nutritional Sciences / Q000193:education*; D010353:Patient Education as Topic / Q000379:methods*; D011203:Poverty; D015397:Program Evaluation
chemical_list: D002784:Cholesterol