title: Does the effect of behavioral counseling on fruit and vegetable intake vary with stage of readiness to change?
abstract: BACKGROUND
  We have recently shown that brief behavioral counseling based on the stage of change (SOC) model stimulates greater increases in fruit and vegetable intake over 12 months than nutritional education in adults living in a low-income urban area. We tested the hypothesis that behavioral counseling would overcome the greater obstacles to change in precontemplators and contemplators compared with those initially in the preparation stage.
  
  
  METHODS
  Two hundred and seventy-one adults took part in a parallel group randomised controlled trial comparing behavioral counseling and nutritional education. Counseling was delivered in two 15-min sessions and accompanied by written material. Self-report changes in fruit and vegetable consumption over 12 months were analysed on an intention-to-treat basis and related to baseline stage of change.
  
  
  RESULTS
  At baseline, 148 (54.6%) of participants were in preparation, 54 (19.9%) in contemplation and 69 (25.5%) in precontemplation. Preparers were younger, more educated and more likely to be female than were precontemplators and contemplators. In the nutritional education group, baseline stage predicted changes over 12 months, with larger increases in fruits and vegetables in the preparation than in the precontemplation or contemplation groups. This was not the case with behavioral counseling, in which increases in consumption were unrelated to baseline stage.
  
  
  CONCLUSIONS
  Tailored behavioral counseling helped to overcome the barriers to increasing fruit and vegetable intake present among participants in contemplation stage but not the precontemplation or preparation stages.
authors.affiliation: Department of Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK. l.porras@public-health.ucl.ac.uk
authors.forename: Linda
authors.initials: L
authors.lastname: Perkins-Porras
authors.forename: Francesco P
authors.initials: FP
authors.lastname: Cappuccio
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rink
authors.forename: Sean
authors.initials: S
authors.lastname: Hilton
authors.forename: Cathy
authors.initials: C
authors.lastname: McKay
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
mesh_terms: D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D004032:Diet / Q000523:psychology*; D005006:Ethnicity; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D044623:Nutrition Therapy / Q000379:methods*; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014675:Vegetables