title: A randomized trial of the Little by Little CD-ROM: demonstrated effectiveness in increasing fruit and vegetable intake in a low-income population.
abstract: BACKGROUND
  Research indicates that low fruit and vegetable intake is a risk factor for many chronic diseases. Despite large-scale education campaigns, the great majority of Americans do not consume recommended levels. We tested the ability of a single brief interactive experience of the Little by Little CD-ROM to increase fruit and vegetable intake in low-income women.
  
  
  METHODS
  A randomized placebo-controlled, parallel-group trial included 481 low-income, female participants: mean age 50.1 years, 48.4% African American, 51.6% non-Hispanic white, and 92.5% below 185% of the federally designated poverty level. Participants received one of three conditions: 1) a one-time experience with the Little by Little CD-ROM, 2) the Little by Little CD-ROM plus two reminder telephone calls, or 3) a stress management CD-ROM (control condition). We assessed baseline and follow-up dietary intake with a modified 24-hour recall.
  
  
  RESULTS
  Two months after the one-time experience with the CD-ROMs, both intervention groups reported significantly higher intakes of fruits and vegetables than the control group. The Little by Little group with reminder calls increased daily intake by 1.32 fruits/vegetables, an 86% greater increase than the control group (P = .016). The Little by Little group without reminder calls increased daily intake by 1.20 fruits/vegetables, a 69% greater increase than the control group (P = .052). Significantly greater movement in Stage of Readiness for Change also occurred in the Little by Little groups compared with the control group.
  
  
  CONCLUSIONS
  The Little by Little CD-ROM may be useful in public health and clinical situations to increase fruit and vegetable intake.
authors.affiliation: Public Health Nutrition Program, School of Public Health, University of California, Berkeley 94720, USA. gblock@berkeley.edu
authors.forename: Gladys
authors.initials: G
authors.lastname: Block
authors.forename: Patricia
authors.initials: P
authors.lastname: Wakimoto
authors.forename: Diane
authors.initials: D
authors.lastname: Metz
authors.forename: Mary L
authors.initials: ML
authors.lastname: Fujii
authors.forename: Nancy
authors.initials: N
authors.lastname: Feldman
authors.forename: Rochelle
authors.initials: R
authors.lastname: Mandel
authors.forename: Barbara
authors.initials: B
authors.lastname: Sutherland
mesh_terms: D016251:CD-ROM; D004032:Diet; D005260:Female; D005638:Fruit; D006266:Health Education / Q000379:methods; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008875:Middle Aged; D011203:Poverty; D012456:Salaries and Fringe Benefits; D014675:Vegetables