title: Fruit and vegetable dietary behavior in response to a low-intensity dietary intervention: the rural physician cancer prevention project.
abstract: BACKGROUND
  Increased fruit and vegetable intake can reduce cancer risk. Information from this study contributes to research exploring health disparities in high-risk dietary behavior.
  
  
  OBJECTIVE
  Changes in fruit and vegetable behavior were evaluated to assess the effects of a low-intensity, physician-endorsed dietary intervention in a rural population.
  
  
  METHODS
  The study was a randomized trial of 754 patients from 3 physician practices in rural Virginia. Low-literacy nutrition education materials and personalized dietary feedback were administered by mail and telephone. Mixed model analysis of variance was used to determine the effect of the intervention on fruit and vegetable intake behavior, knowledge, intentions, and self-efficacy at 1, 6, and 12 months.
  
  
  RESULTS
  The intervention effect was moderated by age, race, sex, and education. Intake at 1 and 6 months was increased for older and younger participants and those with some college, and further maintained at 12 months by those who did not complete high school. African Americans in the intervention group displayed significantly greater intentions to increase fruit/vegetable intake than whites/others. Knowledge of fruit/vegetable recommendations significantly increased in the intervention group at 12 months, particularly for men.
  
  
  CONCLUSIONS
  For the rural population, a low-intensity physician-endorsed self-help dietary intervention was successful in initiating fruit and vegetable dietary changes at 1 and 6 months post-intervention, and increasing intentions to change in African Americans. The relationship of the moderating effects of age, race, sex and education need to be further explored in relation to dietary intervention and dietary behavior change for the rural population.
authors.affiliation: Virginia Commonwealth University, Richmond, Viginia 23298, USA. pedinbor@cvcu.edu
authors.forename: Patricia
authors.initials: P
authors.lastname: Carcaise-Edinboro
authors.forename: Donna
authors.initials: D
authors.lastname: McClish
authors.forename: Amanda C
authors.initials: AC
authors.lastname: Kracen
authors.forename: Deborah
authors.initials: D
authors.lastname: Bowen
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Fries
mesh_terms: D000328:Adult; D004032:Diet; D005260:Female; D005638:Fruit; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control*; D010817:Physician-Patient Relations; D015397:Program Evaluation; D012424:Rural Population; D014675:Vegetables; D014768:Virginia