title: A randomized clinical trial evaluating online interventions to improve fruit and vegetable consumption.
abstract: OBJECTIVE
  We assessed change in fruit and vegetable intake in a population-based sample, comparing an online untailored program (arm 1) with a tailored behavioral intervention (arm 2) and with a tailored behavioral intervention plus motivational interviewing-based counseling via e-mail (arm 3).
  
  
  METHODS
  We conducted a randomized controlled intervention trial, enrolling members aged 21 to 65 years from 5 health plans in Seattle, Washington; Denver, Colorado; Minneapolis, Minnesota; Detroit, Michigan; and Atlanta, Georgia. Participants reported fruit and vegetable intake at baseline and at 3, 6, and 12 months. We assessed mean change in fruit and vegetable servings per day at 12 months after baseline, using a validated self-report fruit and vegetable food frequency questionnaire.
  
  
  RESULTS
  Of 2540 trial participants, 80% were followed up at 12 months. Overall baseline mean fruit and vegetable intake was 4.4 servings per day. Average servings increased by more than 2 servings across all study arms (P<.001), with the greatest increase (+2.8 servings) among participants of arm 3 (P=.05, compared with control). Overall program satisfaction was high.
  
  
  CONCLUSIONS
  This online nutritional intervention was well received, convenient, easy to disseminate, and associated with sustained dietary change. Such programs have promise as population-based dietary interventions.
authors.affiliation: Department of Biostatistics and Research Epidemiology, Henry Ford Hospital and Health Center, One Ford Place 5C, Detroit, MI 48202, USA.
authors.forename: Gwen L
authors.initials: GL
authors.lastname: Alexander
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: McClure
authors.forename: Josephine H
authors.initials: JH
authors.lastname: Calvi
authors.forename: George W
authors.initials: GW
authors.lastname: Divine
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Stopponi
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Rolnick
authors.forename: Jerianne
authors.initials: J
authors.lastname: Heimendinger
authors.forename: Dennis D
authors.initials: DD
authors.lastname: Tolsma
authors.forename: Kenneth
authors.initials: K
authors.lastname: Resnicow
authors.forename: Marci K
authors.initials: MK
authors.lastname: Campbell
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Strecher
authors.forename: Christine Cole
authors.initials: CC
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D054626:Consumer Health Information; D003376:Counseling; D034742:Electronic Mail; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D020407:Internet; D007407:Interviews as Topic / Q000379:methods; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation; D018709:Statistics, Nonparametric; D014481:United States; D014675:Vegetables