title: A quantitative and qualitative approach to understanding fruit and vegetable availability in low-income african-american families with children enrolled in an urban head start program.
abstract: BACKGROUND
  Prior studies have shown low-income African Americans have low intakes of fruits and vegetables, which correlate, in part, to area of residence. To address the dietary problem, behavior-change interventions are most effective when they are theoretically based and compatible with cultural/behavioral characteristics of a given population.
  
  
  OBJECTIVE
  To use the Transtheoretical Model of Behavior Change to determine whether low-income African Americans were in proportionately different stages of change for increasing fruits and vegetables to their young children and identify differences in decision making, self-efficacy, and use of cognitive and behavioral strategies related to fruit and vegetable availability.
  
  
  METHODS
  The two-phase, descriptive study utilized a mixed methodology consisting of a fruit and vegetable survey and focus groups.
  
  
  METHODS
  Convenience sample of low-income African-American parents with children enrolled in an urban area Head Start program.
  
  
  METHODS
  chi(2) test was calculated to examine the distribution of parents into stages of change for increasing fruit and vegetable availability. Analysis of variance was used to test differences in fruit and vegetable availability to children and parents' decision making, self-efficacy, and use of cognitive and behavioral strategies. Content analysis of focus group transcripts was used to triangulate quantitative findings and further explore meanings of survey responses.
  
  
  RESULTS
  Of 94 participants completing the fruit and vegetable survey, 21% staged as precontemplation/contemplation, 25% staged as preparation, and 54% staged as action/maintenance (P<0.001). Parents in action/maintenance stages served significantly more fruits and vegetables (P=0.006) and used behavioral processes significantly more often (P<0.001) compared to parents in precontemplation/contemplation stages. Content analysis of focus group transcripts provided greater insight into the quantitative findings.
  
  
  CONCLUSIONS
  Nutrition education targeting low-income African-American parents in earlier stages of change should address planning and preparing convenient and economical meals and snacks that include fruits and vegetables. Interventions targeting parents in later stages of change should address increasing variety and healthful preparation methods. Interventions for both groups can benefit from social support strategies.
authors.affiliation: Department of Nutritional Sciences, College of Human Environmental Sciences, OklahomaState University, Stillwater, OK 74078, USA. deana.hildebrand@okstate.edu
authors.forename: Deana A
authors.initials: DA
authors.lastname: Hildebrand
authors.forename: Lenka H
authors.initials: LH
authors.lastname: Shriver
mesh_terms: D000328:Adult; D001741:Black or African American / Q000193:education / Q000523:psychology*; D000704:Analysis of Variance; D002675:Child, Preschool; D003657:Decision Making; D004034:Diet Surveys; D018479:Early Intervention, Educational; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D017144:Focus Groups; D005523:Food Supply / Q000706:statistics & numerical data*; D005638:Fruit; D006801:Humans; D008297:Male; D008960:Models, Psychological; D052756:Nutritional Sciences / Q000193:education*; D010290:Parents / Q000193:education / Q000523:psychology; D011203:Poverty; D020377:Self Efficacy; D012944:Social Support; D014505:Urban Population; D014675:Vegetables