A Community-Based Participatory Approach to Personalized, Computer-Generated Nutrition Feedback Reports: The Healthy Environments Partnership

Personalized nutrition feedback has been described as a nutrition information or dietary change strategy based on a specific individual’s food habits.1-3 Computer-tailored personalized NFRs, produced using dietary data collected through individual surveys, are a relatively new approach to dietary change.1,2 Although substantial evidence links high dietary fat and low fruit and vegetable intakes to increased risk of several chronic diseases, including CVD, and despite nutrition and health promotion campaigns, most U.S. adults do not meet recommendations for these dietary factors.4 Personal nutrition messages that are culturally, linguistically, and individually tailored are a promising strategy for dissemination of evidence-based nutrition guidelines to high-risk sociodemographic groups. Despite the incorporation of computer-tailored personalized nutrition counseling in primary care practice5 and worksite settings,4,6,7 community-based applications are limited.8,9 Intensive personal nutrition counseling such as those described in the literature may not be feasible in community settings. Innovative strategies are needed for reaching individuals with nutrition messages who might not otherwise participate in health-promotion activities. Furthermore, the majority of computer nutrition analysis programs produce complex quantitative reports that may be difficult for the general public to interpret.3,5 The use of a CBPR approach can contribute to the development of computer-generated personalized reports that are accessible and easy to interpret, with clear recommendations for dietary change that are beneficial to the participants involved. The primary objective of this article is to describe the use of a CBPR approach10-14 to develop tailored computer-generated NFRs that were disseminated to non-Hispanic black, Hispanic/Latino, and non-Hispanic white community residents who participated in the Detroit HEP survey (n = 919 participants).14 CBPR is a “systematic inquiry, with the participation of those affected by the issue being studied, for the purposes of education and taking action or affecting social change.”12,13 In keeping with the partnership’s CBPR principles described later in this article, the nutrition feedback process presented herein represents one of the primary focus areas for HEP, namely, community involvement in community-wide dissemination of the results and findings in ways that benefit the individuals and communities involved. Results from HEP data analysis have been disseminated widely through community forums, newsletters, and translation to local decision makers, as well as through peer-reviewed publications. In contrast with much of the literature on tailored messages, the nutrition feedback component of HEP described in this article was not designed as an intervention study, but as a strategy to disseminate personalized nutrition results to survey participants. The objective of the CBPR process described herein was to engage community representatives in all phases of the development and dissemination of a personalized NFR as one component of a larger CBPR effort.