Interventions in Nutrition Education and Skills

Study Overview
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Brief Summary
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Healthy eating can be difficult for people who live in poor, geographically isolated regions of the United States. In particular, people who live in Appalachia often experience food insecurity (i.e., their access to adequate food is limited by a lack of money and other resources at times during the year) and lack of access to healthy foods. This pilot study evaluates the effectiveness of motivational interviewing in helping individuals who live in these austere regions improve their diets in the context of limited resources and healthy food availability

Detailed Description
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Participants in three of the counties will receive an education/skills intervention paired with a form of coaching called motivational interviewing (MI) conducted by a trained registered nurse. Three similar counties that do not border any of the intervention counties are serving as controls (these counties receive the same nutrition education/skills intervention without motivational interviewing). All participants will receive cookbooks, cooking classes, food preparation tools, and prepared food dishes to take home to their families. The investigators will measure the impact of motivational interviewing on fresh fruit and vegetable consumption, saturated fat consumption and number of meals cooked at home.

Official Title
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Interventions in Nutrition Education and Skills

Conditions
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Obesity

Intervention / Treatment
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* Behavioral: Motivational Interviewing
* Behavioral: Cooking skills and nutritional education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • People who live in one of six rural Kentucky food desert counties Exclusion Criteria: <16 years old Unable to read/write English Any GI malabsorption disorder that prevents high fiber consumption

Ages Eligible for Study
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Minimum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Control/Intervention Groups (3 sites in each group)
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Motivational Interview (MI)<br>Intervention group participants receive cooking skills and nutritional education via cookbooks, cooking classes, food preparation tools and prepared food dishes to take home to their families, along with monthly motivational interviewing conducted by a trained registered nurse | Behavioral: Motivational Interviewing<br>* Baseline and monthly assessment of barriers/facilitators of dietary change, ambivalence to change and coaching to resolve barriers and ambivalence.<br>|
| Active Comparator: Cooking Skills/Nutritional Education<br>Participants in this arm receive cooking skills and nutritional education via cookbooks, cooking classes, food preparation tools and prepared food dishes to take home to their families. | Behavioral: Cooking skills and nutritional education<br>* Participants in this group will develop an understanding of healthy food options and healthy food preparation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in BLOCK Fruit/Vegetable/Fiber Screener From Baseline at 12 Months | Block Fruit/Vegetable/Fiber Screener is a tool that ranks usual intake of fruit, vegetables, and fiber. Total fruit/vegetable/fiber score can range from 0-50 with higher numbers reflecting greater frequency of fruit, vegetable and fiber consumption. | Baseline, 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Average Saturated Fatty Acid Intake/Day | Using the NCI DHQ II, respondents' frequency of consumption of foods (i.e., meats and oils) and portion size, dietary saturated fat consumption was calculated as average grams/day. Higher grams/day reflect higher consumption of saturated fatty acids. | Baseline, 12 months | 
| Frequency of Fast Food Consumption | Fast food consumption was measured using a single item on the National Cancer Institute Diety History Questionaire (NCI DHQ II) How often did you eat beef hamburgers or cheeseburgers from a fast food or other restaurant? Responses are selected from 11 pre-determined options increasing in frequency from never to 2 or more times per day. Values range from 0 to 10; higher values indicate an increased frequency of fast food consumption. | Baseline and 12 months |