Differences in psychosocial variables by stage of change for fruits and vegetables in older adults

Objective To describe differences in demographic and psychological variables by stage of change for five servings of fruits and vegetables per day in older adults. Design Cross-sectional survey with data collected in the participant\u27s home or the project office by interviewers. Subjects 1,253 community-residing individuals 60 years or older (mean age=75 years) living in East Providence, RI. Measures Stage of change; decisional balance; processes of change; self-efficacy; dietary intake measured by the National Institutes of Health (NIH) Fruit and Vegetable Screener, the 5 A Day Screener, and the NIH Fat Scan; demographics; and anthropometrics. Statistical analyses Variables were compared by stage of change using analysis of variance for continuous variables and χ2 analysis for categorical variables. Servings of fruits and vegetables were transformed (square root) prior to analyses. Results There was a strong effect of stage of change on intake measured by the Fruit and Vegetable Screener [F(2, 1203)=109, P\u3c.001, η2=.154] and the 5 A Day Screener [F(2, 1203)=128, P\u3c.001, η2=.175] with a linear increase from precontemplation to action/maintenance. There was an overall stage effect on decisional balance, processes of change, and self-efficacy [Wilks\u27s λ=.703, F(30, 2132)=13.72, P\u3c.001, multivariate η2=.162], and significant univariate effects for all variables. Conclusions Self-assessed servings ( How many servings do you usually eat? ) can be used for stage classification for older adults. Interventions for older adults in early stages should focus on increasing perceived benefits of healthful eating and cognitive process use. Self-efficacy as well as behavioral processes seem to be important in attaining maintenance

Using focus groups for instrument development: Application of the transtheoretical model to fruit and vegetable behaviors of older adults

The purpose of this focus group research was to identify themes related to fruit and vegetable consumption in older adults that could be used as the basis for instrument development. The Trans- theoretical Model of Behavior Change (TTM) was used as a framework to guide this research. Adults over the age of 60 completed a food frequency screener, and were designated into “low” and “high” fruit and vegetable intake groups. Participants responded to some general as well as stage-specific questions, dependent upon group. Data were analyzed by two independent researchers, and level of agreement was consistently high. Data reduction was accomplished by identification of inductively derived themes. The derived themes made conceptual and operational sense, and were used as a basis for development of quantitative measures related to fruit and vegetable consumption of older adults. Instrument development represents an exciting application of focus group research that deserves increased attention. © 2003 by The Haworth Press, Inc. All rights reserved

Change in fruit and vegetable intake over 24 months in older adults: Results of the SENIOR project intervention

Purpose: We test the efficacy of an intervention based on the transtheoretical model to increase the intake of fruits and vegetables and to describe differences in psychosocial variables based on the achievement of the 5 A Day Program target. Design and Methods: This study is a randomized controlled trial comparing a 12-month fruit and vegetable intervention to a control condition with a 12-month follow-up. Participants included 1,277 community-residing persons who were 60 years of age or older; 834 provided dietary data at all three time points and are included in our outcome analyses. Results: The intervention group increased intake by 0.5 to 1.0 serving more than the control group over 24 months as measured by the NCI Fruit and Vegetable Screener and the 5 A Day Program screener. The majority of the participants (58%) perceived that they maintained 5 or more servings per day for 24 months. These maintainers had a higher intake at each time point for all dietary measures and differed from those who failed to progress (11%) for most transtheoretical model variables. Implications: The intervention was effective in increasing the intake of fruits and vegetables in older adults. Those who maintained their level of perceived intake as 5 or more servings per day consumed 2-4 servings per day more than those who failed to progress. Copyright 2008 by The Gerontological Society of America

Health Correlates of Exercise Behavior and Stage Change in a Community-Based Exercise Intervention for the Elderly: A Pilot Study

The effects of a community-based physical activity intervention grounded in the Transtheoretical Model were investigated in a sample of older adults. The residents (n = 48, mean age = 78.24 ± 6.69, 90% female) of an independent living complex completed pre-and postintervention assessments, including physical, mental, and general health; nutrition; bodily pain; and stages of exercise behavior change. The intervention included posters with stage-based pamphlets (for inactive stages) and in-house exercise sessions (for active participants). The intervention resulted in high exercise maintenance and more progression than regression in exercise stage. More maintainers and progressers improved on the measured variables compared to relapsers. The stage model is a promising framework on which to base and evaluate interventions for this population. The overall impact of the intervention was positive, whether by providing the actual opportunity to exercise or by motivating other physical activity. These results also support the potential quality-of-life impact for this type of intervention in older adults. © 2002, Sage Publications. All rights reserved