The purpose of this competing renewal study is to expand upon the
successful community-level nutrition intervention program developed
for low-income women who are in the Special Supplemental Nutrition
Program for Women, Infants, and Children (WIC) in Maryland. This
study builds on extensive experience working with this population
under an NCI-funded study, -the Maryland WIC 5 A Day Promotion
Program - which focused on increasing consumption of fruits and
vegetables. The Maryland WIC Healthy Eating for a Lifetime Program
will focus on reducing nutrition-related risks for cancer by adding
two new components: 1) decreasing dietary fat and 2) increasing
dietary fiber. The study will extend the highly effective
collaboration over the past four years among researchers at the
University of Maryland and campuses at Baltimore and College Park,
the Maryland Department of Health and Mental Hygiene, and local
health departments in Maryland. Researchers from the University of
Maryland Baltimore County and the University of California at
Berkeley will also collaborate on this project. The study will
consist of women enrolled in WIC and mothers of children enrolled
in WIC. The investigators will also expand their current study to
assess changes in children, age two to four. Approximately 60
percent of participants in the study will be minorities most of whom
are black. After an initial planning phase, the investigators will
conduct a pilot test in one intervention and one control site. After
making any necessary revisions, the will proceed to full-scale
implementation, using a randomized crossover design for 12 WIC sites
located in Baltimore City, and four counties in Maryland. This
multi-faceted intervention program will utilize peer educators as
the cornerstone of its educational efforts. Another important
modality will be direct mail with tailored messages. All of the
intervention strategies have either been successfully tested with
WIC participants as part of the investigators' current study or will
be developed based on their experience working with this population.
The interventions will provide sufficient visibility, education,
environmental supports, and incentives to encourage and facilitate
changes in knowledge, attitudes, self-efficacy, perceived barriers
to change, stage of change, and food consumption in the
participants. All interventions will be based upon extensive
formative research and will be rigorously pre-tested prior to
program implementation.
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