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The Internet is a new technology for health communication in communities. The 5 a Day, the Rio Grande Way website intended to increase fruits and vegetables (FV) consumption was evaluated in a rural region enrolling 755 adults (65% Hispanic, 9% Native American, 88% female) in a randomized pretest-posttest controlled trial in [2002][2003][2004]. A total of 473 (63%) adults completed a 4-month follow-up. The change in daily intake on a food frequency questionnaire (control: mean = − 0.26 servings; intervention: mean = 0.38; estimated difference = 0.64, SD = 0.52, t(df = 416) = 1.22, p = 0.223) and single item (13.9% eating 5+ servings at pretest, 19.8% posttest for intervention; 17.4%, 13.8% for controls; odds ratio (OR) = 1.84, 95% CI = 1.07, 3.17) was in the expected direction but significant only for the single item. Website use was low and variable (logins: M = 3.3, range = 1 to 39.0; total time: M = 22.2 minutes, range = 0 to 322.7), but it was associated positively with fruit and vegetable intake (total time: Spearman r = 0.14, p = 0.004 for food frequency; Spearman r = 0.135, p = 0.004 for single item). A nutrition website may improve FV intake. The comparison on the food frequency measure may have been undermined by its high variability. Websites may be successful in community settings only when they are used enough by adults to influence them.The Internet is a relatively new medium for health communication. It has several characteristics that might be used to improve health promotion: Its ability to span large distances at low cost with standardized information in multimedia formats that promote learning among populations with diverse ages, education, literacy levels, and social circumstances may help to address lower access to health care and transportation problems (Benton Foundation, 1998; U.S. Congress & Office of Technology Assessment, 1991;Walther, Pingree, Hawkins, & Buller, 2005). This article contains a report on diet changes produced by an Internet website among adults in a rural region in the southwestern United States. Rural communities present unique challenges to using this technology-lower Internet use, slower Internet connections, wide variations in computer and Internet skills, and limited training resources and technical support than in urban communities (Benton Foundation, 1998;Horrigan, 2005;Rainie & Horrigan, 2005 Efficacy of Internet-based Nutrition Education for Rural CommunitiesDiet, nutrition, vitamins, and nutritional supplements rank as the third most popular Internet health topic (Fox, 2005), but there is little evidence that it is effective to deliver nutrition education over the Internet in community settings. Internet-based health communication has produced positive changes in diet and related behaviors (Celio et al., 2000;Oenema, Brug, & Lechner, 2001;Oenema, Tan, & Brug, 2005;Papadaki & Scott, 2005;Rothert et al., 2006;Tate, Wing, & Winett, 2001;White et al., 2004;Williamson et al., 2005;Williamson et al., 2006;Winzelberg et al., 2000), although not in all studie...

The AIM process led to environment and policy changes known to increase healthy eating and physical activity.

The field of public health is increasingly using community-based participatory research (CBPR) to address complex health problems such as childhood obesity. Despite the growing momentum and funding base for doing CBPR, little is known about how to undertake intervention planning and implementation in a community-academic partnership. An adapted version of Intervention Mapping (AIM) was created as a tool for university and elementary school partners to create school-level environment and policy changes aimed at increasing student physical activity and healthy eating. After AIM was completed, interviews were conducted with school partners. Findings indicate AIM is closely aligned to 7 of 9 CBPR principles. Examples include equitable involvement of all partners, co-learning, and balancing knowledge generation and community improvement. Shortcomings, lessons learned, and suggestions for strengthening the AIM process are described.