Purpose-To examine the efficacy of an intervention based on the transtheoretical model (TTM) for increasing fruit and vegetable consumption among economically disadvantaged AfricanAmerican adolescents. Design-Pretest-posttest quasi-experimental study.Setting-Youth services agencies located in New York, New Jersey, and Pennsylvania. Agencies were assigned to computer intervention (CIN) and nonintervention control study arms.Subjects-A total of 507 African-American adolescents ages 11 to 14 years.Intervention-Youths in the CIN arm completed four 30-minute intervention sessions tailored on TTM stages and processes of change.Measures-Self-reported fruit and vegetable consumption and stages, pros, cons, and self-efficacy for consumption.Analysis-Intervention effects were examined with analysis of covariance models that were controlled for demographic variables and baseline measures of each outcome. Chi-square analyses were used to examine between-arm differences in youths' stage progressions.Results-After adjustment by covariates, pros (p < .025) and fruit and vegetable consumption (p < .001) varied significantly with study arm. Youths in the CIN arm had higher pro scores and fruit and vegetable consumption than controls. More youths in the CIN arm than in the control arm progressed to later stages and maintained recommended intake levels (p < .05).Conclusions-A TTM-based intervention can increase fruit and vegetable intake and effect positive changes in TTM variables related to intake among economically disadvantaged AfricanAmerican adolescents.Send reprint requests to Jennifer Di Noia, PhD, Columbia University School of Social Work, 1255 Amsterdam Ave., New York, NY 10027; jd201@columbia.edu. NIH Public Access PURPOSESubstantial epidemiologic evidence supports the protective role of fruits and vegetables in the prevention of cancer. 1 Despite the health benefits of a diet rich in fruits and vegetables, fewer than one fourth of African-American adolescents consume the minimum five recommended daily servings and, like U.S. adolescents from other racial/ethnic groups, their average intake decreases with income. 2 Although African-Americans comprise a modest 13% of the U.S. population, cancer incidence and mortality rates are higher among African-Americans than they are among members of any other U.S. racial and ethnic group. 3,4 Their low fruit and vegetable intake and high cancer incidence suggest that economically disadvantaged AfricanAmerican adolescents would benefit from intervention to increase fruit and vegetable consumption.The transtheoretical model (TTM) provides a theoretical framework for developing interventions to modify a variety of health behaviors. 5 The model comprises four constructs: (1) stages of change, the temporal readiness to modify health behavior; (2) decisional balance, the relative importance of the perceived pros and cons of change; (3) situational selfefficacy, confidence in one's ability to modify the behavior across positive social, negative affect, and difficult situations; a...

Although low-income youth are likely to have low or less frequent fruit and vegetable intake, current understanding of the influences on intake in youth is limited. A systematic review of quantitative research on determinants of fruit and vegetable intake among low-income youth (i.e., persons aged <20 years) was conducted. The aims were to identify which determinants have been studied and which are consistently associated with intake. Fifty-eight papers published between 2003 and August 2013 were included. Across studies, 85 unique determinants were identified. Those best supported by evidence were race/ethnicity (with intake consistently higher among Hispanic as compared with African American and white youth), fruit and vegetable preferences, and maternal fruit and vegetable intake. For many potential determinants, the consistency of evidence could not be examined because of a lack of studies. Findings highlight racial/ethnic differences in fruit and vegetable intake and influences on intake that should be considered when designing dietary interventions for low-income youth. Further research on intake determinants in this at-risk population is needed to establish an evidence base to guide interventions.

Observed differences in TTM variables and fruit and vegetable consumption by stage of change in this sample of economically disadvantaged African-American adolescents were consistent with theory and previous applications of the model to fruit and vegetable consumption in adults. With replication studies, the TTM may be appropriate for designing interventions to increase fruit and vegetable consumption among this population.

This study developed and tested an Internet-based gender-specific drug abuse prevention program for adolescent girls. A sample of seventh, eighth, and ninth grade girls (N = 236) from 42 states and 4 Canadian provinces were randomly assigned to an intervention or control group. All girls completed an online pretest battery. Following pretest, intervention girls interacted with a 12-session, Internetbased gender-specific drug prevention program. Girls in both groups completed the measurement battery at posttest and 6-month follow-up. Analysis of posttest scores revealed no differences between groups for 30-day reports of alcohol, marijuana, poly drug use, or total substance use (alcohol and drugs). At 6-month follow-up, between-group effects were found on measures of 30-day alcohol use, marijuana use, poly drug use, and total substance use. Relative to girls in the control group, girls exposed to the Internet-based intervention reported lower rates of use for these substances. Moreover, girls receiving the intervention achieved gains over girls in the control group on normative beliefs and self-efficacy at posttest and 6-month follow-up, respectively.

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Objective-This study tested a CD-ROM intervention with and without a parent involvement component to reduce risk of alcohol use among an urban sample of early adolescents.Method-Youths (N = 514, mean age 11.5 years at recruitment) were assigned randomly by community site to receive the CD-ROM intervention, the CD-ROM plus parent intervention, or no intervention. All youths completed pretest, posttest and three annual follow-up measurements. After pretesting, youths and parents received their respective interventions.Results-Main effects of the intervention and for measurement occasion as well as interaction effects of the intervention by measurement occasion were seen for substance use and related outcomes. Over time, youths in all 3 groups reported increased use of alcohol, tobacco and marijuana; youths who received the interventions reported smaller increases than control youths. At 3-year follow-up, alcohol use was lower for CD-ROM plus parent intervention youths than for CD-ROM only youths, who, in turn, reported less use than controls. Cigarette use was lower for youths in either intervention group than in the control group at posttest and at 1-, 2-and 3-year follow-ups. Marijuana use was lower for youths in either intervention than for controls at 1-, 2-and 3-year follow-ups. Youths in both intervention groups outperformed control youths at posttest and at 1-and 3-year follow-ups on levels of negative and peer influence toward substance use. Finally, at the 3-year follow-up, youths in the CD-ROM plus parent intervention group reported more family involvement in their alcohol use prevention efforts than did youths in the CD-ROM group, who, in turn, reported more positive levels of family involvement than youths in the control group.Conclusions-Study findings modestly support the CD-ROM intervention with and without the parent intervention to reduce alcohol use risks among urban early adolescents.

CD-ROM and the Internet are viable means for disseminating adolescent drug abuse prevention programs to schools, community agencies, and policy-making bodies, and should be increasingly used for dissemination purposes.

National nutrition guidelines emphasize consumption of powerhouse fruits and vegetables (PFV), foods most strongly associated with reduced chronic disease risk; yet efforts to define PFV are lacking. This study developed and validated a classification scheme defining PFV as foods providing, on average, 10% or more daily value per 100 kcal of 17 qualifying nutrients. Of 47 foods studied, 41 satisfied the powerhouse criterion and were more nutrient-dense than were non-PFV, providing preliminary evidence of the validity of the classification scheme. The proposed classification scheme is offered as a tool for nutrition education and dietary guidance.