Efficacy testing of the SAVOR (Sisters Adding Fruits and Vegetables for Optimal Results) intervention among African American women: A randomized controlled trial

Abstract

Background: In the United States, only about 15% of individuals meet daily fruit intake recommendations of 2 cups per day and only 10% meet the vegetable intake recommendations of 3 cups per day. African American women are a high-risk group. In this study, a fourth-generation multi-theory model (MTM) of health behavior change was used to design and evaluate a Sisters Adding Fruits and Vegetables for Optimal Results (SAVOR) intervention for AA women. Methods: The study utilized a randomized controlled trial (RCT) with measurements taken at pretest, posttest (after the three-week intervention) and follow-up (at the end of eight weeks). SAVOR (n=26) was compared to an equivalent knowledge-based intervention (n=28). Process evaluation was done for program fidelity and satisfaction. A validated 38-item self-reported questionnaire was used to measure changes in MTM constructs and past 24-hour consumption of fruits and vegetables. Results: The SAVOR intervention resulted in improvement of mean consumption of fruits and vegetables in the experimental group from pre-test (2.78) to posttest (4.77) to recommended levels at follow-up (5.04) while in the comparison group they remained at around 3 (P<0.0001) Statistically significant changes (P<0.05) were noted for all MTM constructs except for participatory dialogue. Conclusion: The SAVOR intervention was found to be efficacious and established the robustness of MTM. SAVOR can be replicated for future effectiveness trials.

COVID-19 Vaccine Acceptance among College Students: A Theory-Based Analysis

“…For the non-hesitant group, for every unit increase in behavioral confidence, the intention to accept vaccine increased by 0.373 units on a scale of 0 to 4 units. Behavioral confidence has been found to be an important construct in many previous studies conducted using MTM with other health behaviors in college students [ 21 , 22 , 29 ] and other populations [ 19 , 24 ]. Influencing behavioral confidence should be an integral part of all health promotion efforts planned with college students to enhance COVID-19 vaccine uptake.…”

“…For initiation, the MTM suggests that three constructs: participatory dialogue (i.e., whereby the advantages of a behavior change are seen as being more than disadvantages), behavioral confidence (i.e., whereby the person becomes sure in performing any given behavior), and changes in the physical environment (i.e., whereby the person has necessary resources for performing a given behavior) will lead to initiation in a behavior change [ 17 , 18 ]. The MTM is unique in that the constructs can be applied across different health behaviors, and the theory has been used to explain a diverse range of health behaviors [ 19 , 20 , 21 , 22 , 23 , 24 ]. The MTM has advantages over previous health behavior theoretical models, which have yielded mixed findings about behavior change, are shown to lack substantive predictive power, and typically are not situated around long-term behavior change [ 17 ].…”

Explaining Handwashing Behavior in a Sample of College Students during COVID-19 Pandemic Using the Multi-Theory Model (MTM) of Health Behavior Change: A Single Institutional Cross-Sectional Survey

“…MTM has been used in designing similar technology-based brief and specific interventions [ 51 , 52 , 53 ] and can be effectively used for handwashing promotion among college students. The construct of participatory dialogue, which is quite intuitive and points to the underscoring the advantages of handwashing over any possible disadvantages, can be built by effective tailored messaging.…”

Conceptualization of college students’ COVID-19 related mask-wearing behaviors using the Multi-Theory Model of health behavior change

“…This assertion is based on data from previous experimental studies with other behaviors such as physical activity 19 and fruit and vegetable consumption behavior. 29 …”