Using a Toolbox of tailored educational lessons to improve fruit, vegetable, and physical activity behaviors among African American women in California

Abstract

Objective: Evaluate the effectiveness of the Fruit, Vegetable, and Physical Activity Toolbox for Community Educators (Toolbox), an intervention originally designed for Spanish- and English-speaking audiences, in changing knowledge, attitudes, and behavior among low-income African American women.

Design: Quasi-experimental design with treatment and control groups.

Setting: Four community-based organizations and direct health service provider sites.

Participants: African American women ages 18-54 (156 treatment, 171 control), 75% of whom were low income.

Intervention: Six 1-hour Toolbox classes.

Main outcome measures: Knowledge, attitudes, self-efficacy, empowerment, and behavior change related to fruits and vegetables and physical activity.

Analysis: Dependent t tests pre- to posttest and chi-square test between control and treatment groups.

Results: Women in the treatment group reported significant changes in 9 measures of attitude, compared to 1 measure in the control group, as well as 12 measures of confidence and 5 measures of empowerment for which the control group showed no changes. Compared to those in the control group, women in the treatment group were also more likely to make behavioral changes to meet recommendations for fruit and vegetable consumption and physical activity.

Conclusions and implications: Toolbox lessons were effective in increasing participants' knowledge, attitudes, self-efficacy, empowerment, and reported fruit and vegetable- and physical activity-related behaviors.