Effectiveness of an educational program based on Transtheoretical model on fruit and vegetable consumption

Objective (s): The benefit of fruit and vegetable intake in old age is well documented. However, there is evidence that old people do not consume enough fruit and vegetable. The purpose of this study was to evaluate the effectiveness of a theory-based tailored nutritional intervention that aimed to increase the fruit and vegetable intake among elderly Iranians. This quasi-experimental study was performed among a community sample of elderly in Tehran, Iran in year 2008 to 2009. Data were collected at baseline and 4 weeks follow-up. At baseline face-to-face interviews were conducted with the whole sample using a structured questionnaire including items on demographic information, stage of change, self-efficacy, delusional balance, daily servings of fruit and vegetable intake. Four weeks follow-up data were collected after implementing the intervention. The mean age of participants was 64.06 ± 4.48 years and overall two-third of participants were female. At baseline total fruit and vegetable intake was not differed between two groups but it was significantly increased in the intervention group at posttest assessment (mean serving/day in intervention group 3.08± 1.35 vs. 1.79± 1.08 in control group; P = 0.001). Further analysis also indicated that elderly in intervention arm had higher fruit and vegetable intake, perceived benefits and self-efficacy, and lower perceived barriers. Compared with control group, greater proportions of elderly in the intervention group moved from per contemplation to contemplation/preparation and action/maintenance stages (P <0.0001), and from contemplation /preparation to action/maintenance stages (P= 0.004) from pretest to posttest assessments. The findings suggest that TTM is a useful model that can be applied to dietary behavior change, specifically fruit and vegetable consumption among elderly populations.