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Evaluating the dissemination of Body & Soul, an evidence-based fruit and vegetable intake intervention: challenges
Marlyn Allicock1, Marci K Campbell, Carmina G Valle
1Gillings School of Global Public Health, Department of Nutrition, University of North Carolina at Chapel Hill, NC 27599, USA. allicock@email.unc.edu
Objective:
To evaluate whether the evidence-based Body & Soul program, when disseminated and implemented without researcher or agency involvement and support, would achieve results similar to those of earlier efficacy and effectiveness trials.
Design:
Prospective group randomized trial.
Setting:
Churches with predominantly African American membership.
Participants:
A total of 1,033 members from the 15 churches completed baseline surveys. Of these participants, 562 (54.4%) completed the follow-up survey 6 months later.
Intervention:
Church-based nutrition program for African Americans that included pastoral involvement, educational activities, church environmental changes, and peer counseling.
Main Outcome Measure:
Daily fruit and vegetable (FV) intake was assessed at pre- and posttest.
Analysis:
Mixed-effects linear models.
Results:
At posttest, there was no statistically significant difference in daily servings of FVs between the early intervention group participants compared to control group participants (4.7 vs 4.4, P = .38). Process evaluation suggested that added resources such as technical assistance could improve program implementation.
Conclusions And Implications:
The disseminated program may not produce improvements in FV intake equal to those in the earlier efficacy and effectiveness trials, primarily because of a lack of program implementation. Program dissemination may not achieve public health impact unless support systems are strengthened for adequate implementation at the church level.
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