Buller D B, Morrill C, Taren D, Aickin M, Sennott-Miller L, Buller M K, Larkey L, Alatorre C, Wentzel T M
D.B. Buller, AMC Cancer Research Center, Denver, CO, USA.
J Natl Cancer Inst. 1999 Sep 1;91(17):1491-500. doi: 10.1093/jnci/91.17.1491.
The National Cancer Institute recommends that Americans eat at least five daily servings of fruits and vegetables. National strategies to increase consumption may not reach minority and lower socioeconomic populations. In a randomized trial, peer education was tested for effectiveness at increasing fruit and vegetable intake among lower socioeconomic, multicultural labor and trades employees.
Employees (n = 2091) completed a baseline survey and received an 18-month intervention program through standard communication channels (e.g., workplace mail, cafeteria promotions, and speakers). Ninety-three social networks (cliques) of employees were identified, which were pair matched on intake. At an interim survey (during months 8 and 9), 11 cliques no longer existed and 41 matched pairs of cliques containing 905 employees remained, with one clique per pair being randomly assigned to the peer education intervention. Employees who were central in the communication flow of the peer intervention cliques served as peer educators during the last 9 months of the intervention program. Fruit and vegetable intake was measured with 24-hour intake recall and with food-frequency questions in baseline, outcome (i.e., at 18 months), and 6-month follow-up surveys. All P values are two-sided.
By use of multiple regression, statistically significant overall effects of the peer education program were seen in the intake recall (increase of 0.77 total daily servings; P<.0001) and the food-frequency (increase of 0.46 total daily servings; P =.002) questions at the outcome survey. The effect on the total number of servings persisted at the 6-month follow-up survey when measured by the intake recall (increase of 0.41 total daily servings; P =.034) but not the food-frequency (decrease of 0.04 total daily servings; P =.743) questions.
Peer education appears to be an effective means of achieving an increase in fruit and vegetable intake among lower socioeconomic, multicultural adult employees.
美国国立癌症研究所建议美国人每天至少食用五份水果和蔬菜。旨在增加摄入量的国家战略可能无法惠及少数族裔和社会经济地位较低的人群。在一项随机试验中，对同伴教育在提高社会经济地位较低、多元文化的劳工和贸易行业员工的水果和蔬菜摄入量方面的有效性进行了测试。
员工（n = 2091）完成了基线调查，并通过标准沟通渠道（如工作场所邮件、自助餐厅促销活动和演讲者）接受了为期18个月的干预计划。确定了93个员工社交网络（小团体），根据摄入量进行配对。在中期调查（第8和第9个月）时，11个小团体不复存在，剩下41对匹配的小团体，共905名员工，每对小团体中的一个被随机分配到同伴教育干预组。在干预计划的最后9个月里，在同伴干预小团体沟通流程中处于核心位置的员工担任同伴教育者。通过24小时摄入量回忆法以及在基线、结果（即18个月时）和6个月随访调查中的食物频率问题来测量水果和蔬菜摄入量。所有P值均为双侧。
通过多元回归分析，在结果调查中，同伴教育计划在摄入量回忆（每日总摄入量增加0.77份；P<.0001）和食物频率（每日总摄入量增加0.46份；P =.002）问题上显示出具有统计学意义的总体效果。在6个月随访调查中，通过摄入量回忆法测量时，对每日总份数的影响仍然存在（每日总摄入量增加0.41份；P =.034），但通过食物频率问题测量时则不存在（每日总摄入量减少0.04份；P =.743）。
同伴教育似乎是一种有效的方法，可以增加社会经济地位较低、多元文化的成年员工的水果和蔬菜摄入量。
