Buller David B, Woodall W Gill, Zimmerman Donald E, Slater Michael D, Heimendinger Jerianne, Waters Emily, Hines Joan M, Starling Randall, Hau Barbara, Burris-Woodall Patricia, Davis Glenna Sue, Saba Laura, Cutter Gary R
Klein Buendel, Inc., Golden, Colorado 80401, USA.
J Health Commun. 2008 Apr-May;13(3):230-49. doi: 10.1080/10810730801985285.
The Internet is a new technology for health communication in communities. The 5 a Day, the Rio Grande Way website intended to increase fruits and vegetables (FV) consumption was evaluated in a rural region enrolling 755 adults (65% Hispanic, 9% Native American, 88% female) in a randomized pretest-posttest controlled trial in 2002-2004. A total of 473 (63%) adults completed a 4-month follow-up. The change in daily intake on a food frequency questionnaire (control: mean = - 0.26 servings; intervention: mean = 0.38; estimated difference = 0.64, SD = 0.52, t(df = 416) = 1.22, p = 0.223) and single item (13.9% eating 5 + servings at pretest, 19.8% posttest for intervention; 17.4%, 13.8% for controls; odds ratio (OR) = 1.84, 95% CI = 1.07, 3.17) was in the expected direction but significant only for the single item. Website use was low and variable (logins: M = 3.3, range = 1 to 39.0; total time: M = 22.2 minutes, range = 0 to 322.7), but it was associated positively with fruit and vegetable intake (total time: Spearman r = 0.14, p = 0.004 for food frequency; Spearman r = 0.135, p = 0.004 for single item). A nutrition website may improve FV intake. The comparison on the food frequency measure may have been undermined by its high variability. Websites may be successful in community settings only when they are used enough by adults to influence them.
互联网是社区健康交流的一项新技术。“一天五蔬果”项目的里奥格兰德之路网站旨在增加水果和蔬菜(FV)的摄入量,于2002年至2004年在一个农村地区进行了一项随机前测-后测对照试验,该地区招募了755名成年人(65%为西班牙裔,9%为美国原住民,88%为女性)。共有473名(63%)成年人完成了为期4个月的随访。食物频率问卷上的每日摄入量变化(对照组:均值=-0.26份;干预组:均值=0.38;估计差异=0.64,标准差=0.52,t(自由度=416)=1.22,p=0.223)以及单项指标(干预组在前测时有13.9%的人每天食用5份及以上蔬果,后测时为19.8%;对照组分别为17.4%和13.8%;优势比(OR)=1.84,95%置信区间=1.07,3.17)虽呈预期方向,但仅单项指标具有显著性。网站使用率较低且不稳定(登录次数:均值=3.3,范围为1至39.0;总时长:均值=22.2分钟,范围为0至322.7),但与水果和蔬菜摄入量呈正相关(总时长:食物频率问卷的斯皮尔曼相关系数r=0.14,p=0.004;单项指标的斯皮尔曼相关系数r=0.135,p=0.004)。一个营养网站可能会提高水果和蔬菜的摄入量。食物频率测量结果的高变异性可能削弱了其比较效果。只有当成年人充分使用网站以对其产生影响时,网站在社区环境中才可能取得成功。