University of North Carolina at Chapel Hill, Department of Nutrition, Gillings School of Global Public Health and School of Medicine, 2004 Hooker, Chapel Hill, NC 27599, USA.
Patient Educ Couns. 2010 Oct;81(1):37-42. doi: 10.1016/j.pec.2009.11.018. Epub 2009 Dec 30.
Body & Soul, an evidence-based nutrition program for African Americans churches, is currently being disseminated nationally and free of charge by the National Cancer Institute. For dissemination feasibility, the peer counseling training is done via DVD rather than by live trainers. We describe implementation and process evaluation of the peer counseling component under real world conditions.
The study sample included 11 churches (6 early intervention, 5 delayed intervention) in 6 states. Data sources included training observations, post-training debriefing sessions, coordinator interviews, and church participant surveys. Survey data analysis examined associations between exposure to peer counseling and change in dietary intake. Qualitative data were analyzed using the constant comparative method.
Eight of 11 churches initiated the peer counseling program. Recall of talking with a peer counselor was associated with significantly (p<.02) greater fruit and vegetable intake. Data indicate sub-optimal program execution after peer counselor training.
Inconsistent implementation of the peer counseling intervention is likely to dilute program effectiveness in changing nutrition behaviors.
Disseminating evidence-based programs may require added resources, training, quality control, and technical assistance for improving program uptake. Similar to earlier research phases, systematic efforts at the dissemination phase are needed for program success.
“身体与灵魂”是一项面向非裔美国人教会的循证营养计划，目前由美国国家癌症研究所免费在全国范围内推广。为了实现传播的可行性，同伴咨询培训是通过 DVD 进行的，而不是由现场培训师进行。我们描述了在真实环境下同伴咨询部分的实施和过程评估。
研究样本包括来自 6 个州的 11 个教会（6 个早期干预，5 个延迟干预）。数据来源包括培训观察、培训后汇报会议、协调员访谈和教会参与者调查。调查数据分析了同伴咨询的暴露与饮食摄入变化之间的关系。定性数据采用恒比法进行分析。
有 8 个教会启动了同伴咨询计划。与同伴顾问交谈的回忆与水果和蔬菜摄入量的显著增加（p<.02）相关。数据表明，同伴咨询培训后，计划执行情况并不理想。
同伴咨询干预的执行不一致可能会降低改变营养行为的计划效果。
传播基于证据的计划可能需要额外的资源、培训、质量控制和技术援助，以提高计划的参与度。与早期研究阶段类似，传播阶段需要系统的努力才能使计划取得成功。
