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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.154468v1 100/2/319    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Alexander, G. L. Search for Related Content PubMed PubMed Citation Articles by Alexander, G. L. Related Collections Managed Care Health Promotion Media Nutrition/Food Prevention Health Education

Gwen L. Alexander, PhD, Jennifer B. McClure, PhD, Josephine H. Calvi, MPH, George W. Divine, PhD, Melanie A. Stopponi, MPA, Sharon J. Rolnick, PhD, Jerianne Heimendinger, DSc, Dennis D. Tolsma, MPH, Kenneth Resnicow, PhD, Marci K. Campbell, PhD, Victor J. Strecher, PhD, Christine Cole Johnson, PhD and for the MENU Choices Team

Gwen L. Alexander, George W. Divine, and Christine Cole Johnson are with the Department of Biostatistics and Research Epidemiology, Henry Ford Hospital and Health System, Detroit, MI. Jennifer B. McClure is with Group Health Research Institute, Seattle, WA. Josephine H. Calvi and Dennis D. Tolsma are with the Center for Health Research, Kaiser Permanente Georgia, Atlanta. Melanie A. Stopponi is with the Institute for Health Research, Kaiser Permanente Colorado, Denver. Sharon J. Rolnick is with HealthPartners Research Foundation, Minneapolis, MN. Jerianne Heimendinger is with the University of Colorado Health Sciences Center, Denver. Kenneth Resnicow and Victor J. Strecher are with the Department of Health Education and Health Behavior, University of Michigan School of Public Health, Ann Arbor. Marci K. Campbell is with the Department of Nutrition, University of North Carolina School of Public Health, Chapel Hill.

Correspondence: Correspondence can be sent to Christine Cole Johnson, PhD, Department of Biostatistics and Research Epidemiology, Henry Ford Hospital and Health Center, One Ford Place 5C, Detroit, MI 48202 (e-mail cjohnso1{at}hfhs.org). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We assessed change in fruit and vegetable intake in a population-based sample, comparing an online untailored program (arm 1) with a tailored behavioral intervention (arm 2) and with a tailored behavioral intervention plus motivational interviewing–based counseling via e-mail (arm 3).

Methods. We conducted a randomized controlled intervention trial, enrolling members aged 21 to 65 years from 5 health plans in Seattle, Washington; Denver, Colorado; Minneapolis, Minnesota; Detroit, Michigan; and Atlanta, Georgia. Participants reported fruit and vegetable intake at baseline and at 3, 6, and 12 months. We assessed mean change in fruit and vegetable servings per day at 12 months after baseline, using a validated self-report fruit and vegetable food frequency questionnaire.

Results. Of 2540 trial participants, 80% were followed up at 12 months. Overall baseline mean fruit and vegetable intake was 4.4 servings per day. Average servings increased by more than 2 servings across all study arms (P < .001), with the greatest increase (+2.8 servings) among participants of arm 3 (P = .05, compared with control). Overall program satisfaction was high.

Conclusions. This online nutritional intervention was well received, convenient, easy to disseminate, and associated with sustained dietary change. Such programs have promise as population-based dietary interventions.