Personalized nutritional information sent through mail helps improve diets

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Brown University researchers have shown that there is an inexpensive way to help low-income, ethnically diverse people eat better: Send personalized nutrition education materials through the mail. That is the primary finding in a new study to be published in The International Journal of Behavioral Nutrition and Physical Activity. The implications are significant as public policy-makers struggle to find new cost-effective ways to slow the escalating price of health care.

The $2-million Your Health/Su Vida Saludable study funded by the National Cancer Institute showed so much promise that the research team is in the middle of disseminating the program to local community agencies, funded by a $1.3-million grant from the Centers for Disease Control and Prevention.

"It's a lot less expensive to send (people) material in the mail than to sit down with them and do multiple counseling sessions over time. And people really liked the materials," said lead author Kim Gans, associate professor (research) of community health at Brown University and co-director of Brown's Institute for Community Health Promotion.

The initial study began in October 2000 and ran through February 2007. Researchers recruited 1,841 people, mostly in Rhode Island. Slightly more than half were Latino, and 13 percent were African American. About 56 percent of the population involved in the study had a household annual income of less than $20,000. People interested in participating filled out forms at community events or dialed a 1-800 number posted at various public venues.

Once participants were in place, researchers conducted a telephone survey to identify people's dietary habits, what motivated them to eat healthier, and barriers to eating healthier as well as their interests and other personal information.

About a week later, participants received nutrition information in the mail. The information they received depended on which study group they were in. One study group received nutrition brochures from national agencies. The other three study groups received nutrition information that was individually tailored to their needs and interests, based on their answers to the telephone survey. The mailings were written in a simple, easy-to-follow style in English or Spanish.

Of the three tailored study groups, one group received the information all in one mailing. The two other groups received the information split into four mailings during a 12-week period. One of these two groups also received additional surveys between mailings to "re-tailor" the materials.

Gans and the other researchers found that people in the tailored groups had greater increases in vegetable and fruit consumption and larger reductions in their fat intake than those in the nontailored group. Of the nontailored groups, those people who received their information in small batches over time made the strongest improvements in their diets.

Unexpectedly, the researchers also found that less educated consumers benefitted even more from the tailored dietary materials. They improved their fruit and vegetable intake even more than more consumers with more education.

Source: Brown University