Theory of Planned Behavior and implementation intentions to improve fruit and vegetable intake in women of low socioeconomic status

Fruit and vegetable intake (FVI) is an important modifiable risk factor for chronic diseases. Low socioeconomic status (SES) populations demonstrate lower FVI and higher rates of chronic diseases than higher SES groups. Theory-based models and interventions like the Theory of Planned Behavior (TPB) and implementation intentions (II) have been used effectively to explain and influence health behaviors, including FVI, in middle class populations, but have not been evaluated in exclusively low SES populations. This research investigates the efficacy, feasibility and acceptability of the TPB and an II intervention to explain and influence FVI in women of low SES.Participants: Adult female residents of Boston Public Housing developments. TPB constructs and FVI were measuredvia survey. We conducted pilot and feasibility randomized controlled and one-group II intervention studies (n=31) to promote FVI and a qualitative analysis of semi-structured interview data (n=8) to evaluate intervention efficacy, feasibility and acceptability.Intervention and control groups did not increase FVI (intervention + 0.26 servings per day, t(17)=0.73,p=0.476; control +0.50 servings per day, t(9)=1.07,p=0.3111) and no difference in FVI between groups t(26)=0.40,p=0.6934). Feasibility goals were met for randomization (100%vs ≥80%), retention(93.5%vs ≥70%), missing data (2%vs <10%), days to follow up (mean=69.27±42.67 vs