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A systematic review of effect modification
in trials of behavioral interventions 
to increase fruit and vegetable consumption

Di H. Cross1, K.M. Venkat Narayan2, 
Lance A. Waller3, Youngmee Kim4, 
Rachel E. Patzer1, Carol J. Rowland Hogue1

Thomson Reuters, Custom Analytics and Engineered Solutions
1455 Research Blvd, Rockville, MD 20850
Emory University, Hubert Department of Global Health
1518 Clifton Rd. NE, Atlanta, GA 30322
Emory University, Department of Biostatistics and Bioinformatics
1518 Clifton Rd. NE, Atlanta, GA 30322
University of Miami, Department of Psychology
5665 Ponce de Leon Blvd., Coral Gables, FL 33124



Corresponding author:	Youngmee Kim
Department of Psychology
University of Miami
5665 Ponce de Leon Blvd.
Coral Gables, Florida 33124-0751
Phone: (305) 243-2937�
Email: y HYPERLINK "http://www6.miami.edu/UMH/cgi/send-email/1,3342,,00.html?email=ykim@miami.edu" \t "_blank" kim@miami.edu

Running title: Effect modification in trials for FVC
Keywords: effect modification, randomized controlled trial, fruit and vegetable consumption
Word Count: 3,334
Abstract
Although the health benefits of fruit and vegetable consumption (FVC) has been well documented, the evidence supporting the effectiveness of behavioral interventions to increase FVC has not been as consistent.  This review aimed to identify individual and environmental level factors that may explain systematic differences in treatment effects in randomized controlled trials (RCTs) of behavioral interventions to increase FVC through effect modification (EM) and discusses the utility of examining EM in the context of a RCT.
 Reports of behavioral interventions to increase FVC published from 1990-2008 were identified from MedLine, CINAHL, EMBASE, PsychINFO, and the Cochrane Registry of Clinical Trials.  Eligible studies were conducted in a healthy adult population, and reported individual FVC.  Each eligible article was then examined to determine whether any EM analysis was performed.
Of 162 eligible intervention articles, 28 (17.9%) articles based on data from 23 trials reported investigating EM.  Demographic [education (N=13), sex (N=12), age (N=11), race/ethnicity (N=8)] and psychosocial [stage of change (N=10)] variables were most commonly investigated.  Many studies relied on statistical testing to identify EM. 
Analysis of psychosocial and demographic characteristics serves to validate behavioral models or identify sub-groups for targeting.  However, the analytic approach may be applied to environmental characteristics to identify ways of improving intervention efficacy on a population level. Furthermore, statistical testing should not be the only means by which EM is assessed.  Improved understanding of EM may improve the design of interventions and efficiency in allocation of resources for research activities and services delivery.Introduction
	Although chronic disease risk is known to be related to health behaviors such as fruit and vegetable consumption (FVC) ADDIN EN.CITE <EndNote><Cite><Author>Joshipura</Author><Year>2001</Year><RecNum>1263</RecNum><record><rec-number>1263</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1263</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Joshipura, Kaumudi J.</author><author>Hu, Frank B.</author><author>Manson, JoAnn E.</author><author>Stampfer, Meir J.</author><author>Rimm, Eric B.</author><author>Speizer, Frank E.</author><author>Colditz, Graham</author><author>Ascherio, Alberto</author><author>Rosner, Bernard</author><author>Spiegelman, Donna</author><author>Willett, Walter C.</author></authors></contributors><titles><title>The Effect of Fruit and Vegetable Intake on Risk for Coronary Heart Disease</title><secondary-title>Ann Intern Med</secondary-title></titles><periodical><full-title>Ann Intern Med</full-title></periodical><pages>1106-1114</pages><volume>134</volume><number>12</number><dates><year>2001</year><pub-dates><date>June 19, 2001</date></pub-dates></dates><urls><related-urls><url>http://www.annals.org/cgi/content/abstract/134/12/1106</url></related-urls></urls></record></Cite></EndNote>1, poor health behaviors are pervasive.  Less than one quarter of the US population engages in FVC at levels recommended for chronic disease prevention ADDIN EN.CITE <EndNote><Cite><Year>2007</Year><RecNum>290</RecNum><record><rec-number>290</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">290</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors></contributors><titles><title>Fruit and vegetable consumption among adults--United States, 2005</title><secondary-title>MMWR Morb Mortal Wkly Rep</secondary-title></titles><periodical><full-title>MMWR Morb Mortal Wkly Rep</full-title></periodical><pages>213-7</pages><volume>56</volume><number>10</number><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Behavioral Risk Factor Surveillance System</keyword><keyword>*Diet/trends</keyword><keyword>Female</keyword><keyword>*Food Habits</keyword><keyword>*Fruit</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>United States/epidemiology</keyword><keyword>*Vegetables</keyword><keyword>EDAT- 2007/03/17 09:00</keyword><keyword>MHDA- 2007/03/21 09:00</keyword><keyword>AID - mm5610a2 [pii]</keyword><keyword>PST - ppublish</keyword></keywords><dates><year>2007</year><pub-dates><date>2007 Mar 16</date></pub-dates></dates><isbn>1545-861X (Electronic)</isbn><accession-num>17363889</accession-num><urls><related-urls><url>file:///C|/Documents%20and%20Settings/Owner/Local%20Settings/Application%20Data/Quosa/Data/My%20Citations/3g43eb6o28v498icgraajnp9es.qpw</url><url>http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Citation&amp;list_uids=17363889 </url></related-urls></urls><language>eng</language></record></Cite></EndNote>2.  Furthermore, randomized controlled trials (RCTs) of interventions to increase FVC have had limited success ADDIN EN.CITE <EndNote><Cite><Author>Brunner</Author><Year>2007</Year><RecNum>304</RecNum><record><rec-number>304</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">304</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Brunner, E. J.</author><author>Rees, K.</author><author>Ward, K.</author><author>Burke, M.</author><author>Thorogood, M.</author></authors></contributors><titles><title>Dietary advice for reducing cardiovascular risk</title><secondary-title>Cochrane Database Syst Rev</secondary-title></titles><periodical><full-title>Cochrane Database Syst Rev</full-title></periodical><pages>CD002128</pages><number>4</number><keywords><keyword>57-88-5 (Cholesterol)</keyword><keyword>Cardiovascular Diseases/*prevention &amp; control</keyword><keyword>Cholesterol/blood</keyword><keyword>*Diet</keyword><keyword>Diet, Fat-Restricted</keyword><keyword>Dietetics/*methods</keyword><keyword>Humans</keyword><keyword>Randomized Controlled Trials</keyword></keywords><dates><year>2007</year><pub-dates><date>2007</date></pub-dates></dates><isbn>1469-493X (Electronic)</isbn><accession-num>16235299</accession-num><urls></urls><electronic-resource-num>10.1002/14651858</electronic-resource-num><language>eng</language></record></Cite></EndNote>3, suggesting that there is a need to identify alternative ways of improving FVC behavior.
One area that has received increasing attention is the identification of effect modification ADDIN EN.CITE  ADDIN EN.CITE.DATA 4-6 � also called moderation ADDIN EN.CITE <EndNote><Cite><Author>Kraemer</Author><Year>2002</Year><RecNum>1412</RecNum><record><rec-number>1412</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1412</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kraemer, H. C.</author><author>Wilson, T.</author><author>Fairburn, C. G.</author><author>Agras, W. S.</author></authors></contributors><titles><title>Mediators and Moderators of Treatment Effects in Randomized Clinical Trials</title><secondary-title>Archives of General Psychiatry</secondary-title></titles><periodical><full-title>Archives of General Psychiatry</full-title></periodical><pages>877-883</pages><volume>59</volume><number>10</number><dates><year>2002</year></dates><urls></urls></record></Cite></EndNote>6 and intervention- or treatment-effect heterogeneity ADDIN EN.CITE <EndNote><Cite><Author>Greenfield</Author><Year>2007</Year><RecNum>1383</RecNum><record><rec-number>1383</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1383</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Greenfield</author></authors></contributors><titles><title>Heterogeneity of Treatment Effects: Implications for Guidelines, Payment, and Quality Assessment</title><secondary-title>American Journal of Medicine</secondary-title></titles><periodical><full-title>American Journal of Medicine</full-title></periodical><pages>S3-S9</pages><volume>120</volume><number>4A</number><dates><year>2007</year></dates><urls></urls></record></Cite><Cite><Author>Kravitz</Author><Year>2004</Year><RecNum>1272</RecNum><record><rec-number>1272</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1272</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kravitz, Richard L. </author><author>Duan, Naihua</author><author>Braslow, Joel </author></authors></contributors><auth-address>University of California, Davis; University of California, Los Angeles</auth-address><titles><title>Evidence-Based Medicine, Heterogeneity of Treatment Effects, and the Trouble with Averages</title><secondary-title>The Milbank Quarterly</secondary-title></titles><periodical><full-title>The Milbank Quarterly</full-title></periodical><pages>661-687</pages><volume>82</volume><number>4</number><dates><year>2004</year></dates><isbn>1468-0009</isbn><urls><related-urls><url>http://dx.doi.org/10.1111/j.0887-378X.2004.00327.x</url></related-urls></urls></record></Cite></EndNote>7,8.  Effect modification (EM), as it will be referred to in this review, is a difference in the association between a variable, E, and an outcome, O, across different levels of an effect modifier, X ADDIN EN.CITE <EndNote><Cite><Author>Rothman</Author><Year>1998</Year><RecNum>1350</RecNum><record><rec-number>1350</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1350</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Rothman, KJ</author><author>Greenland, S.</author></authors></contributors><titles><title>Modern Epidemiology</title></titles><edition>2nd</edition><dates><year>1998</year></dates><pub-location>New York, NY</pub-location><publisher>Lippincott Williams &amp; Wilkins</publisher><urls></urls></record></Cite></EndNote>9.  This is different from confounding of the relationship between E and O by X, where X is a predictor of the outcome, O, and also associated with the variable E ADDIN EN.CITE <EndNote><Cite><Author>Miettinen</Author><Year>1974</Year><RecNum>1413</RecNum><record><rec-number>1413</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1413</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Miettinen, O.</author></authors></contributors><titles><title>Confounding and effect-modification</title><secondary-title>American Journal of Epidemiology</secondary-title></titles><periodical><full-title>American Journal of Epidemiology</full-title><abbr-1>Am J Epidemiol 149(12):1104-12</abbr-1></periodical><pages>350-353</pages><volume>100</volume><number>5</number><dates><year>1974</year></dates><urls></urls></record></Cite><Cite><Author>Rothman</Author><Year>1998</Year><RecNum>1350</RecNum><record><rec-number>1350</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1350</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Rothman, KJ</author><author>Greenland, S.</author></authors></contributors><titles><title>Modern Epidemiology</title></titles><edition>2nd</edition><dates><year>1998</year></dates><pub-location>New York, NY</pub-location><publisher>Lippincott Williams &amp; Wilkins</publisher><urls></urls></record></Cite></EndNote>9,10.  In this latter case, the association between E and O is the same across levels of X.  Confounding and EM are also distinct from mediation, where E causes X, and X in turn causes the outcome, O ADDIN EN.CITE <EndNote><Cite><Author>Kraemer</Author><Year>2002</Year><RecNum>1412</RecNum><record><rec-number>1412</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1412</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kraemer, H. C.</author><author>Wilson, T.</author><author>Fairburn, C. G.</author><author>Agras, W. S.</author></authors></contributors><titles><title>Mediators and Moderators of Treatment Effects in Randomized Clinical Trials</title><secondary-title>Archives of General Psychiatry</secondary-title></titles><periodical><full-title>Archives of General Psychiatry</full-title></periodical><pages>877-883</pages><volume>59</volume><number>10</number><dates><year>2002</year></dates><urls></urls></record></Cite></EndNote>6.
EM has typically been studied using two methods.  The first is stratified analysis, where the association between E and O is reported for each level of X ADDIN EN.CITE <EndNote><Cite><Author>Rothman</Author><Year>1998</Year><RecNum>1350</RecNum><record><rec-number>1350</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1350</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Rothman, KJ</author><author>Greenland, S.</author></authors></contributors><titles><title>Modern Epidemiology</title></titles><edition>2nd</edition><dates><year>1998</year></dates><pub-location>New York, NY</pub-location><publisher>Lippincott Williams &amp; Wilkins</publisher><urls></urls></record></Cite></EndNote>9.  Meaningful, albeit subjectively determined, differences between these associations would suggest that EM is present.  The second method is the examination of statistical interaction.  In this case, a statistical model is used to study variation in the dependent variable O using E, X, and the product term between E and X as independent variables.  In this method, EM is objectively defined as a statistically significant contribution of the product term between E and X ADDIN EN.CITE <EndNote><Cite><Author>Greenland</Author><Year>1989</Year><RecNum>1414</RecNum><record><rec-number>1414</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1414</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Greenland, S.</author></authors></contributors><titles><title>Modeling and Variable Selection in Epidemiologic Analysis</title><secondary-title>American Journal of Public Health</secondary-title></titles><periodical><full-title>American Journal of Public Health</full-title></periodical><pages>340-349</pages><volume>79</volume><number>3</number><dates><year>1989</year></dates><urls></urls></record></Cite></EndNote>11.
	While both methods have been used to investigate randomized trials, there have been few systematic evaluations of the motivation for such analyses and the subsequent findings.  The purpose of this review is threefold: (1) to document reporting and analysis of EM in behavioral trials of interventions to increase FVC, (2) to examine the motivations such analyses, and (3) to explore the utility of these analysis in improving intervention design and resource allocation.

Materials and Methods
Search Strategy
	A search strategy (Appendix 1) was adapted from previous systematic reviews to identify RCTs of behavioral interventions to increase FVC ADDIN EN.CITE  ADDIN EN.CITE.DATA 3,12-14.  Results were restricted to studies performed among adult, non-institutionalized populations, indexed in CINAHL, MedLine, EMBASE, and PsychInfo databases and the Cochrane Central Register of Controlled Trials, and published between January 1, 1990 and December 31, 2008.  
Eligibility
	The titles and abstracts of all articles identified from the search strategy were evaluated by two reviewers (DHC, REP).  Eligibility was determined based on study aims, study population, and intervention type.  Studies were excluded if the intervention was a pharmaceutical intervention, if there was an environmental modification or policy change component of the intervention, if the intervention was performed exclusively among smokers, and if the study was designed for participants with specific chronic disease conditions (hypercholesterolemia, diabetes or impaired glucose tolerance, hypertension, cancer survivors, etc.) except for overweight/obese.  Studies that recruited from the general population and included some participants with chronic diseases were not excluded from the analysis.  No restrictions were made based on participant recruitment or intervention delivery setting.  Although most studies were randomized trials (individual- or cluster-randomized), studies with pre- and post-intervention measurements only and no control group were not excluded.
Full texts of studies considered to be eligible based on abstracts were retrieved and examined to determine whether individual-level fruit and vegetable consumption were reported for baseline and follow-up evaluations in servings/day, grams/day, or energy-adjusted daily intake, and whether any modification of the intervention effect was examined.  Articles reporting only differences in intervention effect across levels of baseline behavior or levels of intervention dose were not included in the analyses.  References from included articles were searched for additional eligible articles.  Articles that reported only baseline demographic information, baseline FVC, or described study design and motivations of otherwise eligible interventions were entered into the ISI Web of Science database (Thomson Reuters, New York, NY) to identify articles citing the original article and reporting follow-up data.  Those that met the inclusion criteria were included in the review.
Data Extraction
Citation information, intervention design and setting, study population and sample size, a description of the intervention and control (if applicable), evaluation time-points, intervention effect, effect modifier examined, and the direction of the effect modification were extracted from all eligible studies.  Information reported in the text identifying different articles originating from the same study (study name, sample size, intervention description, etc.) were noted and study characteristics of such articles were reported together.  
The direction of effect modification was denoted as (0) for no evidence of effect modification, (+) for a greater intervention effect associated with a greater value of the effect modifier or a greater intervention effect in the non-reference category in comparison to the reference category, or (-) for a smaller intervention effect associated with a greater value of the effect modifier or a smaller intervention effect in the non-reference category of the effect modifier in comparison to the reference category.  For articles using statistical interaction to assess effect modification, statistical significance as reported by the authors was used to determine the presence of effect modification.  Among articles employing stratified methods, intervention effects with a difference greater than two standard errors of one another were recorded as meaningful effect modification.   
Study quality or risk of bias was assessed for each article by examining six sources of potential bias: participant blinding, assessment tools for FVC, randomization success, sample size, loss to follow-up and the appropriateness of statistical analyses.  Since participant blinding to the intervention was not possible, and because all assessments of FVC were self-reported, the evaluation of the potential risk of bias focused on four sources of bias: randomization success, sample size, loss to follow-up, and statistical analysis.  Studies likely to result in bias from two or more of the above sources were categorized as high risk of bias, while those with one potential source were categorized as medium risk of bias.  Articles with little risk of bias from any of the four sources were categorized as low risk of bias. 
No attempt was made to examine un-published studies or studies published in conference proceedings.  Because of the diversity of study characteristics, and the variability in the effect modifiers measured, no attempt was made to arrive at any summary measures of association.

Results
Full texts were retrieved for 468 eligible articles, of which 162 reported FVC.  Among those reporting on FVC, 28 articles (17.3%) with data from 23 distinct trials reported examining EM (Table 1) ADDIN EN.CITE  ADDIN EN.CITE.DATA  ADDIN EN.CITE.DATA 15-42.   Of the 23 trials, 17 were individually-randomized (73.9%) while six (26.1%) were cluster-randomized.  Notable studies excluded were the Working Well Trial ADDIN EN.CITE <EndNote><Cite><Author>Sorensen</Author><Year>1996</Year><RecNum>1391</RecNum><record><rec-number>1391</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1391</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Sorensen, G.</author><author>Thompson, B.</author><author>Glanz, K.</author><author>Feng, Z. D.</author><author>Kinne, S.</author><author>DiClemente, C.</author><author>Emmons, K.</author><author>Heimendinger, J.</author><author>Probart, C.</author><author>Lichtenstein, E.</author></authors></contributors><auth-address>HARVARD UNIV,SCH PUBL HLTH,BOSTON,MA 02115. FRED HUTCHINSON CANC RES CTR,SEATTLE,WA 98104. CANC RES CTR HAWAII,HONOLULU,HI 96813. UNIV HOUSTON,HOUSTON,TX 77004. BROWN UNIV,MIRIAM HOSP,PROVIDENCE,RI 02912. NCI,ROCKVILLE,MD. PENN STATE UNIV,DEPT NUTR,UNIVERSITY PK,PA 16802. OREGON RES INST,EUGENE,OR 97403.&#xD;Sorensen, G, DANA FARBER CANC INST,DIV CANC EPIDEMIOL &amp; CONTROL,44 BINNEY ST,BOSTON,MA 02115.</auth-address><titles><title>Work site-based cancer prevention: Primary results from the Working Well Trial</title><secondary-title>American Journal of Public Health</secondary-title><alt-title>Am. J. Public Health</alt-title></titles><periodical><full-title>American Journal of Public Health</full-title></periodical><pages>939-947</pages><volume>86</volume><number>7</number><keywords><keyword>GENERALIZED LINEAR-MODELS</keyword><keyword>SMOKING CESSATION</keyword><keyword>QUESTIONNAIRE</keyword><keyword>RECORDS</keyword><keyword>INTERVENTION</keyword><keyword>VALIDATION</keyword><keyword>WOMEN</keyword></keywords><dates><year>1996</year><pub-dates><date>Jul</date></pub-dates></dates><isbn>0090-0036</isbn><accession-num>ISI:A1996UX22100007</accession-num><work-type>Article</work-type><urls><related-urls><url>&lt;Go to ISI&gt;://A1996UX22100007</url></related-urls></urls><language>English</language></record></Cite></EndNote>43, the Healthy Directions�Small Business Study ADDIN EN.CITE  ADDIN EN.CITE.DATA 44, and WellWorks-2 ADDIN EN.CITE  ADDIN EN.CITE.DATA 45 which all included components of environment or policy change; High-5 ADDIN EN.CITE <EndNote><Cite><Author>Reynolds</Author><Year>2000</Year><RecNum>1393</RecNum><record><rec-number>1393</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1393</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Reynolds, K. D.</author><author>Franklin, F. A.</author><author>Binkley, D.</author><author>Raczynski, J. M.</author><author>Harrington, K. F.</author><author>Kirk, K. A.</author><author>Person, S.</author></authors></contributors><auth-address>Univ Alabama, Birmingham, AL USA.&#xD;Reynolds, KD, AMC Canc Res Ctr, Ctr Behav Res, 1600 Pierce St, Lakewood, CO 80214 USA.</auth-address><titles><title>Increasing the fruit and vegetable consumption of fourth-graders: Results from the High 5 project</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev. Med.</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><pages>309-319</pages><volume>30</volume><number>4</number><keywords><keyword>child nutrition</keyword><keyword>demographics</keyword><keyword>fruit</keyword><keyword>vegetables</keyword><keyword>CANCER PREVENTION</keyword><keyword>CHILDREN</keyword><keyword>HEALTH</keyword><keyword>5-A-DAY</keyword><keyword>INTERVENTION</keyword><keyword>EDUCATION</keyword><keyword>STUDENTS</keyword><keyword>TRACKING</keyword><keyword>SMOKING</keyword><keyword>PROGRAM</keyword></keywords><dates><year>2000</year><pub-dates><date>Apr</date></pub-dates></dates><isbn>0091-7435</isbn><accession-num>ISI:000086370100009</accession-num><work-type>Article</work-type><urls><related-urls><url>&lt;Go to ISI&gt;://000086370100009</url></related-urls></urls><language>English</language></record></Cite></EndNote>46, Gimme 5 ADDIN EN.CITE <EndNote><Cite><Author>Baranowski</Author><Year>2000</Year><RecNum>1395</RecNum><record><rec-number>1395</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1395</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Baranowski, T.</author><author>Davis, M.</author><author>Resnicow, K.</author><author>Baranowski, J.</author><author>Doyle, C.</author><author>Lin, L. S.</author><author>Smith, M.</author><author>Wang, D. Q. T.</author></authors></contributors><auth-address>Baylor Coll Med, Childrens Nutr Res Ctr, Dept Pediat, Houston, TX 77030 USA. Univ Minnesota, Sch Publ Hlth, Div Epidemiol, Minneapolis, MN 55455 USA. Pfizer Pharmaceut, Groton, CT USA.&#xD;Baranowski, T, Baylor Coll Med, Childrens Nutr Res Ctr, Dept Pediat, 1100 Bates St, Houston, TX 77030 USA.</auth-address><titles><title>Gimme 5 fruit, juice, and vegetables for fun and health: Outcome evaluation</title><secondary-title>Health Education &amp; Behavior</secondary-title><alt-title>Health Educ. Behav.</alt-title></titles><periodical><full-title>Health Education &amp; Behavior</full-title><abbr-1>Health Educ Behav 27(5):649-63</abbr-1></periodical><pages>96-111</pages><volume>27</volume><number>1</number><keywords><keyword>5TH GRADE STUDENTS</keyword><keyword>CHILDRENS FRUIT</keyword><keyword>INCREASE FRUIT</keyword><keyword>CONSUMPTION</keyword><keyword>4TH</keyword><keyword>PROGRAM</keyword><keyword>RELIABILITY</keyword><keyword>PREDICTORS</keyword><keyword>PATTERNS</keyword><keyword>VALIDITY</keyword></keywords><dates><year>2000</year><pub-dates><date>Feb</date></pub-dates></dates><isbn>1090-1981</isbn><accession-num>ISI:000084964700008</accession-num><work-type>Article</work-type><urls><related-urls><url>&lt;Go to ISI&gt;://000084964700008</url></related-urls></urls><language>English</language></record></Cite></EndNote>47, CATCH ADDIN EN.CITE <EndNote><Cite><Author>Perry</Author><Year>1998</Year><RecNum>1394</RecNum><record><rec-number>1394</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1394</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Perry, C.</author><author>Lytle, L. A.</author><author>Feldman, H.</author><author>Nicklas, T.</author><author>Stone, E.</author><author>Zive, M.</author><author>Garceau, A.</author><author>Kelder, S. H.</author></authors></contributors><auth-address>Univ Minnesota, Sch Publ Hlth, Div Epidemiol, Minneapolis, MN 55454 USA.&#xD;Perry, C, Univ Minnesota, Sch Publ Hlth, Div Epidemiol, 1300 S 2nd St,Suite 300, Minneapolis, MN 55454 USA.&#xD;perry@epivax.epi.umn.edu</auth-address><titles><title>Effects of the child and adolescent trial for cardiovascular health (CATCH) on fruit and vegetable intake</title><secondary-title>Journal of Nutrition Education</secondary-title><alt-title>J. Nutr. Educ.</alt-title></titles><periodical><full-title>Journal of Nutrition Education</full-title><abbr-1>J. Nutr. Educ.</abbr-1></periodical><alt-periodical><full-title>Journal of Nutrition Education</full-title><abbr-1>J. Nutr. Educ.</abbr-1></alt-periodical><pages>354-360</pages><volume>30</volume><number>6</number><keywords><keyword>UNITED-STATES</keyword><keyword>CANCER PREVENTION</keyword><keyword>PHYSICAL-ACTIVITY</keyword><keyword>INTERVENTION</keyword><keyword>PROMOTION</keyword><keyword>PROGRAM</keyword><keyword>SMOKING</keyword><keyword>DIET</keyword></keywords><dates><year>1998</year><pub-dates><date>Nov-Dec</date></pub-dates></dates><isbn>0022-3182</isbn><accession-num>ISI:000077367700002</accession-num><work-type>Article</work-type><urls><related-urls><url>&lt;Go to ISI&gt;://000077367700002</url></related-urls></urls><language>English</language></record></Cite></EndNote>48, and Take-5 ADDIN EN.CITE <EndNote><Cite><Author>Cox</Author><Year>1998</Year><RecNum>1396</RecNum><record><rec-number>1396</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1396</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Cox, D. N.</author><author>Anderson, A. S.</author><author>Reynolds, J.</author><author>McKellar, S.</author><author>Lean, M. E. J.</author><author>Mela, D. J.</author></authors></contributors><auth-address>Inst Food Res, Consumer Sci Dept, Reading RG6 6BZ, Berks, England. Univ Glasgow, Dept Human Nutr, Glasgow G31 2ER, Lanark, Scotland.&#xD;Cox, DN, Inst Food Res, Consumer Sci Dept, Reading RG6 6BZ, Berks, England.</auth-address><titles><title>Take Five, a nutrition education intervention to increase fruit and vegetable intakes: impact on consumer choice and nutrient intakes</title><secondary-title>British Journal of Nutrition</secondary-title><alt-title>Br. J. Nutr.</alt-title></titles><periodical><full-title>British Journal of Nutrition</full-title></periodical><pages>123-131</pages><volume>80</volume><number>2</number><keywords><keyword>fruit and vegetables</keyword><keyword>consumer choice</keyword><keyword>nutrient intake</keyword><keyword>nutritional</keyword><keyword>intervention</keyword><keyword>CONSUMPTION</keyword><keyword>5-A-DAY</keyword><keyword>HEALTH</keyword><keyword>DIET</keyword><keyword>FAT</keyword></keywords><dates><year>1998</year><pub-dates><date>Aug</date></pub-dates></dates><isbn>0007-1145</isbn><accession-num>ISI:000076110300003</accession-num><work-type>Article</work-type><urls><related-urls><url>&lt;Go to ISI&gt;://000076110300003</url></related-urls></urls><language>English</language></record></Cite></EndNote>49 which examined FVC in children; and one study examining intervention effect across levels of rurality of study sites performed among recipients of congregate meals ADDIN EN.CITE  ADDIN EN.CITE.DATA 50.  Eight studies were rated as low risk of bias, while 16 were rated medium, and four were rated as having a high risk of bias (Table 1).
In all, five trials reported no significant intervention effect at the end of the trial ADDIN EN.CITE  ADDIN EN.CITE.DATA 29,40-42,51.  Of the remaining 18, 16 trials reporting a statistically significant intervention effect of which six reported an intervention effect of 0.5 srv/day or less; one trial did not compare the randomized groups and thus reported only change in FVC in the dietary intervention group ADDIN EN.CITE <EndNote><Cite><Author>Gambera</Author><Year>1995</Year><RecNum>1326</RecNum><record><rec-number>1326</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1326</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Gambera, P. J.</author><author>Schneeman, B. O.</author><author>Davis, P. A.</author></authors></contributors><titles><title>Use of the Food Guide Pyramid and US Dietary Guidelines to improve dietary intake and reduce cardiovascular risk in active-duty Air Force members</title><secondary-title>Journal of the American Dietetic Association</secondary-title></titles><periodical><full-title>Journal of the American Dietetic Association</full-title></periodical><pages>1268-73</pages><volume>95</volume><number>11</number><dates><year>1995</year><pub-dates><date>Nov</date></pub-dates></dates><accession-num>7594122</accession-num><work-type>Clinical Trial&#xD;Randomized Controlled Trial&#xD;Research Support, U.S. Gov&apos;t, Non-P.H.S.</work-type><urls></urls></record></Cite></EndNote>15; and one trial reported a smaller decline in FVC in the intervention group than in the control group ADDIN EN.CITE <EndNote><Cite><Author>Smeets</Author><Year>2007</Year><RecNum>1338</RecNum><record><rec-number>1338</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1338</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Smeets, T.</author><author>Kremers, S. P. J.</author><author>Brug, J.</author><author>de Vries, H.</author></authors></contributors><auth-address>Department of Health Education and Promotion, Maastricht University, The Netherlands. t.smeets@gvo.unimaas.nl</auth-address><titles><title>Effects of tailored feedback on multiple health behaviors.[erratum appears in Ann Behav Med. 2007 Jul-Aug;34(1):104]</title><secondary-title>Annals of Behavioral Medicine</secondary-title><alt-title>Ann Behav Med</alt-title></titles><periodical><full-title>Annals of Behavioral Medicine</full-title><abbr-1>Ann. Behav. Med.</abbr-1></periodical><alt-periodical><full-title>Ann Behav Med</full-title></alt-periodical><pages>117-23</pages><volume>33</volume><number>2</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>*Behavior Therapy/mt [Methods]</keyword><keyword>Body Mass Index</keyword><keyword>Diet, Fat-Restricted/px [Psychology]</keyword><keyword>Exercise/px [Psychology]</keyword><keyword>*Feedback, Psychological</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Food Habits/px [Psychology]</keyword><keyword>Fruit</keyword><keyword>*Health Behavior</keyword><keyword>Health Knowledge, Attitudes, Practice</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Motivation</keyword><keyword>Smoking Cessation</keyword><keyword>*Therapy, Computer-Assisted</keyword><keyword>Treatment Outcome</keyword><keyword>Vegetables</keyword></keywords><dates><year>2007</year><pub-dates><date>Apr</date></pub-dates></dates><accession-num>17447863</accession-num><urls></urls></record></Cite></EndNote>39.
A total of 39,515 participants were recruited for participation (N range: [32, 5,041], median: N=1,359) with loss to follow-up within studies ranging from 0.0% ADDIN EN.CITE <EndNote><Cite><Author>Gambera</Author><Year>1995</Year><RecNum>1326</RecNum><record><rec-number>1326</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1326</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Gambera, P. J.</author><author>Schneeman, B. O.</author><author>Davis, P. A.</author></authors></contributors><titles><title>Use of the Food Guide Pyramid and US Dietary Guidelines to improve dietary intake and reduce cardiovascular risk in active-duty Air Force members</title><secondary-title>Journal of the American Dietetic Association</secondary-title></titles><periodical><full-title>Journal of the American Dietetic Association</full-title></periodical><pages>1268-73</pages><volume>95</volume><number>11</number><dates><year>1995</year><pub-dates><date>Nov</date></pub-dates></dates><accession-num>7594122</accession-num><work-type>Clinical Trial&#xD;Randomized Controlled Trial&#xD;Research Support, U.S. Gov&apos;t, Non-P.H.S.</work-type><urls></urls></record></Cite></EndNote>15 to 73.9% ADDIN EN.CITE  ADDIN EN.CITE.DATA 27.  Study settings included churches, clinics or primary care facilities, health management organizations, the internet, telephone directories, community-based organizations, and worksites.  The majority of studies were performed in clinical settings (N=12, 52.2%).  Study evaluation ranged from less than one month ADDIN EN.CITE <EndNote><Cite><Author>de Vet</Author><Year>2008</Year><RecNum>1398</RecNum><record><rec-number>1398</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1398</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>de Vet, E.</author><author>de Nooijer, J.</author><author>de Vries, N. K.</author><author>Brug, J.</author></authors></contributors><auth-address>Institute of Health Sciences, Vrije Universiteit, Amsterdam, the Netherlands. emely.de.vet@falw.vu.nl</auth-address><titles><title>Testing the transtheoretical model for fruit intake: comparing web-based tailored stage-matched and stage-mismatched feedback</title><secondary-title>Health Education Research</secondary-title><alt-title>Health Educ Res 23(2):218-27</alt-title></titles><periodical><full-title>Health Education Research</full-title><abbr-1>Health Educ Res 18(4):429-38</abbr-1></periodical><pages>218-27</pages><volume>23</volume><number>2</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Diet/mt [Methods]</keyword><keyword>*Feedback</keyword><keyword>Female</keyword><keyword>*Fruit</keyword><keyword>*Health Education/mt [Methods]</keyword><keyword>Humans</keyword><keyword>*Internet</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Models, Psychological</keyword></keywords><dates><year>2008</year><pub-dates><date>Apr</date></pub-dates></dates><accession-num>17595176</accession-num><urls></urls></record></Cite></EndNote>42 to 24 months ADDIN EN.CITE  ADDIN EN.CITE.DATA 17,19,21,51 and intervention duration ranged from those involving only a one-time exposure ADDIN EN.CITE  ADDIN EN.CITE.DATA 29,39,42 to those administered over a period of 24 months ADDIN EN.CITE <EndNote><Cite><Author>Tilley</Author><Year>1999</Year><RecNum>1343</RecNum><record><rec-number>1343</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1343</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Tilley, BC</author><author>Vernon, SW</author><author>Myers, R</author><author>et al. </author></authors></contributors><titles><title>The Next Step Trial: impact of a worksite colorectal cancer screening promotion program</title><secondary-title>Prev Med</secondary-title></titles><periodical><full-title>Prev Med</full-title></periodical><pages>276-283</pages><volume>28</volume><dates><year>1999</year></dates><urls></urls></record></Cite></EndNote>51.  With only two exceptions ADDIN EN.CITE  ADDIN EN.CITE.DATA 28,37, interventions with evaluations at or beyond 12 months reported larger intervention effects.  Eleven trials were conducted among at-risk populations (low-income, minority, etc.).
The majority of articles reporting on potential effect modifiers focused on demographic variables (Table 2), with 13 studies reported having examined change in FVC by education, 12 by sex, 11 by age, and eight by race/ethnicity.  Despite the number of articles examining differences by demographic variables, three studies concluded there was EM by education ADDIN EN.CITE  ADDIN EN.CITE.DATA 16,27,29 (23.1%), two by sex ADDIN EN.CITE  ADDIN EN.CITE.DATA 15,30 (16.7%), five by age ADDIN EN.CITE  ADDIN EN.CITE.DATA 16,19,23,27,40 (45.5%), and one by race/ethnicity ADDIN EN.CITE <EndNote><Cite><Author>Havas</Author><Year>1998</Year><RecNum>1327</RecNum><record><rec-number>1327</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1327</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Havas, S.</author><author>Anliker, J.</author><author>Damron, D.</author><author>Langenberg, P.</author><author>Ballesteros, M.</author><author>Feldman, R.</author></authors></contributors><auth-address>Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA. shavas@epi.umaryland.edu</auth-address><titles><title>Final results of the Maryland WIC 5-A-Day Promotion Program</title><secondary-title>American Journal of Public Health</secondary-title><alt-title>Am J Public Health</alt-title></titles><periodical><full-title>American Journal of Public Health</full-title></periodical><alt-periodical><full-title>Am J Public Health</full-title></alt-periodical><pages>1161-7</pages><volume>88</volume><number>8</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Child</keyword><keyword>Child, Preschool</keyword><keyword>Cross-Over Studies</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Food Services</keyword><keyword>*Fruit</keyword><keyword>Health Knowledge, Attitudes, Practice</keyword><keyword>*Health Promotion</keyword><keyword>Health Surveys</keyword><keyword>Humans</keyword><keyword>Infant</keyword><keyword>Male</keyword><keyword>Maryland</keyword><keyword>Neoplasms/et [Etiology]</keyword><keyword>*Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>*Nutrition Physiology/ed [Education]</keyword><keyword>Pregnancy</keyword><keyword>*Public Assistance</keyword><keyword>*Vegetables</keyword></keywords><dates><year>1998</year><pub-dates><date>Aug</date></pub-dates></dates><isbn>0090-0036</isbn><accession-num>9702141</accession-num><urls></urls></record></Cite></EndNote>16 (12.5%).  All studies concluding that there were meaningful differences in intervention effect were rated as having a medium or low risk of bias, while none rated with a high risk of bias reported significant effect modification.  Of the four articles that used stratified analysis to examine demographic variables ADDIN EN.CITE  ADDIN EN.CITE.DATA 15,16,19,27, all (100.0%) suggested differences in intervention effect across at least one variable.  In contrast, 15 studies employed statistical significance of a product term to evaluate effect modification, and five ADDIN EN.CITE  ADDIN EN.CITE.DATA 23,29,30,34,40 (33.3%) concluded there was at least one variable across which the intervention effect was significantly different.  Although many studies using statistical interaction to examine EM investigated multiple variables (range one to five), only one article ADDIN EN.CITE <EndNote><Cite><Author>Kristal</Author><Year>2000</Year><RecNum>1332</RecNum><record><rec-number>1332</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1332</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kristal, A. R.</author><author>Curry, S. J.</author><author>Shattuck, A. L.</author><author>Feng, Z.</author><author>Li, S.</author></authors></contributors><auth-address>Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA. akristal@fhcrc.org</auth-address><titles><title>A randomized trial of a tailored, self-help dietary intervention: the Puget Sound Eating Patterns study</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 31(4):380-9</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><pages>380-9</pages><volume>31</volume><number>4</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Body Mass Index</keyword><keyword>Cohort Studies</keyword><keyword>*Diet, Fat-Restricted/mt [Methods]</keyword><keyword>Dietary Fiber/ad [Administration &amp; Dosage]</keyword><keyword>Feasibility Studies</keyword><keyword>Female</keyword><keyword>*Food Habits</keyword><keyword>*Fruit</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Obesity/dh [Diet Therapy]</keyword><keyword>Questionnaires</keyword><keyword>Risk Factors</keyword><keyword>Treatment Outcome</keyword><keyword>*Vegetables</keyword><keyword>Washington</keyword></keywords><dates><year>2000</year><pub-dates><date>Oct</date></pub-dates></dates><accession-num>11006063</accession-num><urls></urls></record></Cite></EndNote>23 found more than one significant source of EM.
After demographic variables, psychosocial variables were next most commonly examined.  Stage of change was the most frequently evaluated, with analyses in eight articles ADDIN EN.CITE  ADDIN EN.CITE.DATA 17,23,26-28,32,37,42 reporting on 10 distinct studies (Table 3).  Five studies ADDIN EN.CITE  ADDIN EN.CITE.DATA 23,26,27,32,37 concluded that there was a meaningful differences in intervention (62.5%).  Of these five studies, two ADDIN EN.CITE  ADDIN EN.CITE.DATA 27,37 used stratified analysis.  However, the direction of association was inconsistent.  Three studies reported an increase in intervention effect with increasing stage of change (from precontemplator to maintenance) ADDIN EN.CITE  ADDIN EN.CITE.DATA 23,27,32 and two reported the reverse ADDIN EN.CITE  ADDIN EN.CITE.DATA 26,37.  
There were generally no differences reported by baseline intention to change FVC behavior (examined in two studies ADDIN EN.CITE  ADDIN EN.CITE.DATA 18,23), and only one ADDIN EN.CITE  ADDIN EN.CITE.DATA 36 of three studies examining baseline motivation ADDIN EN.CITE  ADDIN EN.CITE.DATA 24,36,39 reported a significant difference in intervention effect.  In addition, one study examined intervention effect by need for cognition ADDIN EN.CITE <EndNote><Cite><Author>Williams-Piehota</Author><Year>2006</Year><RecNum>1344</RecNum><record><rec-number>1344</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1344</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Williams-Piehota, P.</author><author>Pizarro, J.</author><author>Navarro Silvera, S. A.</author><author>Mowad, L.</author><author>Salovey, P.</author><author>Williams-Piehota, Pamela</author><author>Pizarro, Judith</author><author>Navarro Silvera, Stephanie A.</author><author>Mowad, Linda</author><author>Salovey, Peter</author></authors></contributors><titles><title>Need for cognition and message complexity in motivating fruit and vegetable intake among callers to the cancer information service</title><secondary-title>Health Communication</secondary-title></titles><periodical><full-title>Health Communication</full-title></periodical><pages>75-84</pages><volume>19</volume><number>1</number><dates><year>2006</year></dates><accession-num>16519594</accession-num><work-type>Randomized Controlled Trial&#xD;Research Support, N.I.H., Extramural</work-type><urls></urls></record></Cite></EndNote>38 and another examined intervention effect by self-efficacy ADDIN EN.CITE <EndNote><Cite><Author>Sorensen</Author><Year>2007</Year><RecNum>1400</RecNum><record><rec-number>1400</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1400</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Sorensen, G.</author><author>Stoddard, A. M.</author><author>Dubowitz, T.</author><author>Barbeau, E. M.</author><author>Bigby, J.</author><author>Emmons, K. M.</author><author>Berkman, L. F.</author><author>Peterson, K. E.</author></authors></contributors><titles><title>The influence of social context on changes in fruit and vegetable consumption: results of the healthy directions studies</title><secondary-title>American Journal of Public Health</secondary-title></titles><periodical><full-title>American Journal of Public Health</full-title></periodical><pages>1216-1227</pages><volume>97</volume><number>7</number><keywords><keyword>Diet</keyword><keyword>Fruit</keyword><keyword>Health Behavior -- Ethnology</keyword><keyword>Neoplasms -- Prevention and Control</keyword><keyword>Social Class</keyword><keyword>Vegetables</keyword><keyword>Adult</keyword><keyword>Clinical Trials</keyword><keyword>Ethnic Groups</keyword><keyword>Female</keyword><keyword>Linear Regression</keyword><keyword>Male</keyword><keyword>Massachusetts</keyword><keyword>Middle Age</keyword><keyword>Neoplasms -- Epidemiology</keyword><keyword>Neoplasms -- Ethnology</keyword><keyword>Nutritional Status</keyword><keyword>Risk Assessment</keyword><keyword>Work Environment</keyword></keywords><dates><year>2007</year></dates><isbn>0090-0036</isbn><urls><related-urls><url>Publisher URL: www.cinahl.com/cgi-bin/refsvc?jid=114&amp;accno=2009637431</url><url>http://search.ebscohost.com/login.aspx?direct=true&amp;db=cin20&amp;AN=2009637431&amp;site=ehost-live</url></related-urls></urls></record></Cite></EndNote>34.  Neither found differential intervention effects.  One study examining autonomy showed a significantly greater intervention effect with greater baseline autonomy ADDIN EN.CITE  ADDIN EN.CITE.DATA 40.
	In addition to demographic and psychosocial variables, studies also examined social-contextual variables and health-related indicators, albeit more rarely.  One study examined social networks, social norms and food security and reported no difference in intervention effect observed across levels of these variables ADDIN EN.CITE <EndNote><Cite><Author>Sorensen</Author><Year>2007</Year><RecNum>1400</RecNum><record><rec-number>1400</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1400</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Sorensen, G.</author><author>Stoddard, A. M.</author><author>Dubowitz, T.</author><author>Barbeau, E. M.</author><author>Bigby, J.</author><author>Emmons, K. M.</author><author>Berkman, L. F.</author><author>Peterson, K. E.</author></authors></contributors><titles><title>The influence of social context on changes in fruit and vegetable consumption: results of the healthy directions studies</title><secondary-title>American Journal of Public Health</secondary-title></titles><periodical><full-title>American Journal of Public Health</full-title></periodical><pages>1216-1227</pages><volume>97</volume><number>7</number><keywords><keyword>Diet</keyword><keyword>Fruit</keyword><keyword>Health Behavior -- Ethnology</keyword><keyword>Neoplasms -- Prevention and Control</keyword><keyword>Social Class</keyword><keyword>Vegetables</keyword><keyword>Adult</keyword><keyword>Clinical Trials</keyword><keyword>Ethnic Groups</keyword><keyword>Female</keyword><keyword>Linear Regression</keyword><keyword>Male</keyword><keyword>Massachusetts</keyword><keyword>Middle Age</keyword><keyword>Neoplasms -- Epidemiology</keyword><keyword>Neoplasms -- Ethnology</keyword><keyword>Nutritional Status</keyword><keyword>Risk Assessment</keyword><keyword>Work Environment</keyword></keywords><dates><year>2007</year></dates><isbn>0090-0036</isbn><urls><related-urls><url>Publisher URL: www.cinahl.com/cgi-bin/refsvc?jid=114&amp;accno=2009637431</url><url>http://search.ebscohost.com/login.aspx?direct=true&amp;db=cin20&amp;AN=2009637431&amp;site=ehost-live</url></related-urls></urls></record></Cite></EndNote>34.  A four studies examined smoking status ADDIN EN.CITE  ADDIN EN.CITE.DATA 16,23,27,31 and three examined baseline BMI status ADDIN EN.CITE  ADDIN EN.CITE.DATA 23,39,51.  Of these studies, only one study reported any difference in intervention effect with a smaller intervention effect among smokers ADDIN EN.CITE  ADDIN EN.CITE.DATA 27.  One study found a greater intervention effect with increasing level of participant food responsibility, but no difference by number of restaurant meals consumed ADDIN EN.CITE <EndNote><Cite><Author>Kristal</Author><Year>2000</Year><RecNum>1332</RecNum><record><rec-number>1332</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1332</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kristal, A. R.</author><author>Curry, S. J.</author><author>Shattuck, A. L.</author><author>Feng, Z.</author><author>Li, S.</author></authors></contributors><auth-address>Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA. akristal@fhcrc.org</auth-address><titles><title>A randomized trial of a tailored, self-help dietary intervention: the Puget Sound Eating Patterns study</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 31(4):380-9</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><pages>380-9</pages><volume>31</volume><number>4</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Body Mass Index</keyword><keyword>Cohort Studies</keyword><keyword>*Diet, Fat-Restricted/mt [Methods]</keyword><keyword>Dietary Fiber/ad [Administration &amp; Dosage]</keyword><keyword>Feasibility Studies</keyword><keyword>Female</keyword><keyword>*Food Habits</keyword><keyword>*Fruit</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Obesity/dh [Diet Therapy]</keyword><keyword>Questionnaires</keyword><keyword>Risk Factors</keyword><keyword>Treatment Outcome</keyword><keyword>*Vegetables</keyword><keyword>Washington</keyword></keywords><dates><year>2000</year><pub-dates><date>Oct</date></pub-dates></dates><accession-num>11006063</accession-num><urls></urls></record></Cite></EndNote>23.
Investigator-cited justification for examining effect modification varied by the effect modifier examined.  Those studies examining psychosocial effect modifiers commonly cited validation of behavioral models as the motivation for the analysis ADDIN EN.CITE  ADDIN EN.CITE.DATA 17,26,28,32,42.   Examination of demographic variables, when explicitly stated, was motivated in determining the generalizability of results ADDIN EN.CITE  ADDIN EN.CITE.DATA 20,33,41, identifying subgroups for subsequent targeting of the intervention ADDIN EN.CITE  ADDIN EN.CITE.DATA 27,41, determining public health importance or impact ADDIN EN.CITE  ADDIN EN.CITE.DATA 30, or simply because such effect modification had been reported in previous studies ADDIN EN.CITE  ADDIN EN.CITE.DATA 25.  One study, performed by Sorensen et al., cited findings from observational studies as the motivation for examining effect modification ADDIN EN.CITE <EndNote><Cite><Author>Sorensen</Author><Year>2007</Year><RecNum>1400</RecNum><record><rec-number>1400</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1400</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Sorensen, G.</author><author>Stoddard, A. M.</author><author>Dubowitz, T.</author><author>Barbeau, E. M.</author><author>Bigby, J.</author><author>Emmons, K. M.</author><author>Berkman, L. F.</author><author>Peterson, K. E.</author></authors></contributors><titles><title>The influence of social context on changes in fruit and vegetable consumption: results of the healthy directions studies</title><secondary-title>American Journal of Public Health</secondary-title></titles><periodical><full-title>American Journal of Public Health</full-title></periodical><pages>1216-1227</pages><volume>97</volume><number>7</number><keywords><keyword>Diet</keyword><keyword>Fruit</keyword><keyword>Health Behavior -- Ethnology</keyword><keyword>Neoplasms -- Prevention and Control</keyword><keyword>Social Class</keyword><keyword>Vegetables</keyword><keyword>Adult</keyword><keyword>Clinical Trials</keyword><keyword>Ethnic Groups</keyword><keyword>Female</keyword><keyword>Linear Regression</keyword><keyword>Male</keyword><keyword>Massachusetts</keyword><keyword>Middle Age</keyword><keyword>Neoplasms -- Epidemiology</keyword><keyword>Neoplasms -- Ethnology</keyword><keyword>Nutritional Status</keyword><keyword>Risk Assessment</keyword><keyword>Work Environment</keyword></keywords><dates><year>2007</year></dates><isbn>0090-0036</isbn><urls><related-urls><url>Publisher URL: www.cinahl.com/cgi-bin/refsvc?jid=114&amp;accno=2009637431</url><url>http://search.ebscohost.com/login.aspx?direct=true&amp;db=cin20&amp;AN=2009637431&amp;site=ehost-live</url></related-urls></urls></record></Cite></EndNote>34.  For a large proportion of articles examined ADDIN EN.CITE  ADDIN EN.CITE.DATA 15,16,18,19,21,23,29,35,37,51 (N=10, 35.7%), there was no explicitly stated motivation for examining effect modification.  
	Despite increasing interest in studying EM in RCTs ADDIN EN.CITE  ADDIN EN.CITE.DATA 4,5,7, there are few articles that report on such findings in the behavior intervention literature and there has been limited.  To the authors� knowledge, systematic examination of EM analysis in the effect of interventions to increase FVC has been performed in only one other review article, conducted by Oldroyd et al. ADDIN EN.CITE <EndNote><Cite><Author>Oldroyd</Author><Year>2008</Year><RecNum>1257</RecNum><record><rec-number>1257</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1257</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Oldroyd, J</author><author>Burns, C</author><author>Lucas, P</author><author>Haikerwal, A</author><author>Waters, E</author></authors></contributors><titles><title>The effectiveness of nutrition interventions on dietary outcomes by relative social disadvantage: a systematic review</title><secondary-title>Journal of Epidemiology and Community Health</secondary-title></titles><periodical><full-title>Journal of Epidemiology and Community Health</full-title></periodical><pages>573-579</pages><volume>62</volume><dates><year>2008</year></dates><urls></urls></record></Cite></EndNote>52.  There was no overlap in the articles included by Oldroyd et al. and in this study due to difference in inclusion criteria � in particular, their inclusion of studies conducted among children ADDIN EN.CITE  ADDIN EN.CITE.DATA 46,53,54.  Oldroyd et al. concluded that few articles reported examining intervention effect modification, consistent with our finding that fewer than one out of every five studies reported examining EM.
However, it is possible that these analyses are more commonly performed than they are reported.  This is likely because EM may not reach statistical significance.  Many studies included in this analysis did indeed report no statistically significant effect modification.  However, barring the circumstances where a homogeneous intervention effect may be expected for an intervention designed for and administered within a homogeneous sample, such a lack of heterogeneity may be counter-intuitive given the conventional wisdom that �one size does not fit all� ADDIN EN.CITE <EndNote><Cite><Author>Whitlock</Author><Year>2002</Year><RecNum>1416</RecNum><record><rec-number>1416</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1416</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Whitlock, Evelyn P.</author><author>Orleans, C. Tracy</author><author>Pender, Nola</author><author>Allan, Janet</author></authors></contributors><titles><title>Evaluating Primary Care Behavioral Counseling Interventions: An Evidence-Based Approach</title><secondary-title>American Journal of Preventive Medicine</secondary-title></titles><periodical><full-title>American Journal of Preventive Medicine</full-title></periodical><pages>267-284</pages><volume>22</volume><number>4</number><dates><year>2002</year></dates><urls></urls></record></Cite><Cite><Author>Kravitz</Author><Year>2004</Year><RecNum>1272</RecNum><record><rec-number>1272</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1272</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kravitz, Richard L. </author><author>Duan, Naihua</author><author>Braslow, Joel </author></authors></contributors><auth-address>University of California, Davis; University of California, Los Angeles</auth-address><titles><title>Evidence-Based Medicine, Heterogeneity of Treatment Effects, and the Trouble with Averages</title><secondary-title>The Milbank Quarterly</secondary-title></titles><periodical><full-title>The Milbank Quarterly</full-title></periodical><pages>661-687</pages><volume>82</volume><number>4</number><dates><year>2004</year></dates><isbn>1468-0009</isbn><urls><related-urls><url>http://dx.doi.org/10.1111/j.0887-378X.2004.00327.x</url></related-urls></urls></record></Cite></EndNote>8,55.  This suggests that the assumption that interventions should have heterogeneous effects is wrong, or that the methods by which heterogeneity is quantified and identified is wrong.
Indeed, these findings suggests that less reliance on statistical significance in favor of careful examination of the magnitude of and patterns in the intervention effect across subgroups may be more likely to lead investigators to accurately conclude that there is meaningful modification of the intervention effect.  Because analysis of EM is often conducted as part of a secondary aim rather than as a primary aim of an intervention study, lack of statistical significance may likely be due to inadequate statistical power.  It is well known that stratified analysis is likely to be under powered for detecting a significant intervention effect ADDIN EN.CITE <EndNote><Cite><Author>Hayward</Author><Year>2006</Year><RecNum>1417</RecNum><record><rec-number>1417</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1417</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hayward, Rodney A.</author><author>Kent, David M.</author><author>Vijan, Sandeep</author><author>Hofer, Timothy P.</author></authors></contributors><titles><title>Multivariables risk prediction can greatly enhance the statistical power of clinical trial subgroup analysis</title><secondary-title>BMC Medical Research Methodology</secondary-title></titles><periodical><full-title>BMC Medical Research Methodology</full-title></periodical><volume>6</volume><number>18</number><dates><year>2006</year></dates><urls></urls></record></Cite></EndNote>56.  As an additional disadvantage, stratified analysis requires multiple testing and introduces the possibility of obtaining false positive results ADDIN EN.CITE <EndNote><Cite><Author>Kraemer</Author><Year>2006</Year><RecNum>1273</RecNum><record><rec-number>1273</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1273</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kraemer, Helena C.</author><author>Frank, Ellen</author><author>Kupfer, David J.</author></authors></contributors><titles><title>Moderators of Treatment Outcomes: Clinical, Research, and Policy Importance</title><secondary-title>Jama</secondary-title></titles><periodical><full-title>Jama</full-title></periodical><pages>1286-1289</pages><volume>296</volume><number>10</number><dates><year>2006</year><pub-dates><date>September 13, 2006</date></pub-dates></dates><urls><related-urls><url>http://jama.ama-assn.org</url></related-urls></urls><electronic-resource-num>10.1001/jama.296.10.1286</electronic-resource-num></record></Cite></EndNote>5.  These reasons are often stated as support for the alternative method: examining the statistical significance of the product term in a statistical model ADDIN EN.CITE <EndNote><Cite><Author>Kraemer</Author><Year>2006</Year><RecNum>1273</RecNum><record><rec-number>1273</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1273</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kraemer, Helena C.</author><author>Frank, Ellen</author><author>Kupfer, David J.</author></authors></contributors><titles><title>Moderators of Treatment Outcomes: Clinical, Research, and Policy Importance</title><secondary-title>Jama</secondary-title></titles><periodical><full-title>Jama</full-title></periodical><pages>1286-1289</pages><volume>296</volume><number>10</number><dates><year>2006</year><pub-dates><date>September 13, 2006</date></pub-dates></dates><urls><related-urls><url>http://jama.ama-assn.org</url></related-urls></urls><electronic-resource-num>10.1001/jama.296.10.1286</electronic-resource-num></record></Cite></EndNote>5.  However, the power for detecting such an effect is dependent on the proportion of participants simultaneously exposed to the intervention and the potential modifier.  Again, such an analysis would likely be under powered.  In addition, multiple testing remains a problem given the number of potential modifiers often examined.  As such, both methods � examining effect modification through a statistical interaction operationalized as a product term in the model, or through stratified analysis � offer similar disadvantages in traditional trial analyses.  However, while the direct statistical testing possible with the analysis of statistical interaction is often stated as an advantage of that method, the use of a single criterion of statistical significance � particularly where power is nearly guaranteed to be less than adequate � over-simplifies the picture.  In contrast, stratified analysis demands examination of magnitudes of the intervention effects across sub-groups precisely because direct comparison is not automatically made in the analysis.  Given limited statistical power, stratified analysis may be more interpretable and therefore more accessible to broader audiences, and more likely to lead to conclusions useful for informing future studies.
	However, beyond merely identifying effect modification, there is also a question of motivation.  Why is the identification of EM important?  What do these analyses tell us about the intervention?  What, if anything, do they tell us about the effect modifier?
Although demographic variables were the most commonly studied effect modifiers, few authors explicitly stated a motivation for examining them.  In addition, many investigators may have examined effect modification by demographic variables but did not report their results due to statistically null findings.  Given null findings, investigators may not report having investigated EM because of the motivation for investigating EM.  The most commonly cited reasons for investigating demographic variables were to identify subgroups among which the intervention had a different effect, or to determine whether the estimated intervention effect was generalizable.  If no differences in intervention effect were found across demographic variables, then there would be no reason to report having examined effect modification.   
If differences in intervention effect are identified across demographic variables, limited resources can then be spent most efficiently by administering the intervention to segments of the population among whom the intervention was most effective.  However, this does not address the public health problem of pervasive, poor health behaviors because sub-populations among whom interventions are less effective � often including underserved, or high-risk populations � are precisely the segments of the population in most need of help.  Perhaps motivated by these findings, targeted interventions have been designed for such populations often with moderate success.  However, beyond targeting sub-groups, little else has been done with the information garnered from effect modification across demographic characteristics.  Indeed, this would appear to make sense since these characteristics are not modifiable.  However, investigators should be wary, as demographic characteristics may merely serve as proxies for other modifiable characteristics in a more complex causal mechanism ADDIN EN.CITE <EndNote><Cite><Author>Hogue</Author><Year>1997</Year><RecNum>1402</RecNum><record><rec-number>1402</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1402</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Carol J. Rowland Hogue</author></authors></contributors><titles><title>Getting to the Why</title><secondary-title>Epidemiology</secondary-title></titles><periodical><full-title>Epidemiology</full-title></periodical><pages>230</pages><volume>8</volume><number>3</number><dates><year>1997</year></dates><urls></urls></record></Cite><Cite><Author>Lovasi</Author><Year>2009</Year><RecNum>1421</RecNum><record><rec-number>1421</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1421</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lovasi, Gina S.</author><author>Hutson, Malo A.</author><author>Guerra, Monica</author><author>Neckerman, Kathryn M.</author></authors></contributors><titles><title>Built Environments and Obesity in Disadvantaged Populations</title><secondary-title>Epidemiol Rev</secondary-title></titles><periodical><full-title>Epidemiol Rev</full-title></periodical><pages>mxp005</pages><dates><year>2009</year><pub-dates><date>July 9, 2009</date></pub-dates></dates><urls><related-urls><url>http://epirev.oxfordjournals.org/cgi/content/abstract/mxp005v1</url></related-urls></urls><electronic-resource-num>10.1093/epirev/mxp005</electronic-resource-num></record></Cite></EndNote>57,58.
	Among investigators of psychosocial modifiers, the most commonly cited motivation was testing or validating a behavioral model.  In this case, modifying variables are of primary interest � not only to identify groups that will benefit from the intervention in its current form, but also to improve the design of interventions in the future by understanding the mechanisms by which the intervention under investigation did and did not work.  This approach is commendable, but has not been taken full advantage of in the literature, its application having been restricted to psycho-social variables.  While behavioral models may be a resource for identifying variables predictive of behavior, increasingly recognized is the importance of factors predictive of behavior change ADDIN EN.CITE <EndNote><Cite><Author>Brug</Author><Year>2005</Year><RecNum>1403</RecNum><record><rec-number>1403</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1403</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Brug, J.</author><author>Oenema, A.</author><author>Ferreira, I.</author></authors></contributors><titles><title>Theory, evidence and Intervention Mapping to improve behavior nutrition and physical activity interventions</title><secondary-title>International Journal of Behavioral Nutrition and Physical Activity</secondary-title></titles><periodical><full-title>International Journal of Behavioral Nutrition and Physical Activity</full-title></periodical><volume>2</volume><number>2</number><dates><year>2005</year></dates><urls></urls></record></Cite></EndNote>59.  In addition to individuals� motivations and abilities to execute a behavior, external or environmental factors such as opportunities for behaviors are also important in changing behavior ADDIN EN.CITE <EndNote><Cite><Author>Brug</Author><Year>2005</Year><RecNum>1403</RecNum><record><rec-number>1403</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1403</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Brug, J.</author><author>Oenema, A.</author><author>Ferreira, I.</author></authors></contributors><titles><title>Theory, evidence and Intervention Mapping to improve behavior nutrition and physical activity interventions</title><secondary-title>International Journal of Behavioral Nutrition and Physical Activity</secondary-title></titles><periodical><full-title>International Journal of Behavioral Nutrition and Physical Activity</full-title></periodical><volume>2</volume><number>2</number><dates><year>2005</year></dates><urls></urls></record></Cite><Cite><Author>Rothschild</Author><Year>1999</Year><RecNum>1405</RecNum><record><rec-number>1405</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1405</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Rothschild, M. L.</author></authors></contributors><titles><title>Carrots, Sticks, and Promises: A Conceptual Framework for the Management of Public Health and the Social Issue Behaviors</title><secondary-title>Journal of Marketing</secondary-title></titles><periodical><full-title>Journal of Marketing</full-title></periodical><pages>24-37</pages><volume>63</volume><dates><year>1999</year></dates><urls></urls></record></Cite></EndNote>59,60.  One resource for identifying such characteristics is the observational literature where environmental factors such as access to grocers ADDIN EN.CITE <EndNote><Cite><Author>Caldwell</Author><Year>2009</Year><RecNum>1244</RecNum><record><rec-number>1244</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1244</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Caldwell, Erin M.</author><author>Miller Kobayashi, M.</author><author>DuBow, W. M.</author><author>Wytinck, S. M.</author></authors></contributors><titles><title>Perceived access to fruits and vegetables associated with increased consumption</title><secondary-title>Public Health Nutrition</secondary-title></titles><periodical><full-title>Public Health Nutrition</full-title></periodical><pages>1-8</pages><volume>Forthcoming</volume><number>-1</number><dates><year>2009</year></dates><isbn>1368-9800</isbn><urls><related-urls><url>http://journals.cambridge.org/action/displayAbstract?fromPage=online&amp;aid=3109588&amp;fulltextType=RA&amp;fileId=S1368980008004308</url></related-urls></urls><electronic-resource-num>doi:10.1017/S1368980008004308</electronic-resource-num><access-date>2006</access-date></record></Cite></EndNote>61, pricing of produce ADDIN EN.CITE <EndNote><Cite><Author>Beydouna</Author><Year>2008</Year><RecNum>1250</RecNum><record><rec-number>1250</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1250</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Beydouna, MA</author><author>Powerll, LM</author><author>Wanga, Y</author></authors></contributors><titles><title>The association of fast food, fruit and vegetable prices with dietary intakes among US adults: Is there modification by family income?</title><secondary-title>Social Science &amp; Medicine</secondary-title></titles><periodical><full-title>Social Science &amp; Medicine</full-title></periodical><pages>2218-2229</pages><volume>66</volume><number>11</number><keywords><keyword>USA</keyword><keyword>Obesity</keyword><keyword>Food prices</keyword><keyword>Dietary intake</keyword><keyword>Dietary quality</keyword><keyword>Fast food consumption</keyword><keyword>Family income</keyword></keywords><dates><year>2008</year><pub-dates><date>June 2008</date></pub-dates></dates><urls></urls></record></Cite></EndNote>62, presence of fast food chains ADDIN EN.CITE <EndNote><Cite><Author>Austin</Author><Year>2005</Year><RecNum>332</RecNum><record><rec-number>332</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">332</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Austin, S. B.</author><author>Melly, S. J.</author><author>Sanchez, B. N.</author><author>Patel, A.</author><author>Buka, S.</author><author>Gortmaker, S. L.</author></authors></contributors><titles><title>Clustering of Fast-Food Restaurants Around Schools: A Novel Application of Spatial Statistics to the Study of Food Environments</title><secondary-title>Am J Public Health</secondary-title></titles><periodical><full-title>Am J Public Health</full-title></periodical><pages>1575-1581</pages><volume>95</volume><dates><year>2005</year><pub-dates><date>2005</date></pub-dates></dates><urls><related-urls><url>file:///C|/Documents%20and%20Settings/Owner/Local%20Settings/Application%20Data/Quosa/Data/My%20Citations/hu4copfd6arkl5i27a45gef7b4.qpw </url></related-urls></urls></record></Cite></EndNote>63, among others ADDIN EN.CITE <EndNote><Cite><Author>Lovasi</Author><Year>2009</Year><RecNum>1421</RecNum><record><rec-number>1421</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1421</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lovasi, Gina S.</author><author>Hutson, Malo A.</author><author>Guerra, Monica</author><author>Neckerman, Kathryn M.</author></authors></contributors><titles><title>Built Environments and Obesity in Disadvantaged Populations</title><secondary-title>Epidemiol Rev</secondary-title></titles><periodical><full-title>Epidemiol Rev</full-title></periodical><pages>mxp005</pages><dates><year>2009</year><pub-dates><date>July 9, 2009</date></pub-dates></dates><urls><related-urls><url>http://epirev.oxfordjournals.org/cgi/content/abstract/mxp005v1</url></related-urls></urls><electronic-resource-num>10.1093/epirev/mxp005</electronic-resource-num></record></Cite></EndNote>58 have been studied.  However, only one study included in this review ADDIN EN.CITE <EndNote><Cite><Author>Sorensen</Author><Year>2007</Year><RecNum>1400</RecNum><record><rec-number>1400</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1400</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Sorensen, G.</author><author>Stoddard, A. M.</author><author>Dubowitz, T.</author><author>Barbeau, E. M.</author><author>Bigby, J.</author><author>Emmons, K. M.</author><author>Berkman, L. F.</author><author>Peterson, K. E.</author></authors></contributors><titles><title>The influence of social context on changes in fruit and vegetable consumption: results of the healthy directions studies</title><secondary-title>American Journal of Public Health</secondary-title></titles><periodical><full-title>American Journal of Public Health</full-title></periodical><pages>1216-1227</pages><volume>97</volume><number>7</number><keywords><keyword>Diet</keyword><keyword>Fruit</keyword><keyword>Health Behavior -- Ethnology</keyword><keyword>Neoplasms -- Prevention and Control</keyword><keyword>Social Class</keyword><keyword>Vegetables</keyword><keyword>Adult</keyword><keyword>Clinical Trials</keyword><keyword>Ethnic Groups</keyword><keyword>Female</keyword><keyword>Linear Regression</keyword><keyword>Male</keyword><keyword>Massachusetts</keyword><keyword>Middle Age</keyword><keyword>Neoplasms -- Epidemiology</keyword><keyword>Neoplasms -- Ethnology</keyword><keyword>Nutritional Status</keyword><keyword>Risk Assessment</keyword><keyword>Work Environment</keyword></keywords><dates><year>2007</year></dates><isbn>0090-0036</isbn><urls><related-urls><url>Publisher URL: www.cinahl.com/cgi-bin/refsvc?jid=114&amp;accno=2009637431</url><url>http://search.ebscohost.com/login.aspx?direct=true&amp;db=cin20&amp;AN=2009637431&amp;site=ehost-live</url></related-urls></urls></record></Cite></EndNote>34 explicitly cited the observational literature as the motivator for examining potential effect modifiers.  Furthermore, this was the only study that examined environmental-level effect modifiers.
Investigators must make better use of the observational literature as a resource for identifying modifiable, environmental-level variables which are potential modifiers of the effects of behavioral interventions.  This would aid in designing studies and allocating resources.  Furthermore, the identification of environmental-level characteristics may aid in addressing the public health problem of pervasive, poor health behaviors by identifying a means by which existing interventions can be made to be more effective on a population level.  In much the same way that physicians may first address a modifying risk factor before prescribing a drug to an individual with elevated risks of adverse effects or attenuated benefits, public health policy-makers may address modifiable, environmental-level risk factors on a population level before administering other individual- or policy-level interventions.
	Based on these findings, we make four recommendations.  
First, we recommend that investigators more consistently report when effect modification is investigated, even when findings are not statistically significant.  
Second, we recommend that statistical significance should be only one criterion by which meaningful effect modification is identified.  In particular, patterns and trends in intervention effect or differences in magnitude should be given more weight in light of the necessary, external constraints on power to detect EM in RCTs.  Such reporting will document apparent associations and allow for more focused hypotheses in future studies with appropriate power for studying EM. 
Third, the choice of variables for which effect modification is examined should be guided by specific causal hypotheses.  Investigators should be aware of their motivation for investigating EM, and identify relevant potential modifiers based on that motivation.  
Fourth and last, we recommend that investigators expand the list of potential modifiers to include environmental-level characteristics.  This makes it possible not only to identify populations where interventions will be most effective, but also makes it possible to change population-level characteristics in order to make interventions effective in all segments of the population.  This can most effectively be accomplished by incorporating the knowledge obtained from the observational literature with data obtained from randomized trials.
Table 1. Characteristics of included studies
Trial NameCitationRisk of BiasEM AnalysisDesignSettingPopulation
(Loss to f/up)InterventionControlEvaluationsFindingsGambera et al, 1995  ADDIN EN.CITE <EndNote><Cite><Author>Gambera</Author><Year>1995</Year><RecNum>614</RecNum><record><rec-number>614</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">614</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Gambera, P. J.</author><author>Schneeman, B. O.</author><author>Davis, P. A.</author></authors></contributors><titles><title>Use of the Food Guide Pyramid and US Dietary Guidelines to improve dietary intake and reduce cardiovascular risk in active-duty Air Force members</title><secondary-title>Journal of the American Dietetic Association</secondary-title></titles><periodical><full-title>Journal of the American Dietetic Association</full-title></periodical><pages>1268-73</pages><volume>95</volume><number>11</number><dates><year>1995</year><pub-dates><date>Nov</date></pub-dates></dates><accession-num>7594122</accession-num><work-type>Clinical Trial&#xD;Randomized Controlled Trial&#xD;Research Support, U.S. Gov&apos;t, Non-P.H.S.</work-type><urls></urls></record></Cite></EndNote>15MediumSRCTAir Force Base in Sacramento, California32 active-duty Air Force members
(0.0%)90 days; dietary counseling, fitness programFitness only0, 90 daysSignificant 3.4 srv/day increase in FVC among those in diet+fitness at 90 days; control group consumption not reportedMaryland WIC 5-a-Day Promotion ProgramHavas et al, 1998  ADDIN EN.CITE  ADDIN EN.CITE.DATA 16LowScRT16 WIC sites, Maryland3,122 mothers over 18 years of age
(24.5, 26.3%)6 months; group sessions, print material, personalized mailingsDelayed intervention0, 8, 20 monthsSignificant 0.4 srv/day greater increase in intervention compared to controls at 20-month follow-upCampbell et al, 2008  ADDIN EN.CITE  ADDIN EN.CITE.DATA 17MediumPTMarcus et al, 1998  ADDIN EN.CITE <EndNote><Cite><Author>Marcus</Author><Year>1998</Year><RecNum>85</RecNum><record><rec-number>85</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">85</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Marcus, A. C.</author><author>Heimendinger, J.</author><author>Wolfe, P.</author><author>Rimer, B. K.</author><author>Morra, M.</author><author>Cox, D.</author><author>Lang, P. J.</author><author>Stengle, W.</author><author>Van Herle, M. P.</author><author>Wagner, D.</author><author>Fairclough, D.</author><author>Hamilton, L.</author></authors></contributors><auth-address>AMC Cancer Research Center, Denver, Colorado, 80214, USA.</auth-address><titles><title>Increasing fruit and vegetable consumption among callers to the CIS: results from a randomized trial</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><alt-periodical><full-title>Preventive Medicine</full-title><abbr-1>Prev Med</abbr-1></alt-periodical><pages>S16-28</pages><volume>27</volume><number>5 Pt 1</number><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Female</keyword><keyword>*Food Habits</keyword><keyword>Fruit</keyword><keyword>*Health Education/mt [Methods]</keyword><keyword>Humans</keyword><keyword>*Information Services</keyword><keyword>Likelihood Functions</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Multivariate Analysis</keyword><keyword>*Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>Pilot Projects</keyword><keyword>Program Evaluation</keyword><keyword>Telephone</keyword><keyword>United States</keyword><keyword>Vegetables</keyword></keywords><dates><year>1998</year><pub-dates><date>Sep-Oct</date></pub-dates></dates><isbn>0091-7435</isbn><accession-num>9808821</accession-num><urls></urls></record></Cite></EndNote>18MediumPTRCTCallers to 6 NCIS Centers2,126 callers to six regional call centers
(39.5%)Tailored educational message, concrete behavioral suggestions, print materialsNo materials0, 4 weeks, 4 monthsSignificant 0.7 srv/day greater increase among intervention than controls at 4 weeks, 0.4 srv/day greater increase at 4 monthsBlack Churches United for Better HealthCampbell et al, 1999  ADDIN EN.CITE  ADDIN EN.CITE.DATA 19MediumScRT
50 churches in 10 rural, eastern North Carolina counties3,737 African-American participants
(32.6, 33.0%)20 months; Tailored bulletins, lay health advisors, activities, pastor and community support, etc.Delayed intervention0, 1, 2 yearsSignificant 0.66 srv/day greater increase in intervention than controls at 2 year follow-upCampbell et al, 2008  ADDIN EN.CITE  ADDIN EN.CITE.DATA 17
MediumPTWomen�s HealthTrialCoates et al, 1999  ADDIN EN.CITE  ADDIN EN.CITE.DATA 20HighPTRCTClinics in Atlanta, GA; Birmingham, AL; and Miami, FL2,208 post-menopausal women, aged 50-79
(73.1%)2 years; multiple group counseling sessionsSelf-help material0, 6, 12, 18 months0.6 to 0.8 srv/day significantly greater increase among intervention than controlsTreatwell 5 a Day Sorensen et al, 1999 ADDIN EN.CITE  ADDIN EN.CITE.DATA 21LowPTcRT
22 worksites in eastern Massachusetts1,359 employees 
(3.9, 8.2%)19.5 months; worksite intervention: educational sessions, activities, plus minimal intervention; worksite plus family interventionMinimal: NCI cancer hotline, 1hr nutritional education session0, 2 yearsSignificant 0.5 to 1.2 srv/day greater increase in worksite intervention than control at 2 yearsCampbell et al, 2008 ADDIN EN.CITE  ADDIN EN.CITE.DATA 17
MediumPTNext Step TrialTilley et al, 1999 ADDIN EN.CITE <EndNote><Cite><Author>Tilley</Author><Year>1999</Year><RecNum>124</RecNum><record><rec-number>124</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">124</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Tilley, B. C.</author><author>Glanz, K.</author><author>Kristal, A. R.</author><author>Hirst, K.</author><author>Li, S.</author><author>Vernon, S. W.</author><author>Myers, R.</author></authors></contributors><auth-address>Department of Biostatistics and Research Epidemiology, Henry Ford Health Sciences Center, Detroit, Michigan, USA.</auth-address><titles><title>Nutrition intervention for high-risk auto workers: results of the Next Step Trial</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 28(3):284-92</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><alt-periodical><full-title>Preventive Medicine</full-title><abbr-1>Prev Med 28(3):284-92</abbr-1></alt-periodical><pages>284-92</pages><volume>28</volume><number>3</number><keywords><keyword>Adult</keyword><keyword>Automobiles</keyword><keyword>Colorectal Neoplasms/et [Etiology]</keyword><keyword>*Colorectal Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>Diet/px [Psychology]</keyword><keyword>Diet, Fat-Restricted</keyword><keyword>Dietary Fiber</keyword><keyword>Energy Metabolism</keyword><keyword>Female</keyword><keyword>Health Behavior</keyword><keyword>*Health Education/og [Organization &amp; Administration]</keyword><keyword>Humans</keyword><keyword>Industry</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Nutrition Physiology/ed [Education]</keyword><keyword>*Occupational Health Services/og [Organization &amp; Administration]</keyword><keyword>Questionnaires</keyword></keywords><dates><year>1999</year><pub-dates><date>Mar</date></pub-dates></dates><accession-num>10072747</accession-num><urls></urls></record></Cite></EndNote>22LowPT �=0.20cRT
28 automobile manufacturing sites in 5 US states5,042 employees
(30.9%)2 years; classes, print materials, personalized dietary feedbackNo materials 0, 1, 2 yearsNo significant difference in change at 1 or 2 yearsPuget Sound Healthy Eating Patterns Study Kristal et al, 2000  ADDIN EN.CITE <EndNote><Cite><Author>Kristal</Author><Year>2000</Year><RecNum>134</RecNum><record><rec-number>134</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">134</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kristal, A. R.</author><author>Curry, S. J.</author><author>Shattuck, A. L.</author><author>Feng, Z.</author><author>Li, S.</author></authors></contributors><auth-address>Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA. akristal@fhcrc.org</auth-address><titles><title>A randomized trial of a tailored, self-help dietary intervention: the Puget Sound Eating Patterns study</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 31(4):380-9</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><alt-periodical><full-title>Preventive Medicine</full-title><abbr-1>Prev Med 31(4):380-9</abbr-1></alt-periodical><pages>380-9</pages><volume>31</volume><number>4</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Body Mass Index</keyword><keyword>Cohort Studies</keyword><keyword>*Diet, Fat-Restricted/mt [Methods]</keyword><keyword>Dietary Fiber/ad [Administration &amp; Dosage]</keyword><keyword>Feasibility Studies</keyword><keyword>Female</keyword><keyword>*Food Habits</keyword><keyword>*Fruit</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Obesity/dh [Diet Therapy]</keyword><keyword>Questionnaires</keyword><keyword>Risk Factors</keyword><keyword>Treatment Outcome</keyword><keyword>*Vegetables</keyword><keyword>Washington</keyword></keywords><dates><year>2000</year><pub-dates><date>Oct</date></pub-dates></dates><accession-num>11006063</accession-num><urls></urls></record></Cite></EndNote>23Medium
PT
RCTGroup Health Cooperative of Puget Sound HMO, Washington State1,459 enrollees, age 18-69
(17.4, 17.4%)Print materials, dietary analysis, motivational phone callNo materials0,3,12 monthsSignificant 0.5 srv/day greater increase among intervention compared to controls at 3 and 12 monthsSatia et al, 2001  ADDIN EN.CITE <EndNote><Cite><Author>Satia</Author><Year>2001</Year><RecNum>156</RecNum><record><rec-number>156</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">156</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Satia, J. A.</author><author>Kristal, A. R.</author><author>Curry, S.</author><author>Trudeau, E.</author></authors></contributors><auth-address>Fred Hutchinson Cancer Research Center, Cancer Prevention Research Program, Seattle, WA 98109-1024, USA. jsatia@fhcrc.org.</auth-address><titles><title>Motivations for healthful dietary change</title><secondary-title>Public Health Nutrition</secondary-title><alt-title>Public Health Nutr 4(5):953-9</alt-title></titles><periodical><full-title>Public Health Nutrition</full-title><abbr-1>Public Health Nutr</abbr-1></periodical><alt-periodical><full-title>Public Health Nutrition</full-title><abbr-1>Public Health Nutr 4(5):953-9</abbr-1></alt-periodical><pages>953-9</pages><volume>4</volume><number>5</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>*Diet/px [Psychology]</keyword><keyword>*Dietary Fats/ad [Administration &amp; Dosage]</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>*Food Habits/px [Psychology]</keyword><keyword>*Fruit</keyword><keyword>Health Behavior</keyword><keyword>Health Status</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Motivation</keyword><keyword>Peer Group</keyword><keyword>Self Concept</keyword><keyword>*Vegetables</keyword><keyword>0 (Dietary Fats)</keyword></keywords><dates><year>2001</year><pub-dates><date>Oct</date></pub-dates></dates><accession-num>11784408</accession-num><urls></urls></record></Cite></EndNote>24MediumSEat for Life TrialResnicow et al, 2001  ADDIN EN.CITE  ADDIN EN.CITE.DATA 25MediumPT �=0.20cRT14 black churches, Atlanta metropolitan area1,011 participants 
(14.8, 14.8%)Group 2: self-help intervention and 1 cue call; Group 3: self-help intervention, 1 cue call, 3 counseling callsDelayed intervention0, 1 year1.0 to 1.4 srv/day greater increase in group 3 than controls; 1.0 to 1.1 srv/day greater increase in group 2 than controlsResnicow et al, 2003  ADDIN EN.CITE <EndNote><Cite><Author>Resnicow</Author><Year>2003</Year><RecNum>183</RecNum><record><rec-number>183</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">183</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Resnicow, K.</author><author>McCarty, F.</author><author>Baranowski, T.</author></authors></contributors><auth-address>School of Public Health, University of Michagan, Ann Arbor, MI 48109, USA. kresnic@sph.emory.edu</auth-address><titles><title>Are precontemplators less likely to change their dietary behavior? A prospective analysis</title><secondary-title>Health Education Research</secondary-title><alt-title>Health Educ Res 18(6):693-705</alt-title></titles><periodical><full-title>Health Education Research</full-title><abbr-1>Health Educ Res</abbr-1></periodical><alt-periodical><full-title>Health Education Research</full-title><abbr-1>Health Educ Res 18(6):693-705</abbr-1></alt-periodical><pages>693-705</pages><volume>18</volume><number>6</number><keywords><keyword>Adaptation, Psychological</keyword><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>*African Continental Ancestry Group/px [Psychology]</keyword><keyword>Aged</keyword><keyword>*Diet/px [Psychology]</keyword><keyword>Female</keyword><keyword>Food Habits/px [Psychology]</keyword><keyword>Fruit</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Models, Psychological</keyword><keyword>*Motivation</keyword><keyword>Prospective Studies</keyword><keyword>*Religion and Psychology</keyword><keyword>Vegetables</keyword></keywords><dates><year>2003</year><pub-dates><date>Dec</date></pub-dates></dates><accession-num>14654502</accession-num><urls></urls></record></Cite></EndNote>26MediumPTMaryland WIC Food for Life ProgramHavas et al, 2003  ADDIN EN.CITE  ADDIN EN.CITE.DATA 27MediumScRT10 WIC sites, Maryland 2,066 mothers
(73.9%)6 months; various educational media, activities, individualized feedback, incentives, and phone callsDelayed intervention0, 8, 20 monthsSignificant 0.4 srv/day greater increase in intervention compared to controls at 8 monthsJohn et al, 2003  ADDIN EN.CITE <EndNote><Cite><Author>John</Author><Year>2003</Year><RecNum>179</RecNum><record><rec-number>179</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">179</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>John, J. H.</author><author>Yudkin, P. L.</author><author>Neil, H. A.</author><author>Ziebland, S.</author></authors></contributors><auth-address>Division of Public Health and Primary Health Care, University of Oxford, Institute of HeOX3alth Sciences, Old Road, Headington, Oxford OX3 7LF, UK.</auth-address><titles><title>Does stage of change predict outcome in a primary-care intervention to encourage an increase in fruit and vegetable consumption?</title><secondary-title>Health Education Research</secondary-title><alt-title>Health Educ Res 18(4):429-38</alt-title></titles><periodical><full-title>Health Education Research</full-title><abbr-1>Health Educ Res</abbr-1></periodical><alt-periodical><full-title>Health Education Research</full-title><abbr-1>Health Educ Res 18(4):429-38</abbr-1></alt-periodical><pages>429-38</pages><volume>18</volume><number>4</number><keywords><keyword>Adult</keyword><keyword>Case-Control Studies</keyword><keyword>Female</keyword><keyword>*Food Habits</keyword><keyword>*Fruit</keyword><keyword>Great Britain</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Primary Health Care</keyword><keyword>Questionnaires</keyword><keyword>*Vegetables</keyword></keywords><dates><year>2003</year><pub-dates><date>Aug</date></pub-dates></dates><accession-num>12939125</accession-num><urls></urls></record></Cite></EndNote>28LowSRCT
2 primary care centers, Oxfordshire, UK729 participants aged 25-64 
(5.3%)6 months; negotiation to change behavior, print materials, 2-week self-monitoring diaryDelayed intervention0, 6 monthsSignificant 1.4 srv/day greater increase in intervention than controlsBlock et al, 2004  ADDIN EN.CITE <EndNote><Cite><Author>Block</Author><Year>2004</Year><RecNum>191</RecNum><record><rec-number>191</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">191</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Block, G.</author><author>Wakimoto, P.</author><author>Metz, D.</author><author>Fujii, M. L.</author><author>Feldman, N.</author><author>Mandel, R.</author><author>Sutherland, B.</author></authors></contributors><auth-address>Public Health Nutrition Program, School of Public Health, University of California, Berkeley 94720, USA. gblock@berkeley.edu</auth-address><titles><title>A randomized trial of the Little by Little CD-ROM: demonstrated effectiveness in increasing fruit and vegetable intake in a low-income population</title><secondary-title>Preventing Chronic Disease</secondary-title><alt-title>Prev Chronic Dis 1(3):A08</alt-title></titles><periodical><full-title>Preventing Chronic Disease</full-title><abbr-1>Prev Chronic Dis 1(3):A08</abbr-1></periodical><alt-periodical><full-title>Preventing Chronic Disease</full-title><abbr-1>Prev Chronic Dis 1(3):A08</abbr-1></alt-periodical><pages>A08</pages><volume>1</volume><number>3</number><keywords><keyword>*Cd-rom</keyword><keyword>*Diet</keyword><keyword>Female</keyword><keyword>*Fruit</keyword><keyword>Health Education/mt [Methods]</keyword><keyword>*Health Education</keyword><keyword>Health Promotion/mt [Methods]</keyword><keyword>*Health Promotion</keyword><keyword>Humans</keyword><keyword>Middle Aged</keyword><keyword>Poverty</keyword><keyword>Salaries and Fringe Benefits</keyword><keyword>*Vegetables</keyword></keywords><dates><year>2004</year><pub-dates><date>Jul</date></pub-dates></dates><accession-num>15670429</accession-num><urls></urls></record></Cite></EndNote>29LowPTRCTlCommunity-based organizations, California491 African American or Non-Hispanic White, age 40-65, low income, female
(2.0%)One-time experience; Group One: Little-by-Little CD-ROM; Group Two: Little-by-Little CD-ROM plus two reminder phone callsStress management CD-ROM0, 2 monthsNo significant difference in change intakeDiabetes Prevention ProgramMayer-Davis et al, 2004  ADDIN EN.CITE  ADDIN EN.CITE.DATA 30LowPT �=0.10RCT27 clinical centers throughout the US2,934 adults
(9.3%)Lifestyle modification; written materials, annual review with case manager, at least monthly contact with interventionistStandard care, placebo0, 1 yearSignificant >1.5 srv/day greater increase in intervention compared to placeboSteptoe et al, 2004 ADDIN EN.CITE  ADDIN EN.CITE.DATA 31Medium
PTRCTPrimary care center, South London, UK271 participants aged 18-70, low-income
(19.6, 19.6%)2 weeks, behavioral counselingNutrition education0, 8 weeks, 12 monthsSignificant 0.6 srv/day greater increase in intervention compared to controls at 12 monthsPerkins-Porras et al, 2005  ADDIN EN.CITE <EndNote><Cite><Author>Perkins-Porras</Author><Year>2005</Year><RecNum>240</RecNum><record><rec-number>240</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">240</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Perkins-Porras, L.</author><author>Cappuccio, F. P.</author><author>Rink, E.</author><author>Hilton, S.</author><author>McKay, C.</author><author>Steptoe, A.</author></authors></contributors><auth-address>Department of Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK. l.porras@public-health.ucl.ac.uk</auth-address><titles><title>Does the effect of behavioral counseling on fruit and vegetable intake vary with stage of readiness to change?</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 40(3):314-20</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><alt-periodical><full-title>Preventive Medicine</full-title><abbr-1>Prev Med 40(3):314-20</abbr-1></alt-periodical><pages>314-20</pages><volume>40</volume><number>3</number><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>*Behavior Therapy/mt [Methods]</keyword><keyword>*Diet/px [Psychology]</keyword><keyword>Ethnic Groups</keyword><keyword>*Feeding Behavior/px [Psychology]</keyword><keyword>Female</keyword><keyword>*Fruit</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Motivation</keyword><keyword>*Nutrition Therapy/mt [Methods]</keyword><keyword>Socioeconomic Factors</keyword><keyword>Treatment Outcome</keyword><keyword>*Vegetables</keyword></keywords><dates><year>2005</year><pub-dates><date>Mar</date></pub-dates></dates><accession-num>15533545</accession-num><urls></urls></record></Cite></EndNote>32LowPTHealthy Directions � Health Centers StudyEmmons et al, 2005  ADDIN EN.CITE  ADDIN EN.CITE.DATA 33LowPTRCT10 community health centers, greater Boston area2,219 participants, aged 18-75
(11.9, 11.9%)Tailored print materials, 1 in-person and 4 telephone counseling, links to local activities Usual care0, 8 monthsSignificant 0.3 srv/day greater increase in intervention than control at 8 monthsSorensen et al, 2007  ADDIN EN.CITE <EndNote><Cite><Author>Sorensen</Author><Year>2007</Year><RecNum>518</RecNum><record><rec-number>518</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">518</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Sorensen, G.</author><author>Stoddard, A. M.</author><author>Dubowitz, T.</author><author>Barbeau, E. M.</author><author>Bigby, J.</author><author>Emmons, K. M.</author><author>Berkman, L. F.</author><author>Peterson, K. E.</author></authors></contributors><titles><title>The influence of social context on changes in fruit and vegetable consumption: results of the healthy directions studies</title><secondary-title>American Journal of Public Health</secondary-title></titles><periodical><full-title>American Journal of Public Health</full-title><abbr-1>Am J Public Health</abbr-1></periodical><pages>1216-1227</pages><volume>97</volume><number>7</number><keywords><keyword>Diet</keyword><keyword>Fruit</keyword><keyword>Health Behavior -- Ethnology</keyword><keyword>Neoplasms -- Prevention and Control</keyword><keyword>Social Class</keyword><keyword>Vegetables</keyword><keyword>Adult</keyword><keyword>Clinical Trials</keyword><keyword>Ethnic Groups</keyword><keyword>Female</keyword><keyword>Linear Regression</keyword><keyword>Male</keyword><keyword>Massachusetts</keyword><keyword>Middle Age</keyword><keyword>Neoplasms -- Epidemiology</keyword><keyword>Neoplasms -- Ethnology</keyword><keyword>Nutritional Status</keyword><keyword>Risk Assessment</keyword><keyword>Work Environment</keyword></keywords><dates><year>2007</year></dates><isbn>0090-0036</isbn><urls><related-urls><url>Publisher URL: www.cinahl.com/cgi-bin/refsvc?jid=114&amp;accno=2009637431</url><url>http://search.ebscohost.com/login.aspx?direct=true&amp;db=cin20&amp;AN=2009637431&amp;site=ehost-live</url></related-urls></urls></record></Cite></EndNote>34MediumPTHeimendinger et al, 2005  ADDIN EN.CITE <EndNote><Cite><Author>Heimendinger</Author><Year>2005</Year><RecNum>232</RecNum><record><rec-number>232</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">232</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Heimendinger, J.</author><author>O&apos;Neill, C.</author><author>Marcus, A. C.</author><author>Wolfe, P.</author><author>Julesburg, K.</author><author>Morra, M.</author><author>Allen, A.</author><author>Davis, S.</author><author>Mowad, L.</author><author>Perocchia, R. S.</author><author>Ward, J. D.</author><author>Strecher, V.</author><author>Warnecke, R.</author><author>Nowak, M.</author><author>Graf, I.</author><author>Fairclough, D.</author><author>Bryant, L.</author><author>Lipkus, I.</author></authors></contributors><auth-address>AMC Cancer Research Center, Denver, Colorado 80829, USA. Jerianneb@earthlink.net</auth-address><titles><title>Multiple tailored messages are effective in increasing fruit and vegetable consumption among callers to the Cancer Information Service</title><secondary-title>Journal of Health Communication</secondary-title><alt-title>J Health Commun 10 Suppl 1:65-82</alt-title></titles><periodical><full-title>Journal of Health Communication</full-title><abbr-1>J Health Commun 10 Suppl 1:65-82</abbr-1></periodical><alt-periodical><full-title>Journal of Health Communication</full-title><abbr-1>J Health Commun 10 Suppl 1:65-82</abbr-1></alt-periodical><pages>65-82</pages><volume>10 Suppl 1</volume><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>*Diet</keyword><keyword>Female</keyword><keyword>*Fruit</keyword><keyword>*Health Promotion/mt [Methods]</keyword><keyword>Humans</keyword><keyword>*Information Services</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Research Design</keyword><keyword>United States</keyword><keyword>*Vegetables</keyword></keywords><dates><year>2005</year></dates><accession-num>16377601</accession-num><urls></urls></record></Cite></EndNote>35
HighPTRCT6 NCIS regional call centers3,402 callers
(43.4%)11 months; ST: control plus tailored material; MT: control plus multiple tailored material; MRT: control plus multiple re-tailored materialUntailored, brief educational message, print materials0, 5, 12 monthsSignificant 0.6 srv/day greater increase in multiple re-tailored compared to untailored at 12 monthsKreuter et al, 2005  ADDIN EN.CITE  ADDIN EN.CITE.DATA 36MediumSRCT10 urban health centers, St. Louis, MO1,241 low-income African �American women, aged 18-65
(29.0%)18 months; behavioral construct (BCT) and/or culturally relevant tailored (CRT) print materialsDelayed intervention/Usual care1,6,18 monthsNo significant difference at 6 months, 0.4 srv/day greater increase in BCT+CRT group compared to controls at 18 monthsRichards et al, 2006  ADDIN EN.CITE <EndNote><Cite><Author>Richards</Author><Year>2006</Year><RecNum>262</RecNum><record><rec-number>262</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">262</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Richards, A.</author><author>Kattelmann, K. K.</author><author>Ren, C.</author></authors></contributors><auth-address>Nutrition, Food Science, and Hospitality Department, South Dakota State University, Brookings, SD 57707, USA.</auth-address><titles><title>Motivating 18- to 24-year-olds to increase their fruit and vegetable consumption</title><secondary-title>Journal of the American Dietetic Association</secondary-title><alt-title>J Am Diet Assoc 106(9):1405-11</alt-title></titles><periodical><full-title>Journal of the American Dietetic Association</full-title></periodical><alt-periodical><full-title>Journal of the American Dietetic Association</full-title><abbr-1>J Am Diet Assoc 106(9):1405-11</abbr-1></alt-periodical><pages>1405-11</pages><volume>106</volume><number>9</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Algorithms</keyword><keyword>Chi-Square Distribution</keyword><keyword>Diet</keyword><keyword>Female</keyword><keyword>*Fruit</keyword><keyword>Health Education/mt [Methods]</keyword><keyword>*Health Promotion/mt [Methods]</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>*Motivation</keyword><keyword>*Nutrition Physiology/ed [Education]</keyword><keyword>Periodicals as Topic</keyword><keyword>Questionnaires</keyword><keyword>*Self Efficacy</keyword><keyword>Statistics, Nonparametric</keyword><keyword>Students</keyword><keyword>*Vegetables</keyword></keywords><dates><year>2006</year><pub-dates><date>Sep</date></pub-dates></dates><accession-num>16963345</accession-num><urls></urls></record></Cite></EndNote>37MediumSRCTCollege students, Midwest rural land grand university437 students, age 18-24
(28.1%)4 months; stage-matched print material, motivational interviewing, email contactNo materials or contact0, 4 monthsSignificant 0.9 srv/day greater increase in intervention compared to controls at 4 monthsWilliams-Piehota et al, 2006  ADDIN EN.CITE <EndNote><Cite><Author>Williams-Piehota</Author><Year>2006</Year><RecNum>642</RecNum><record><rec-number>642</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">642</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Williams-Piehota, P.</author><author>Pizarro, J.</author><author>Navarro Silvera, S. A.</author><author>Mowad, L.</author><author>Salovey, P.</author><author>Williams-Piehota, Pamela</author><author>Pizarro, Judith</author><author>Navarro Silvera, Stephanie A.</author><author>Mowad, Linda</author><author>Salovey, Peter</author></authors></contributors><titles><title>Need for cognition and message complexity in motivating fruit and vegetable intake among callers to the cancer information service</title><secondary-title>Health Communication</secondary-title></titles><periodical><full-title>Health Communication</full-title></periodical><pages>75-84</pages><volume>19</volume><number>1</number><dates><year>2006</year></dates><accession-num>16519594</accession-num><work-type>Randomized Controlled Trial&#xD;Research Support, N.I.H., Extramural</work-type><urls></urls></record></Cite></EndNote>38HighPTRCTNew England NCIS Call Center517 adult callers
(39.1%)3 months; Complex phone message and tailored print materialSimple phone message and materials0, 1 ,4  monthsAbout 0.2 srv/day greater increase in complex message group than simple message group at 4 monthsSmeets et al, 2007  ADDIN EN.CITE <EndNote><Cite><Author>Smeets</Author><Year>2007</Year><RecNum>297</RecNum><record><rec-number>297</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">297</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Smeets, T.</author><author>Kremers, S. P. J.</author><author>Brug, J.</author><author>de Vries, H.</author></authors></contributors><auth-address>Department of Health Education and Promotion, Maastricht University, The Netherlands. t.smeets@gvo.unimaas.nl</auth-address><titles><title>Effects of tailored feedback on multiple health behaviors.[erratum appears in Ann Behav Med. 2007 Jul-Aug;34(1):104]</title><secondary-title>Annals of Behavioral Medicine</secondary-title><alt-title>Ann Behav Med</alt-title></titles><periodical><full-title>Annals of Behavioral Medicine</full-title></periodical><alt-periodical><full-title>Annals of Behavioral Medicine</full-title><abbr-1>Ann Behav Med</abbr-1></alt-periodical><pages>117-23</pages><volume>33</volume><number>2</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>*Behavior Therapy/mt [Methods]</keyword><keyword>Body Mass Index</keyword><keyword>Diet, Fat-Restricted/px [Psychology]</keyword><keyword>Exercise/px [Psychology]</keyword><keyword>*Feedback, Psychological</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Food Habits/px [Psychology]</keyword><keyword>Fruit</keyword><keyword>*Health Behavior</keyword><keyword>Health Knowledge, Attitudes, Practice</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Motivation</keyword><keyword>Smoking Cessation</keyword><keyword>*Therapy, Computer-Assisted</keyword><keyword>Treatment Outcome</keyword><keyword>Vegetables</keyword></keywords><dates><year>2007</year><pub-dates><date>Apr</date></pub-dates></dates><accession-num>17447863</accession-num><urls></urls></record></Cite></EndNote>39HighPTRCT25 worksites in two towns, national phone directory, The Netherlands2,821 adults
(23.6%)Tailored print materials1 un-tailored letter0, 3 monthsSignificantly smaller decline among intervention than controls at 3 months1Resnicow et al, 2008  ADDIN EN.CITE  ADDIN EN.CITE.DATA 40MediumPT �=0.10RCT2 integrated health-care delivery systems; Atlanta and Detroit metropolitan areas512 African-Americans, aged 21 to 70
(17.4%)Tailored newsletters based on self-determination theory and motivational interviewingNewsletters tailored on demographics and social cognitive variables0, 3 monthsNo significant difference in change in intakeRural Physician Cancer Prevention ProjectCarcaise-Edinboro et al, 2008  ADDIN EN.CITE <EndNote><Cite><Author>Carcaise-Edinboro</Author><Year>2008</Year><RecNum>454</RecNum><record><rec-number>454</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">454</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Carcaise-Edinboro, P.</author><author>McClish, D.</author><author>Kracen, A. C.</author><author>Bowen, D.</author><author>Fries, E.</author></authors></contributors><titles><title>Fruit and vegetable dietary behavior in response to a low-intensity dietary intervention: the rural physician cancer prevention project</title><secondary-title>Journal of Rural Health</secondary-title></titles><periodical><full-title>Journal of Rural Health</full-title></periodical><pages>299-305</pages><volume>24</volume><number>3</number><keywords><keyword>Diet</keyword><keyword>Fruit</keyword><keyword>Neoplasms -- Prevention and Control</keyword><keyword>Physician-Patient Relations</keyword><keyword>Rural Population</keyword><keyword>Vegetables</keyword><keyword>Adult</keyword><keyword>Clinical Trials</keyword><keyword>Female</keyword><keyword>Health Promotion</keyword><keyword>Male</keyword><keyword>Middle Age</keyword><keyword>Program Evaluation</keyword><keyword>Virginia</keyword></keywords><dates><year>2008</year></dates><isbn>0890-765X</isbn><urls><related-urls><url>Publisher URL: www.cinahl.com/cgi-bin/refsvc?jid=1056&amp;accno=2010062236</url><url>http://search.ebscohost.com/login.aspx?direct=true&amp;db=cin20&amp;AN=2010062236&amp;site=ehost-live</url></related-urls></urls></record></Cite></EndNote>41MediumPTRCT3 primary care practices, rural Virginia754 patients, age 18-72
(17.4%)5-8 weeks; recruitment letter, baseline dietary analysis, personalized feedback, print materials, phone callsRecruitment letter, baseline dietary analysis0, 1, 6, 12 monthsNot presented overallDe Vet et al, 2008  ADDIN EN.CITE <EndNote><Cite><Author>de Vet</Author><Year>2008</Year><RecNum>309</RecNum><record><rec-number>309</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">309</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>de Vet, E.</author><author>de Nooijer, J.</author><author>de Vries, N. K.</author><author>Brug, J.</author></authors></contributors><auth-address>Institute of Health Sciences, Vrije Universiteit, Amsterdam, the Netherlands. emely.de.vet@falw.vu.nl</auth-address><titles><title>Testing the transtheoretical model for fruit intake: comparing web-based tailored stage-matched and stage-mismatched feedback</title><secondary-title>Health Education Research</secondary-title><alt-title>Health Educ Res 23(2):218-27</alt-title></titles><periodical><full-title>Health Education Research</full-title><abbr-1>Health Educ Res</abbr-1></periodical><alt-periodical><full-title>Health Education Research</full-title><abbr-1>Health Educ Res 23(2):218-27</abbr-1></alt-periodical><pages>218-27</pages><volume>23</volume><number>2</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Diet/mt [Methods]</keyword><keyword>*Feedback</keyword><keyword>Female</keyword><keyword>*Fruit</keyword><keyword>*Health Education/mt [Methods]</keyword><keyword>Humans</keyword><keyword>*Internet</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Models, Psychological</keyword></keywords><dates><year>2008</year><pub-dates><date>Apr</date></pub-dates></dates><accession-num>17595176</accession-num><urls></urls></record></Cite></EndNote>42MediumPTRCTDutch internet research company775 adult
(26.1%)One-time experience; stage-matched feedbackNon-stage-matched feedback0, 2-9, 9-16 daysNo significant difference in change intakeEM: Effect modification
S: Stratified analysis
PT: product term
Loss to f/up: Loss to follow-upRCT: Randomized controlled trial
cRT: cluster-randomized trial
WIC:Women, Infants and Children
NCIS: National Cancer Information ServiceHMO: Health Maintenance Organization
Notes:
1. no change in fruit vs 0.2 pieces/day decline; 0.5 gm decline in vegetables vs. 10.4 gm/day decline in intervention and controls respectively
	

Table 2.  Potential effect modifiers examined: demographic characteristics 
Trial NameCitationMale              (vs. Female)Older AgeHigher EducationMarriedHigher IncomeWhite            (vs. Non-White)Immigrant/ Birth statusEmployedLiving situationOccupationCar access (Yes  vs. No)N/AGambera et al,1995  ADDIN EN.CITE <EndNote><Cite><Author>Gambera</Author><Year>1995</Year><RecNum>614</RecNum><record><rec-number>614</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">614</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Gambera, P. J.</author><author>Schneeman, B. O.</author><author>Davis, P. A.</author></authors></contributors><titles><title>Use of the Food Guide Pyramid and US Dietary Guidelines to improve dietary intake and reduce cardiovascular risk in active-duty Air Force members</title><secondary-title>Journal of the American Dietetic Association</secondary-title></titles><periodical><full-title>Journal of the American Dietetic Association</full-title></periodical><pages>1268-73</pages><volume>95</volume><number>11</number><dates><year>1995</year><pub-dates><date>Nov</date></pub-dates></dates><accession-num>7594122</accession-num><work-type>Clinical Trial&#xD;Randomized Controlled Trial&#xD;Research Support, U.S. Gov&apos;t, Non-P.H.S.</work-type><urls></urls></record></Cite></EndNote>15(-)1Maryland WIC 5-a-Day Promotion ProgramHavas et al, 1998  ADDIN EN.CITE  ADDIN EN.CITE.DATA 16(-)(+)(+)(+)2(-)Campbell et al, 2008  ADDIN EN.CITE  ADDIN EN.CITE.DATA 17N/AMarcus et al, 1998  ADDIN EN.CITE <EndNote><Cite><Author>Marcus</Author><Year>1998</Year><RecNum>85</RecNum><record><rec-number>85</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">85</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Marcus, A. C.</author><author>Heimendinger, J.</author><author>Wolfe, P.</author><author>Rimer, B. K.</author><author>Morra, M.</author><author>Cox, D.</author><author>Lang, P. J.</author><author>Stengle, W.</author><author>Van Herle, M. P.</author><author>Wagner, D.</author><author>Fairclough, D.</author><author>Hamilton, L.</author></authors></contributors><auth-address>AMC Cancer Research Center, Denver, Colorado, 80214, USA.</auth-address><titles><title>Increasing fruit and vegetable consumption among callers to the CIS: results from a randomized trial</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><alt-periodical><full-title>Preventive Medicine</full-title><abbr-1>Prev Med</abbr-1></alt-periodical><pages>S16-28</pages><volume>27</volume><number>5 Pt 1</number><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Female</keyword><keyword>*Food Habits</keyword><keyword>Fruit</keyword><keyword>*Health Education/mt [Methods]</keyword><keyword>Humans</keyword><keyword>*Information Services</keyword><keyword>Likelihood Functions</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Multivariate Analysis</keyword><keyword>*Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>Pilot Projects</keyword><keyword>Program Evaluation</keyword><keyword>Telephone</keyword><keyword>United States</keyword><keyword>Vegetables</keyword></keywords><dates><year>1998</year><pub-dates><date>Sep-Oct</date></pub-dates></dates><isbn>0091-7435</isbn><accession-num>9808821</accession-num><urls></urls></record></Cite></EndNote>18(0)(0)(0)Black Churches United for Better Health ProjectCampbell et al, 1999  ADDIN EN.CITE  ADDIN EN.CITE.DATA 19(0)(+)(0)(+)3(0)Campbell et al, 2008  ADDIN EN.CITE  ADDIN EN.CITE.DATA 17Women�s Health TrialCoates et al, 1999  ADDIN EN.CITE  ADDIN EN.CITE.DATA 20(0)(0)4Treatwell 5 a Day Sorensen et al, 1999  ADDIN EN.CITE  ADDIN EN.CITE.DATA 21(0)(0)(0)5(0)Campbell et al, 2008  ADDIN EN.CITE  ADDIN EN.CITE.DATA 17Next Step TrialTilley et al, 1999  ADDIN EN.CITE <EndNote><Cite><Author>Tilley</Author><Year>1999</Year><RecNum>124</RecNum><record><rec-number>124</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">124</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Tilley, B. C.</author><author>Glanz, K.</author><author>Kristal, A. R.</author><author>Hirst, K.</author><author>Li, S.</author><author>Vernon, S. W.</author><author>Myers, R.</author></authors></contributors><auth-address>Department of Biostatistics and Research Epidemiology, Henry Ford Health Sciences Center, Detroit, Michigan, USA.</auth-address><titles><title>Nutrition intervention for high-risk auto workers: results of the Next Step Trial</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 28(3):284-92</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><alt-periodical><full-title>Preventive Medicine</full-title><abbr-1>Prev Med 28(3):284-92</abbr-1></alt-periodical><pages>284-92</pages><volume>28</volume><number>3</number><keywords><keyword>Adult</keyword><keyword>Automobiles</keyword><keyword>Colorectal Neoplasms/et [Etiology]</keyword><keyword>*Colorectal Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>Diet/px [Psychology]</keyword><keyword>Diet, Fat-Restricted</keyword><keyword>Dietary Fiber</keyword><keyword>Energy Metabolism</keyword><keyword>Female</keyword><keyword>Health Behavior</keyword><keyword>*Health Education/og [Organization &amp; Administration]</keyword><keyword>Humans</keyword><keyword>Industry</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Nutrition Physiology/ed [Education]</keyword><keyword>*Occupational Health Services/og [Organization &amp; Administration]</keyword><keyword>Questionnaires</keyword></keywords><dates><year>1999</year><pub-dates><date>Mar</date></pub-dates></dates><accession-num>10072747</accession-num><urls></urls></record></Cite></EndNote>22(0)(0)(0)6Puget Sound Healthy Eating Patterns Study Kristal et al, 2000  ADDIN EN.CITE <EndNote><Cite><Author>Kristal</Author><Year>2000</Year><RecNum>134</RecNum><record><rec-number>134</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">134</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kristal, A. R.</author><author>Curry, S. J.</author><author>Shattuck, A. L.</author><author>Feng, Z.</author><author>Li, S.</author></authors></contributors><auth-address>Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA. akristal@fhcrc.org</auth-address><titles><title>A randomized trial of a tailored, self-help dietary intervention: the Puget Sound Eating Patterns study</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 31(4):380-9</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><alt-periodical><full-title>Preventive Medicine</full-title><abbr-1>Prev Med 31(4):380-9</abbr-1></alt-periodical><pages>380-9</pages><volume>31</volume><number>4</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Body Mass Index</keyword><keyword>Cohort Studies</keyword><keyword>*Diet, Fat-Restricted/mt [Methods]</keyword><keyword>Dietary Fiber/ad [Administration &amp; Dosage]</keyword><keyword>Feasibility Studies</keyword><keyword>Female</keyword><keyword>*Food Habits</keyword><keyword>*Fruit</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Obesity/dh [Diet Therapy]</keyword><keyword>Questionnaires</keyword><keyword>Risk Factors</keyword><keyword>Treatment Outcome</keyword><keyword>*Vegetables</keyword><keyword>Washington</keyword></keywords><dates><year>2000</year><pub-dates><date>Oct</date></pub-dates></dates><accession-num>11006063</accession-num><urls></urls></record></Cite></EndNote>23(0)(+)(-)7Satia et al, 2001  ADDIN EN.CITE <EndNote><Cite><Author>Satia</Author><Year>2001</Year><RecNum>156</RecNum><record><rec-number>156</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">156</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Satia, J. A.</author><author>Kristal, A. R.</author><author>Curry, S.</author><author>Trudeau, E.</author></authors></contributors><auth-address>Fred Hutchinson Cancer Research Center, Cancer Prevention Research Program, Seattle, WA 98109-1024, USA. jsatia@fhcrc.org.</auth-address><titles><title>Motivations for healthful dietary change</title><secondary-title>Public Health Nutrition</secondary-title><alt-title>Public Health Nutr 4(5):953-9</alt-title></titles><periodical><full-title>Public Health Nutrition</full-title><abbr-1>Public Health Nutr</abbr-1></periodical><alt-periodical><full-title>Public Health Nutrition</full-title><abbr-1>Public Health Nutr 4(5):953-9</abbr-1></alt-periodical><pages>953-9</pages><volume>4</volume><number>5</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>*Diet/px [Psychology]</keyword><keyword>*Dietary Fats/ad [Administration &amp; Dosage]</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>*Food Habits/px [Psychology]</keyword><keyword>*Fruit</keyword><keyword>Health Behavior</keyword><keyword>Health Status</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Motivation</keyword><keyword>Peer Group</keyword><keyword>Self Concept</keyword><keyword>*Vegetables</keyword><keyword>0 (Dietary Fats)</keyword></keywords><dates><year>2001</year><pub-dates><date>Oct</date></pub-dates></dates><accession-num>11784408</accession-num><urls></urls></record></Cite></EndNote>24Eat for Life TrialResnicow et al,2001 ADDIN EN.CITE  ADDIN EN.CITE.DATA 25(0)(0)(0)(0)Resnicow et al, 2003  ADDIN EN.CITE <EndNote><Cite><Author>Resnicow</Author><Year>2003</Year><RecNum>183</RecNum><record><rec-number>183</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">183</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Resnicow, K.</author><author>McCarty, F.</author><author>Baranowski, T.</author></authors></contributors><auth-address>School of Public Health, University of Michagan, Ann Arbor, MI 48109, USA. kresnic@sph.emory.edu</auth-address><titles><title>Are precontemplators less likely to change their dietary behavior? A prospective analysis</title><secondary-title>Health Education Research</secondary-title><alt-title>Health Educ Res 18(6):693-705</alt-title></titles><periodical><full-title>Health Education Research</full-title><abbr-1>Health Educ Res</abbr-1></periodical><alt-periodical><full-title>Health Education Research</full-title><abbr-1>Health Educ Res 18(6):693-705</abbr-1></alt-periodical><pages>693-705</pages><volume>18</volume><number>6</number><keywords><keyword>Adaptation, Psychological</keyword><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>*African Continental Ancestry Group/px [Psychology]</keyword><keyword>Aged</keyword><keyword>*Diet/px [Psychology]</keyword><keyword>Female</keyword><keyword>Food Habits/px [Psychology]</keyword><keyword>Fruit</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Models, Psychological</keyword><keyword>*Motivation</keyword><keyword>Prospective Studies</keyword><keyword>*Religion and Psychology</keyword><keyword>Vegetables</keyword></keywords><dates><year>2003</year><pub-dates><date>Dec</date></pub-dates></dates><accession-num>14654502</accession-num><urls></urls></record></Cite></EndNote>26fMaryland WIC Food for Life ProgramHavas et al, 2003  ADDIN EN.CITE  ADDIN EN.CITE.DATA 27(+)(+)(0)8N/AJohn et al, 2003  ADDIN EN.CITE <EndNote><Cite><Author>John</Author><Year>2003</Year><RecNum>179</RecNum><record><rec-number>179</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">179</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>John, J. H.</author><author>Yudkin, P. L.</author><author>Neil, H. A.</author><author>Ziebland, S.</author></authors></contributors><auth-address>Division of Public Health and Primary Health Care, University of Oxford, Institute of HeOX3alth Sciences, Old Road, Headington, Oxford OX3 7LF, UK.</auth-address><titles><title>Does stage of change predict outcome in a primary-care intervention to encourage an increase in fruit and vegetable consumption?</title><secondary-title>Health Education Research</secondary-title><alt-title>Health Educ Res 18(4):429-38</alt-title></titles><periodical><full-title>Health Education Research</full-title><abbr-1>Health Educ Res</abbr-1></periodical><alt-periodical><full-title>Health Education Research</full-title><abbr-1>Health Educ Res 18(4):429-38</abbr-1></alt-periodical><pages>429-38</pages><volume>18</volume><number>4</number><keywords><keyword>Adult</keyword><keyword>Case-Control Studies</keyword><keyword>Female</keyword><keyword>*Food Habits</keyword><keyword>*Fruit</keyword><keyword>Great Britain</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Primary Health Care</keyword><keyword>Questionnaires</keyword><keyword>*Vegetables</keyword></keywords><dates><year>2003</year><pub-dates><date>Aug</date></pub-dates></dates><accession-num>12939125</accession-num><urls></urls></record></Cite></EndNote>28N/ABlock et al, 2004  ADDIN EN.CITE <EndNote><Cite><Author>Block</Author><Year>2004</Year><RecNum>191</RecNum><record><rec-number>191</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">191</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Block, G.</author><author>Wakimoto, P.</author><author>Metz, D.</author><author>Fujii, M. 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Notes:
1.2 srv/day greater increase among women in intervention than men in intervention.  No comparison with control group.
Most effective among white (0.73 srv/day greater in intervention) and other (1.72 srv/day greater increase).  May be due to unstable estimates in the �other� group.
Intervention most effective among those married (+0.81 srv/day), widow, divorced, or other (0.92 srv/day).  Less effective among those single (+0.28 srv/day)
Intervention most effective among whites (+0.71 srv/day at 6 months), less effective among Hispanics (+0.28 srv/day at 6 months) and blacks (+0.55 srv/day at 6 months)
Alone or with others
Retirement status
More effective among those living alone or with adults (0.64 srv/day) than those with children (0.15 srv/day)
Blacks increased -0.39 srv/day in controls, 0.09 in intervention.  Whites increased -0.02 srv/day in controls, 0.27 srv/day in intervention
Poverty status
Respondent�s and respondents� parents� country of birth
Crowding in household
Table 3.  Potential effect modifiers examined: psychosocial, social-contextual, health, and food habits 
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A.</author></authors></contributors><titles><title>Use of the Food Guide Pyramid and US Dietary Guidelines to improve dietary intake and reduce cardiovascular risk in active-duty Air Force members</title><secondary-title>Journal of the American Dietetic Association</secondary-title></titles><periodical><full-title>Journal of the American Dietetic Association</full-title></periodical><pages>1268-73</pages><volume>95</volume><number>11</number><dates><year>1995</year><pub-dates><date>Nov</date></pub-dates></dates><accession-num>7594122</accession-num><work-type>Clinical Trial&#xD;Randomized Controlled Trial&#xD;Research Support, U.S. Gov&apos;t, Non-P.H.S.</work-type><urls></urls></record></Cite></EndNote>15Maryland WIC 5-a-Day Promotion ProgramHavas et al, 1998  ADDIN EN.CITE  ADDIN EN.CITE.DATA 16(0)1Campbell et al, 2008  ADDIN EN.CITE  ADDIN EN.CITE.DATA 17(0)N/AMarcus et al, 1998  ADDIN EN.CITE <EndNote><Cite><Author>Marcus</Author><Year>1998</Year><RecNum>85</RecNum><record><rec-number>85</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">85</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Marcus, A. C.</author><author>Heimendinger, J.</author><author>Wolfe, P.</author><author>Rimer, B. K.</author><author>Morra, M.</author><author>Cox, D.</author><author>Lang, P. J.</author><author>Stengle, W.</author><author>Van Herle, M. 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Notes:
Reported as significant in paper.  However, estimated effects are within 2 SEs of one another.
About 1 srv/day increase among all stages except maintenance which had no change
Greatest intervention effect among contemplators (~1.6 srv/day greater intervention effect) than pre-contemplators (0.4 srv/day) or preparation (~-0.2 srv/day)
0.5 srv/day greater intervention effect among pre-action than action group
References
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Appendix 1
Intervention-related search terms. Adapted from Brunner et al. ADDIN EN.CITE <EndNote><Cite><Author>Brunner</Author><Year>2005</Year><RecNum>304</RecNum><record><rec-number>304</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">304</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Brunner, E. J.</author><author>Thorogood, M.</author><author>Rees, K.</author><author>Hewitt, G.</author></authors></contributors><titles><title>Dietary advice for reducing cardiovascular risk</title><secondary-title>Cochrane Database Syst Rev</secondary-title></titles><periodical><full-title>Cochrane Database Syst Rev</full-title></periodical><pages>CD002128</pages><number>4</number><keywords><keyword>57-88-5 (Cholesterol)</keyword><keyword>Cardiovascular Diseases/*prevention &amp; control</keyword><keyword>Cholesterol/blood</keyword><keyword>*Diet</keyword><keyword>Diet, Fat-Restricted</keyword><keyword>Dietetics/*methods</keyword><keyword>Humans</keyword><keyword>Randomized Controlled Trials</keyword></keywords><dates><year>2005</year><pub-dates><date>2005</date></pub-dates></dates><isbn>1469-493X (Electronic)</isbn><accession-num>16235299</accession-num><urls><related-urls><url>file:///C|/Documents%20and%20Settings/Owner/Local%20Settings/Application%20Data/Quosa/Data/My%20Citations/fpn3rdt4s19470qjheifij5c5k.qpw</url><url>http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Citation&amp;list_uids=16235299 </url></related-urls></urls><language>eng</language></record></Cite></EndNote>64, Hillsdon et al. ADDIN EN.CITE <EndNote><Cite><Author>Hillsdon</Author><Year>2005</Year><RecNum>111</RecNum><record><rec-number>111</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">111</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Foster, C.</author><author>Hillsdon, M.</author><author>Thorogood, M.</author></authors></contributors><titles><title>Interventions for promoting physical activity</title><secondary-title>Cochrane Database Syst Rev</secondary-title></titles><periodical><full-title>Cochrane Database Syst Rev</full-title></periodical><pages>CD003180. pub2.</pages><number>1</number><keywords><keyword>*Exercise</keyword><keyword>Health Promotion/*methods</keyword><keyword>Humans</keyword><keyword>Physical Fitness</keyword><keyword>Randomized Controlled Trials</keyword></keywords><dates><year>2005</year><pub-dates><date>2005</date></pub-dates></dates><isbn>1469-493X (Electronic)</isbn><accession-num>15674903</accession-num><urls><related-urls><url>file:///C|/Documents%20and%20Settings/Owner/Local%20Settings/Application%20Data/Quosa/Data/My%20Citations/m7vvf0sgesjk70pfb4c6db1dvs.qpw</url><url>http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Citation&amp;list_uids=15674903 </url></related-urls></urls><electronic-resource-num>DOI: 10.1002/14651858</electronic-resource-num><language>eng</language></record></Cite></EndNote>12, Kremers et al, ADDIN EN.CITE <EndNote><Cite><Author>Kremers</Author><Year>2007</Year><RecNum>473</RecNum><record><rec-number>473</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">473</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kremers, S. P.</author><author>de Bruijn, G. J.</author><author>Droomers, M.</author><author>van Lenthe, F.</author><author>Brug, J.</author></authors></contributors><titles><title>Moderators of environmental intervention effects on diet and activity in youth</title><secondary-title>Am J Prev Med</secondary-title></titles><periodical><full-title>Am J Prev Med</full-title></periodical><pages>163-72</pages><volume>32</volume><number>2</number><keywords><keyword>Adolescent</keyword><keyword>Australia</keyword><keyword>Child</keyword><keyword>Child, Preschool</keyword><keyword>*Diet</keyword><keyword>*Environment</keyword><keyword>*Exercise</keyword><keyword>Humans</keyword><keyword>United States</keyword></keywords><dates><year>2007</year><pub-dates><date>2007 Feb</date></pub-dates></dates><isbn>0749-3797 (Print)</isbn><accession-num>17197152</accession-num><urls><related-urls><url>file:///C|/Documents%20and%20Settings/Owner/Local%20Settings/Application%20Data/Quosa/Data/My%20Citations/j20gcv631lk4dfi3sa138s2jq8.qpw</url><url>http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Citation&amp;list_uids=17197152 </url></related-urls></urls><language>eng</language></record></Cite></EndNote>13.  Combined using the �or� operator.
explode �Communication�/ all subheadings
explode �Practice-Guidelines�/ all subheadings
explode �Counseling� tree: 3/ all subheadings
explode �Diet-Therapy�/ all subheadings
explode �Health-Education�/ all subheadings
explode �Life-Style�/ all subheadings
diet* adj (therap* or educat* or counsel* or intervention* or treatment*)
nutriti* adj (therap* or educat* or counsel* or intervention*)
health adj (therap* or counsel* or educat*)
group adj counsel*
brief adj intervention*
health adj behav* adj intervention*
advice
leaflet*
video*
guideline*
lifestyle* near chang*
diet* near chang*
intake* near (increas* or decreas* or reduc* or rais* or low* or
chang* or restrict* or high*)
consumption near (increas* or decreas* or reduc* or rais* or low*
or chang* or restrict* or high*)
(salt or sodium) near (decreas* or reduc* or low* or chang* or
restrict*)
(fat* or cholesterol) near (decreas* or reduc* or low* or chang* or
restrict*)
(fish or fruit* or vegetable*) near (increas* or rais* or chang* or
high*)
Health education/
Primary prevention/
Health promotion/
Behaviour therapy
Cognitive therapy
Primary health care
Workplace/
promot$.tw.
educat$.tw.
program$.tw.
health promotion
intervention

Diet-related search terms. Adapted from Brunner et al. ADDIN EN.CITE <EndNote><Cite><Author>Brunner</Author><Year>2005</Year><RecNum>304</RecNum><record><rec-number>304</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">304</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Brunner, E. J.</author><author>Thorogood, M.</author><author>Rees, K.</author><author>Hewitt, G.</author></authors></contributors><titles><title>Dietary advice for reducing cardiovascular risk</title><secondary-title>Cochrane Database Syst Rev</secondary-title></titles><periodical><full-title>Cochrane Database Syst Rev</full-title></periodical><pages>CD002128</pages><number>4</number><keywords><keyword>57-88-5 (Cholesterol)</keyword><keyword>Cardiovascular Diseases/*prevention &amp; control</keyword><keyword>Cholesterol/blood</keyword><keyword>*Diet</keyword><keyword>Diet, Fat-Restricted</keyword><keyword>Dietetics/*methods</keyword><keyword>Humans</keyword><keyword>Randomized Controlled Trials</keyword></keywords><dates><year>2005</year><pub-dates><date>2005</date></pub-dates></dates><isbn>1469-493X (Electronic)</isbn><accession-num>16235299</accession-num><urls><related-urls><url>file:///C|/Documents%20and%20Settings/Owner/Local%20Settings/Application%20Data/Quosa/Data/My%20Citations/fpn3rdt4s19470qjheifij5c5k.qpw</url><url>http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Citation&amp;list_uids=16235299 </url></related-urls></urls><language>eng</language></record></Cite></EndNote>64 and Kremers et al ADDIN EN.CITE <EndNote><Cite><Author>Kremers</Author><Year>2007</Year><RecNum>473</RecNum><record><rec-number>473</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">473</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kremers, S. P.</author><author>de Bruijn, G. J.</author><author>Droomers, M.</author><author>van Lenthe, F.</author><author>Brug, J.</author></authors></contributors><titles><title>Moderators of environmental intervention effects on diet and activity in youth</title><secondary-title>Am J Prev Med</secondary-title></titles><periodical><full-title>Am J Prev Med</full-title></periodical><pages>163-72</pages><volume>32</volume><number>2</number><keywords><keyword>Adolescent</keyword><keyword>Australia</keyword><keyword>Child</keyword><keyword>Child, Preschool</keyword><keyword>*Diet</keyword><keyword>*Environment</keyword><keyword>*Exercise</keyword><keyword>Humans</keyword><keyword>United States</keyword></key +,/09:DERSW]^_`ijst�������������������������������������������Ŷ�����������~q~h�L}CJH*OJQJaJh�
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(words><dates><year>2007</year><pub-dates><date>2007 Feb</date></pub-dates></dates><isbn>0749-3797 (Print)</isbn><accession-num>17197152</accession-num><urls><related-urls><url>file:///C|/Documents%20and%20Settings/Owner/Local%20Settings/Application%20Data/Quosa/Data/My%20Citations/j20gcv631lk4dfi3sa138s2jq8.qpw</url><url>http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Citation&amp;list_uids=17197152 </url></related-urls></urls><language>eng</language></record></Cite></EndNote>13.  Combined using the �or� operator.
explode �Fruit�/ all subheadings
explode �Vegetables�/ all subheadings
explode �Food-Habits�/ all subheadings
�Diet�/ all subheadings
�Diet-Therapy�/ all subheadings
diet* in ti,ab
food* in ti,ab
mediterranean* in ti,ab
vegetable* in ti,ab
fruit* in ti,ab
legum* in ti,ab
roughage in ti,ab
5-a-day
food habits
food
fruit and vegetable consumption
fruits
nutrition
Diet- and intervention-related search terms were combined using the �and� operator.








 PAGE   \* MERGEFORMAT 23




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W.</author></authors></contributors><auth-address>School of Public Health, University of North Carolina, Chapel Hill 27599, USA. marci_campbell@unc.edu</auth-address><titles><title>Fruit and vegetable consumption and prevention of cancer: the Black Churches United for Better Health project</title><secondary-title>American Journal of Public Health</secondary-title><alt-title>Am J Public Health 89(9):1390-6</alt-title></titles><periodical><full-title>American Journal of Public Health</full-title></periodical><alt-periodical><full-title>American Journal of Public Health</full-title><abbr-1>Am J Public Health 89(9):1390-6</abbr-1></alt-periodical><pages>1390-6</pages><volume>89</volume><number>9</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>*African Americans</keyword><keyword>Age Factors</keyword><keyword>Aged</keyword><keyword>*Clergy</keyword><keyword>Educational Status</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>*Food Habits/eh [Ethnology]</keyword><keyword>*Fruit</keyword><keyword>*Health Knowledge, Attitudes, Practice</keyword><keyword>*Health Promotion/og [Organization &amp; Administration]</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Marital Status</keyword><keyword>Middle Aged</keyword><keyword>Neoplasms/eh [Ethnology]</keyword><keyword>*Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>North Carolina</keyword><keyword>Program Evaluation</keyword><keyword>Questionnaires</keyword><keyword>*Religion</keyword><keyword>Rural Health</keyword><keyword>*Vegetables</keyword></keywords><dates><year>1999</year><pub-dates><date>Sep</date></pub-dates></dates><accession-num>10474558</accession-num><urls></urls></record></Cite><Cite><Author>Coates</Author><Year>1999</Year><RecNum>1323</RecNum><record><rec-number>1323</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1323</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Coates, R. 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K.</author></authors></contributors><auth-address>Department of Epidemiology, Emory University, Atlanta, GA, USA.</auth-address><titles><title>The Women&apos;s Health Trial Feasibility Study in Minority Populations: changes in dietary intakes</title><secondary-title>American Journal of Epidemiology</secondary-title><alt-title>Am J Epidemiol 149(12):1104-12</alt-title></titles><periodical><full-title>American Journal of Epidemiology</full-title><abbr-1>Am J Epidemiol 149(12):1104-12</abbr-1></periodical><alt-periodical><full-title>American Journal of Epidemiology</full-title><abbr-1>Am J Epidemiol 149(12):1104-12</abbr-1></alt-periodical><pages>1104-12</pages><volume>149</volume><number>12</number><keywords><keyword>Aged</keyword><keyword>Alabama/ep [Epidemiology]</keyword><keyword>*Dietary Fats/ad [Administration &amp; Dosage]</keyword><keyword>*Energy Intake</keyword><keyword>Feasibility Studies</keyword><keyword>Female</keyword><keyword>Florida/ep [Epidemiology]</keyword><keyword>Georgia/ep [Epidemiology]</keyword><keyword>Humans</keyword><keyword>Middle Aged</keyword><keyword>*Minority Groups/sn [Statistics &amp; Numerical Data]</keyword><keyword>Nutrition Surveys</keyword><keyword>*Women&apos;s Health</keyword><keyword>0 (Dietary Fats)</keyword></keywords><dates><year>1999</year><pub-dates><date>Jun 15</date></pub-dates></dates><accession-num>10369504</accession-num><urls></urls></record></Cite><Cite><Author>Sorensen</Author><Year>1999</Year><RecNum>1339</RecNum><record><rec-number>1339</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1339</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Sorensen, G.</author><author>Stoddard, A.</author><author>Peterson, K.</author><author>Cohen, N.</author><author>Hunt, M. 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N.</author><author>Baranowski, T.</author></authors></contributors><auth-address>Rollins School of Public Health, Emory University, 1520 Clifton Rd, Atlanta, GA 30322 (kresnic@sph.emory.edu)</auth-address><titles><title>A motivational interviewing intervention to increase fruit and vegetable intake through black churches: results of the Eat for Life Trial</title><secondary-title>American Journal of Public Health</secondary-title></titles><periodical><full-title>American Journal of Public Health</full-title></periodical><pages>1686-1693</pages><volume>91</volume><number>10</number><keywords><keyword>Blacks -- Psychosocial Factors</keyword><keyword>Motivation</keyword><keyword>Interviews -- Methods</keyword><keyword>Religion and Psychology</keyword><keyword>Fruit -- Therapeutic Use</keyword><keyword>Vegetables -- Therapeutic Use</keyword><keyword>Nutritional Counseling</keyword><keyword>Funding Source</keyword><keyword>Intervention Trials</keyword><keyword>Georgia</keyword><keyword>Random Assignment</keyword><keyword>Cultural Sensitivity</keyword><keyword>Support, Psychosocial</keyword><keyword>Focus Groups</keyword><keyword>Telephone</keyword><keyword>Behavioral Changes</keyword><keyword>Questionnaires</keyword><keyword>Food Habits</keyword><keyword>Validity</keyword><keyword>Coefficient Alpha</keyword><keyword>Self-Efficacy</keyword><keyword>Repeated Measures</keyword><keyword>Analysis of Variance</keyword><keyword>Data Analysis Software</keyword><keyword>P-Value</keyword><keyword>Statistical Significance</keyword><keyword>Male</keyword><keyword>Female</keyword><keyword>Adult</keyword><keyword>Middle Age</keyword><keyword>Aged</keyword><keyword>Aged, 80 and Over</keyword></keywords><dates><year>2001</year></dates><isbn>0090-0036</isbn><urls><related-urls><url>Publisher URL: www.cinahl.com/cgi-bin/refsvc?jid=114&amp;accno=2002137590</url><url>http://search.ebscohost.com/login.aspx?direct=true&amp;db=cin20&amp;AN=2002137590&amp;site=ehost-live</url></related-urls></urls></record></Cite><Cite><Author>Resnicow</Author><Year>2003</Year><RecNum>1335</RecNum><record><rec-number>1335</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1335</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Resnicow, K.</author><author>McCarty, F.</author><author>Baranowski, T.</author></authors></contributors><auth-address>School of Public Health, University of Michagan, Ann Arbor, MI 48109, USA. kresnic@sph.emory.edu</auth-address><titles><title>Are precontemplators less likely to change their dietary behavior? 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Redwood Street, Baltimore, MD 21201, USA. shavas@epi.umaryland.edu</auth-address><titles><title>Final results of the Maryland WIC Food for Life Program.[erratum appears in Prev Med. 2004 May;38(5):668]</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 37(5):406-16</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><pages>406-16</pages><volume>37</volume><number>5</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Cross-Over Studies</keyword><keyword>Diet Surveys</keyword><keyword>Dietary Fats</keyword><keyword>Dietary Fiber</keyword><keyword>*Energy Intake</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Food Habits/px [Psychology]</keyword><keyword>*Food Services/og [Organization &amp; Administration]</keyword><keyword>Fruit</keyword><keyword>*Health Education/og [Organization &amp; Administration]</keyword><keyword>Health Knowledge, Attitudes, Practice</keyword><keyword>Humans</keyword><keyword>Maryland</keyword><keyword>*Maternal Nutrition Physiology/ed [Education]</keyword><keyword>*Mothers/ed [Education]</keyword><keyword>Mothers/px [Psychology]</keyword><keyword>Neoplasms/et [Etiology]</keyword><keyword>*Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>Poverty/px [Psychology]</keyword><keyword>*Poverty</keyword><keyword>Program Evaluation</keyword><keyword>Regression Analysis</keyword><keyword>Vegetables</keyword><keyword>0 (Dietary Fats)</keyword></keywords><dates><year>2003</year><pub-dates><date>Nov</date></pub-dates></dates><accession-num>14572425</accession-num><urls></urls></record></Cite></EndNote>�&D<EndNote><Cite><Author>Kristal</Author><Year>2000</Year><RecNum>1332</RecNum><record><rec-number>1332</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1332</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kristal, A. 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A prospective analysis</title><secondary-title>Health Education Research</secondary-title><alt-title>Health Educ Res 18(6):693-705</alt-title></titles><periodical><full-title>Health Education Research</full-title><abbr-1>Health Educ Res 18(4):429-38</abbr-1></periodical><alt-periodical><full-title>Health Education Research</full-title><abbr-1>Health Educ Res 18(6):693-705</abbr-1></alt-periodical><pages>693-705</pages><volume>18</volume><number>6</number><keywords><keyword>Adaptation, Psychological</keyword><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>*African Continental Ancestry Group/px [Psychology]</keyword><keyword>Aged</keyword><keyword>*Diet/px [Psychology]</keyword><keyword>Female</keyword><keyword>Food Habits/px [Psychology]</keyword><keyword>Fruit</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Models, Psychological</keyword><keyword>*Motivation</keyword><keyword>Prospective Studies</keyword><keyword>*Religion and Psychology</keyword><keyword>Vegetables</keyword></keywords><dates><year>2003</year><pub-dates><date>Dec</date></pub-dates></dates><accession-num>14654502</accession-num><urls></urls></record></Cite><Cite><Author>Kristal</Author><Year>2000</Year><RecNum>1332</RecNum><record><rec-number>1332</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1332</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kristal, A. R.</author><author>Curry, S. J.</author><author>Shattuck, A. L.</author><author>Feng, Z.</author><author>Li, S.</author></authors></contributors><auth-address>Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA. akristal@fhcrc.org</auth-address><titles><title>A randomized trial of a tailored, self-help dietary intervention: the Puget Sound Eating Patterns study</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 31(4):380-9</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><pages>380-9</pages><volume>31</volume><number>4</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Body Mass Index</keyword><keyword>Cohort Studies</keyword><keyword>*Diet, Fat-Restricted/mt [Methods]</keyword><keyword>Dietary Fiber/ad [Administration &amp; Dosage]</keyword><keyword>Feasibility Studies</keyword><keyword>Female</keyword><keyword>*Food Habits</keyword><keyword>*Fruit</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Obesity/dh [Diet Therapy]</keyword><keyword>Questionnaires</keyword><keyword>Risk Factors</keyword><keyword>Treatment Outcome</keyword><keyword>*Vegetables</keyword><keyword>Washington</keyword></keywords><dates><year>2000</year><pub-dates><date>Oct</date></pub-dates></dates><accession-num>11006063</accession-num><urls></urls></record></Cite><Cite><Author>Havas</Author><Year>2003</Year><RecNum>1328</RecNum><record><rec-number>1328</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1328</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Havas, S.</author><author>Anliker, J.</author><author>Greenberg, D.</author><author>Block, G.</author><author>Block, T.</author><author>Blik, C.</author><author>Langenberg, P.</author><author>DiClemente, C.</author></authors></contributors><auth-address>Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 660 W. Redwood Street, Baltimore, MD 21201, USA. shavas@epi.umaryland.edu</auth-address><titles><title>Final results of the Maryland WIC Food for Life Program.[erratum appears in Prev Med. 2004 May;38(5):668]</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 37(5):406-16</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><pages>406-16</pages><volume>37</volume><number>5</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Cross-Over Studies</keyword><keyword>Diet Surveys</keyword><keyword>Dietary Fats</keyword><keyword>Dietary Fiber</keyword><keyword>*Energy Intake</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Food Habits/px [Psychology]</keyword><keyword>*Food Services/og [Organization &amp; Administration]</keyword><keyword>Fruit</keyword><keyword>*Health Education/og [Organization &amp; Administration]</keyword><keyword>Health Knowledge, Attitudes, Practice</keyword><keyword>Humans</keyword><keyword>Maryland</keyword><keyword>*Maternal Nutrition Physiology/ed [Education]</keyword><keyword>*Mothers/ed [Education]</keyword><keyword>Mothers/px [Psychology]</keyword><keyword>Neoplasms/et [Etiology]</keyword><keyword>*Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>Poverty/px [Psychology]</keyword><keyword>*Poverty</keyword><keyword>Program Evaluation</keyword><keyword>Regression Analysis</keyword><keyword>Vegetables</keyword><keyword>0 (Dietary Fats)</keyword></keywords><dates><year>2003</year><pub-dates><date>Nov</date></pub-dates></dates><accession-num>14572425</accession-num><urls></urls></record></Cite></EndNote>D<EndNote><Cite><Author>Havas</Author><Year>2003</Year><RecNum>1328</RecNum><record><rec-number>1328</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1328</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Havas, S.</author><author>Anliker, J.</author><author>Greenberg, D.</author><author>Block, G.</author><author>Block, T.</author><author>Blik, C.</author><author>Langenberg, P.</author><author>DiClemente, C.</author></authors></contributors><auth-address>Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 660 W. Redwood Street, Baltimore, MD 21201, USA. shavas@epi.umaryland.edu</auth-address><titles><title>Final results of the Maryland WIC Food for Life Program.[erratum appears in Prev Med. 2004 May;38(5):668]</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 37(5):406-16</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><pages>406-16</pages><volume>37</volume><number>5</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Cross-Over Studies</keyword><keyword>Diet Surveys</keyword><keyword>Dietary Fats</keyword><keyword>Dietary Fiber</keyword><keyword>*Energy Intake</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Food Habits/px [Psychology]</keyword><keyword>*Food Services/og [Organization &amp; Administration]</keyword><keyword>Fruit</keyword><keyword>*Health Education/og [Organization &amp; Administration]</keyword><keyword>Health Knowledge, Attitudes, Practice</keyword><keyword>Humans</keyword><keyword>Maryland</keyword><keyword>*Maternal Nutrition Physiology/ed [Education]</keyword><keyword>*Mothers/ed [Education]</keyword><keyword>Mothers/px [Psychology]</keyword><keyword>Neoplasms/et [Etiology]</keyword><keyword>*Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>Poverty/px [Psychology]</keyword><keyword>*Poverty</keyword><keyword>Program Evaluation</keyword><keyword>Regression Analysis</keyword><keyword>Vegetables</keyword><keyword>0 (Dietary Fats)</keyword></keywords><dates><year>2003</year><pub-dates><date>Nov</date></pub-dates></dates><accession-num>14572425</accession-num><urls></urls></record></Cite><Cite><Author>Richards</Author><Year>2006</Year><RecNum>1336</RecNum><record><rec-number>1336</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1336</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Richards, A.</author><author>Kattelmann, K. K.</author><author>Ren, C.</author></authors></contributors><auth-address>Nutrition, Food Science, and Hospitality Department, South Dakota State University, Brookings, SD 57707, USA.</auth-address><titles><title>Motivating 18- to 24-year-olds to increase their fruit and vegetable consumption</title><secondary-title>Journal of the American Dietetic Association</secondary-title><alt-title>J Am Diet Assoc 106(9):1405-11</alt-title></titles><periodical><full-title>Journal of the American Dietetic Association</full-title></periodical><pages>1405-11</pages><volume>106</volume><number>9</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Algorithms</keyword><keyword>Chi-Square Distribution</keyword><keyword>Diet</keyword><keyword>Female</keyword><keyword>*Fruit</keyword><keyword>Health Education/mt [Methods]</keyword><keyword>*Health Promotion/mt [Methods]</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>*Motivation</keyword><keyword>*Nutrition Physiology/ed [Education]</keyword><keyword>Periodicals as Topic</keyword><keyword>Questionnaires</keyword><keyword>*Self Efficacy</keyword><keyword>Statistics, Nonparametric</keyword><keyword>Students</keyword><keyword>*Vegetables</keyword></keywords><dates><year>2006</year><pub-dates><date>Sep</date></pub-dates></dates><accession-num>16963345</accession-num><urls></urls></record></Cite></EndNote>�D<EndNote><Cite><Author>Kristal</Author><Year>2000</Year><RecNum>1332</RecNum><record><rec-number>1332</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1332</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kristal, A. 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L.</author><author>Feng, Z.</author><author>Li, S.</author></authors></contributors><auth-address>Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA. akristal@fhcrc.org</auth-address><titles><title>A randomized trial of a tailored, self-help dietary intervention: the Puget Sound Eating Patterns study</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 31(4):380-9</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><pages>380-9</pages><volume>31</volume><number>4</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Body Mass Index</keyword><keyword>Cohort Studies</keyword><keyword>*Diet, Fat-Restricted/mt [Methods]</keyword><keyword>Dietary Fiber/ad [Administration &amp; Dosage]</keyword><keyword>Feasibility Studies</keyword><keyword>Female</keyword><keyword>*Food Habits</keyword><keyword>*Fruit</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>*Obesity/dh [Diet Therapy]</keyword><keyword>Questionnaires</keyword><keyword>Risk Factors</keyword><keyword>Treatment Outcome</keyword><keyword>*Vegetables</keyword><keyword>Washington</keyword></keywords><dates><year>2000</year><pub-dates><date>Oct</date></pub-dates></dates><accession-num>11006063</accession-num><urls></urls></record></Cite><Cite><Author>Havas</Author><Year>2003</Year><RecNum>1328</RecNum><record><rec-number>1328</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1328</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Havas, S.</author><author>Anliker, J.</author><author>Greenberg, D.</author><author>Block, G.</author><author>Block, T.</author><author>Blik, C.</author><author>Langenberg, P.</author><author>DiClemente, C.</author></authors></contributors><auth-address>Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 660 W. Redwood Street, Baltimore, MD 21201, USA. shavas@epi.umaryland.edu</auth-address><titles><title>Final results of the Maryland WIC Food for Life Program.[erratum appears in Prev Med. 2004 May;38(5):668]</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 37(5):406-16</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><pages>406-16</pages><volume>37</volume><number>5</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Cross-Over Studies</keyword><keyword>Diet Surveys</keyword><keyword>Dietary Fats</keyword><keyword>Dietary Fiber</keyword><keyword>*Energy Intake</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Food Habits/px [Psychology]</keyword><keyword>*Food Services/og [Organization &amp; Administration]</keyword><keyword>Fruit</keyword><keyword>*Health Education/og [Organization &amp; Administration]</keyword><keyword>Health Knowledge, Attitudes, Practice</keyword><keyword>Humans</keyword><keyword>Maryland</keyword><keyword>*Maternal Nutrition Physiology/ed [Education]</keyword><keyword>*Mothers/ed [Education]</keyword><keyword>Mothers/px [Psychology]</keyword><keyword>Neoplasms/et [Etiology]</keyword><keyword>*Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>Poverty/px [Psychology]</keyword><keyword>*Poverty</keyword><keyword>Program Evaluation</keyword><keyword>Regression Analysis</keyword><keyword>Vegetables</keyword><keyword>0 (Dietary Fats)</keyword></keywords><dates><year>2003</year><pub-dates><date>Nov</date></pub-dates></dates><accession-num>14572425</accession-num><urls></urls></record></Cite><Cite><Author>Perkins-Porras</Author><Year>2005</Year><RecNum>1333</RecNum><record><rec-number>1333</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1333</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Perkins-Porras, L.</author><author>Cappuccio, F. 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Redwood Street, Baltimore, MD 21201, USA. shavas@epi.umaryland.edu</auth-address><titles><title>Final results of the Maryland WIC Food for Life Program.[erratum appears in Prev Med. 2004 May;38(5):668]</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 37(5):406-16</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><pages>406-16</pages><volume>37</volume><number>5</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Cross-Over Studies</keyword><keyword>Diet Surveys</keyword><keyword>Dietary Fats</keyword><keyword>Dietary Fiber</keyword><keyword>*Energy Intake</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Food Habits/px [Psychology]</keyword><keyword>*Food Services/og [Organization &amp; Administration]</keyword><keyword>Fruit</keyword><keyword>*Health Education/og [Organization &amp; Administration]</keyword><keyword>Health Knowledge, Attitudes, Practice</keyword><keyword>Humans</keyword><keyword>Maryland</keyword><keyword>*Maternal Nutrition Physiology/ed [Education]</keyword><keyword>*Mothers/ed [Education]</keyword><keyword>Mothers/px [Psychology]</keyword><keyword>Neoplasms/et [Etiology]</keyword><keyword>*Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>Poverty/px [Psychology]</keyword><keyword>*Poverty</keyword><keyword>Program Evaluation</keyword><keyword>Regression Analysis</keyword><keyword>Vegetables</keyword><keyword>0 (Dietary Fats)</keyword></keywords><dates><year>2003</year><pub-dates><date>Nov</date></pub-dates></dates><accession-num>14572425</accession-num><urls></urls></record></Cite><Cite><Author>Carcaise-Edinboro</Author><Year>2008</Year><RecNum>1322</RecNum><record><rec-number>1322</rec-number><foreign-keys><key app="EN" db-id="ww5esxvfhapsw2e0vpqx9zr12t0fwzfdaw0w">1322</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Carcaise-Edinboro, P.</author><author>McClish, D.</author><author>Kracen, A. 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la�lyt8Z	`D<EndNote><Cite><Author>Havas</Author><Year>1998</Year><RecNum>83</RecNum><record><rec-number>83</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">83</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Havas, S.</author><author>Anliker, J.</author><author>Damron, D.</author><author>Langenberg, P.</author><author>Ballesteros, M.</author><author>Feldman, R.</author></authors></contributors><auth-address>Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA. shavas@epi.umaryland.edu</auth-address><titles><title>Final results of the Maryland WIC 5-A-Day Promotion Program</title><secondary-title>American Journal of Public Health</secondary-title><alt-title>Am J Public Health</alt-title></titles><periodical><full-title>American Journal of Public Health</full-title><abbr-1>Am J Public Health</abbr-1></periodical><alt-periodical><full-title>American Journal of Public Health</full-title><abbr-1>Am J Public Health</abbr-1></alt-periodical><pages>1161-7</pages><volume>88</volume><number>8</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Child</keyword><keyword>Child, Preschool</keyword><keyword>Cross-Over Studies</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Food Services</keyword><keyword>*Fruit</keyword><keyword>Health Knowledge, Attitudes, Practice</keyword><keyword>*Health Promotion</keyword><keyword>Health Surveys</keyword><keyword>Humans</keyword><keyword>Infant</keyword><keyword>Male</keyword><keyword>Maryland</keyword><keyword>Neoplasms/et [Etiology]</keyword><keyword>*Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>*Nutrition Physiology/ed [Education]</keyword><keyword>Pregnancy</keyword><keyword>*Public Assistance</keyword><keyword>*Vegetables</keyword></keywords><dates><year>1998</year><pub-dates><date>Aug</date></pub-dates></dates><isbn>0090-0036</isbn><accession-num>9702141</accession-num><urls></urls></record></Cite></EndNote>�$$If�l!vh5�85��5��5��5�v5��5�F5��5�	X5�	
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la�lyt8Z	�D<EndNote><Cite><Author>Campbell</Author><Year>2008</Year><RecNum>305</RecNum><record><rec-number>305</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">305</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Campbell, M. K.</author><author>McLerran, D.</author><author>Turner-McGrievy, G.</author><author>Feng, Z.</author><author>Havas, S.</author><author>Sorensen, G.</author><author>Buller, D.</author><author>Beresford, S. A.</author><author>Nebeling, L.</author></authors></contributors><auth-address>Department of Nutrition, University of North Carolina, Chapel Hill, NC 27599, USA. marci_campbell@unc.edu</auth-address><titles><title>Mediation of adult fruit and vegetable consumption in the National 5 A Day for Better Health community studies</title><secondary-title>Annals of Behavioral Medicine</secondary-title><alt-title>Ann Behav Med 35(1):49-60</alt-title></titles><periodical><full-title>Annals of Behavioral Medicine</full-title></periodical><alt-periodical><full-title>Annals of Behavioral Medicine</full-title><abbr-1>Ann Behav Med 35(1):49-60</abbr-1></alt-periodical><pages>49-60</pages><volume>35</volume><number>1</number><keywords><keyword>*Adaptation, Psychological</keyword><keyword>Adult</keyword><keyword>Attitude to Health</keyword><keyword>Cross-Sectional Studies</keyword><keyword>*Diet/px [Psychology]</keyword><keyword>Eating/px [Psychology]</keyword><keyword>Effect Modifiers (Epidemiology)</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>*Food Habits/px [Psychology]</keyword><keyword>Fruit</keyword><keyword>Health Education</keyword><keyword>*Health Knowledge, Attitudes, Practice</keyword><keyword>Health Promotion</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Outcome Assessment (Health Care)</keyword><keyword>*Personal Autonomy</keyword><keyword>Psychology</keyword><keyword>*Self Efficacy</keyword><keyword>Vegetables</keyword></keywords><dates><year>2008</year><pub-dates><date>Feb</date></pub-dates></dates><accession-num>18347904</accession-num><urls></urls></record></Cite></EndNote>�$$If�l!vh5�85��5��5��5�v5��5�F5��5�	X5�	
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la�lyt8Z	�	D<EndNote><Cite><Author>Campbell</Author><Year>1999</Year><RecNum>107</RecNum><record><rec-number>107</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">107</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Campbell, M. K.</author><author>Demark-Wahnefried, W.</author><author>Symons, M.</author><author>Kalsbeek, W. D.</author><author>Dodds, J.</author><author>Cowan, A.</author><author>Jackson, B.</author><author>Motsinger, B.</author><author>Hoben, K.</author><author>Lashley, J.</author><author>Demissie, S.</author><author>McClelland, J. W.</author></authors></contributors><auth-address>School of Public Health, University of North Carolina, Chapel Hill 27599, USA. marci_campbell@unc.edu</auth-address><titles><title>Fruit and vegetable consumption and prevention of cancer: the Black Churches United for Better Health project</title><secondary-title>American Journal of Public Health</secondary-title><alt-title>Am J Public Health 89(9):1390-6</alt-title></titles><periodical><full-title>American Journal of Public Health</full-title><abbr-1>Am J Public Health</abbr-1></periodical><alt-periodical><full-title>American Journal of Public Health</full-title><abbr-1>Am J Public Health 89(9):1390-6</abbr-1></alt-periodical><pages>1390-6</pages><volume>89</volume><number>9</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>*African Americans</keyword><keyword>Age Factors</keyword><keyword>Aged</keyword><keyword>*Clergy</keyword><keyword>Educational Status</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>*Food Habits/eh [Ethnology]</keyword><keyword>*Fruit</keyword><keyword>*Health Knowledge, Attitudes, Practice</keyword><keyword>*Health Promotion/og [Organization &amp; Administration]</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Marital Status</keyword><keyword>Middle Aged</keyword><keyword>Neoplasms/eh [Ethnology]</keyword><keyword>*Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>North Carolina</keyword><keyword>Program Evaluation</keyword><keyword>Questionnaires</keyword><keyword>*Religion</keyword><keyword>Rural Health</keyword><keyword>*Vegetables</keyword></keywords><dates><year>1999</year><pub-dates><date>Sep</date></pub-dates></dates><accession-num>10474558</accession-num><urls></urls></record></Cite></EndNote>�$$If�l!vh5�85��5��5��5�v5��5�F5��5�	X5�	
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la�lyt8Z	�D<EndNote><Cite><Author>Campbell</Author><Year>2008</Year><RecNum>305</RecNum><record><rec-number>305</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">305</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Campbell, M. K.</author><author>McLerran, D.</author><author>Turner-McGrievy, G.</author><author>Feng, Z.</author><author>Havas, S.</author><author>Sorensen, G.</author><author>Buller, D.</author><author>Beresford, S. A.</author><author>Nebeling, L.</author></authors></contributors><auth-address>Department of Nutrition, University of North Carolina, Chapel Hill, NC 27599, USA. marci_campbell@unc.edu</auth-address><titles><title>Mediation of adult fruit and vegetable consumption in the National 5 A Day for Better Health community studies</title><secondary-title>Annals of Behavioral Medicine</secondary-title><alt-title>Ann Behav Med 35(1):49-60</alt-title></titles><periodical><full-title>Annals of Behavioral Medicine</full-title></periodical><alt-periodical><full-title>Annals of Behavioral Medicine</full-title><abbr-1>Ann Behav Med 35(1):49-60</abbr-1></alt-periodical><pages>49-60</pages><volume>35</volume><number>1</number><keywords><keyword>*Adaptation, Psychological</keyword><keyword>Adult</keyword><keyword>Attitude to Health</keyword><keyword>Cross-Sectional Studies</keyword><keyword>*Diet/px [Psychology]</keyword><keyword>Eating/px [Psychology]</keyword><keyword>Effect Modifiers (Epidemiology)</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>*Food Habits/px [Psychology]</keyword><keyword>Fruit</keyword><keyword>Health Education</keyword><keyword>*Health Knowledge, Attitudes, Practice</keyword><keyword>Health Promotion</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Outcome Assessment (Health Care)</keyword><keyword>*Personal Autonomy</keyword><keyword>Psychology</keyword><keyword>*Self Efficacy</keyword><keyword>Vegetables</keyword></keywords><dates><year>2008</year><pub-dates><date>Feb</date></pub-dates></dates><accession-num>18347904</accession-num><urls></urls></record></Cite></EndNote>�$$If�l!vh5�85��5��5��5�v5��5�F5��5�	X5�	
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la�lyt8Z	HD<EndNote><Cite><Author>Coates</Author><Year>1999</Year><RecNum>109</RecNum><record><rec-number>109</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">109</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Coates, R. J.</author><author>Bowen, D. J.</author><author>Kristal, A. R.</author><author>Feng, Z.</author><author>Oberman, A.</author><author>Hall, W. D.</author><author>George, V.</author><author>Lewis, C. E.</author><author>Kestin, M.</author><author>Davis, M.</author><author>Evans, M.</author><author>Grizzle, J. E.</author><author>Clifford, C. K.</author></authors></contributors><auth-address>Department of Epidemiology, Emory University, Atlanta, GA, USA.</auth-address><titles><title>The Women&apos;s Health Trial Feasibility Study in Minority Populations: changes in dietary intakes</title><secondary-title>American Journal of Epidemiology</secondary-title><alt-title>Am J Epidemiol 149(12):1104-12</alt-title></titles><periodical><full-title>American Journal of Epidemiology</full-title><abbr-1>Am J Epidemiol</abbr-1></periodical><alt-periodical><full-title>American Journal of Epidemiology</full-title><abbr-1>Am J Epidemiol 149(12):1104-12</abbr-1></alt-periodical><pages>1104-12</pages><volume>149</volume><number>12</number><keywords><keyword>Aged</keyword><keyword>Alabama/ep [Epidemiology]</keyword><keyword>*Dietary Fats/ad [Administration &amp; Dosage]</keyword><keyword>*Energy Intake</keyword><keyword>Feasibility Studies</keyword><keyword>Female</keyword><keyword>Florida/ep [Epidemiology]</keyword><keyword>Georgia/ep [Epidemiology]</keyword><keyword>Humans</keyword><keyword>Middle Aged</keyword><keyword>*Minority Groups/sn [Statistics &amp; Numerical Data]</keyword><keyword>Nutrition Surveys</keyword><keyword>*Women&apos;s Health</keyword><keyword>0 (Dietary Fats)</keyword></keywords><dates><year>1999</year><pub-dates><date>Jun 15</date></pub-dates></dates><accession-num>10369504</accession-num><urls></urls></record></Cite></EndNote>�$$If�l!vh5�85��5��5��5�v5��5�F5��5�	X5�	
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la�lyt8Z	�D<EndNote><Cite><Author>Sorensen</Author><Year>1999</Year><RecNum>121</RecNum><record><rec-number>121</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">121</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Sorensen, G.</author><author>Stoddard, A.</author><author>Peterson, K.</author><author>Cohen, N.</author><author>Hunt, M. K.</author><author>Stein, E.</author><author>Palombo, R.</author><author>Lederman, R.</author></authors></contributors><auth-address>Division of Cancer Epidemiology and Control, Dana-Farber Cancer Institute, Boston, MA 02115, USA. glorian_sorensen@dfci.harvard.edu</auth-address><titles><title>Increasing fruit and vegetable consumption through worksites and families in the treatwell 5-a-day study</title><secondary-title>American Journal of Public Health</secondary-title><alt-title>Am J Public Health 89(1):54-60</alt-title></titles><periodical><full-title>American Journal of Public Health</full-title><abbr-1>Am J Public Health</abbr-1></periodical><alt-periodical><full-title>American Journal of Public Health</full-title><abbr-1>Am J Public Health 89(1):54-60</abbr-1></alt-periodical><pages>54-60</pages><volume>89</volume><number>1</number><keywords><keyword>Adult</keyword><keyword>Boston</keyword><keyword>*Diet</keyword><keyword>Family/px [Psychology]</keyword><keyword>*Family</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Food Habits/px [Psychology]</keyword><keyword>*Fruit</keyword><keyword>*Health Education/og [Organization &amp; Administration]</keyword><keyword>Health Knowledge, Attitudes, Practice</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>*Nutrition Physiology/ed [Education]</keyword><keyword>*Occupational Health Services/og [Organization &amp; Administration]</keyword><keyword>Program Evaluation</keyword><keyword>Questionnaires</keyword><keyword>*Vegetables</keyword><keyword>*Workplace</keyword></keywords><dates><year>1999</year><pub-dates><date>Jan</date></pub-dates></dates><accession-num>9987465</accession-num><urls></urls></record></Cite></EndNote>�$$If�l!vh5�85��5��5��5�v5��5�F5��5�	X5�	
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la�ytg]`D<EndNote><Cite><Author>Havas</Author><Year>1998</Year><RecNum>83</RecNum><record><rec-number>83</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">83</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Havas, S.</author><author>Anliker, J.</author><author>Damron, D.</author><author>Langenberg, P.</author><author>Ballesteros, M.</author><author>Feldman, R.</author></authors></contributors><auth-address>Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA. shavas@epi.umaryland.edu</auth-address><titles><title>Final results of the Maryland WIC 5-A-Day Promotion Program</title><secondary-title>American Journal of Public Health</secondary-title><alt-title>Am J Public Health</alt-title></titles><periodical><full-title>American Journal of Public Health</full-title><abbr-1>Am J Public Health</abbr-1></periodical><alt-periodical><full-title>American Journal of Public Health</full-title><abbr-1>Am J Public Health</abbr-1></alt-periodical><pages>1161-7</pages><volume>88</volume><number>8</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Child</keyword><keyword>Child, Preschool</keyword><keyword>Cross-Over Studies</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Food Services</keyword><keyword>*Fruit</keyword><keyword>Health Knowledge, Attitudes, Practice</keyword><keyword>*Health Promotion</keyword><keyword>Health Surveys</keyword><keyword>Humans</keyword><keyword>Infant</keyword><keyword>Male</keyword><keyword>Maryland</keyword><keyword>Neoplasms/et [Etiology]</keyword><keyword>*Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>*Nutrition Physiology/ed [Education]</keyword><keyword>Pregnancy</keyword><keyword>*Public Assistance</keyword><keyword>*Vegetables</keyword></keywords><dates><year>1998</year><pub-dates><date>Aug</date></pub-dates></dates><isbn>0090-0036</isbn><accession-num>9702141</accession-num><urls></urls></record></Cite></EndNote>�$$If�!v
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la�ytg]�	D<EndNote><Cite><Author>Campbell</Author><Year>1999</Year><RecNum>107</RecNum><record><rec-number>107</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">107</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Campbell, M. K.</author><author>Demark-Wahnefried, W.</author><author>Symons, M.</author><author>Kalsbeek, W. D.</author><author>Dodds, J.</author><author>Cowan, A.</author><author>Jackson, B.</author><author>Motsinger, B.</author><author>Hoben, K.</author><author>Lashley, J.</author><author>Demissie, S.</author><author>McClelland, J. W.</author></authors></contributors><auth-address>School of Public Health, University of North Carolina, Chapel Hill 27599, USA. marci_campbell@unc.edu</auth-address><titles><title>Fruit and vegetable consumption and prevention of cancer: the Black Churches United for Better Health project</title><secondary-title>American Journal of Public Health</secondary-title><alt-title>Am J Public Health 89(9):1390-6</alt-title></titles><periodical><full-title>American Journal of Public Health</full-title><abbr-1>Am J Public Health</abbr-1></periodical><alt-periodical><full-title>American Journal of Public Health</full-title><abbr-1>Am J Public Health 89(9):1390-6</abbr-1></alt-periodical><pages>1390-6</pages><volume>89</volume><number>9</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>*African Americans</keyword><keyword>Age Factors</keyword><keyword>Aged</keyword><keyword>*Clergy</keyword><keyword>Educational Status</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>*Food Habits/eh [Ethnology]</keyword><keyword>*Fruit</keyword><keyword>*Health Knowledge, Attitudes, Practice</keyword><keyword>*Health Promotion/og [Organization &amp; Administration]</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Marital Status</keyword><keyword>Middle Aged</keyword><keyword>Neoplasms/eh [Ethnology]</keyword><keyword>*Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>North Carolina</keyword><keyword>Program Evaluation</keyword><keyword>Questionnaires</keyword><keyword>*Religion</keyword><keyword>Rural Health</keyword><keyword>*Vegetables</keyword></keywords><dates><year>1999</year><pub-dates><date>Sep</date></pub-dates></dates><accession-num>10474558</accession-num><urls></urls></record></Cite></EndNote>�$$If�!v
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la�ytg]HD<EndNote><Cite><Author>Coates</Author><Year>1999</Year><RecNum>109</RecNum><record><rec-number>109</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">109</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Coates, R. J.</author><author>Bowen, D. J.</author><author>Kristal, A. R.</author><author>Feng, Z.</author><author>Oberman, A.</author><author>Hall, W. D.</author><author>George, V.</author><author>Lewis, C. E.</author><author>Kestin, M.</author><author>Davis, M.</author><author>Evans, M.</author><author>Grizzle, J. E.</author><author>Clifford, C. K.</author></authors></contributors><auth-address>Department of Epidemiology, Emory University, Atlanta, GA, USA.</auth-address><titles><title>The Women&apos;s Health Trial Feasibility Study in Minority Populations: changes in dietary intakes</title><secondary-title>American Journal of Epidemiology</secondary-title><alt-title>Am J Epidemiol 149(12):1104-12</alt-title></titles><periodical><full-title>American Journal of Epidemiology</full-title><abbr-1>Am J Epidemiol</abbr-1></periodical><alt-periodical><full-title>American Journal of Epidemiology</full-title><abbr-1>Am J Epidemiol 149(12):1104-12</abbr-1></alt-periodical><pages>1104-12</pages><volume>149</volume><number>12</number><keywords><keyword>Aged</keyword><keyword>Alabama/ep [Epidemiology]</keyword><keyword>*Dietary Fats/ad [Administration &amp; Dosage]</keyword><keyword>*Energy Intake</keyword><keyword>Feasibility Studies</keyword><keyword>Female</keyword><keyword>Florida/ep [Epidemiology]</keyword><keyword>Georgia/ep [Epidemiology]</keyword><keyword>Humans</keyword><keyword>Middle Aged</keyword><keyword>*Minority Groups/sn [Statistics &amp; Numerical Data]</keyword><keyword>Nutrition Surveys</keyword><keyword>*Women&apos;s Health</keyword><keyword>0 (Dietary Fats)</keyword></keywords><dates><year>1999</year><pub-dates><date>Jun 15</date></pub-dates></dates><accession-num>10369504</accession-num><urls></urls></record></Cite></EndNote>�$$If�!v
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la�ytg]�D<EndNote><Cite><Author>Campbell</Author><Year>2008</Year><RecNum>305</RecNum><record><rec-number>305</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">305</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Campbell, M. K.</author><author>McLerran, D.</author><author>Turner-McGrievy, G.</author><author>Feng, Z.</author><author>Havas, S.</author><author>Sorensen, G.</author><author>Buller, D.</author><author>Beresford, S. A.</author><author>Nebeling, L.</author></authors></contributors><auth-address>Department of Nutrition, University of North Carolina, Chapel Hill, NC 27599, USA. marci_campbell@unc.edu</auth-address><titles><title>Mediation of adult fruit and vegetable consumption in the National 5 A Day for Better Health community studies</title><secondary-title>Annals of Behavioral Medicine</secondary-title><alt-title>Ann Behav Med 35(1):49-60</alt-title></titles><periodical><full-title>Annals of Behavioral Medicine</full-title></periodical><alt-periodical><full-title>Annals of Behavioral Medicine</full-title><abbr-1>Ann Behav Med 35(1):49-60</abbr-1></alt-periodical><pages>49-60</pages><volume>35</volume><number>1</number><keywords><keyword>*Adaptation, Psychological</keyword><keyword>Adult</keyword><keyword>Attitude to Health</keyword><keyword>Cross-Sectional Studies</keyword><keyword>*Diet/px [Psychology]</keyword><keyword>Eating/px [Psychology]</keyword><keyword>Effect Modifiers (Epidemiology)</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>*Food Habits/px [Psychology]</keyword><keyword>Fruit</keyword><keyword>Health Education</keyword><keyword>*Health Knowledge, Attitudes, Practice</keyword><keyword>Health Promotion</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Outcome Assessment (Health Care)</keyword><keyword>*Personal Autonomy</keyword><keyword>Psychology</keyword><keyword>*Self Efficacy</keyword><keyword>Vegetables</keyword></keywords><dates><year>2008</year><pub-dates><date>Feb</date></pub-dates></dates><accession-num>18347904</accession-num><urls></urls></record></Cite></EndNote>�$$If�!v
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D<EndNote><Cite><Author>Kreuter</Author><Year>2005</Year><RecNum>236</RecNum><record><rec-number>236</rec-number><foreign-keys><key app="EN" db-id="s0svf5sdu0w2x5ex9wqxwfs6s5rfva9eazpw">236</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kreuter, M. W.</author><author>Sugg-Skinner, C.</author><author>Holt, C. L.</author><author>Clark, E. M.</author><author>Haire-Joshu, D.</author><author>Fu, Q.</author><author>Booker, A. C.</author><author>Steger-May, K.</author><author>Bucholtz, D.</author></authors></contributors><auth-address>Health Communication Research Laboratory and Center of Excellence in Cancer Communication Research, Department of Community Health, School of Public Health, Saint Louis University (SLU), 3545 Lafayette Avenue, St. Louis, MO 63104, USA. kreuter@slu.edu</auth-address><titles><title>Cultural tailoring for mammography and fruit and vegetable intake among low-income African-American women in urban public health centers</title><secondary-title>Preventive Medicine</secondary-title><alt-title>Prev Med 41(1):53-62</alt-title></titles><periodical><full-title>Preventive Medicine</full-title></periodical><alt-periodical><full-title>Preventive Medicine</full-title><abbr-1>Prev Med 41(1):53-62</abbr-1></alt-periodical><pages>53-62</pages><volume>41</volume><number>1</number><keywords><keyword>Adult</keyword><keyword>*African Americans/sn [Statistics &amp; Numerical Data]</keyword><keyword>Age Factors</keyword><keyword>*Attitude to Health/eh [Ethnology]</keyword><keyword>Behavior Therapy/mt [Methods]</keyword><keyword>Breast Neoplasms/eh [Ethnology]</keyword><keyword>*Breast Neoplasms/pc [Prevention &amp; Control]</keyword><keyword>Community Health Centers</keyword><keyword>Cultural Diversity</keyword><keyword>*Diet</keyword><keyword>Educational Status</keyword><keyword>Female</keyword><keyword>Fruit</keyword><keyword>*Health Education/mt [Methods]</keyword><keyword>Humans</keyword><keyword>*Mammography</keyword><keyword>Middle Aged</keyword><keyword>Poverty</keyword><keyword>Probability</keyword><keyword>Reference Values</keyword><keyword>Risk Assessment</keyword><keyword>Sensitivity and Specificity</keyword><keyword>Statistics, Nonparametric</keyword><keyword>Teaching Materials</keyword><keyword>United States</keyword><keyword>Urban Health</keyword><keyword>Vegetables</keyword></keywords><dates><year>2005</year><pub-dates><date>Jul</date></pub-dates></dates><accession-num>15916993</accession-num><urls></urls></record></Cite></EndNote>�$$If�!v
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