Effectiveness of a multicomponent intervention for modifying the nutritional practices of college students

Abstract

Appropriate nutrition is linked to the prevention of several major diseases, yet over 50% of Americans do not eat diets sufficient in the necessary proportions of protein, vitamins, and minerals. Increased interest in health prevention has led to the development of a variety of programs designed to change dietary habits. Most have been only marginally successful. One explanation for their failure is the lack of consideration given to the characteristics of the targeted population in the development of the programs. In this study, a five week multicomponent intervention was designed using marketing and psychological principles to increase the selection of dinner entrees low in fat, calories, and sugar and to improve participants‘ knowledge of and attitude toward appropriate nutrition. Subjects were 8600 students who ate in the dining halls of a large southeastern university. The study investigated the additive effectiveness of three intervention components in three dining halls. One dining hall received availability; the second, availability plus point of choice information; the third, availability‘ plus point of choice information plus an incentive program. The results were derived from three separate sources: cafeteria data, survey data, and individual data. Cafeteria results were not significant. Inspection of daily selection data revealed wide fluctuation in selection across entrees, indicating dramatic changes in student preferences. Inspection of weekly selection means revealed that the incentive program combined with increased availability and point of choice information was initially effective in increasing the selection of the Perfect Balance entree. Prompting was the most effective intervention, yielding an average increase of 31.5% in selection of the Perfect Balance entree. Survey data indicated a minor increase in knowledge in. the information condition. Across all conditions there was a decrease in self-efficacy. Forty-four individuals were involved in a tracking project designed to assess whether the aggregate impact of the interventions reflected consistent change within specific individuals or intermittent change across all individuals. Analyses indicated a significant increase in selection behavior across time ( p <.05). The condition by phase interaction approached significance ( p =.07). The greatest change occurred in the incentive condition with a 16% increase, compared to a .3% increase in the information condition, and a 2.5% increase in the availability condition. The social marketing analysis of the study reveals several important barriers to change: resistance from staff and administration, poor quality entrees, student distrust of the dining hall administration, and limited availability of certain entrees.