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      Increasing Fruit and Vegetable Consumption Through a Healthy Eating Blog: A Feasibility Study

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          Abstract

          Background

          Despite efforts made by public health organizations to improve consumption of fruits and vegetables, populations in developed countries usually eat less than the minimum recommended. Social media, such as blogs, represent a unique opportunity for improving knowledge translation in health care because they facilitate interactive communication between the public and health professionals. However, no studies have yet evaluated the effect of blogs to promote dietary behavior changes.

          Objective

          Our study aims to conduct a preliminary assessment before undertaking a full randomized controlled trial (RCT) of the feasibility of using an evidence-based healthy eating blog promoting the consumption of fruits and vegetables among adult women.

          Methods

          A total of 80 women aged 18 years and older (mean 42, SD 13 years) eating less than five servings per day of fruit and vegetables (mean 2.75, SD 1.84 servings) were recruited. Participants were randomized to the healthy eating blog group (n=40), which included a weekly blog post over a 6-month period, or to a control group (n=40) that had no exposure to the healthy eating blog. Blog posts were written by a registered dietitian and focused on the improvement of fruit and vegetable consumption. We targeted four main determinants of the behavior that were identified as the best predictors for fruit and vegetable intake by two systematic reviews: (1) knowledge, (2) attitude, (3) self-efficacy, and (4) motivation. The intervention was considered feasible if (1) more than 70% of questionnaires were completed, (2) attendance rate was more than 90% for in-person appointments with the research coordinator, (3) participants accessed at least 75% of the blog posts, and (4) the attrition rate was less than 25%. Blog access was assessed by collecting the blog browsing history data for each participant.

          Results

          During the intervention, 26 posts were published on the blog. Pre- (baseline) and postintervention (6 months) questionnaires were completed by mean 97% (SD 3%) of participants. All participants attended their in-person appointments. Women accessed mean 87% (SD 7%) of the posts published during the intervention. Only 3% (2/80) of participants dropped out of the study. Between the healthy eating blog and control groups, a difference of 1.0 servings of fruits and vegetables ( P<.001) indicated moderate effects of the intervention (Cohen d=0.54).

          Conclusions

          These results suggest that an intervention using a healthy eating blog meets preestablished feasibility criteria. A larger-scale RCT using the same methodology will be conducted to assess the impact of a healthy eating blog on the dietary habits of women.

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          Most cited references50

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          American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity.

          The American Cancer Society (ACS) publishes Nutrition and Physical Activity Guidelines to serve as a foundation for its communication, policy, and community strategies and, ultimately, to affect dietary and physical activity patterns among Americans. These Guidelines, published approximately every 5 years, are developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and they reflect the most current scientific evidence related to dietary and activity patterns and cancer risk. The ACS Guidelines focus on recommendations for individual choices regarding diet and physical activity patterns, but those choices occur within a community context that either facilitates or creates barriers to healthy behaviors. Therefore, this committee presents recommendations for community action to accompany the 4 recommendations for individual choices to reduce cancer risk. These recommendations for community action recognize that a supportive social and physical environment is indispensable if individuals at all levels of society are to have genuine opportunities to choose healthy behaviors. The ACS Guidelines are consistent with guidelines from the American Heart Association and the American Diabetes Association for the prevention of coronary heart disease and diabetes, as well as for general health promotion, as defined by the 2010 Dietary Guidelines for Americans and the 2008 Physical Activity Guidelines for Americans. Copyright © 2012 American Cancer Society, Inc.
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            Design and analysis of pilot studies: recommendations for good practice.

            Pilot studies play an important role in health research, but they can be misused, mistreated and misrepresented. In this paper we focus on pilot studies that are used specifically to plan a randomized controlled trial (RCT). Citing examples from the literature, we provide a methodological framework in which to work, and discuss reasons why a pilot study might be undertaken. A well-conducted pilot study, giving a clear list of aims and objectives within a formal framework will encourage methodological rigour, ensure that the work is scientifically valid and publishable, and will lead to higher quality RCTs. It will also safeguard against pilot studies being conducted simply because of small numbers of available patients.
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                Author and article information

                Contributors
                Journal
                JMIR Res Protoc
                JMIR Res Protoc
                ResProt
                JMIR Research Protocols
                JMIR Publications (Toronto, Canada )
                1929-0748
                April 2017
                18 April 2017
                : 6
                : 4
                : e59
                Affiliations
                [1] 1Institute of Nutrition and Functional Foods Laval University Quebec, QCCanada
                [2] 2Population Health and Optimal Health Practices Research Unit CHU de Québec Research Center Quebec, QCCanada
                [3] 3Faculty of Nursing Laval University Quebec, QCCanada
                [4] 4Department of Medicine University of Toronto Toronto, ONCanada
                Author notes
                Corresponding Author: Sophie Desroches sophie.desroches@ 123456fsaa.ulaval.ca
                Author information
                http://orcid.org/0000-0002-0433-7247
                http://orcid.org/0000-0002-0404-8883
                http://orcid.org/0000-0002-5953-1055
                http://orcid.org/0000-0002-0151-2345
                http://orcid.org/0000-0001-7081-4809
                http://orcid.org/0000-0002-0782-5457
                http://orcid.org/0000-0002-6106-832X
                http://orcid.org/0000-0003-0797-605X
                Article
                v6i4e59
                10.2196/resprot.6622
                5413798
                28420600
                4c56e054-77c6-40d6-91d1-5023d6b50e80
                ©Marie-Eve Caplette, Véronique Provencher, Véronique Bissonnette-Maheux, Marilyn Dugrenier, Annie Lapointe, Marie-Pierre Gagnon, Sharon Straus, Sophie Desroches. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 18.04.2017.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                : 7 September 2016
                : 17 November 2016
                : 29 December 2016
                : 11 February 2017
                Categories
                Original Paper
                Original Paper

                blogs,nutrition,healthy eating,knowledge translation,feasibility

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