Differences in psychosocial variables by stage of change for fruits and vegetables in older adults

Objective To describe differences in demographic and psychological variables by stage of change for five servings of fruits and vegetables per day in older adults. Design Cross-sectional survey with data collected in the participant's home or the project office by interviewers. Subjects 1,253 community-residing individuals 60 years or older (mean age = 75 years) living in East Providence, RI. Measures Stage of change; decisional balance; processes of change; self-efficacy; dietary intake measured by the National Institutes of Health (NIH) Fruit and Vegetable Screener, the 5 A Day Screener, and the NIH Fat Scan; demographics; and anthropometrics. Statistical Analyses Variables were compared by stage of change using analysis of variance for continuous variables and chi(2) analysis for categorical variables. Servings of fruits and vegetables were transformed (square root) prior to analyses. Results There was a strong effect of stage of change on intake measured by the Fruit and Vegetable Screener [F-(2,F-1203)=109, P<.001, eta(2)=.154] and the 5 A Day Screener [F-(2,F- 1203)=128, P<.001, eta(2)=.175] with a linear increase from precontemplation to action/maintenance. There was an overall stage effect on decisional balance, processes of change, and self-efficacy [Wilks's lambda=.703, F-(30,F- 2132)=13.72, P<.001, multivariate eta(2)=.162], and significant univariate effects for all variables. Conclusions Self-assessed servings ("How many servings do you usually eat?") can be used for stage classification for older adults. Interventions for older adults in early stages should focus on increasing perceived benefits of healthful eating and cognitive process use. Self-efficacy as well as behavioral processes seem to be important in attaining maintenance.