FORMATIVE EVALUATION FOR PLANNING A NUTRITION INTERVENTION - RESULTS FROM FOCUS GROUPS

This paper describes findings from focus groups conducted as formative evaluation in planning a dietary intervention for hypercholesterolemi a in rural North Dakota and Minnesota. The researchers were interested in learning about attitudes, beliefs, and behavior in the areas of sc reening for high cholesterol, experience with dietary changes to lower cholesterol, experience with physicians as a source of dietary advice , and reactions to several dietary interventions. In response to quest ions regarding the efficacy of dietary treatment, a common belief was that an individual's cholesterol level was largely determined by genet ics. Participants indicated that pressure from children to buy and pre pare certain foods, social eating, eating out, time constraints, and m issing the taste of favorite high-fat foods made dietary change diffic ult. Participants gave examples of how advice from their physicians ha d been too extreme and too general or vague. Focus group participants indicated that (1) frequent follow-up the first year is needed to main tain motivation; (2) food records should be prescribed by the physicia n in order to increase self-monitoring compliance; (3) materials shoul d provide specific skill-building advice; (4) repetition reduces confu sion; and (5) classes should be led by a health professional. Recommen dations are made for nutrition education programs designed for rural p opulations.