Randomized trial testing the effect of peer education at increasing fruit and vegetable intake

Background: The National Cancer Institute recommends that Americans eat at least five daily servings of fruits and vegetables. National strategies to increase consumption may not reach minority and lower socioeconomic populat ions. In a randomized trial, peer education was tested for effectiveness at increasing fruit and vegetable intake among lower socioeconomic, multicult ural labor and trades employees. Methods: Employees (n = 2091) completed a baseline survey and received an 18-month intervention program through stand ard communication channels (e.g., workplace mail, cafeteria promotions, and speakers), Ninety-three social networks (cliques) of employees were identi fied, which were pair matched on intake. At an interim survey (during month s 8 and 9), 11 cliques no longer existed and 41 matched pairs of cliques co ntaining 905 employees remained, with one clique per pair being randomly as signed to the peer education intervention. Employees who were central in th e communication flow of the peer intervention cliques served as peer educat ors during the last 9 months of the intervention program. Fruit and vegetab le intake was measured with 24-hour intake recall and with food-frequency q uestions in baseline, outcome (i.e., at 18 months), and 6-month follow-up s urveys, All P values are two-sided. Results: By use of multiple regression, statistically significant overall effects of the peer education program me re seen in the intake recall (increase of 0.77 total daily servings; P < .0 001) and the food-frequency (increase of 0.46 total daily servings; P = .00 2) questions at the outcome survey. The effect on the total number of servi ngs persisted at the 6-month follow-up survey when measured by the intake r ecall (increase of 0.41 total daily servings; P = .034) but not the food-fr equency (decrease of 0.04 total daily servings; P = .743) questions, Conclu sions: Peer education appears to be an effective means of achieving an incr ease in fruit and vegetable intake among lower socioeconomic, multicultural adult employees.