Stages of change and the intake of dietary fat in African-American women: Improving stage assignment using the Eating Styles Questionnaire

Objective To develop an algorithm for determining the stage of change for d ietary fat intake in African-American women. Design We examined the relationships between stage of change, dietary fat i ntake, and associated eating behaviors and developed an assessment tool for placing subjects in their appropriate stage of change. Subjects Working class and middle-income African-American women in Nashvill e, Tenn; 174 in study 1 and 208 in study 2. Statistical analyses Fat and fi ber intake by stage of change was examined using multivariate analysis of v ariance. Hierarchical cluster analysis was performed using Ward's method. Results A significant difference in fat intake was noted between women tryi ng to change their intake and those not trying to change in study 1 (P<.001 ) and study 2 (P<.03). Of those trying to change, only 34% (study 1) and 9% (study 2) of subjects reported fat intakes below the Healthy People 2000 g oal of 30% of energy from fat. In study 1, cluster analysis identified 14 g roups of foods that significantly separated subjects into not trying, nonco mpliant, and compliant categories. Compliant subjects ate out less; ate few er snack foods and less chicken, meat, and fat; and ate more fruits, vegeta bles, breakfast foods, and low-ist products. These results led to developme nt of the Eating Styles Questionnaire (study 2), which facilitated more app ropriate placement of the noncompliant group in stages of change for dietar y fat intake. Applications/conclusions These data support the stage construct of the Tran stheoretical Model for dietary fat reduction in African-American women. Mor eover, the Eating Styles Questionnaire (ESQ) can improve determination of s tage of change for this group of women. The ESQ can be used to diagnose the eating styles that contribute to a high-fat intake and help in the design of interventions to lower fat intakes.