Winkleby Lab In the Prevention Research Center

Stanford Nutrition Action Program (SNAP)

Specific Aims:

The purpose of the proposed research program is to develop and test nutrition education methods and materials for adults with low literacy skills in order to improve their cardiovascular disease (CVD) risk. The Stanford Center for Research in Disease Prevention (SCRDP) has an established history of developing CVD prevention materials for use in community settings, using both face-to-face and mediated methods, the latter including print and electronic media. While many of these have been suitable for adults with low literacy skills, none were developed specifically for low-literate populations. The proposed study will allow us to adapt existing materials and develop new materials in order to create an innovative nutrition education program for low-literate adults.  This program will be designed with separate modules that can be widely used in different settings and specifically matched to audience needs.  The proposed research will draw on the interdisciplinary educational development strengths of the SCRDP and enable us to investigate ways to reach multi-ethnic populations at high risk for developing CVD.  We will utilize our contacts with local agencies and indigent communities, as well as our established skills in clinical investigation, epidemiology, intervention studies, and data analysis.

The specific aims of this research are to:

1. Conduct intensive formative evaluation involving experts in literacy, nutrition, and research design as well as community health workers, food service providers and low literacy people;

2. Design an innovative CVD nutrition program, composed of distinct education modules, that utilizes face-to-face, participatory education and mediated materials for adults with limited literacy skills;

3. Conduct a randomized, controlled study in 240 low-income, poorly educated adults that tests this special CVD nutrition intervention program (SI) against an existing traditional-style nutrition education program (UC) for its ability to improve nutrition knowledge and behavior, decrease dietary fat intake, and reduce capillary blood cholesterol over a five-month period;

4. Modify and supplement the education modules from the special nutrition program using the experience from the randomized study, making them useful in other settings that serve low-literate populations;

5.  Implement and evaluate the modules from the nutrition program in two new settings; one at the individual level (low-literate adults in a non-classroom setting) and one at the environmental level  (service organizations providing free food to low-income, low-literate populations);

6. Explore the feasibility of disseminating the nutrition program and education modules through multiple distribution channels to local and national groups serving low-literate populations.


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