Activity + Eating: Small Steps to a Healthier You

Small Steps to a Healthier You BookletHealth Professional and Parent Program Evaluation Results

Evaluation Summary


Overview 
Our Activity + Eating: Small Steps to a Healthier You (A+E) is an eight-page interactive nutrition education booklet for adults. The A+E booklet consists of diet and physical activity recommendations, tips for overcoming barriers to healthy behaviors, self-assessments, behavioral charting and goal-setting activities. The A&E booklet is based upon Social Cognitive Theory, utilizing self-monitoring, goal-setting and reinforcement activities to increase self-efficacy to engage in healthy weight-related behaviors. Materials are available in English and Spanish.

A 2010 evaluation assessed the effectiveness of the A+E booklet at changing knowledge and behaviors related to physical activity and healthy dietary practices. Adults were recruited from local businesses and from an adult education English language learner program. Participants were assigned to an intervention group that received the Activity + Eating booklet or a control group based on recruitment site or class. Dietary behaviors and knowledge, physical activity, height, and weight were assessed through self-report pre- and post- (1 month) and follow-up (3 months) surveys. Participants received the A+E booklet via direct mail at local business sites and went through the materials independently. Participants from the adult education program went through the booklet as a group during class time.

An overwhelming 77% said that they would do something different about their diet and exercise habits. Behaviors that individuals identified they would like to change included to "stop skipping meals", to "eat a variety of foods" and to "use 10 minute increments three times a day to set an exercise pattern".

After 1 month, half of the A+E program participants had read at least 75% of the booklet. On average, participants completed 3 out of the 5 tools and activities in the booklet. The booklet content was rated most highly in terms of being informative and received the lowest score for clarity. Although there were no changes in dietary intake or knowledge among local business participants between the pre- and post- survey, "extra" foods such as sweets and low-nutrient food consumption significantly decreased and lean meat consumption significantly increased from pre- to post- survey. These participants showed significant improvements in moderate and total physical activity between the pre- and post- survey, and significant improvements in vigorous physical activity between the pre- and follow-up survey. On the other hand, adult education participants did not show any significant improvements in dietary intake, knowledge, physical activity or BMI between the pre- and post- or follow-up surveys.

Overall, evaluation results suggest that participants who received the A+E booklet read most of the booklet and completed over half of the activities. Findings indicate that the A+E booklet has the potential to increase physical activity in adults with a higher level of education (e.g., local business employees). The inconclusive results for change in diet and BMI could be due to weaknesses in the overall evaluation design.

As a result of the evaluation process, the A+E booklet was revised. To address content clarity, the reading level of the program was reduced to the sixth grade level, the food chart and physical activity journal were simplified and a food diary was added. Initial feedback from health professionals indicates that the revised booklet is easier to read, offers more opportunity for client reflection and increased opportunity for goal setting. Future evaluation and testing will identify psychosocial and behavior change outcomes in adult consumers.

For more information about the new booklet, check this description page: Activity + Eating.