Using a Toolbox of tailored educational lessons to improve fruit, vegetable, and physical activity behaviors among African American women in California.

OBJECTIVE Evaluate the effectiveness of the Fruit, Vegetable, and Physical Activity Toolbox for Community Educators (Toolbox), an intervention originally designed for Spanish- and English-speaking audiences, in changing knowledge, attitudes, and behavior among low-income African American women. DESIGN Quasi-experimental design with treatment and control groups. SETTING Four community-based organizations and direct health service provider sites. PARTICIPANTS African American women ages 18-54 (156 treatment, 171 control), 75% of whom were low income. INTERVENTION Six 1-hour Toolbox classes. MAIN OUTCOME MEASURES Knowledge, attitudes, self-efficacy, empowerment, and behavior change related to fruits and vegetables and physical activity. ANALYSIS Dependent t tests pre- to posttest and chi-square test between control and treatment groups. RESULTS Women in the treatment group reported significant changes in 9 measures of attitude, compared to 1 measure in the control group, as well as 12 measures of confidence and 5 measures of empowerment for which the control group showed no changes. Compared to those in the control group, women in the treatment group were also more likely to make behavioral changes to meet recommendations for fruit and vegetable consumption and physical activity. CONCLUSIONS AND IMPLICATIONS Toolbox lessons were effective in increasing participants' knowledge, attitudes, self-efficacy, empowerment, and reported fruit and vegetable- and physical activity-related behaviors.