| Cardiovascular disease is the leading cause of death in the US. Many programs focus on reducing risk factors, but successful behavior change is difficult to achieve. Food Steps, a program based on the transtheoretical model, helps individuals assess readiness to initiate change. This study examined whether Food Steps is more successful when presented as a worksite program enhanced by facilitation of an occupational health nurse as compared to the standard correspondence format.;Participants were recruited at two companies. The Enhanced Program Group received Food Steps along with weekly meetings; the Standard Program Group used the correspondence format. Total cholesterol, HDL, and LDL levels were drawn. Multiple covariates were examined.;Analyses indicated statistically significant differences between groups in gender, with the Standard group having more females (chi² (1, N = 356) = 5.55, p = 0.02); and higher education levels (chi² (2, N = 356) = 12.44, p < 0.01). MANOVA determined scores for the Pros & Cons of Change were significant between companies (Wilks lambda = 0.92, F (3, 352) = 10.14, p < 0.01, Partial eta² = 0.08, Power = 1.00). However, after controlling for gender, education, and pros & cons scores, MANCOVA indicated these variables did not interfere with results.;Finally, binary logistic regression was performed to determine if ending Stage of Readiness to Change, Pros & Cons, and Temptation scores increased predictability of group membership. The final step was significant, chi² (3, N = 356) = 265.28, p < 0.01, meaning there is a significant difference in scores by group (Enhanced v. Standard). For every one point increase in stage of readiness, participants were 29.63 times as likely to be in the Standard Group, meaning the Standard Group was more successful in advancing stage of change. For every one point increase in pros and cons score, participants were 0.04 times as likely to be in the Enhanced Program Group, meaning the Enhanced Group demonstrated better understanding of the positive aspects of change. The variable temptation did not significantly contribute to the model. Neither program resulted in statistically significant changes in lipoprotein levels, (F) = 1.10, p = 0.35. |
