Walk Texas! 5-A-Day Intervention for Women, Infants, and Children Clients: A Quasi-Experimental Study

This study was conducted to evaluate the Walk Texas! Clinical Counseling Guide for Nutrition, which is a brief, stage-based nutritional counseling guide designed for use in clinical settings. This study utilized a pre-test post-test quasi–experimental design, with two intervention and two comparison clinics that were matched for size and ethnicity. Intervention participants were staged for readiness to meet the 5-A-Day criteria for fruits and vegetables (F&V) and provided stage-based counseling. Women, Infant, and Children (WIC) counselors were trained to utilize the Walk Texas! brief staging instrument and to provide all counseling. Primary measures included: stage of change, barriers to change, attitudes toward F&V, self-efficacy, and self-reports of F&V consumption. These were collected at baseline and during follow-up visits to the WIC clinic. A total of 433 participants completed pre-test data across the four sites. A number of individuals transferred from their original clinic or did not return to their clinic during the study (n=62). Of the remaining 371 participants, a total of 225 participants returned at least two surveys, for a response rate of 60.6%. These were primarily native Spanish speaking, Hispanic women, of low educational level. Results were mixed. Although there was no significant increase in the cognitive constructs (self-efficacy, attitudes, etc.), participants in the intervention clinics reported a significant increase in stage of change and a composite measure of F&V intake. In contrast, participants in the control clinics reported no change in these variables. Thus, there appears to be some utility in the use of the Walk Texas! Clinical Counseling Guide for Nutrition in this population.