Randomized trial on the 5 a day, the Rio Grande Way Website, a web-based program to improve fruit and vegetable consumption in rural communities.

The Internet is a new technology for health communication in communities. The 5 a Day, the Rio Grande Way website intended to increase fruits and vegetables (FV) consumption was evaluated in a rural region enrolling 755 adults (65% Hispanic, 9% Native American, 88% female) in a randomized pretest-posttest controlled trial in 2002-2004. A total of 473 (63%) adults completed a 4-month follow-up. The change in daily intake on a food frequency questionnaire (control: mean = - 0.26 servings; intervention: mean = 0.38; estimated difference = 0.64, SD = 0.52, t(df = 416) = 1.22, p = 0.223) and single item (13.9% eating 5 + servings at pretest, 19.8% posttest for intervention; 17.4%, 13.8% for controls; odds ratio (OR) = 1.84, 95% CI = 1.07, 3.17) was in the expected direction but significant only for the single item. Website use was low and variable (logins: M = 3.3, range = 1 to 39.0; total time: M = 22.2 minutes, range = 0 to 322.7), but it was associated positively with fruit and vegetable intake (total time: Spearman r = 0.14, p = 0.004 for food frequency; Spearman r = 0.135, p = 0.004 for single item). A nutrition website may improve FV intake. The comparison on the food frequency measure may have been undermined by its high variability. Websites may be successful in community settings only when they are used enough by adults to influence them.

Integrating Usability Testing into the Development of a 5 a Day Nutrition Website for At-risk Populations in the American Southwest.

The following article documents an iterative, user-oriented process to develop a nutrition education website for a rural multicultural population. Study participants were purposefully recruited from a six-county region in Southern Colorado and Northern New Mexico representing the range of ethnic backgrounds, demographics and computer experience of the site's target audience. Three studies are presented. Study one, using a card-sorting process produced a basic shallow and broad structure for the website. Study two, using verbal protocol analysis of the prototype website identified six recurring problems and Study three, using verbal protocol analysis of the nearly completed website identified nine recurring problems. The website was redesigned to eliminate the problems and recommendations were provided for training users.