The Treatwell 5-a-Day Program

Highlights
Program Title The Treatwell 5-a-Day Program
Purpose Worksite program designed to increase fruit and vegetable consumption. (1999)
Program Focus Behavior Modification
Population Focus Employees
Topic Diet/Nutrition
Age Adults (40-65 years), Older Adults (65+ years), Young Adults (19-39 years)
Gender Female, Male
Race/Ethnicity Black, not of Hispanic or Latino origin, Hispanic or Latino, White, not of Hispanic or Latino origin
Setting Home-based, Workplace
Origination United States
Funded by NCI (Grant number(s): CA597285)
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Details about Reach
Reach
20.0%
Details about Effectiveness
Effectiveness
33.3%
Details about Adoption
Adoption
60.0%
Details about Implementation
Implementation
57.1%
The Need

Consistent evidence points to the protective role played by consumption of fruits and vegetables in many epithelial cancers. Diet has been estimated to contribute to approximately 35% of all cancer incidence. Despite this strong scientific evidence, research indicates that only 20% to 30% of Americans meet recommendations to consume 5 or more servings of fruits and vegetables per day. Worksites are an ideal channel for promoting dietary change because they (1) provide access to a large segment of the population (approximately 70% of American adults are employed); (2) can be offered repeatedly, thus increasing the likelihood of motivating behavior change in persons who are at various stages of readiness; and (3) permit support for individual behavior change attempts by modifying the environment and social norms. 

The Program
Description

The Treatwell 5-a-Day Program aims to increase fruit and vegetable consumption among individuals at the worksite. As a component of a broader health promotion program, Treatwell seeks to build support for behavior change from coworkers, household members, and the worksite environment. Its components include:
-- Periodic exposure to national 5-a-Day media campaigns and promotion of the National Cancer Institute's Cancer Information Service Hot Line (1-800-4CANCER)
-- A 1-hour general nutrition presentation and taste test
-- Creation of an employee advisory board to develop and implement the programs
-- A kick-off event
-- The Eatwell 5-a-Day discussion series, which consists of ten 30-minute sessions on purchasing   and preparing healthful meals
-- At least one educational campaign each year that lasted 3-5 weeks
-- Increasing availability of fruits and vegetables at the workplace
-- Family activities that include a learn-at-home program (Fit-in-5), newsletters and other mailings, and an annual family festival 

Implementation Guide

The Implementation Guide is a resource for implementing this program. It provides important information about the staffing and functions necessary for administering this program in the user's setting. Additionally, the steps needed to carry out the research-tested program, relevant program materials, and information for evaluating the program are included. The Implementation Guide can be viewed and downloaded in the Products page.

Time Required

Time varies depending on the needs of the worksite as determined by the employee advisory board. For the study, the intervention was implemented over a 20-month period. 

Intended Audience

The intended audience for the Treatwell 5-a-Day Program is working adults.

Suitable Settings

This intervention is suitable for implementation in a worksite setting.

Required Resources

The protocol, Best Practices Manual, is required, and adaptations are encouraged. Costs associated with the program's implementation are not provided.

About the Study

Twenty-two worksites were randomly assigned to three groups: (1) a minimal intervention control group, (2) a worksite intervention, and (3) a worksite-plus-family intervention (Treatwell). Each of the three groups received three core components: exposure to 5-a-Day media campaigns, promotion of the National Cancer Institute's Cancer Information Service Hotline, and a 1-hour general nutrition presentation and taste test. 

In addition to the core components, the worksite and worksite-plus-family intervention conditions included (1) worker participation in program planning and implementation, (2) programs to change individual behavior (e.g., taste tests, self-assessments with feedback, contests), and (3) programs to change the worksite environment (e.g., healthy snacks in break rooms and vending machines; the placement of posters, videos, and brochures in places where employees eat).

The worksite-plus-family condition also included (1) a written learn-at-home program, "Fit in 5", (2) an annual family newsletter, (3) an annual family festival, and (4) periodic mailings of materials to families. 

Key Findings
  • The worksite-plus-family intervention (Treatwell) was more successful in increasing fruit and vegetable consumption than the control condition. On average, workers in the worksite-only intervention group reported a 7% increase in consumption and those in the worksite-plus-family condition reported a 19% increase (p=.02), while the control group reported no significant change in their consumption. 

Publications
Primary
Secondary

Sorensen G, Stoddard AM, LaMontagne AD, Emmons K, Hunt MK, Youngstrom R, McLellan D, Christiani DC. (2002). A Comprehensive Worksite Cancer Prevention Intervention: Behavior Change Results from a Randomized Controlled Trial. Cancer Causes & Control, 13, 493-502.

Sorensen G, Hunt MK, Cohen N, Stoddard A, Stein E, Phillips J, Baker F, Combe C, Hebert J, Palombo R. (1998). Worksite and Family Education for Dietary Change: The Treatwell 5-a-Day Program. Health Education Research, 13(4), 577-591.

Hunt MK, Stoddard AM, Peterson K, Sorensen G, Hebert JR, Cohen N. (1998). Comparison of Dietary Assessment Measures in the Treatwell 5-a-Day Study. Journal of the American Dietetic Association, 98(9), 1021-1023.

Cohen NL, Stoddard AM, Sarouhkhanians S, Sorensen G. (1998). Barriers toward Fruit and Vegetable Consumption in a Multiethnic Worksite Population. Journal of Nutrition Education, 30 (6), 381-386.

Hunt MK, Lederman R, Potter S, Stoddard A, Sorensen G. (2000). Results of Employee Involvement in Planning and Implementing the Treatwell 5-a-Day Work-Site Study. Health Education & Behavior, 27(2), 223-231.

Hunt MK, Lederman R, Stoddard A, Potter S, Phillips J, Sorensen G. (2000). Process Tracking Results from the Treatwell 5-a-Day Worksite Study. American Journal of Health Promotion, 14(3), 179-187.

Hebert JR, Peterson KE, Hurley TG, Stoddard AM, Cohen N, Field AE, Sorensen G. (2001). The Effect of Social Desirability Trait on Self-Reported Dietary Measures among Multi-Ethnic Female Health Center Employees. Annals of Epidemiology, 11, 417-427.

Sorensen G, Stoddard A, Macario E. (1998). Social Support and Readiness to Make Dietary Changes. Health Education & Behavior, 25(5), 586-598.

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Updated: 04/20/2016
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