Helping Families Move Towards Healthier Choices: Combining Motivational Interviewing and Boosters to Increase Fruit and Vegetable Consumption with WIC Participants

Background: In order to meet the challenge of increasing fruit and vegetable consumption in young children the WIC program must carefully assess each aspect of its nutrition education efforts. Making a transition from a provider-centered to client-centered counseling style is a key area for assessment.

Goal: To determine whether Motivational Interviewing (MI) alone, or coupled with boosters increases the frequency with which WIC parents offer fruits and vegetables to their preschoolers.

Methods: Three hundred and sixty families were recruited from 3 local WIC clinics to provide baseline data on the frequency of offering of fruits and vegetables and to identify their barriers to increasing it. After collection of baseline data, Staff were trained in MI. For the second part of the study, 600 new families were randomized to receive MI alone or MI plus boosters. The boosters were based on Stages of Change and tailored to the individual's primary barrier. Both groups completed the diet assessment three times, at six month intervals.

Results: The most frequently identified barrier to increasing fruits and vegetables was the child's pickiness. There were no significant differences between groups in frequency of offering of fruits and vegetables. However, a qualitative evaluation done with WIC staff found significant transformations as a result of MI training. A survey of booster recipients found the items were well received.

Discussion: Motivational interviewing increases job satisfaction for WIC staff. The use of Stages of Change coupled with commercial marketing strategies is a promising strategy for guiding creation of written materials.