Mediation of adult fruit and vegetable consumption in the national 5 a day for better health community studies

Marci Kramish Campbell, Dale McLerran, Gabrielle Turner-Mcgrievy, Ziding Feng, Stephen Havas, Glorian Sorensen, David Buller, Shirley A.A. Beresford, Linda Nebeling

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


Background: The 5 A Day for Better Health community studies demonstrated in randomized trials the efficacy of population-based strategies to increase fruit and vegetable consumption in diverse geographic areas and settings. Purpose: Mediation analysis can help to elucidate the theoretical basis of changing dietary habits. This is important for informing more powerful cancer prevention and control interventions to achieve broad public health impact. Methods: Five sites that focused on adults were included in mediation analyses to determine whether theoretically derived constructs assessed at baseline and follow-up contributed to explaining change in fruit and vegetable (F&V) consumption. These variables were knowledge, self-efficacy, and autonomy/responsibility. Stage of change also was considered as a potential moderating variable. Results: Self-efficacy and knowledge of the 5 A Day recommendation increased in those who received the interventions and were positively associated with higher F&V. Mediation of intervention effect was demonstrated for these variables. Autonomy/responsibility did not meet the criteria for mediation. There was no evidence of differential effect of mediators according to baseline stage. Conclusions: The present study findings provide strong support for mediation of F&V consumption by two variables: self-efficacy and knowledge. The authors discuss the findings in relation to study limitations and future research directions.

Original languageEnglish (US)
Pages (from-to)49-60
Number of pages12
JournalAnnals of Behavioral Medicine
Issue number1
StatePublished - Feb 2008


  • Cancer prevention
  • Fruit and vegetable consumption
  • Health promotion
  • Mediation

ASJC Scopus subject areas

  • Psychology(all)
  • Psychiatry and Mental health


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