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The purpose of this project was to compare the impact of Internet nutrition education to traditional nutrition education on Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participant fruit and vegetable consumption. Interventions were delivered at 15 WIC clinics after normal WIC clinic operations or delivered online. A total of 692 and 872 participants from eight WIC agencies self-enrolled into two phases. A quasi-experimental design using an interrupted time series to determine the impact of two methods of nutrition education and follow-up nutrition counseling was used. Data were collected online and at Michigan WIC clinics during 2005-2007 at 3-month intervals during a 9-month period (per phase). Two Internet nutrition education modules were compared to WIC traditional nutrition education, which included either group classes or a self-guided nutrition education information mall. All interventions were based on the same program learning objectives. Optional motivational negotiation counseling followed 3 months post-intervention. Stage of change progression, belief in ability to change, and fruit and vegetable consumption were measured at baseline, immediately after the intervention, and 3 and 6 months post-intervention. Significance (P<0.05) was analyzed using independent samples t tests, χ(2) distribution, and sample tests for differences in binomial proportions. The Internet group experienced substantial positive differences in stage of change progression, perception that the intervention was helpful and easy to use, and fruit and vegetable consumption. Traditional nutrition education required follow-up counseling to achieve fruit and vegetable consumption levels similar to the Internet nutrition education group. Based on these findings, this study supports Internet nutrition education as a viable alternative to traditional nutrition education for increasing fruit and vegetable consumption in some WIC clients., (Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.)

Objective: To determine the usefulness and impact of on stage of change associated with 8 WIC client nutrition issues., Design: Cross-sectional design. Data were collected through an online survey and via Web pages visited by clients for each module., Setting: intervention and data collection are Internet-based., Participants: 39,541 WIC participants from 7 states completed a module and online survey. Subjects were likely between the ages of 18 and 34, residing in Michigan, Illinois, or Indiana, and accessing the Internet from home., Interventions: Intervention included 5 online modules focusing on parent-child feeding behaviors., Variables Measured: Impact variables included stage of change movement, user belief in ability to engage in behavior, and perception of site usefulness., Analysis: Data were reported using frequency, ANOVA (analysis of variance) (P < . 01), and chi-square (P < .01) analyses., Results: Movement in stage was greatest for the "picky eater" (PE) module. Contemplation as the beginning stage had the greatest stage movement. Participants responded well to all measures of site usefulness. User belief in ability to engage in behavior was associated with 7 of the 8 modules., Implications for Research and Practice: is a highly popular and viable method for impacting movement in stage of change with a number of parent-child feeding issues.

Patterns of Internet-based menu item selection can occur for a number of reasons, many of which may not be based on interest in topic. It then becomes important to ensure menu order is devised in a way that ensures the greatest accuracy in matching user need with selection. This study examined the impact of menu rotation on the selection of Internet-based parent-child feeding behavior education and behavior change modules by participants in the Women, Infants and Children (WIC) program across seven states. Five modules were rotated over a course of 4 weeks, each having the opportunity to be listed in all positions in the menu sequence, resulting in a significant (p less than 0.01) difference in module access. Modules listed in first and second position observed greater access than the other modules, with the exception of the module "make meals and snacks simple," which retained consistent access trends regardless of position. Overall, modules in the first two positions observed the greatest access, regardless of module title. This study provides evidence of the importance for website developers to consider menu design when developing Internet-based health promotion programming. (Contains 2 tables and 1 figure.)