Assessing stages of change for fruit and vegetable intake in young adults: a combination of traditional staging algorithms and food-frequency questionnaires

Adequate fruit and vegetable intake is strongly associated with a reduced risk for various chronic diseases. US national surveys show that 18- to-24-year-olds are not consuming enough of these foods. Theory-based nutrition interventions, e.g. stage-tailored education programs, are needed for promoting fruit and vegetable consumption in this age group. Accurate stage assignment is the basis for developing effective stage-tailored interventions. In the current study, three different methods were compared for assigning stages of change in fruit and vegetable intakes by young adults. Significant differences in food intake, decisional balance and self-efficacy were found between respondents with concordant responses to the traditional stage algorithm and the food-frequency questionnaire (FFQ) and those with discordant responses. The stage assignment method that combined the staging algorithm and FFQ identified a distinct stage, labeled 'non-reflective action', in addition to the traditional five stages of change. This stage lay between the preparation and action stages with regard to food intake and psychosocial variables. Implications of the findings were discussed for future intervention programs that attempt to promote fruit and vegetable intake.