Evaluating the Dissemination of Body & Soul, an Evidence-based Fruit and Vegetable Intake Intervention: Challenges for Dissemination and Implementation Research

ObjectiveTo evaluate whether the evidence-based Body & Soul program, when disseminated and implemented without researcher or agency involvement and support, would achieve results similar to those of earlier efficacy and effectiveness trials.DesignProspective group randomized trial.SettingChurches with predominantly African American membership.ParticipantsA total of 1,033 members from the 15 churches completed baseline surveys. Of these participants, 562 (54.4%) completed the follow-up survey 6 months later.InterventionChurch-based nutrition program for African Americans that included pastoral involvement, educational activities, church environmental changes, and peer counseling.Main Outcome MeasureDaily fruit and vegetable (FV) intake was assessed at pre- and posttest.AnalysisMixed-effects linear models.ResultsAt posttest, there was no statistically significant difference in daily servings of FVs between the early intervention group participants compared to control group participants (4.7 vs 4.4, P = .38). Process evaluation suggested that added resources such as technical assistance could improve program implementation.Conclusions and ImplicationsThe disseminated program may not produce improvements in FV intake equal to those in the earlier efficacy and effectiveness trials, primarily because of a lack of program implementation. Program dissemination may not achieve public health impact unless support systems are strengthened for adequate implementation at the church level.