OBJECTIVES: This National Cancer Institute-funded study sought to increase fruit and vegetable consumption among women served by the WIC program in Maryland. METHODS: Over a 2-year period, a multifaceted intervention program using a randomized crossover design sought to increase fruit and vegetable consumption at 16 WIC program sites in Baltimore City and 6 Maryland counties. Participants were surveyed at baseline, 2 months postintervention, and 1 year later. RESULTS: Two months postintervention, mean daily consumption had increased by 0.56 +/- 0.11 servings in intervention participants and 0.13 +/- 0.07 servings in control participants (P = .002). Intervention participants also showed greater changes in stages of change, knowledge, attitudes, and self-efficacy. Changes in consumption were closely related to number of nutrition sessions attended, baseline stage of change, race, and education. One year later, mean consumption had increased by an additional 0.27 servings in both intervention and control participants. CONCLUSIONS: Dietary changes to prevent cancer can be achieved and sustained in this hard-to-reach, low-income population. However, many obstacles must be overcome to achieve such changes.

Numbers of nursing home beds now exceed hospital beds in the United States and are usually occupied by women. Urinary incontinence is very common and may be managed with long-term urethral catheters. Bacteriuria invariably results, yet its clinical consequences are not well known. We studied 47 catheterized and bacteriuric women for almost 25 patient-years. The incidence of febrile episodes of possible urinary origin was 1.1 episodes/100 patient-days. Because these were diagnoses of exclusion, even this low incidence may be an overestimate. Most of these episodes were of less than or equal to 38.3 C (101.0 F), lasted for less than one day, and resolved without antibiotic therapy. Six deaths, half the total from all causes, occurred during these episodes, an incidence 60 times that during afebrile periods. Deaths and bacteremias were significantly associated with episodes of greater than or equal to 38.8 C (102.0 F). In the individual patient, these risks should be weighed against benefits of patient comfort, family satisfaction, and prevention and management of decubitus ulcers.

This study sought to examine: (a) the relative effects of baseline demographic and psychosocial factors and an intensive nutritional intervention on changes in fruit and vegetable consumption in low-income, ethnically diverse women served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program in Maryland; (b) whether this intervention, designed to modify psychosocial factors associated with fruit and vegetable consumption, was successful in changing these factors; and (c) whether changes in these factors were associated with increased consumption. The same women from 15 WIC program sites were surveyed at baseline and postintervention 8 months later. Women randomized to the intervention group showed significantly greater mean change in self-efficacy, attitudes, social support, and knowledge of national consumption recommendations than control group women. Changes in all psychosocial factors were significantly associated with nutrition session attendance and increased consumption. In a hierarchical model, changes in these factors accounted for most of the intervention effect on increased consumption.

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