Karen E. Peterson
Design of an intervention addressing multiple levels of influence on dietary and activity patterns of low-income, postpartum women
lowincome multiethnic women elevated risk obesity chronic diseases yet influences different levels may act barriers changing risk behaviors following birth child childrearing social isolation exacerbate influences social ecological framework integrates behaviorchange strategies different levels providing strong theoretical base developing interventions highrisk population primary purpose randomized controlled trial test efficacy educational model delivered communitybased paraprofessionals improving diet activity weight loss among new mothers 12month postpartum period 6month maintenance period model fosters institutional change support behavior changes influenced intrapersonal interpersonal levels collaboration federal programs lowincome families special supplemental food program women infants children wic expanded food nutrition education program efnep participants randomized usual care eg wic nutrition breastfeeding education enhanced efnep intervention arm consisting usual wic care plus sustained multicomponent intervention including home visits group classes monthly telephone counseling shown efficacious program readily sustainable existing federal agencies