The influence of health behavior clusters on dietary change

Background The goal of this study was to identify cancer preventive health behavior clusters and to determine if clusters responded differently to a year-long intervention to increase fruit and vegetable consumption. Methods The North Carolina Strategies for Improving Diet, Exercise, and Screening (NC STRIDES) is a health communications intervention (n = 595) among colorectal cancer survivors and a comparison population. Cluster analysis was used to identify nonoverlapping groups based on fruit and vegetable intake (servings/day), physical activity (minutes/day), multivitamin use (yes/no), and body mass index (kg/m2). Logistic regression was performed to assess positive change in fruit and vegetable servings, using the healthiest cluster as the reference group. Results Five clusters were formed; they differed significantly by health behaviors and demographics. Clusters 1 and 2 (those following the “Healthy Choices” and “Eating Well” patterns) were eating more than 5 A Day before the intervention (8.6 and 6.9 servings/day), and did not show any increase. Cluster 3 (“Physically Active”) reported an increase of 1.3 servings/day to reach 5.4 servings/day, and Clusters 4 and 5 (“Average Americans” and “Most Challenged”) improved one serving/day for final intakes of 5.2 and 5.0 servings/day. Conclusions These findings illustrate some differences in magnitude of response to a fruit and vegetable intervention based on health behavior profiles. Creating clusters or other categories from baseline health behaviors may help to further improve targeting and/or tailoring in health promotion interventions.