| Methods |
Cluster RCT of cross‐over design. Sites were switched 4 months after completion of phase 1. Each site acted as own control, using intention to treat analysis. Phase 1 participants were not eligible to enrol in phase 2. Specially employed peer educators conducted the intervention. |
| Participants |
Women on low incomes recruited from a government funded special supplemental nutrition program for women infants and children in Baltimore City. 16 sites where this program was carried out were randomised, involving 3122 women, of whom 40.5% were aged between 18‐24, 26.5% between 25‐29 and 33% 30 years or more. |
| Interventions |
Five a day promotional program where the goal was to increase fruit and vegetable consumption by at least half a serving per day. Peer educators delivered 2 types of nutrition education ‐ brief messages regarding increasing fruit and vegetable consumption at enrolment, and 3 group discussions of 45 minutes during the 6 month intervention period which included personal goal setting, overcoming perceived barriers and maintenance strategies. Printed materials, visual aids and booklets with recipes were distributed. Four individually tailored letters were sent over the 6 month period. Comparison group received no intervention. Follow‐up at 8 months. |
| Outcomes |
Fruit and vegetable servings per day. |
| Notes |
|
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Unclear risk |
See Table 1 |
| Allocation concealment (selection bias) |
Unclear risk |
See Table 1 |
| Blinding of participants and personnel (performance bias)
All outcomes |
Unclear risk |
See Table 1 |
| Blinding of outcome assessment (detection bias)
All outcomes |
Unclear risk |
See Table 1 |
| Incomplete outcome data (attrition bias)
All outcomes |
Unclear risk |
See Table 1 |
