The Stanford Nutrition Action Program: a dietary fat intervention for low-literacy adults

Am J Public Health. 1997 Dec;87(12):1971-6. doi: 10.2105/ajph.87.12.1971.


Objectives: This study was undertaken to test the effectiveness of the Stanford Nutrition Action Program, an experimental trial to reduce dietary fat intake among low-literacy, low-income adults.

Methods: Twenty-four paired adult education classes (351 participants, 85% women, mean age = 31 years) were randomly assigned to receive a newly developed dietary fat curriculum (the Stanford Nutrition Action Program) or an existing general nutrition curriculum. Food frequency and nutrition-related data, body mass index, and capillary blood cholesterol were collected at baseline and at two postintervention follow-ups.

Results: The Stanford Nutrition Action Program classes showed significantly greater net improvements in nutrition knowledge (+7.7), attitudes (/0.2), and self-efficacy (-0.2) than the general nutrition classes; they also showed significantly greater reductions in the percentage of calories from total (-2.3%) and saturated (-0.9%) fat. There were no significant differences in body mass index or blood cholesterol. All positive intervention effects were maintained for 3 months postintervention.

Conclusions: The Stanford Nutrition Action Program curriculum, tailored to the cultural, economic, and learning needs of low-literacy, low-income adults, was significantly more effective in achieving fat-related nutritional changes than the general nutrition curriculum.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Body Mass Index
  • Cholesterol / blood
  • Curriculum*
  • Diet, Fat-Restricted*
  • Educational Status*
  • Female
  • Follow-Up Studies
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Nutritional Sciences / education*
  • Patient Education as Topic / methods*
  • Poverty
  • Program Evaluation


  • Cholesterol