The U.S. Dietary Guidelines recommend low-fat milk consumption, and Supplemental Nutrition Assistance Program Education (SNAP-Ed) programs follow these guidelines to develop health education programs for SNAP recipients. This study evaluated a multilevel media intervention promoting low-fat milk use among Oklahoma SNAP recipients, a population often missed. Behavior change was measured with pre- and postintervention telephone interviews with SNAP recipients ( n = 860). Immediately following the intervention, self-reported purchases of 1% milk, the focus of behavior change, significantly increased to 7.9% from 4.1%-a relative improvement of 92.7%, χ2(1, n = 824) = 5.8, p = .02. Milk nutrition knowledge scores significantly improved as well, t(846) = 2.9, p = .004, and low-fat milk users exhibited more milk nutrition knowledge than high-fat milk users, t(437) = 4.0, p = .000. The intervention, which resonated with the priority audience, was well received ( Mdn = 6, 1, 7). Factors contributing to its success included a gain-based message strategy and clearly articulating the desired behavior. Salient messages personalized the issues and concerns raised by the priority audience-all the vitamins and minerals without the fat. Findings suggest that matching gender and ethnicity mediated the effect among those most resistant to substituting low-fat for high-fat milk.
Keywords: behavior change; health education; health promotion; nutrition; outcome evaluation; program planning and evaluation; social marketing health communication.