5 A Day for Better Health Program Evaluation Report: Program Description

As previously noted, the 5 A Day Program was proposed as a 5-year collaborative effort between the NCI and the PBH. In addition, the NCI planned to fund community coalitions or health departments to develop, implement, and evaluate community health-education interventions. The major planned components of the 5 A Day Program included a media campaign, retail point-of-purchase program, and community-level interventions. A coordinating committee, composed of two representatives each from the NCI and the PBH, directed the project. The roles of the NCI were to maintain the scientific credibility of the program, plan and conduct evaluations, create an RFA for developing community interventions, and develop materials and training through the NCI/OCC. The roles of the PBH were defined as performing public relations functions, fundraising and providing in-kind support, implementing the point-of-purchase plan, recruiting additional partners, and monitoring implementation of the campaign. The roles of the licensed state health departments included developing coalitions with the food industry, monitoring implementation and conducting evaluations of state programs, and providing local placement of publicity.

Funding and Program Plan

Funding for the 5 A Day Program was initially projected to be up to $25 million, from FY 1992 through FY 1996. A sixth year (FY 1997), with up to $2 million in funding, was subsequently included to allow completion of evaluation efforts, production of program materials, and communication of the message (see Table 1). Activities for the 5 A Day Program were scheduled to occur in two phases: Phase I (Year 1) activities involved creating a strategic plan, revising the California 5 A Day materials, collecting and analyzing baseline data, planning the national media campaign and point-of-purchase programs, and developing the RFA for community coalitions. The NCI created two new staff positions, a program director and evaluation manager, to support the 5 A Day Program. Phase II (Years 2-5) activities were directed toward implementing the 5 A Day Program based on the strategic plan. During Year 2, the NCI would be responsible for implementing the national media campaign, developing program materials, and monitoring industry participation and campaigns. Industry partners would distribute program materials and implement the point-of-purchase program. Also during Year 2, the RFA would be advertised to invite coalitions/health departments to serve as channels for creating state and local-level intervention programs. During Years 3 and 4, Year 2 activities would continue; in addition, community-level projects would develop a national network to maintain consistent scientific quality and to compare data across studies. Year 5 would include continuation of 5 A Day activities and an assessment of the program's effectiveness. If the assessment included a recommendation to continue the 5 A Day Program, strategic planning would begin during Year 5. Otherwise, if the program were terminated, 5 A Day interventions would be transferred to the community programs for continuation, and a final evaluation would be completed.

Evaluations planned for the 5 A Day Program included those of outcome, process, and implementation. The outcome evaluation would determine whether a change in public awareness and knowledge had occurred. National trends in consumption of vegetables and fruit would be obtained from existing national surveys as well as from the study baseline and followup surveys. The process evaluation was intended to be a formative evaluation to establish whether the program was appropriate for the target subpopulations, and was to include an assessment of materials and communication strategies. The implementation evaluation was intended to consist of measures of industry participation, implementation of community interventions, and media coverage of the 5 A Day Program.

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