2.4. Intervention to Encourage the Consumption of Fruits and Vegetables
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The individuals in the CG participated in the routine activities of the health service, which consisted of regular guided practice of physical exercises, three times a week, lasting one hour, in addition to specific health education actions carried out by PHC professionals, except for those related to FV consumption. IG participants additionally participated in a collective intervention to encourage the consumption of FV that lasted seven months. The intervention was planned and developed by a multidisciplinary team (nutritionists, psychologist, and educator) with experience in health education and food and nutrition education, and applied by nutritionists and psychologists, supported by nutrition students, under the supervision of the main researcher [Nutritional intervention was based on the Transtheoretical Model and on the dialogic and problematizing pedagogy proposed by Paulo Freire [Change processes, on the other hand, establish the understanding of how change occurs at different stages, and it can be cognitive, more focused on the initial stages of change; or behavioral, better serving the final stages of change [The Transtheoretical Model was associated with the dialogic and problematizing pedagogy proposed by Paulo Freire in order to contribute to the design of actions capable of promoting the empowerment and autonomy of individuals. According to this approach, dialogue is the guiding thread for liberation, autonomy, and citizenship, being indispensable in the design of educational interventions [For the development of the intervention, the participants were allocated into three groups according to the stages of change: pre-action (contemplation and pre-contemplation stages), preparation, and action (action and maintenance stages) [The themes of the educational actions were defined based on the previous qualitative investigation of practices, obstacles, facilitators, and social representations of FV consumption among the PAS users [In all, 10 workshops were planned (structured work with groups focused around a central issue), and 4 actions in the environment (modifications in the environment with the insertion of unusual objects into the routine of the health service in order to promote reflection), repeated 540 and 171 times, respectively. A total of 4449 postcards in three formats were also distributed with eight different motivational messages aimed at the consumption of FV; a booklet informing about the importance of FV consumption, cleaning, purchase, and storage was also distributed in addition to healthy recipes. More details on the nutritional intervention are described in the article by Menezes et al. [The average percentage of participants’ adherence to the nutritional intervention was 58.3%, with 24.3% having low adherence (30% or less participation), 26.5% having medium (31 to 70% participation), and 49.2% having high adherence (>70% participation) [