1
|
Campos SF, Lopes MS, dos Santos LC, de Freitas PP, Lopes ACS. Evaluation of Nutrient Consumption for the Prevention of Chronic Diseases in Health Promotion Services: A Controlled and Randomized Community Trial to Promote Fruits and Vegetables. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6267. [PMID: 37444114 PMCID: PMC10341051 DOI: 10.3390/ijerph20136267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023]
Abstract
To evaluate the effectiveness of a collective intervention to encourage the consumption of fruits and vegetables on the nutrients intake for the prevention of chronic non-communicable diseases (NCDs), a randomized controlled community trial was conducted with a representative sample from the Health Academy Program. While the individuals in the control group (CG) participated in regular physical exercise, those in the intervention group (IG) also participated in a collective intervention. After 12 months, IG and CG showed a reduction in energy, omega 3 and sodium intake and an increase in the consumption of carbohydrates, fiber, vitamins, and minerals. Individuals from the CG showed an increase in phosphorus consumption and, in the IG, a reduction in the consumption of total, saturated, and polyunsaturated fats as well as an increase in the consumption of monounsaturated fats was seen. In both groups, there was an increase in the prevalence of adequate nutrients. Participation in the nutritional intervention was associated with lower consumption of energy and protein in the diet. The results pointed to the importance of individuals' participation in the program, which, associated with nutritional intervention, promoted an improvement in the nutrient profile of the diet and the prevention and control of NCDs.
Collapse
Affiliation(s)
- Suellen Fabiane Campos
- Department of Nutrition, Nursing School, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil; (S.F.C.); (L.C.d.S.); (P.P.d.F.)
| | - Mariana Souza Lopes
- Department of Nutrition, Health Science Center, Federal University of Paraíba, João Pessoa 58051-900, Brazil;
| | - Luana Caroline dos Santos
- Department of Nutrition, Nursing School, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil; (S.F.C.); (L.C.d.S.); (P.P.d.F.)
| | - Patrícia Pinheiro de Freitas
- Department of Nutrition, Nursing School, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil; (S.F.C.); (L.C.d.S.); (P.P.d.F.)
| | - Aline Cristine Souza Lopes
- Department of Nutrition, Nursing School, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil; (S.F.C.); (L.C.d.S.); (P.P.d.F.)
| |
Collapse
|
2
|
Ullmann GR, Faria DPBD, Zihlmann KF, Speridião PDGL. Attitudes and practice of caregivers for cow's milk allergy according to stages of behavior change. REVISTA PAULISTA DE PEDIATRIA 2022; 40:e2021133. [PMID: 35674551 PMCID: PMC9172849 DOI: 10.1590/1984-0462/2022/40/2021133in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/08/2021] [Indexed: 11/22/2022]
Abstract
Objective: To verify the attitudes and practices of dietary management for cow's milk allergy by caregivers according to the stages of behavior change. Methods: Observational, cross-sectional study involving 30 caregivers of children with cow's milk allergy who were followed up in a specialized outpatient clinic, from July 2018 to May 2019. Data collection included a structured questionnaire about sociodemographic aspects, social classification and an adapted algorithm to classify the stages of behavior change based on a trans-theoretical model. Results: Most caregivers (26/30) were females aged 20 to 48 years and belonging to social classes C, D and E. Regarding the stages of behavior change for the dietary management of cow's milk allergy according to the model, 80% of the participants (24/30) were in the action stage, while 20% (6/30) were in the maintenance stage. Conclusions: The attitudes and practices of caregivers for the dietary management of cow's milk allergy are influenced by feelings and emotions that can interfere with communication and the understanding of dietary guidelines; however, these caregivers are in different stages of action and maintenance to change behavior that correspond to their attitudes and practices.
Collapse
|
3
|
Smriti D, Kao TSA, Rathod R, Shin JY, Peng W, Williams J, Mujib MI, Colosimo M, Huh-Yoo J. MICA: Motivational Interviewing Conversational Agent for Parents as Proxies for their Children in Healthy Eating (Preprint). JMIR Hum Factors 2022; 9:e38908. [PMID: 36206036 PMCID: PMC9587490 DOI: 10.2196/38908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 12/02/2022] Open
Abstract
Background Increased adoption of off-the-shelf conversational agents (CAs) brings opportunities to integrate therapeutic interventions. Motivational Interviewing (MI) can then be integrated with CAs for cost-effective access to it. MI can be especially beneficial for parents who often have low motivation because of limited time and resources to eat healthy together with their children. Objective We developed a Motivational Interviewing Conversational Agent (MICA) to improve healthy eating in parents who serve as a proxy for health behavior change in their children. Proxy relationships involve a person serving as a catalyst for behavior change in another person. Parents, serving as proxies, can bring about behavior change in their children. Methods We conducted user test sessions of the MICA prototype to understand the perceived acceptability and usefulness of the MICA prototype by parents. A total of 24 parents of young children participated in 2 user test sessions with MICA, approximately 2 weeks apart. After parents’ interaction with the MICA prototype in each user test session, we used qualitative interviews to understand parents’ perceptions and suggestions for improvements in MICA. Results Findings showed participants’ perceived usefulness of MICAs for helping them self-reflect and motivating them to adopt healthier eating habits together with their children. Participants further suggested various ways in which MICA can help them safely manage their children’s eating behaviors and provide customized support for their proxy needs and goals. Conclusions We have discussed how the user experience of CAs can be improved to uniquely offer support to parents who serve as proxies in changing the behavior of their children. We have concluded with implications for a larger context of designing MI-based CAs for supporting proxy relationships for health behavior change.
Collapse
Affiliation(s)
- Diva Smriti
- College of Computing and Informatics, Drexel University, Philadelphia, PA, United States
| | - Tsui-Sui Annie Kao
- College of Nursing, Michigan State University, East Lansing, MI, United States
| | - Rahil Rathod
- Tata Consultancy Services, Edison, NJ, United States
| | - Ji Youn Shin
- College of Design, University of Minnesota, Minneapolis, MN, United States
| | - Wei Peng
- College of Communication Arts and Sciences, Michigan State University, East Lansing, MI, United States
| | - Jake Williams
- College of Computing and Informatics, Drexel University, Philadelphia, PA, United States
| | - Munif Ishad Mujib
- College of Computing and Informatics, Drexel University, Philadelphia, PA, United States
| | | | - Jina Huh-Yoo
- College of Computing and Informatics, Drexel University, Philadelphia, PA, United States
| |
Collapse
|
4
|
Ullmann GR, Faria DPBD, Zihlmann KF, Speridião PDGL. Atitudes e práticas de cuidadores sobre a alergia ao leite de vaca segundo os estágios de mudança do comportamento. REVISTA PAULISTA DE PEDIATRIA 2022. [DOI: 10.1590/1984-0462/2022/40/2021133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
RESUMO Objetivo: Verificar as atitudes e práticas do manejo dietético da alergia ao leite de vaca por cuidadores segundo os estágios de mudança do comportamento. Métodos: Trata-se de estudo observacional e transversal que contou com 30 cuidadores de crianças com alergia ao leite de vaca, atendidas em ambulatório especializado, no período de julho de 2018 a maio de 2019. A coleta de dados contou com formulário estruturado que incluiu aspectos sociodemográficos, classificação social e algoritmo adaptado para classificar os estágios de mudança do comportamento de acordo com o modelo transteórico. Resultados: A maioria dos cuidadores (26/30) é do sexo feminino, com idade entre 20 e 48 anos e pertence às classes sociais C, D e E. Quanto aos estágios de mudança do comportamento em relação ao manejo dietético da alergia ao leite de vaca, segundo o modelo transteórico, é possível observar que 80% dos participantes (24/30) se encontram no estágio de ação, enquanto 20% (6/30) no estágio de manutenção. Conclusões: As atitudes e práticas de cuidadores de crianças sobre o manejo dietético na alergia ao leite de vaca são influenciadas por sentimentos e emoções que podem interferir na comunicação e no entendimento das orientações dietéticas. Esses cuidadores se encontram em estágios de ação e manutenção em relação à mudança de comportamento correspondentes às suas atitudes e práticas.
Collapse
|
5
|
Jadgal MS, Alizadeh S, Alizadeh -Siuki H, Sadeghi S, Salehian T, Zareipour M. The effect of theory - Based educational intervention on consumption of smokeless tobacco products by merchants' guilds. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:428. [PMID: 35071634 PMCID: PMC8719556 DOI: 10.4103/jehp.jehp_86_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/17/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Smokeless tobacco (SLT) products are highly addictive and contain at least 28 carcinogenic chemicals. The purpose of this study was to determine the effect of theory-based on the Transtheoretical Model of Behavior Change on consumption of SLT products by Merchants' Guilds in 2018. MATERIALS AND METHODS The present quasi-experimental research was conducted over one intervention group. The research population consisted of all consumers of the SLT products among the merchants' guilds in Chabahar City, Iran in 2018. Data were gathered from 320 individuals by simple random sampling using a valid and reliable researcher-made questionnaire. The intervention program was designed based on the Transtheoretical Model of Behavior Change cognitive processes and lasted 6 months. After the intervention, the same questionnaires were administered among the participants. The data were analyzed by SPSS version 20 using the descriptive and analytical tests. RESULTS In the preintervention phase, the participants' mean scores of the cognitive processes at the precontemplation, contemplation, and preparation stages were 29.16 ± 4.63, 25.07 ± 3.84, and 12.12 ± 1.63, respectively. At the postintervention phase, mean scores of the precontemplation, contemplation, and preparation stages reached to 40.5 ± 5.96, 38.8 ± 5.03, and 35.5 ± 4.23, respectively. Furthermore, the participants' mean sores at the action and maintenance stages were 36.4 ± 4.57 and 43.3 ± 3.29, respectively. According to the ANOVA, a significant relationship was found between cognitive processes at the preintervention phase and stages of change (P < 0.001). CONCLUSIONS Individuals can improve from the precontemplation, contemplation, and preparation phases to the action and maintenance stages by attending based on Transtheoretical Model of Behavior Change educational interventions. It is suggested that the structure of this model be used to reduce high-risk behaviors in other occupations.
Collapse
Affiliation(s)
- Mohammad Saeed Jadgal
- Department of Public Health, School of Nursing and Midwifery, Iranshahr University of Medical Sciences, Chabahar, Iran
| | - Somayeh Alizadeh
- Department of Health Education and Promotion, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hadi Alizadeh -Siuki
- Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Saeedeh Sadeghi
- Department of Health Education and Promotion, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Tahmineh Salehian
- Department of Nursing and Midwifery, Iranshahr University of Medical Sciences, Chabahar, Iran
| | - Moradali Zareipour
- Department of Public Health, School of Health, Khoy University of Medical Sciences, Khoy, Iran
| |
Collapse
|
6
|
Eshah NF, Mosleh SM, Al-Smadi A. The Decisional Balance Toward Health Behaviors Among Patients With Hypertension. Clin Nurs Res 2020; 30:977-984. [PMID: 33131320 DOI: 10.1177/1054773820967548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The decisional balance is related to the transtheoretical model, and involves weighting the pros and cons of performing a behavior. The study aimed to assess hypertensive patients' decisional balances about smoking, weight control, and physical exercise. A cross-section descriptive correlation design was used, and 110 patients were recruited using convenience sampling in outpatient clinics. The decisional balance was measured using "Decisional Balance Scales," which assess an individual's decisional balance related to smoking, weight control, and physical exercise behaviors. The results predicted that Jordanian hypertensive patients with higher physical exercise decisional balance and higher weight decisional balance had lower smoking decisional behaviors. Nurses can foster health promotion and behavioral change by employing interventions that improve decisional balances. Improving the decisional balance of one behavior would have a positive impact on other behaviors. Thus, designing multidimensional interventions might be effective for modifying different types of health behaviors, and fostering health promotion practices.
Collapse
Affiliation(s)
| | - Sultan M Mosleh
- Faculty of Nursing, Mutah University, Jordan, UAE.,Higher colleges of Technology, Fujairah, UAE
| | - Ahmed Al-Smadi
- Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| |
Collapse
|
7
|
Ng WM, Cheung K. A feasibility study of a WhatsApp-delivered Transtheoretical Model-based intervention to promote healthy eating habits for firefighters in Hong Kong: a cluster randomized controlled trial. Trials 2020; 21:518. [PMID: 32532313 PMCID: PMC7291567 DOI: 10.1186/s13063-020-04258-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 03/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Firefighters' health is often affected by a high prevalence of obesity and cardiovascular diseases, which are common risk factors for sudden cardiac death. The aim of this study is to investigate the feasibility of enhancing healthy eating habits in firefighters through an education programme. METHODS This will be a cluster randomized control trial study. The participants will be assigned randomly into either control (health promotion pamphlet) or intervention (health promotion pamphlet and education materials through WhatsApp) groups. Changes in healthy eating habits will be assessed by a self-administered questionnaire and anthropometric measurements at three different time points. DISCUSSION More education is required in order to improve firefighters' eating habits. TRIAL REGISTRATION ISRCTN registry identifier: Registered on 8 April 2019 ISRCTN95472464.
Collapse
Affiliation(s)
- Wing Man Ng
- Division of Science, Engineering and Health Studies, College of Professional and Continuing Education, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Kin Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| |
Collapse
|
8
|
Yoshida H, Maddock JE. Relationship Between Health Behaviors and Obesity in a Sample of Hawai'i's 4 Most Populous Ethnicities. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2020; 79:104-111. [PMID: 32328581 PMCID: PMC7175354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Proactive health behavior change and maintenance are essential for preventing obesity and other lifestyle diseases. Few studies have examined the relationship between eating behavior and physical condition among multiethnic samples. In this study, ethnic differences were examined to obtain basic data on health education for improvement of obesity in Hawai'i. The intake of fruits and vegetables and exercise habits in each of the transtheoretical model stages of change were evaluated in the 4 most populous ethnic groups in Hawai'i in terms of how the participants' health behaviors were associated with obesity. The participants comprised 2795 white, Native Hawaiian, Filipino, and Japanese adults (age range, 18-55 years). There are 4 main findings of this study. First, there were differences in fruit and vegetable intake and exercise habits in each transtheoretical model stage among the ethnic groups. Second, there were differences in attitudes regarding nutrition and healthy food intake and self-efficacy regarding exercise in each ethnic group. Third, items that have the potential to improve obesity in the theory of planned behavior differed, particularly among men, in the 4 ethnic groups. Finally, a low percentage of participants recognized that the recommended number of servings of fruits and vegetables was 5 or more. Education for men may be particularly important. The findings indicate that modified health education approaches may be needed in accordance with the ethnicity of the population.
Collapse
Affiliation(s)
- Hiroko Yoshida
- Correspondence to: Hiroko Yoshida PhD; Division of Food and Nutrition, Nakamura Gakuen University Junior College, 5-7-1 Befu, Jonan-ku, Fukuoka 814-0198, Japan;
| | - Jay E. Maddock
- Department of Environmental and Occupational Health, Texas A&M University, College Station, TX (JEM)
| |
Collapse
|
9
|
Sardi L, Idri A, Carrillo de Gea JM, Toval Á, Fernández-Alemán JL. Applying trans-theoretical model for blood donation among Spanish adults: a cross-sectional study. BMC Public Health 2019; 19:1724. [PMID: 31870328 PMCID: PMC6929449 DOI: 10.1186/s12889-019-8046-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 12/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relying solely on altruistic appeals may fail to fulfil the increasing demand for blood supplies. Current research has largely been attempted to determine and understand motives that serve as blood donation drivers. The Trans-Theoretical Model of behaviour change (TTM) can be used to conceptualise the process of intentional blood donation behaviour. METHODS A cross sectional survey of Spanish adults was conducted. The final sample consisted of 504 individuals who were administered a self-report questionnaire including the measures of demographic characteristics, Stages of Change, Processes of Change, Self-efficacy and Decisional Balance. Data were analysed by frequency analysis, MANOVA/ANOVA and correlation analysis. RESULTS Findings indicated that most of the behavioural and cognitive processes of change, self-efficacy and physical cons differentiated participants across the stages of change of blood donation. In contrast, eligibility cons and pros were less influential in stage transitions. Furthermore, significant correlations were observed between TTM constructs except for the physical cons and the processes of change. CONCLUSIONS The present study extensively supports and replicates the applicability of the TTM to blood donation behaviour change and offers important implications for the development of effective stage-matched interventions to increase blood donation.
Collapse
Affiliation(s)
- Lamyae Sardi
- Software Project Management research team, ENSIAS, University Mohammed V, Rabat, Morocco.
| | - Ali Idri
- Software Project Management research team, ENSIAS, University Mohammed V, Rabat, Morocco.,Complex Systems Engineering, University Mohamed VI Polytechnic, Ben Guerir, Morocco
| | | | - Ángel Toval
- Department of Human Anatomy and Psychobiology, School of Medicine, University of Murcia, Murcia, Spain.,Institute of Biomedical Research of Murcia (IMIB), Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | | |
Collapse
|
10
|
Hashemzadeh M, Rahimi A, Zare-Farashbandi F, Alavi-Naeini AM, Daei A. Transtheoretical Model of Health Behavioral Change: A Systematic Review. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2019; 24:83-90. [PMID: 30820217 PMCID: PMC6390443 DOI: 10.4103/ijnmr.ijnmr_94_17] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background: Transtheoretical model (TTM) is one of the most commonly used methods in behavioral change modeling. The aim of this study was to conduct a systematic review (SR) to determine research gaps with regard to this template with an emphasis on intervention for patients with chronic diseases (CDs). Materials and Methods: ISI-WOS, Scopus, PubMed, SID, and Magiran databases were examined systematically and on the basis of defined criteria. Titles, abstracts, and full texts of articles retrieved were examined for the presence of defined criteria. Then finalized articles were analyzed in consensus meetings. After that, references of selected articles and full text of those meeting the criteria were also analyzed. Results: We screened 103 articles, excluded 27 in abstract review and 34 in full-text review, leaving 42 articles for critical appraisal. Then the references of these 42 articles were also screened. Fifty articles were excluded on abstract review and 5 on full-text review, leaving 15 articles. The result of the analysis of 57 final articles of this SR determined that 28 articles were about aspects of TTM and 5 stages of change were the most commonly used aspect. Eight articles used TTM in intervention about CDs. A total of 21 articles examined TTM's pros and cons, most of which were about TTM's pros. Conclusions: The majority of studies focused on the effectiveness of TTM on the behavioral change management. This finding supported the hypothesis that TTM can be applied in the prevention of CDs.
Collapse
Affiliation(s)
- Mozhdeh Hashemzadeh
- School of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Rahimi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Zare-Farashbandi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Mansur Alavi-Naeini
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azra Daei
- Department of Community Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
11
|
Abstract
Excess added sugars, particularly in the form of sugar-sweetened beverages, is a leading cause of tooth decay in US children. Although added sugar intake is rooted in behavioral and social factors, few evidence-based, theory-driven socio-behavioral strategies are currently available to address added sugar intake. Dental health professionals are in a position to help identify and address problematic sugar-related behaviors in pediatric patients and advocate for broader upstream approaches, including taxes, warning labels, and policy changes, that can help reduce added sugar intake, prevent tooth decay, and improve health outcomes in vulnerable child populations.
Collapse
Affiliation(s)
- Donald L Chi
- Department of Oral Health Sciences, University of Washington, School of Dentistry, Box 357475, B509 Health Sciences Building, Seattle, WA 98195-7475, USA.
| | - JoAnna M Scott
- Research and Graduate Programs, University of Missouri Kansas City, School of Dentistry, 650 E. 25th Street, Kansas City, MO 64108, USA
| |
Collapse
|
12
|
Zeidan B, Partridge SR, Balestracci K, Allman-Farinelli M. Congruence of stage-of-change for fruit, vegetables and take-out foods with consumption. ACTA ACUST UNITED AC 2018. [DOI: 10.1108/nfs-05-2017-0101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Young adults frequently engage in sub-optimal dietary behaviours, such as inadequate intakes of fruits and vegetables and excessive consumption of take-out meals. Theory-based interventions are suggested to promote dietary change. The transtheoretical model is an example that stages an individual’s readiness to change behaviours as precontemplation, contemplation, preparation, action and maintenance, and includes a series of processes that help people move between stages. The purpose of this study is to investigate whether self-reported usual dietary intakes of fruits and vegetables and take-out foods differ by reported stage-of-change.
Design/methodology/approach
Cross-sectional data from 250 overweight young adults, aged 18-35 years, who enrolled in a lifestyle intervention to prevent weight gain are analysed. Participant’s stage-of-change for increasing fruit and vegetable intakes and reducing take-out foods is determined using staging algorithms. This is compared with self-reported dietary intakes over the past month using a food frequency questionnaire. Differences in intakes and variety by stage-of-change are compared for fruits, vegetables and take-out foods.
Findings
Take-out foods differed between stages (p < 0.0001), with lower weekly intakes in action (309 g) and maintenance (316 g) compared with preparation (573 g). Daily fruit intakes and variety scores varied by stage-of-change (p < 0.0001), being highest for action and maintenance (261 g and 263 g, respectively, and variety scores of 1 and 2) compared with precontemplation, contemplation and preparation (all = 100 g and 0 for variety). Daily vegetable consumption and variety scores differed by stage (p = 0.009 and p = 0.025, respectively) being highest for action/maintenance (204 g and 2 for variety) versus precontemplation and preparation (<110 g daily and Variety 1).
Practical implications
The finding of no differences in intakes between precontemplation, contemplation or preparation stages implies that the adoption of the dietary behaviours is not a continuum but a move from pre-action to actioning the target intakes. This means that for planning health promotion and dietary counselling, assigning people to the three different pre-action stages may be unnecessary.
Originality/value
This study is the first to examine the congruence of self-reported readiness to change behaviour with dietary intakes of take-out foods as well as variety of fruit and vegetables in overweight young adults.
Collapse
|
13
|
Filgueiras AR, Sawaya AL. INTERVENÇÃO MULTIDISCIPLINAR E MOTIVACIONAL PARA TRATAMENTO DE ADOLESCENTES OBESOS BRASILEIROS DE BAIXA RENDA: ESTUDO PILOTO. REVISTA PAULISTA DE PEDIATRIA 2018; 36:186-191. [PMID: 29694491 PMCID: PMC6038782 DOI: 10.1590/1984-0462/;2018;36;2;00014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 07/28/2017] [Indexed: 12/28/2022]
Abstract
Objective: To test a multidisciplinary and motivational intervention for the treatment
of Brazilian obese and low-income adolescents (Z score>2 BMI-for-age)
that used nutritional counseling without dietary control. Methods: An intervention protocol was developed including periodical nutritional
education workshops, individual nutritional counseling guided by the stages
of eating behavior of the Trans Theoretical Model of Behavior Change,
physical exercise, psychological counseling, recreational activities, and
clinical follow-up for 13 months in a sample of 21 adolescents (11-17 years
old). Results: The rate of treatment withdrawal (9.5%) was lower than that seen in dietary
control studies (30-60%). Initially, 70% of the sample was in the
pre-contemplation behavior stage and, in the end, 100% of the remaining
adolescents were in the stages of action or maintenance. There was a mean
reduction in BMI-for-age (p=0.038) and visceral fat (M±SD=3.67±1.19 and
2.78±0.78 cm, p=0.02, initial and final, respectively). The percentage of
fat mass decreased and that of lean mass increased (42±5 and 38±8, p=0.04,
58±6 and 61±8%, p=0.03, respectively). Conclusions: The intervention seems to be effective in generating a lifestyle change,
accompanied by anthropometric profile and body composition improvement. The
intervention protocol may offer easy adaptation and low-cost methodology for
health services, with high adherence and low abandonment rates.
Collapse
|
14
|
Cook AS, O'Leary F, Allman-Farinelli M. The relationship between process use and stage of change for sugary drinks. J Hum Nutr Diet 2018; 31:697-703. [PMID: 29575214 DOI: 10.1111/jhn.12548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Decreasing sugar-sweetened beverage consumption may reduce obesity and obesity-related diseases. To better understand what processes could facilitate a reduction in sugary beverage intake, we examined the relationship between stage-of-change and use of 10 processes of change. Secondarily, reliability of the measure was assessed. METHODS A cross-sectional study was conducted, using a newly developed stage-of-change and process of change questionnaire. Participants (n = 105; male, n = 28) were aged between 18 and 60 years. A one-way analysis of variance, with Tukey's and Benjamini-Hochberg post hoc tests, was used to compare process use by stages. Paired t-tests were used to compare total cognitive and total behavioural process use within each stage. Cronbach's α coefficient and mean inter-item correlation was used to assess internal consistency. Reliability of repeated items was examined using kappa. RESULTS Cognitive and behavioural processes were used more in the contemplation/preparation and maintenance stages than in precontemplation (all P < 0.05). Compared to precontemplation, process use was significantly higher in contemplation/preparation for five individual processes, action for four processes and maintenance for five processes. The use of dramatic relief and self liberation was lower in maintenance than contemplation/preparation. Across the stages, the use of eight of the 10 processes differed. The use of consciousness raising, self re-evaluation and self liberation differed between stages more frequently than other processes. CONCLUSIONS The use of many processes differed by stage and could be incorporated into programmes aiming to assist adults in reducing their consumption of sugary drinks.
Collapse
Affiliation(s)
- A S Cook
- Western Sydney University, Penrith, NSW, Australia
| | - F O'Leary
- SOLES in the Charles Perkins Centre D17, University of Sydney, Sydney, NSW, Australia
| | - M Allman-Farinelli
- SOLES in the Charles Perkins Centre D17, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
15
|
Giacobbi PR. Theoretical, Critical, and Practical Reflections on the Long-Term Maintenance of Health Behavior Change. Am J Lifestyle Med 2016; 10:377-380. [PMID: 30202296 DOI: 10.1177/1559827616662435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This commentary is in response to Joseph, Daniel, Thind, Benitez and Pekmezi (2014). They reviewed randomized controlled trials (RCTs) that included long-term follow-up assessments at least 6 months post-intervention. Their main purpose was to understand which theory or model used by researchers could help explain the long-term maintenance of health behaviors once the intervention was withdrawn in trials focused on physical activity, dietary behavior, and excessive alcohol consumption. Results showed that social cognitive theory (SCT) and transtheoretical model (TTM) were used most often and associated with long-term behavior change compared to self-determination theory (SDT), theory of planned behavior (TPB), or the social-ecological model (SEM). SDT showed encouraging findings while the evidence was unclear for the TPB and the SEM. Here it is argued that scientists should continually reflect on the utility of theory over time and the efforts by Joseph and colleagues should be commended. It is also useful to distinguish theories, which are more specified and offer more generalized statements, than models. Models, such as the TPB and SEM, have incorporated elements of other theories but are typically viewed as tools to characterize behavior. For instance, in 10 studies reviewed by Joseph and colleagues the SCT and TTM were used in an integrative manner. An example of an integrated model is presented that incorporates elements of SDT, TPB, and SCT in an effort to highlight how integrating elements from multiple theories may be useful.
Collapse
Affiliation(s)
- Peter R Giacobbi
- Departments of Sport Science and Epidemiology, College of Physical Activity and Sport Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia
| |
Collapse
|
16
|
Yusufov M, Paiva AL, Redding CA, Lipschitz JM, Gokbayrak NS, Greene G, Rossi JS, Blissmer B, Velicer WF, Prochaska JO. Fat Reduction Efforts. Health Promot Pract 2015; 17:116-26. [DOI: 10.1177/1524839915606423] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This research examined dynamic transtheoretical model (TTM) constructs for dietary fat reduction. This secondary data analysis pooled three large population-based TTM-tailored school, worksite, medical, and home-based intervention studies and examined use of constructs across three groups organized by longitudinal progress (dynatypes): Maintainers, Relapsers, and Stable Non-Changers. The criteria for successful change, at the time, were that less than 30% of calories came from fat. A total of 2,718 adults met criteria for an unhealthy diet at baseline. The majority of participants were female, White, married, and middle-aged. Demographics, Stage of Change, Processes of Change, Decisional Balance, and Temptations were measured. Dynatype groups were assessed with reliable and valid scales assessing constructs at baseline and 6, 12, and 24 months. Analyses included a multivariate analysis of variance followed by a series of analyses of variance, with Tukey follow-up tests assessing differences in use of TTM constructs across the three groups at each time point. Relapsers and Maintainers were similar in their use of all TTM Processes of Change at baseline, with the exception of Self-Liberation (η2 = 0.15, p < .001) and Reinforcement Management (η2 = 0.01, p < .001). Although Relapsers reverted to an unhealthy diet, their overall greater use of Processes of Change suggests that their behaviors and strategy use remain better than that of the Stable Non-Changer group. Results suggest that specific cognitive and behavioral constructs may contribute differentially to intervention outcomes.
Collapse
|
17
|
Cook AS, O'Leary F, Allman-Farinelli M. Behavioural and cognitive processes adults use to change their fruit and vegetable consumption. Nutr Diet 2014. [DOI: 10.1111/1747-0080.12147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Amelia S Cook
- Department of Nutrition & Metabolism; School of Molecular Bioscience; The University of Sydney; Sydney New South Wales Australia
| | - Fiona O'Leary
- Department of Nutrition & Metabolism; School of Molecular Bioscience; The University of Sydney; Sydney New South Wales Australia
| | - Margaret Allman-Farinelli
- Department of Nutrition & Metabolism; School of Molecular Bioscience; The University of Sydney; Sydney New South Wales Australia
| |
Collapse
|
18
|
Abstract
The increases in preventable chronic diseases and the rising costs of health care are unsustainable. The US Army Surgeon General's vision to transition from a health care system to a system of health requires the identification of key health enablers to facilitate the adoption of healthy behaviors. In support of this vision, the US Army Telemedicine and Advanced Technology Research Center hosted a workshop in April 2013 titled "Incentives to Create and Sustain Change for Health." Members of government and academia participated to identify key health enablers that could ultimately be leveraged by technology. The key health enablers discussed included (1) public health messaging, (2) changing health habits and the environmental influence on health, (3) goal setting and tracking, (4) the role of incentives in behavior-change intervention, and (5) the role of peer and social networks on change. This report summarizes leading evidence and the group consensus on evidence-based practices with respect to the key enablers in creating healthy behavior change.
Collapse
|