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Tailored, iterative, printed dietary feedback is as effective as group education in improving dietary behaviours: results from a randomised control trial in middle-aged adults with cardiovascular risk factors.

Wright JL, Sherriff JL, Dhaliwal SS, Mamo JC - Int J Behav Nutr Phys Act (2011)

Bottom Line: Descriptive statistics, paired t-tests and general linear models adjusted for baseline dietary intake, age and gender were used to examine the effectiveness of different nutrition interventions.The TF group reported a significantly greater increase in fruit intake (0.3 serves/d P = 0.031) in comparison to GE and the C group.All three intervention groups showed a reduction in total saturated fat intake.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Public Health, Faculty of Health Science, Curtin University of Technology, Perth, Western Australia, Australia.

ABSTRACT

Background: Tailored nutrition interventions have been shown to be more effective than non-tailored materials in changing dietary behaviours, particularly fat intake and fruit and vegetable intake. But further research examining efficacy of tailored nutrition education in comparison to other nutrition education methods and across a wider range of dietary behaviours is needed. The Stages to Healthy Eating Patterns Study (STEPs) was an intervention study, in middle-aged adults with cardiovascular risk factors, to examine the effectiveness of printed, tailored, iterative dietary feedback delivered by mail in improving short-term dietary behaviour in the areas of saturated fat, fruit, vegetable and grain and cereal intake.

Methods: STEPs was a 3-month randomised controlled trial with a pre and post-test design. There were three experimental conditions: 1) tailored, iterative, printed dietary feedback (TF) with three instalments mail-delivered over a 3-month period that were re-tailored to most recent assessment of dietary intake, intention to change and assessment of self-adequacy of dietary intake. Tailoring for dietary intake was performed on data from a validated 63-item combination FFQ designed for the purpose 2) small group nutrition education sessions (GE): consisting of two 90-minute dietitian-led small group nutrition education sessions and 3) and a wait-listed control (C) group who completed the dietary measures and socio-demographic questionnaires at baseline and 3-months later. Dietary outcome measures in the areas of saturated fat intake (g), and the intake of fruit (serves), vegetables (serves), grain and cereals as total and wholegrain (serves) were collected using 7-day estimated dietary records. Descriptive statistics, paired t-tests and general linear models adjusted for baseline dietary intake, age and gender were used to examine the effectiveness of different nutrition interventions.

Results: The TF group reported a significantly greater increase in fruit intake (0.3 serves/d P = 0.031) in comparison to GE and the C group. All three intervention groups showed a reduction in total saturated fat intake. GE also had a within-group increase in mean vegetable intake after 3 months, but this increase was not different from changes in the other groups.

Conclusions: In this study, printed, tailored, iterative dietary feedback was more effective than small group nutrition education in improving the short-term fruit intake behaviour, and as effective in improving saturated fat intake of middle-aged adults with cardiovascular risk factors. This showed that a low-level dietary intervention could achieve modest dietary behaviour changes that are of public health significance.

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Related in: MedlinePlus

Stages of Change questionnaire: question structure and stage classification details. Stage of change classification included both behavioural intention and objective assessment of dietary intake.
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Figure 2: Stages of Change questionnaire: question structure and stage classification details. Stage of change classification included both behavioural intention and objective assessment of dietary intake.

Mentions: Stage of change (SOC) questions for fruit, vegetables, grain and cereal foods and saturated fat intake behaviours were based on those developed and validated by Lechner et al. [19] and Ling and Horwath [24]. Sample question structure and staging algorithm for SOC is detailed in Figure 2. Stage classification incorporated objective assessment of food behaviour by the combination FFQ. Self efficacy regarding ability to: increase the intake of fruit, vegetable and, grain and cereal foods; choose low fat dairy products; choose trimmed and lean meat and poultry; reduce consumption of high fat sweets and desserts; reduce consumption of high fat snacks and take away foods; and reduce or substitute use of high saturated fat in cooking or added to foods was assessed with a one-item question, using a 4-point scale (1-very confident, 4- not at all confident) as used by Brug et al. [17] and Campbell et al [25]. Perceptions of the benefits and barriers to change for each food behaviour area, and knowledge of current dietary goals were assessed using the standardised questions assessing these areas included in the Western Australian Health Department Nutrition Monitoring Survey [26] and the Australian 1995 National Nutrition Survey [27].


Tailored, iterative, printed dietary feedback is as effective as group education in improving dietary behaviours: results from a randomised control trial in middle-aged adults with cardiovascular risk factors.

Wright JL, Sherriff JL, Dhaliwal SS, Mamo JC - Int J Behav Nutr Phys Act (2011)

Stages of Change questionnaire: question structure and stage classification details. Stage of change classification included both behavioural intention and objective assessment of dietary intake.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3117757&req=5

Figure 2: Stages of Change questionnaire: question structure and stage classification details. Stage of change classification included both behavioural intention and objective assessment of dietary intake.
Mentions: Stage of change (SOC) questions for fruit, vegetables, grain and cereal foods and saturated fat intake behaviours were based on those developed and validated by Lechner et al. [19] and Ling and Horwath [24]. Sample question structure and staging algorithm for SOC is detailed in Figure 2. Stage classification incorporated objective assessment of food behaviour by the combination FFQ. Self efficacy regarding ability to: increase the intake of fruit, vegetable and, grain and cereal foods; choose low fat dairy products; choose trimmed and lean meat and poultry; reduce consumption of high fat sweets and desserts; reduce consumption of high fat snacks and take away foods; and reduce or substitute use of high saturated fat in cooking or added to foods was assessed with a one-item question, using a 4-point scale (1-very confident, 4- not at all confident) as used by Brug et al. [17] and Campbell et al [25]. Perceptions of the benefits and barriers to change for each food behaviour area, and knowledge of current dietary goals were assessed using the standardised questions assessing these areas included in the Western Australian Health Department Nutrition Monitoring Survey [26] and the Australian 1995 National Nutrition Survey [27].

Bottom Line: Descriptive statistics, paired t-tests and general linear models adjusted for baseline dietary intake, age and gender were used to examine the effectiveness of different nutrition interventions.The TF group reported a significantly greater increase in fruit intake (0.3 serves/d P = 0.031) in comparison to GE and the C group.All three intervention groups showed a reduction in total saturated fat intake.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Public Health, Faculty of Health Science, Curtin University of Technology, Perth, Western Australia, Australia.

ABSTRACT

Background: Tailored nutrition interventions have been shown to be more effective than non-tailored materials in changing dietary behaviours, particularly fat intake and fruit and vegetable intake. But further research examining efficacy of tailored nutrition education in comparison to other nutrition education methods and across a wider range of dietary behaviours is needed. The Stages to Healthy Eating Patterns Study (STEPs) was an intervention study, in middle-aged adults with cardiovascular risk factors, to examine the effectiveness of printed, tailored, iterative dietary feedback delivered by mail in improving short-term dietary behaviour in the areas of saturated fat, fruit, vegetable and grain and cereal intake.

Methods: STEPs was a 3-month randomised controlled trial with a pre and post-test design. There were three experimental conditions: 1) tailored, iterative, printed dietary feedback (TF) with three instalments mail-delivered over a 3-month period that were re-tailored to most recent assessment of dietary intake, intention to change and assessment of self-adequacy of dietary intake. Tailoring for dietary intake was performed on data from a validated 63-item combination FFQ designed for the purpose 2) small group nutrition education sessions (GE): consisting of two 90-minute dietitian-led small group nutrition education sessions and 3) and a wait-listed control (C) group who completed the dietary measures and socio-demographic questionnaires at baseline and 3-months later. Dietary outcome measures in the areas of saturated fat intake (g), and the intake of fruit (serves), vegetables (serves), grain and cereals as total and wholegrain (serves) were collected using 7-day estimated dietary records. Descriptive statistics, paired t-tests and general linear models adjusted for baseline dietary intake, age and gender were used to examine the effectiveness of different nutrition interventions.

Results: The TF group reported a significantly greater increase in fruit intake (0.3 serves/d P = 0.031) in comparison to GE and the C group. All three intervention groups showed a reduction in total saturated fat intake. GE also had a within-group increase in mean vegetable intake after 3 months, but this increase was not different from changes in the other groups.

Conclusions: In this study, printed, tailored, iterative dietary feedback was more effective than small group nutrition education in improving the short-term fruit intake behaviour, and as effective in improving saturated fat intake of middle-aged adults with cardiovascular risk factors. This showed that a low-level dietary intervention could achieve modest dietary behaviour changes that are of public health significance.

Show MeSH
Related in: MedlinePlus