Mediating Factors in Dietary Change: Understanding the Impact of a Worksite Nutrition Intervention

2000 ◽  
Vol 27 (1) ◽  
pp. 112-125 ◽  
Author(s):  
Alan R. Kristal ◽  
Karen Glanz ◽  
Barbara C. Tilley ◽  
Shuhui Li

This report, based on 1,795 participants in the Next Step Trial, examines how a dietary intervention program affected mediating factors for dietary change. The model tested whether intervention increased predisposing (skills, knowledge, and beliefs) and enabling (social support and norms) factors for change and advanced participants into action and maintenance stages of change. The intervention significantly increased both predisposing factors for dietary change and the likelihood of moving into or remaining in action and maintenance stages of change. Changes in predisposing and enabling factors and stage of change at follow-up (regardless of stage at baseline) were associated with significant dietary change. Changes in mediating variables explained between 34% and 55% of the effects of the dietary intervention. These results support the value of measuring mediating factors as part of dietary intervention evaluations and suggest that interventions that target norms and eating environments in addition to skills and knowledge may further increase intervention effectiveness.

Author(s):  
Laura Croce ◽  
Cristina Pallavicini ◽  
Silvia Crotti ◽  
Francesca Coperchini ◽  
Linda Minnelli ◽  
...  

Abstract Purpose The relationship between thyroid function and obesity is a widely investigated one. The impact of thyroid hormones in determining the outcome of dietary/lifestyle interventions remains to be fully elucidated. The aim of this study was to compare basal and post dietary-intervention circulating thyroid-function parameters, lipid profile and fasting-glucose in euthyroid obese patients according to a success or failure of a dietary intervention program. Methods In a retrospective longitudinal case–control study we enrolled 50 euthyroid obese patients who experienced a success in dietary intervention, as defined by a BMI reduction of at least 5% from baseline (Success Group) and 50 sex and age-matched euthyroid obese patients who experienced failure in dietary intervention as defined by either stable or increased body weight throughout the follow-up (Failure Group). Serum thyroid function parameters and metabolic profile at baseline and at the end of follow-up were collected. Results At baseline, the two groups showed similar BMI, total-cholesterol, HDL-cholesterol and fasting-blood-glucose, but patients in Success Group had a significantly higher TSH as compared with Failure Group (2.20 ± 0.97 vs 1.66 ± 0.73, respectively, p < 0.001). Throughout a mean follow-up of 21.4 months TSH significantly decreased in Success Group (2.20 ± 0.97 vs 2.06 ± 0.98; p = 0.029) and increased in Failure Group (1.63 ± 0.72 vs 2.01 ± 0.99; p < 0.001). Multiple regression analysis showed that the outcome of the dietary intervention was significantly and independently related to baseline BMI (0.925; 0.861–0.993), age (0.957; 0.922–0.993), TSH (0.531; 0.290–0.973) and TSH-changes (1.011; 1.000–1.022) during follow-up. Conclusions Baseline serum TSH level is related to the final outcome of a dietary intervention program in obese patients. Level of evidence III Evidence obtained from a retrospective cohort or case–control analytic studies.


Author(s):  
Caitlin R. Semsarian ◽  
Gabrielle Rigney ◽  
Peter A. Cistulli ◽  
Yu Sun Bin

University students consistently report poor sleep. We conducted a before-and-after study to evaluate the impact of an online 10-week course on undergraduate students’ sleep knowledge, attitudes, and behaviours at 6-month follow-up. Data were collected via baseline course surveys (August–September 2020) and follow-up surveys distributed via email (February–March 2021). n = 212 students completed baseline surveys and n = 75 (35%) completed follow-up. Students retained to follow-up possessed higher baseline sleep knowledge and received higher course grades. At the 6-month follow-up, sleep knowledge had increased (mean score out of 5: 3.0 vs. 4.2, p < 0.001). At baseline, 85% of students aimed to increase their sleep knowledge and 83% aimed to improve their sleep. At follow-up, 91% reported being more knowledgeable and 37% reported improved sleep. A novel Stages of Change item revealed that 53% of students’ attitudes towards their sleep behaviours had changed from baseline. There was a reduction in sleep latency at follow-up (mean 33.3 vs. 25.6 min, p = 0.015), but no change in the total Pittsburgh Sleep Quality Index score. In summary, completion of an online course led to increased sleep and circadian knowledge and changed sleep attitudes, with no meaningful change in sleep behaviours. Future interventions should consider components of behavioural change that go beyond the knowledge–attitudes–behaviour continuum.


2019 ◽  
Vol 22 (13) ◽  
pp. 2500-2508 ◽  
Author(s):  
Kamer Gur ◽  
Saime Erol ◽  
Hasibe Kadioglu ◽  
Ayse Ergun ◽  
Rukiye Boluktas

AbstractObjective:The present study aimed to evaluate the impact of a Transtheoretical Model-based programme titled ‘Fruit &amp; Vegetable-Friendly’ on the fruit and vegetable (F&amp;V) consumption of adolescents.Design:A quasi-experimental study. The ‘Fruit &amp; Vegetable-Friendly’, a multicomponent intervention based on the Transtheoretical Model, was completed in eight weeks. The data were collected one week before the intervention, one week after the completion of the intervention and six months after the post-test with an F&amp;V intake questionnaire and the stages of change, processes of change (α = 0·91), situational self-efficacy (α = 0·91) and decisional balance (α = 0·90 for pros, α = 0·87 for cons) scales. Data were analysed with the Friedman, Wilcoxon and marginal homogeneity tests.Setting:A public secondary school in Istanbul, Turkey.Participants:Seven hundred and two adolescents.Results:The mean (sd) F&amp;V intake of adolescents in the passive stages rose from the daily average at the time of the pre-test of 3·40 (1·79) portions to 5·45 (2·54) portions on the post-test and to 5·75 (2·70) portions on the follow-up test (P &lt; 0·01). While the students in the passive stages represented 41·6 % of the participants prior to the programme, this rate fell to 23·7 % at the post-test and to 22·7 % at the follow-up. Students in the active stages first represented 58·5 % of the participants; this rate rose to 76·4 % at the post-test and to 77·2 % at the follow-up test.Conclusions:The programme was effective in increasing the amount of F&amp;V the adolescents consumed on a daily basis.


2017 ◽  
Vol 41 (S1) ◽  
pp. S196-S197
Author(s):  
M. Gomez Revuelta ◽  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
V. Gajardo Galan ◽  
G. Pardo de Santayana Jenaro ◽  
...  

IntroductionThe first five years after the onset of a first episode of psychosis (FEP) are crucial for long term outcome. In this period, the risk of relapse is particularly high. Consequences of relapse include an increased risk of neurotoxicity, chronicity, hospitalization, decreased response to treatment, increased economic burden and functional impairment.ObjectivesTo discern the influence of cannabis on relapse as it may contribute to adopt specific measures in patients during early stages of the illness.Material and methodsPAFIP is an early intervention program for patients with a FEP. Between January 2005 and January 2011, 163 patients were recruited for this study. They were followed-up during 3 years at intervals of three months. The sample was divided into three groups: (1) those non-cannabis users neither before the FEP nor during follow-up (nn), (2) consumers before the FEP and during follow-up (ss) and (3) consumers before the FEP that gave up consumption during follow-up (sn).ResultsNo statistically significant differences between the three groups were observed but a trend (P = 0.057) towards a more enduring survival in Group 3 (sn). (Kaplan–Meier curve and detailed Log Rank Test results will be included in the final poster).ConclusionsCannabis has a detrimental effect on schizophrenia. The interruption of its use could contribute to improve the outcome of the disease, as the results of our study suggest.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2017 ◽  
Vol 41 (S1) ◽  
pp. S136-S137
Author(s):  
M. Gomez Revuelta ◽  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
M. Fernández Rodríguez ◽  
D. Abejas Díez ◽  
...  

IntroductionThe association between cannabis and psychosis makes crucial the intervention on cannabis use disorder at first episodes of psychosis (FEP), especially among young population. In this group of patients, the harmful potential of cannabis is more evident by its influence on neurodevelopment. However, the nature of the association cannabis-psychosis is not clearly described. It seems to represent a mediating factor for an increased risk of psychosis in healthy and high-risk populations, determining an earlier age of onset and worsening long term outcome.ObjectivesTo assess the impact of cannabis in terms of functional and clinical prognosis in patients recruited after a FEP.Material and methodsPAFIP is an early intervention program for early stages of psychosis. One hundred and sixty-three were included, followed-up at regular intervals of six months for three years with administration of clinical and functional scales (BPRS, SAPS, SANS, CDRS, GAF and Drake). Patients were divided into three groups: (1) those non-users neither before the onset nor during follow-up (nn) PEP, (2) consumers before the FEP and during follow-up (ss) and (3) consumers before the FEP that gave up consumption during follow-up (sn).ResultsNo statistically significant differences were observed in terms of functionality at three-year follow-up endpoint but a trend to a better-preserved functionality in the sn group. The sn group presented lower scores in scales for positive symptoms with respect to the comparison groups.ConclusionsThe interruption in cannabis use may have a beneficial effect on short-term clinical prognosis and functionality on long term.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 36 (7) ◽  
pp. 782-807 ◽  
Author(s):  
Bryna Shatenstein ◽  
Marie-Jeanne Kergoat ◽  
Isabelle Reid

A 6-month dietary intervention program was designed for community-dwelling older adults with Alzheimer’s disease. Sixty-seven persons aged 70 years and above were recruited with their caregivers from six hospital memory and geriatric outpatient clinics, and allocated to intervention ( n = 34 dyads) or control group ( n = 33 dyads). Usual diet was assessed by a validated food frequency questionnaire and current diet by two nonconsecutive diet recalls or records corroborated by caregivers, at recruitment (T1) and exit from the study (T2). Intervention participants received targeted dietary recommendations; control participants received Canada’s Food Guide leaflets. The program was assessed using paired and independent t tests and nonparametric statistics. Fat intakes increased at T2 within intervention participants (54 ± 16 vs. 67 ± 23 g, p = .013), and there was a tendency for higher energy, protein, and calcium intakes at T2 within this group. Proportions with adequate protein intakes almost doubled from T1 to T2 in intervention group women ( p = .028) but decreased in female controls ( p = .030). Longer follow-up is necessary to determine persistence of benefits.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Nada Radwan ◽  
Beth Senne-Duff ◽  
Jesus Cuellar Fuentes

Abstract Objectives We evaluated the impact on growth in children 5 years of age and younger of a community- based nutrition intervention program in a coastal Peruvian community. Mother's in an “invasion” community were recruited to participate in the study. Interested mothers were trained as community agents. Nurses and community agents measured weight and height of children monthly and checked for parasites. Children were evaluated for anemia and micronutrient supplementation was provided. During the home visits nutrition education would be provided. Women participated in workshops on nutrition, water, gardening, and health and social concerns. Children were assessed over 16 months. Methods Growth was assessed by calculating Z-scores for weight-for-age (WZ) and height-for-age (HZ), A linear mixed model was adjusted to each response variable to assess its change over time. Because there were underweight and overweight children in the group analysis was conducted on subjects with initial WZ (WZI) < -1 or >2. For HZ only children with initial HZ (HZi) <-1 were included in a separate analysis. Results The analysis used 247 subjects, 115 (46.6%) females and 132 (53.4%) males. The The 95% confidence interval for month included a value of zero, indicating that, on average, ZW does not change over time for the ZWi <-1. However, in the severely overweight group ZW decreased, on average, by 0.325 units for each month that the subject was evaluated. In the HZi <-1 group the coefficient of month indicated that HZ increased at an average rate of 0.0156 units per month. The HZ did not change overtime when all children were included in the analysis. Conclusions The intervention seems to have been effective in improving the underweight condition of the children who were moderately to severely underweight and in decreasing weight in severely overweight children. In addition, children that started severely or moderately shorter than normal experienced a gain in height over the time they were evaluated. Funding Sources University of the Incarnate Word.


2010 ◽  
Vol 16 (2) ◽  
pp. 147 ◽  
Author(s):  
Sylvia E. M. Pomeroy ◽  
Robyn P. Cant

The aim of this project was to describe general practitioners’ (GPs’) decision-making process for reducing nutrition risk in cardiac patients through referring a patient to a dietitian. The setting was primary care practices in Victoria. The method we employed was mixed methods research: in Study 1, 30 GPs were interviewed. Recorded interviews were transcribed and narratives analysed thematically. Study 2 involved a survey of statewide random sample of GPs. Frequencies and analyses of variance were used to explore the impact of demographic variables on decisions to refer. We found that the referral decision involved four elements: (i) synthesising management information; (ii) forecasting outcomes; (iii) planning management; and (iv) actioning referrals. GPs applied cognitive and collaborative strategies to develop a treatment plan. In Study 2, doctors (248 GPs, 30%) concurred with identified barriers/enabling factors for patients’ referral. There was no association between GPs’ sex, age or hours worked per week and referral factors. We conclude that a GP’s judgment to offer a dietetic referral to an adult patient is a four element reasoning process. Attention to how these elements interact may assist clinical decision making. Apart from the sole use of prescribed medications/surgical procedures for cardiac care, patients offered a dietetic referral were those who were considered able to commit to dietary change and who were willing to attend a dietetic consultation. Improvements in provision of patients’ nutrition intervention information to GPs are needed. Further investigation is justified to determine how to resolve this practice gap.


2009 ◽  
Vol 23 (5) ◽  
pp. 320-323 ◽  
Author(s):  
Nangel M. Lindberg ◽  
Victor J. Stevens ◽  
K. Sabina Smith ◽  
Russell E. Glasgow ◽  
Deborah J. Toobert

Purpose. To assess the efficacy of an intervention designed to increase appropriate use of breast self-examination (BSE). Methods. Two-armed randomized clinical trial of cancer-control interventions in women that compared a BSE intervention program to a dietary intervention, which served as the control group. The study was conducted at a large health maintenance organization in Portland, Oregon. Participants were 616 female members of the health maintenance organization who were aged 40 to 70 years. The intervention consisted of a 30- to 45-minute individual counseling session that featured BSE instruction, training and practice with silicone models, identification of barriers to BSE, and problem-solving. This intervention was followed by two brief follow-up telephone calls. The study outcome measure was self-reported BSE practice, which included duration, frequency, and specific elements of exam. Results. The study had a 90% response rate. At the 1-year follow-up, χ2 analyses showed that significantly more individuals in the BSE intervention (59%) reported adequate BSE performance compared with those in the control group (12.2%; p < .001). Conclusions. This brief intervention was successful in encouraging women to perform adequate BSEs. Although the role of the BSE in patient care remains controversial, these results show that even brief intervention programs can be effective at encouraging self-screening for cancer. This intervention could easily be modified to target other screening practices (e.g., skin or testicular cancer screening) that are associated with reduced cancer morbidity and mortality.


2013 ◽  
Vol 4 (1) ◽  
pp. 120-130 ◽  
Author(s):  
Bizu Gelaye ◽  
Abera Kumie ◽  
Nigusu Aboset ◽  
Yemane Berhane ◽  
Michelle A. Williams

We sought to evaluate the impact of a hygiene and sanitation intervention program among school-children to control active trachoma and intestinal parasitic infections. This longitudinal epidemiologic study was conducted among 630 students in rural Ethiopia. Baseline and follow-up surveys were conducted to evaluate the impact of a three-pronged intervention program: (i) construction of ventilated improved pit latrines; (ii) provision of clean drinking water; and (iii) hygiene education. Socio-demographic information was collected using a structured questionnaire. Presence of trachoma and intestinal parasitic infections were evaluated using standard procedures. At baseline, 15% of students had active trachoma, while 6.7% of them were found to have active trachoma post-intervention (p &lt; 0.001). Similar improvements were noted for parasitic infections. At baseline, 7% of students were reported to have helminthic infections and 30.2% protozoa infections. However, only 4% of students had any helminthic infection and 13.4% (p &lt; 0.001) of them were found to have any protozoa infection during follow-up surveys. Improvements were also noted in students' knowledge and attitudes towards hygiene and sanitation. In summary, the results of our study demonstrated that provision of a comprehensive and targeted sanitation intervention program was successful in reducing the burden of trachoma and intestinal parasitic infection among schoolchildren.


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