Investigating Fruit and Vegetable Consumption Using the Transtheoretical Model

Abstract Background Literature has shown a tendency of inadequate dietary intake among youth, consequently, nutritional interventions are required. The transtheoretical model (TTM) classifies individuals based on their readiness to change. This model is widely used for health education interventions with proven efficacy. Purpose This review aimed to weigh the strength of evidence about the TTM usage in nutritional interventions for adolescents and its effectiveness regarding dietary intake. Methods This study followed the PRISMA guidelines. Eligible studies were input into Mendeley software. The Adolec, Google Scholar, LILACS, PsycINFO, PubMed, Science Direct and Web of Science databases were searched. Only full original articles written in English, Spanish or Portuguese on randomized controlled trials and quasi-experimental designs that applied the TTM in the design of nutritional interventions targeting adolescents were included, with no restrictions on publication date. The quality and risk of bias was evaluated with the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results The initial search yielded 3779 results. Three studies were rated as strong, six as moderate and five as weak. The final sample of 14 articles included adolescents that were mostly recruited from schools, with interventions ranging from one month to three years. The TTM was used alone or combined with other behavior-change theories and most of the interventions involved digital technology. The nutritional topics covered included fruit and vegetable consumption, low-fat diet, and cooking skills. Four studies presented improvement in fruit and vegetable consumption and four progressed through stages of change. Participants from two interventions reduced fat intake. At the end of one intervention, all the participants were in action and maintenance stages. Conclusion The TTM seems to be a successful strategy for nutritional intervention aiming at improving dietary intake in adolescents. Its application in different contexts shows that the TTM is flexible and possible to be implemented in many settings. The use of the model is shown to be restricted to the stage of change’ construct. Further studies should use all constructs of the TTM in the design and compare the TTM with other behavior-change theories to better understand its effectiveness.

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Application of the Transtheoretical Model to Fruit and Vegetable Consumption among Economically Disadvantaged African-American Adolescents: Preliminary Findings

American Journal of Health Promotion ◽

10.4278/0890-1171-20.5.342 ◽

2006 ◽

Vol 20 (5) ◽

pp. 342-348 ◽

Cited By ~ 55

Author(s):

Jennifer Di Noia ◽

Steven P. Schinke ◽

James O. Prochaska ◽

Isobel R. Contento

Keyword(s):

African American ◽

Transtheoretical Model ◽

Self Efficacy ◽

Economically Disadvantaged ◽

Vegetable Consumption ◽

African American Adolescents ◽

Decisional Balance ◽

Fruit And Vegetable Consumption ◽

Processes Of Change ◽

Fruit And Vegetable

Purpose. To examine the application of the transtheoretical model (TTM) to fruit and vegetable consumption among economically disadvantaged African-American adolescents. Methods. Scales for measuring decisional balance, situational self-efficacy, and processes of change for fruit and vegetable consumption were developed and pretested with 57 economically disadvantaged African-American adolescents. The scales and measures for assessing stages of change, demographic variables, and fruit and vegetable consumption were administered to a separate sample of 262 participants. t-tests for independent samples and analysis of variance were used to examine differences in TTM variables and fruit and vegetable consumption across stages of change. Results. Two-factor solutions for decisional balance and processes of change and a three-factor solution for situational self-efficacy provided the best fit to the data. Alpha coefficients of reliability for the scales ranged from .77 (experiential change processes) to .91 (pros). Participants in action-maintenance stages evidenced higher pros, self-efficacy, and fruit and vegetable consumption and significantly lower cons than did participants in precontemplation and contemplation-preparation stages. Also, participants in action-maintenance stages used processes of change more frequently than did those in precontemplation-contemplation-preparation stages. The use of experiential and behavioral processes within these stages did not differ significantly, as posited. Discussion. Observed differences in TTM variables and fruit and vegetable consumption by stage of change in this sample of economically disadvantaged African-American adolescents were consistent with theory and previous applications of the model to fruit and vegetable consumption in adults. With replication studies, the TTM may be appropriate for designing interventions to increase fruit and vegetable consumption among this population.

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The Application of Transtheoretical Model to Identify Metabolic Control and Fruit and Vegetable Consumption in Patients With Type 2 Diabetes

Caspian Journal of Health Research ◽

10.29252/cjhr.3.1.10 ◽

2018 ◽

Vol 3 (1) ◽

pp. 10-14

Author(s):

Maryam Zavarmoghadam ◽

Rabiollah Farmanbar ◽

Isa Mohammadi zeidi ◽

Saeed omidi ◽

◽

...

Keyword(s):

Type 2 Diabetes ◽

Metabolic Control ◽

Transtheoretical Model ◽

Vegetable Consumption ◽

Fruit And Vegetable Consumption ◽

Fruit And Vegetable

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The transtheoretical model as applied to dietary behaviour and outcomes

Nutrition Research Reviews ◽

10.1017/s0954422407747881 ◽

2007 ◽

Vol 20 (1) ◽

pp. 46-73 ◽

Cited By ~ 36

Author(s):

Leslie Spencer ◽

Christopher Wharton ◽

Sheila Moyle ◽

Troy Adams

Keyword(s):

Transtheoretical Model ◽

Dietary Fat ◽

Vegetable Consumption ◽

Internal Validity ◽

Fruit And Vegetable Consumption ◽

The Body ◽

Assessment Tools ◽

Dietary Behaviour ◽

Fruit And Vegetable ◽

Effective Interventions

The transtheoretical model (TTM) is a behavioural theory that describes behaviour change as occurring in five stages, ranging from precontemplation to maintenance. The purpose of the present paper is to review and synthesise the literature published since 1999 on applications of the TTM to dietary behaviour so that the evidence for the use of assessment tools and interventions based on this model might be evaluated. Six databases were identified and searched using combinations of key words. Sixty-five original, peer-reviewed studies were identified and summarised in one of three tables using the following categories: population (n21), intervention (n25) and validation (n19). Internal validity ratings were given to each intervention, and the body of intervention studies as a whole was rated. The evidence for using stage-based interventions is rated as suggestive in the areas of fruit and vegetable consumption and dietary fat reduction. Valid and reliable staging algorithms are available for fruit and vegetable consumption and dietary fat intake, and are being developed for other dietary behaviours. Few assessment tools have been developed for other TTM constructs. Given the popularity of TTM-based assessments and interventions, more research is warranted to identify valid and reliable assessment tools and effective interventions. While the evidence supports the validity of the TTM to describe populations and to form interventions, evidence of the effectiveness of TTM-based interventions is not conclusive.

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Transtheoretical model-based nutritional interventions in adolescents: a systematic review

10.21203/rs.2.22185/v4 ◽

2020 ◽

Author(s):

Jennifer Nakabayashi Langamer ◽

Giselle Rha-isa Melo ◽

Natacha Toral

Keyword(s):

Behavior Change ◽

Dietary Intake ◽

Transtheoretical Model ◽

Readiness To Change ◽

Vegetable Consumption ◽

Fruit And Vegetable Consumption ◽

Publication Date ◽

Fruit And Vegetable ◽

Nutritional Interventions ◽

Behavior Change Theories

Abstract Background: Literature has shown a tendency of inadequate dietary intake among youth, consequently, nutritional interventions are required. The transtheoretical model (TTM) classifies individuals based on their readiness to change. This model is widely used for health education interventions with proven efficacy. Purpose: This review aimed to weigh the strength of evidence about the TTM usage in nutritional interventions for adolescents and its effectiveness regarding dietary intake.Methods: This study followed the PRISMA guidelines. Eligible studies were input into Mendeley software. The Adolec, Google Scholar, LILACS, PsycINFO, PubMed, Science Direct and Web of Science databases were searched. Only full original articles written in English, Spanish or Portuguese on randomized controlled trials and quasi-experimental designs that applied the TTM in the design of nutritional interventions targeting adolescents were included, with no restrictions on publication date. The quality and risk of bias was evaluated with the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies.Results: The initial search yielded 3779 results. Three studies were rated as strong, six as moderate and five as weak. The final sample of 14 articles included adolescents that were mostly recruited from schools, with interventions ranging from one month to three years. The TTM was used alone or combined with other behavior-change theories and most of the interventions involved digital technology. The nutritional topics covered included fruit and vegetable consumption, low-fat diet, and cooking skills. Four studies presented improvement in fruit and vegetable consumption and four progressed through stages of change. Participants from two interventions reduced fat intake. At the end of one intervention, all the participants were in action and maintenance stages. Conclusion: The TTM seems to be a successful strategy for nutritional intervention aiming at improving dietary intake in adolescents. Its application in different contexts shows that the TTM is flexible and possible to be implemented in many settings. The use of the model is shown to be restricted to the stage of change’ construct. Further studies should use all constructs of the TTM in the design and compare the TTM with other behavior-change theories to better understand its effectiveness.

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Transtheoretical model-based nutritional interventions in adolescents: a systematic review

10.21203/rs.2.22185/v2 ◽

2020 ◽

Author(s):

Jennifer Nakabayashi Langamer ◽

Giselle Rha-isa Melo ◽

Natacha Toral

Keyword(s):

Behavior Change ◽

Dietary Intake ◽

Transtheoretical Model ◽

Readiness To Change ◽

Vegetable Consumption ◽

Fruit And Vegetable Consumption ◽

Publication Date ◽

Fruit And Vegetable ◽

Nutritional Interventions ◽

Behavior Change Theories

Abstract Background: Literature has shown a tendency of inadequate dietary intake among youth, consequently, nutritional interventions are required. The Transtheoretical Model (TTM) classifies individuals based on their readiness to change. This model is widely used for health education interventions with proven efficacy. Purpose: This review aimed to weigh the strength of evidence about the TTM usage in nutritional interventions for adolescents. Methods: The Adolec, Google Scholar, LILACS, PsycINFO, PubMed, Science Direct and Web of Science databases were searched. Only full original articles written in English, Spanish or Portuguese on randomized controlled trials and quasi-experimental designs that applied the TTM in the design of nutritional interventions targeting adolescents were included, with no restrictions on publication date. Results: The initial search yielded 3779 results. The final sample of 14 articles included adolescents that were mostly recruited from schools, with interventions ranging from one month to three years. The TTM was used alone or combined with other behavior-change theories and most of the interventions involved digital technology. The nutritional topics covered included fruit and vegetable consumption, low-fat diet, and cooking skills. Four studies presented improvement in fruit and vegetable consumption and also four progressed through stages of change. Participants from two interventions reduced fat intake. In other two interventions, participants presented weight loss. At the end of one intervention, all the participants were in action and maintenance stages. Conclusion: The TTM seems to be a successful strategy for nutritional intervention aiming at improving dietary intake in adolescents. Its application in different contexts shows that the TTM is flexible and possible to be implemented in many settings. The use of the model in the development of the intervention is shown to be restricted to the stage of change’ construct and focused on promoting a tailored intervention. Further studies comparing the TTM with other behavior-change theories should be conducted to better understand its effectiveness.

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