Mediators and moderators of nutrition intervention effects in remote Indigenous Australia.
Mediators and moderators of nutrition intervention effects in remote Indigenous Australia.
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DOI：
10.1017/s0007114518000880
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发表时间：
2018-06
期刊：
影响因子：
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通讯作者：
Ball K
中科院分区：
文献类型：
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作者：
Brimblecombe J;Ferguson M;Barzi F;Brown C;Ball K
我们进行了一项纵向饮食干预研究，以评估基于商店的干预对澳大利亚偏远地区土著社区的调节因子和调节因子以及随之而来的饮食行为的影响。我们分别在基线（T1）、干预结束（T2）和干预后24周（T3）评估了148名、85名和73名成年参与者（92%为女性）的水果、蔬菜、水和含糖软饮料、调节剂和调节剂的饮食摄入量。调节因子包括感知负担能力和自我效能。调节因素是吃更多水果和蔬菜和食品安全的障碍。混合效应模型用于确定介质和调节因子随时间的变化以及它们与每种饮食结果之间的关联。感知蔬菜负担能力从T1 （19%; 95% CI 11,27）增加到T2 (38%; 95% CI 25,51) (P= 0.004)，并在T3时恢复到基线水平。从T1到T3，多吃水果和蔬菜，少喝软饮料的高自我效能感有所下降。据报道，与T1相比，T3时软饮料摄入量减少了27% (95% CI - 44, - 4； P= 0.02)；所有其他结果测量均未观察到随时间的变化。无论时间如何，蔬菜摄入量与烹饪和尝试新蔬菜的自我效能、无障碍和食品安全呈正相关。饮食干预在某种程度上提高了蔬菜的可负担性，但可能不足以克服其他限制行为改变的中介和调节因素。在这种情况下，如果不解决行为改变的潜在制约因素，就很难实现有意义的饮食改善。
We conducted a longitudinal dietary intervention study to assess the impact of a store-based intervention on mediators and moderators and consequent dietary behaviour in Indigenous communities in remote Australia. We assessed dietary intake of fruit, vegetable, water and sweetened soft drink, mediators and moderators among 148, eighty-five and seventy-three adult participants (92 % women) at baseline (T1), end of intervention (T2) and at 24 weeks post intervention (T3), respectively. Mediators included perceived affordability and self-efficacy. Moderators were barriers to eat more fruit and vegetables and food security. Mixed-effects models were used to determine changes in mediators and moderators with time and associations between these and each dietary outcome. Perceived vegetable affordability increased from T1 (19 %; 95 % CI 11, 27) to T2 (38 %; 95 % CI 25, 51) (P=0·004) and returned to baseline levels at T3. High self-efficacy to eat more fruit and vegetables and to drink less soft drink decreased from T1 to T3. A reduction in soft drink intake of 27 % (95 % CI −44, −4; P=0·02) was reported at T3 compared with T1; no changes with time were observed for all other outcome measures. Regardless of time, vegetable intake was positively associated with self-efficacy to cook and try new vegetables, no barriers and food security. The dietary intervention went someway to improving perceived affordability of vegetables but was probably not strong enough to overcome other mediators and moderators constraining behaviour change. Meaningful dietary improvement in this context will be difficult to achieve without addressing underlying constraints to behaviour change.