Tailoring a fruit and vegetable intervention on novel motivational constructs: Results of a randomized study
Tailoring a fruit and vegetable intervention on novel motivational constructs: Results of a randomized study
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DOI：
10.1007/s12160-008-9028-9
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发表时间：
2008-04-01
影响因子：
3.8
通讯作者：
Wiese, Cheryl
中科院分区：
文献类型：
--
作者：
Resnicow, Ken;Davis, Rachel E.;Wiese, Cheryl
迄今为止，量身定制的卫生通信一直基于一套相当狭隘的理论结构。目的：本研究旨在检验基于印刷品的水果和蔬菜（F & V）干预是否基于自决理论（SDT）和动机访谈（MI）的相对新颖的结构，从而增加干预的影响、感知相关性和项目满意度。该研究还旨在探索可能调节干预反应的用户特征。方法从两个综合医疗服务系统中招募非裔美国成年人，一个位于底特律地铁地区，另一个位于亚特兰大地铁地区，然后随机接收3个月内的三份量身定制的通讯。一组简报仅针对人口统计和社会认知变量（控制条件）进行定制，而另一组（实验条件）则针对SDT和MI原则和策略进行定制。通讯的主要焦点和研究的主要结果是通过两种简短的自我报告方法评估水果和蔬菜摄入量。对自主支持的偏好在基线时通过一个单一项目进行评估：“一般来说，当涉及到我的健康时，我宁愿专家告诉我应该怎么做”。大多数组间差异是用变化分数来检验的。结果共纳入1650名符合条件的受试者512名（31%），其中423名提供了完整的3个月随访数据。考虑到整个样本，在3个月的随访中，两组之间的每日F和V摄入量没有显著差异。两组人都表现出了相似的增长，短形式的每天一份左右，长形式的每天半份左右。然而，干预组与自主支持沟通的偏好以及年龄之间存在显著的相互作用。具体来说，在实验干预中，在基线时偏好自主支持沟通方式的个体，其f&v摄入量增加了1.07份，而对照组为0.43份。在年轻的对照组中，f&v摄入量的变化更大，为0.59份，而实验组为0.29份。相反，年龄较大的实验组参与者的f&v变化更大，为1.09份，而年龄较大的对照组为0.48份。结论：我们的研究证实了评估个体差异作为量身定制健康干预的潜在调节因素的重要性。对于那些喜欢自主支持沟通风格的人来说，根据价值观和其他动机结构进行剪裁可以增强信息的影响和感知的相关性。
Background Tailored health communications to date have been based on a rather narrow set of theoretical constructs.Purpose This study was designed to test whether tailoring a print-based fruit and vegetable (F & V) intervention on relatively novel constructs from self-determination theory (SDT) and motivational interviewing (MI) increases intervention impact, perceived relevance, and program satisfaction. The study also aimed to explore possible user characteristics that may moderate intervention response.Methods African American adults were recruited from two integrated health care delivery systems, one based in the Detroit Metro area and the other in the Atlanta Metro area, and then randomized to receive three tailored newsletters over 3 months. One set of newsletters was tailored only on demographic and social cognitive variables (control condition), whereas the other (experimental condition) was tailored on SDT and MI principles and strategies. The primary focus of the newsletters and the primary outcome for the study was fruit and vegetable intake assessed with two brief self-report measures. Preference for autonomy support was assessed at baseline with a single item: "In general, when it comes to my health I would rather an expert just tell me what I should do". Most between-group differences were examined using change scores.Results A total of 512 (31%) eligible participants, of 1,650 invited, were enrolled, of which 423 provided complete 3-month follow-up data. Considering the entire sample, there were no significant between-group differences in daily F & V intake at 3 month follow-up. Both groups showed similar increases of around one serving per day of F & V on the short form and half a serving per day on the long form. There were, however, significant interactions of intervention group with preference for autonomy-supportive communication as well as with age. Specifically, individuals in the experimental intervention who, at baseline, preferred an autonomy-supportive style of communication increased their F & V intake by 1.07 servings compared to 0.43 servings among controls. Among younger controls, there was a larger change in F & V intake, 0.59 servings, than their experimental group counterparts, 0.29 servings. Conversely, older experimental group participants showed a larger change in F & V, 1.09 servings, than older controls, 0.48.Conclusion Our study confirms the importance of assessing individual differences as potential moderators of tailored health interventions. For those who prefer an autonomy-supportive style of communication, tailoring on values and other motivational constructs can enhance message impact and perceived relevance.