Development of a peer support intervention to encourage dietary behaviour change towards a Mediterranean diet in adults at high cardiovascular risk
Development of a peer support intervention to encourage dietary behaviour change towards a Mediterranean diet in adults at high cardiovascular risk
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DOI：
10.1186/s12889-018-6108-z
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发表时间：
2018-10-22
影响因子：
4.5
通讯作者：
Woodside, Jayne V.
中科院分区：
文献类型：
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作者：
McEvoy, Claire T.;Moore, Sarah E.;Woodside, Jayne V.
背景地中海饮食（MD）干预被证明可以显著降低心血管疾病（CVD）风险，但通常是资源密集型的，并由卫生专业人员提供。有相当大的兴趣，制定干预措施，目标是持续的饮食行为的变化，是可行的，以扩大更广泛的公共卫生利益。本文的目的是描述的过程中用于开发一个同伴支持干预，鼓励饮食行为的改变对MD在非地中海成年人在高CVD risk.MethodsThe医学研究理事会（MRC）和行为变化轮（BCW）框架和COM-B（能力，机会，动机，行为）的理论模型被用来指导干预开发过程。我们使用证据综合和定性研究相结合的方法，与目标人群、卫生专业人员和社区卫生人员一起，在三个主要阶段制定干预措施：（1）我们确定了证据基础，并选择了需要改变的饮食行为，（二）我们开发了一个理论基础，为干预如何可能鼓励行为改变向MD和选定的干预功能，可以驱动所需的MD行为变化，（3）我们定义的干预内容和modelled outcomes.ResultsA理论为基础的，文化上量身定制的，同伴支持干预开发的目标是专门针对行为变化对MD在目标人群。干预是一个基于小组的计划，由受过训练的同龄志愿者在12个月内提供，并纳入了增强社会支持，自我效能，解决问题，知识，和态度，以解决所确定的障碍，采用一个MD从COM-B analysis.ConclusionsThe MRC和BCW框架提供了一个系统的和互补的过程，发展的理论-基于同伴支持的干预措施，以鼓励非地中海地区心血管疾病高风险成年人的饮食行为改变。下一步是使用随机对照试验设计评估可行性、可接受性和饮食行为改变结果，以响应同伴支持干预（向MD和营养生物标志物的改变）。
BackgroundMediterranean diet (MD) interventions are demonstrated to significantly reduce cardiovascular disease (CVD) risk but are typically resource intensive and delivered by health professionals. There is considerable interest to develop interventions that target sustained dietary behaviour change and that are feasible to scale-up for wider public health benefit. The aim of this paper is to describe the process used to develop a peer support intervention to encourage dietary behaviour change towards a MD in non-Mediterranean adults at high CVD risk.MethodsThe Medical Research Council (MRC) and Behaviour Change Wheel (BCW) frameworks and the COM-B (Capability, Opportunity, Motivation, Behaviour) theoretical model were used to guide the intervention development process. We used a combination of evidence synthesis and qualitative research with the target population, health professionals, and community health personnel to develop the intervention over three main stages: (1) we identified the evidence base and selected dietary behaviours that needed to change, (2) we developed a theoretical basis for how the intervention might encourage behaviour change towards a MD and selected intervention functions that could drive the desired MD behaviour change, and (3) we defined the intervention content and modelled outcomes.ResultsA theory-based, culturally tailored, peer support intervention was developed to specifically target behaviour change towards a MD in the target population. The intervention was a group-based program delivered by trained peer volunteers over 12-months, and incorporated strategies to enhance social support, self-efficacy, problem-solving, knowledge, and attitudes to address identified barriers to adopting a MD from the COM-B analysis.ConclusionsThe MRC and BCW frameworks provided a systematic and complementary process for development of a theory-based peer support intervention to encourage dietary behaviour change towards a MD in non-Mediterranean adults at high CVD risk. The next step is to evaluate feasibility, acceptability, and diet behaviour change outcomes in response to the peer support intervention (change towards a MD and nutrient biomarkers) using a randomized controlled trial design.