Trial of 2 TeleComputer Diet Change Maintenace Programs

健康行为改变干预侧重于获得短期干预效果；很少有研究这样做 评估中期和长期结果，更少的人评估旨在维持 增强初步干预效果。此外，行为理论还没有被开发用于维护或应用于 维护干预设计到它对于行为改变启动的程度。最后，对于印心和 为了维持重要的健康相关行为，需要以人群为基础的干预措施，将 面对面专业干预的有效性和大众媒体节目的覆盖范围。这可以通过以下方式实现 基于电信技术的干预，基于适当的行为改变理论和 训练有素的专业人士的启发式。 本提案的目的是适应和评估完全自动化的、基于电话的饮食行为 改变干预，在先前的研究中被证明是有效的，以维持饮食改变。这个 研究的重点将是通过增加水果和蔬菜的消费(F&V)和改善整体状况来降低癌症风险 饮食质量。 将通过随机数字拨号从大城市地区招募具有代表性的1531名成年人 参与双臂随机对照试验，并分配到有效的自动饮食行为改变计划(电话： 基于SCT和目标设置理论的饮食或TLC-饮食关联护理)或仅评估的控制条件。 那些对干预有反应的参与者(将他们每天的F&V消费量增加1份)(n=405)将 被随机分配到3个分支之一：(1)仅评估控制条件，(2)基于维护干预 关于SCT和目标设置理论(TLC-EAT.Extended[TCL-EAT.EXT])，以及(3)基于 新理论(目标系统理论[GST])(TLC-EAT.Goal Management[TLC-EAT.GM])。商品及服务税侧重于 管理其他生活目标，以便有针对性的“新”目标(具体的饮食行为)得到保护和加强。 维护干预将持续6个月，随后将进行18个月的观察。所有小组在以下位置进行评估 基线、3、6、9、12、15、18和24个月。 研究假设为：(1)饮食量的所有后续时间点的TLC-EAT.GM&GT；TLC-EAT.EXT&GT；控制 以及(2)干预效果将由SCT预测的行为因素(自我效能， 等)和GST(球门屏蔽等)。

Health behavior change interventions have focused on obtaining short-term intervention effects; few studies have evaluated mid-term and long-term outcomes, and even fewer have evaluated interventions that are designed to maintain and enhance initial intervention effects. Moreover, behavior theory has not been developed for maintenance or applied to maintenance intervention design to the degree that it has for behavior change initiation. Finally, for both the initiation and maintenance of important health-related behavior, there is a need for population-based interventions that combine the effectiveness of face-to-face professional intervention and the reach of mass-media programs. This may be achieved by telecommunications technology-based interventions that are based on appropriate behavior change theory and the heuristics of trained professionals. The aim of the present proposal is to adapt and evaluate a totally automated, telephone-based dietary behavior change intervention that has been shown to be efficacious in a previous study to the maintenance of dietary change. The study will focus on reducing cancer risk by increasing consumption of fruits and vegetables (F&V) and improving overall diet quality. A representative sample of 1531 adults from a large urban area will be recruited through random digit dialing to participate in a 2-arm RCT with assignment to an efficacious automated dietary behavior change program (Telephone- Linked Care for Diet or TLC-DIET) based on SCT and Goal Setting Theory or to an assessment only control condition. Those participants who respond to the intervention (increase their daily consumption of F&V by > 1 serving) (n=405) will be randomly assigned to one of 3 arms: (1) an assessment only control condition, (2) a maintenance intervention based on SCT and Goal Setting Theory (TLC-EAT.Extended [TCL-EAT.EXT], and (3) a maintenance intervention based on a novel theory (Goal Systems Theory [GST]) (TLC-EAT.Goal Management [TLC-EAT.GM]). GST focuses on the management of other life goals such that the targeted "new" goal (specific dietary behavior) is protected and enhanced. The maintenance interventions will last for 6 months, following by 18 months of observation. All groups are assessed at baseline, 3, 6, 9, 12, 15, 18, and 24 months. The study hypotheses are (1) TLC-EAT.GM > TLC-EAT.EXT > Control at all follow-up time points for F&V consumption and overall diet quality, and (2) intervention effects will be mediated by behavioral factors predicted by SCT (self-efficacy, etc.) and GST (goal shielding, etc.).