Trial of 2 TeleComputer Diet Change Maintenace Programs

描述(申请人提供)：健康行为改变干预措施侧重于获得短期干预效果；很少有研究评估中期和长期结果，更少的研究评估旨在维持和增强初步干预效果的干预措施。此外，行为理论还没有为维护而发展，也没有像行为改变启动那样应用于维护干预设计。最后，对于发起和维持重要的与健康有关的行为，都需要以人群为基础的干预措施，将面对面的专业干预的有效性与大众媒体方案的覆盖范围相结合。这可以通过以电信技术为基础的干预措施来实现，这些干预措施基于适当的行为改变理论和训练有素的专业人员的启发。 本建议的目的是适应和评估一种完全自动化的、基于电话的饮食行为改变干预，该干预在先前的一项研究中被证明对维持饮食改变是有效的。这项研究将重点放在通过增加水果和蔬菜(F&V)的消费和改善整体饮食质量来降低癌症风险。 将通过随机数字拨号从大城市地区招募1531名具有代表性的成年人参加双臂随机对照试验，分配到基于SCT和目标设置理论的有效自动饮食行为改变计划(电话连接的饮食护理或TLC饮食)或仅限评估的对照条件。那些对干预有反应的参与者(将他们每天的F&V摄入量增加1份)(n=405)将被随机分配到3个组中的一个：(1)仅限评估的控制条件，(2)基于SCT和目标设置理论的维持干预(TLC-EAT)。扩展的[TCL-EAT.EXT]，以及(3)基于新理论(目标系统理论[GST])的维护干预(TLC-EAT。目标管理[TLC-EAT.GM])。商品及服务税侧重于对其他生活目标的管理，以便有针对性的“新”目标(具体饮食行为)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。所有组在基线、3、6、9、12、15、18和24个月进行评估。 研究假设为(1)TLC-EAT.GM&GT；TLC-EAT.EXT&GT；TLC-EAT.EXT&GT；(2)干预效果将由SCT预测的行为因素(自我效能感等)中介。和GST(球门屏蔽等)。

DESCRIPTION (provided by applicant): 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.).