Trial of 2 TeleComputer Diet Change Maintenace Programs

健康行为改变干预措施主要集中在获得短期干预效果;很少有研究 评估了中期和长期结果，甚至更少的人评估了旨在维持 提高初期干预效果。此外，行为理论还没有被开发用于维护或应用于 维持干预设计达到启动行为改变的程度。最后，对于启动和 维持重要的健康相关行为，需要以人群为基础的干预措施，结合联合收割机， 面对面专业干预的有效性和大众媒体方案的覆盖面。这可以通过 电信技术为基础的干预措施，是基于适当的行为改变理论和 训练有素的专业人员的物流。 本提案的目的是适应和评估一个完全自动化的，基于电话的饮食行为 在先前的研究中已证明对维持饮食变化有效的改变干预。的 这项研究的重点是通过增加水果和蔬菜（F&V）的消费来降低癌症风险， 饮食质量 将通过随机数字拨号从一个大城市地区招募1531名成年人的代表性样本， 参加一项2组随机对照试验，分配到一个有效的自动饮食行为改变计划（电话- 饮食相关护理或TLC-DIET）或仅评估对照条件。 那些对干预有反应的参与者（增加他们的每日F&V消费量> 1份）（n=405）将 被随机分配到3组之一：（1）仅评估对照条件，（2）基于维持干预的 SCT和目标设定理论（TLC-EAT.扩展[TCL-EAT.EXT]），以及（3）基于 新理论（目标系统理论[GST]）（TLC-EAT.目标管理[TLC-EAT.GM]）。GST专注于 ·管理其他生活目标，从而保护和增强有针对性的“新”目标（特定饮食行为）。 维持干预将持续6个月，随后进行18个月的观察。所有组均在 基线、3、6、9、12、15、18和24个月。 研究假设为（1）在所有随访时间点，对于F&V消耗，TLC-EAT.GM > TLC-EAT. EXT>对照 和整体饮食质量，以及（2）干预效果将由SCT预测的行为因素介导（自我效能， 等等）。和GST（目标屏蔽等）。

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.).