Stage-Matched Nutrition Guidance: Stages of Change and Fat Consumption in Dutch Patients at Elevated Cardiovascular Risk
article
Objective To assess the effects of stage-matched nutrition counseling on stages of change and fat intake. Design Controlled clinical trial. Setting 9 family practices in a family medicine practice network. Participants 143 patients at elevated cardiovascular risk, aged 40 to 70 years. Intervention
Intervention patients received stage-matched counseling from their family physician and a dietitian. Control patients received usual care. Main Outcome Measures Stages of change and fat intake were measured at baseline and after 6 and 12 months. Analysis Chi-squared tests, t tests, and regression analyses (α = .05) were conducted. Results More patients in the intervention group than in the control group were in the postpreparation stage after 6 months (70% vs 55%; P < .01) but not after 12 months (70% vs 55%; P = .10). Between 0 and 12 months, the reduction in total fat intake (-5.6% kcal vs -2.4% kcal) was largest in the intervention group. Conclusions and Implications Stage-matched nutrition counseling promotes movement through stages of change, resulting in a reduced fat intake. Our results partly support stages of change as a tool for behavior change. Movement across stages of change was not a mediating factor in the intervention effects. Research should focus on feasible ways to keep patients in the postpreparation stage.
Intervention patients received stage-matched counseling from their family physician and a dietitian. Control patients received usual care. Main Outcome Measures Stages of change and fat intake were measured at baseline and after 6 and 12 months. Analysis Chi-squared tests, t tests, and regression analyses (α = .05) were conducted. Results More patients in the intervention group than in the control group were in the postpreparation stage after 6 months (70% vs 55%; P < .01) but not after 12 months (70% vs 55%; P = .10). Between 0 and 12 months, the reduction in total fat intake (-5.6% kcal vs -2.4% kcal) was largest in the intervention group. Conclusions and Implications Stage-matched nutrition counseling promotes movement through stages of change, resulting in a reduced fat intake. Our results partly support stages of change as a tool for behavior change. Movement across stages of change was not a mediating factor in the intervention effects. Research should focus on feasible ways to keep patients in the postpreparation stage.
Topics
TNO Identifier
1017522
DOI
https://dx.doi.org/10.1016/S1499-4046(06)60385-0
Source title
Journal of Nutrition Education and Behavior
Pages
228-237