Cynthia W Kelly1. 1. School of Nursing, Xavier University, Cincinnati, OH 45207, USA. kellyc3@xavier.edu
Abstract
AIMS AND OBJECTIVES: To determine the predictive validity of three behavioural variables on changes in diet: commitment to health (commitment), confidence in ability to change dietary behaviours (confidence) and belief about the importance of changing dietary behaviours (importance). BACKGROUND: Literature supports the Transtheoretical Model of Behavior Change as a framework for understanding dietary behaviour change. Less certain are behavioural variables associated with stage movement for action to maintenance stage for dietary behaviour change. This research considered three variables: self-efficacy ('confidence'), decisional balance scale ('importance') and 'commitment'. Published literature supports the importance of each of these behavioural variables, but not their predictive abilities. DESIGN: A cross-sectional survey was used for 499 manufacturing workers from multiple work-sites. METHODS: Subjects' dietary health behaviours were measured by determining how long they consistently ate a low-fat diet, with analysis of variance addressing the stages-of-change model: precontemplation, contemplation, preparation, action, maintenance. RESULTS: Commitment best predicted change from action to maintenance stage (p < 0·05). Importance (p < 0·05) was somewhat significant, but confidence (p > 0·05) was not. CONCLUSIONS: Commitment was the best predictor of dietary change, from the action to the maintenance stage of change. RELEVANCE TO CLINICAL PRACTICE: Clinicians working with patients in the action stage of dietary change can use a stage-based approach and should evaluate commitment to health as part of an overall assessment. Those with high-level commitment will successfully change from action to maintenance with minimal professional assistance. Those with middle-level commitment risk relapse to a pre-action stage will benefit most from professional intervention. Those in the lower level of commitment are most likely to revert to a pre-action stage of change and may be not be ready for dietary change.
AIMS AND OBJECTIVES: To determine the predictive validity of three behavioural variables on changes in diet: commitment to health (commitment), confidence in ability to change dietary behaviours (confidence) and belief about the importance of changing dietary behaviours (importance). BACKGROUND: Literature supports the Transtheoretical Model of Behavior Change as a framework for understanding dietary behaviour change. Less certain are behavioural variables associated with stage movement for action to maintenance stage for dietary behaviour change. This research considered three variables: self-efficacy ('confidence'), decisional balance scale ('importance') and 'commitment'. Published literature supports the importance of each of these behavioural variables, but not their predictive abilities. DESIGN: A cross-sectional survey was used for 499 manufacturing workers from multiple work-sites. METHODS: Subjects' dietary health behaviours were measured by determining how long they consistently ate a low-fat diet, with analysis of variance addressing the stages-of-change model: precontemplation, contemplation, preparation, action, maintenance. RESULTS: Commitment best predicted change from action to maintenance stage (p < 0·05). Importance (p < 0·05) was somewhat significant, but confidence (p > 0·05) was not. CONCLUSIONS: Commitment was the best predictor of dietary change, from the action to the maintenance stage of change. RELEVANCE TO CLINICAL PRACTICE: Clinicians working with patients in the action stage of dietary change can use a stage-based approach and should evaluate commitment to health as part of an overall assessment. Those with high-level commitment will successfully change from action to maintenance with minimal professional assistance. Those with middle-level commitment risk relapse to a pre-action stage will benefit most from professional intervention. Those in the lower level of commitment are most likely to revert to a pre-action stage of change and may be not be ready for dietary change.
Authors: Lorraine B Robbins; Jiying Ling; Stacey M Wesolek; Anamaria S Kazanis; Kelly A Bourne; Ken Resnicow Journal: Am J Health Promot Date: 2016-11-17