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Table 2 Intervention characteristics

From: Effectiveness of interventions to promote healthy diet in primary care: systematic review and meta-analysis of randomised controlled trials

Study (Year)

Mode(s) of administration

Intervention intensity

Stated theoretical approach

Use of theory

Intervention techniques used*

Total techniques used

CT techniques used

Control condition

Baron (1990) [33]

Face to face, individually or in small groups, supported by booklet, delivered by nurses.

Dietary advice and a booklet with advice on diet, promotional materials displayed at the practice. 30 min per session, individually or in groups, brief follow up sessions were scheduled at one and three months after entry into the study

none

N/A

1. provide information on consequences of the behaviour

3

0

No dietary advice

21. Provide instruction on how to perform the behaviour

27. use of follow-up prompts

Beresford (1997) [35]

1) Face to face - physician introduces self-help booklet;

Self-help booklet and physician endorsement to promote dietary change such as improving health, following the changing social norm to eat lower fat, higher fibre foods, and doing something positive for oneself. Introduction of booklet taking less than 3 minutes, 2 weeks later, a reminder letter signed by physician sent to the participants who had received the intervention.

Social learning theory

No

1. provide information on consequences of behaviour

8

2

No intervention/ usual care

3. provide information regarding others’ approval

2) mailed reminder letter

5. goal setting (behaviour)

8. Barrier identification and problem solving?

9. Set graded tasks

19. Provide feedback on performance

21. provide information on how to do the behaviour

27. Use of follow up prompts

Coates (1999) [28]

Face to face, in groups, delivered by nutritionists

Dietary counselling sessions in groups that met weekly for 6 weeks, bi-weekly for 6 weeks, monthly for 9 months and then quarterly until 18 months. Group members shared experiences.

None

N/A

5. goal setting – behaviour

8

2

Not counselled, but given Dietary Guidelines for Americans

8. problem solving

12. prompt rewards contingent on effort/success towards behaviour and on successful behaviour

16. prompt self monitoring

21. provide information on how to perform the behaviour

22. model/demonstrate the behaviour

26. prompt practice

29. plan social support

Fries(2005) [34]

Mail plus one phone call – no information on the professional group (if any) of staff making the phone call

Intervention by telephone and mail. Including personalized dietary feedback, low-literacy self-help booklets. Phone call 2 weeks after the personalised dietary feedback with brief counselling. Information booklet: mailed in staggered format, one each week immediately after the intervention phone call.

Community-based social marketing, social cognitive theory, TTM

Yes – stage of change from the TTM

5. goal setting – behaviour

8

2

No intervention

8. problem solving

12 prompt rewards contingent on effort/success towards behaviour and on successful behaviour

16. prompt self monitoring

21. provide information on how to perform the behaviour

22. model/demonstrate the behaviour

26. prompt practice

29 plan social support

Gann (2003) [36]

Face to face - group sessions plus two individual sessions – no information on the professional group (if any) of staff delivering the sessions

Classroom nutrition education plus individual counselling with 18 group classes and 2 individual meetings in 12 months. To maximize the impact of intervention, appropriate foods and meals were prepared and served at intervention sessions to reinforce new eating behaviours and demonstrate the ease of preparations. Sessions included discussion and practice of shopping, label reading, and meal preparation techniques, eating out and convenience foods

None

N/A

21. provide information on how to perform the behaviour

2

0

No intervention until after end of study

22. model/demonstrate the behaviour

Kristal (2000) [32]

Mail plus one phone call delivered by a “trained health educator”

Tailored dietary intervention including i) a package of self-help materials, ii) dietary analysis with behavioural feedback, iii) a motivational phone call, and iv) 'semi-monthly’ newsletters.

Social learning theory, TTM, diet individuation model

Yes – intervention tailored to stage of change, motives for changing diet and stated interest in dietary change

1. provide information about the consequences of the behaviour

7

2

Usual care (No intervention)

5. goal setting – behaviour

9. set graded tasks

19. provide feedback on behaviour

21. instruction on how to perform the behaviour

22. model/demonstrate the behaviour (?)

27. use of follow-up prompts

Roderick (1997) [29]

Face to face – individual sessions, delivered by nurses plus two “further assessment” sessions delivered by GP if CVD risk factors elevated

Dietary advice aimed for food substitution after the review of the type, quantity and frequency of key foods consumed. Specially designed dietary sheets were given out. Review at second visit. 3 and 6 month reviews and GP referral if cardiovascular risk factors elevated.

None

N/A

5. goal setting- behaviour

3 or 4***

2 or 3**

Standard health education leaflet, Guide to healthy eating

10 prompt review of behavioural goals

16. or 17.(For some) self-monitoring – not quite clear if this was of the behaviour or of weight.

21. instruction on how to perform the behaviour

Sacerdote (2006) [30]

Face to face – individual session, delivered by GP, supported by booklet

Personalised nutritional intervention, based on a brochure about diet and health that summarized the Italian Guidelines for a Correct Nutrition 1998 and on a 15 min educational intervention, 2 follow-up visits to the GP.

None

N/A

1. provide information about the consequences of behaviour

2

0

A simpler and non personalized conversation without the use of a brochure.

21. provide instruction on how to perform the behaviour

Stevens (2003) [31]

Face to face – individual sessions plus phone calls delivered by master’s degree level health counsellors, supported by print materials

Individual 45 minute counselling sessions and telephone support. Print out of the counselling session along with nutrition education materials including descriptions of the desired dietary pattern and advice. Second 45 minute visit, 2–3 weeks after the first.

Social cognitive theory, TTM

Yes – personal barriers, self efficacy and stage of change

5. goal setting – behaviour

7

3

No dietary advice, however advised on Breast Self Examination(BSE)

8. barrier identification and problem solving

9. set graded tasks

10. prompt review of behavioural goals

19. provide feedback on performance

21. provide instruction on how to perform the behaviour

37. motivational interviewing

Takahashi (2006) [27]

Face to face, individual sessions plus one group session, postal newsletters. Professional group of those delivering the intervention unclear

Two 15 min dietary counselling sessions, a group lecture and two newsletters

None

N/A

5. goal setting – behaviour

3

2

No intervention

19. provide feedback on performance

     

21. provide instruction on how to do the behaviour

   
  1. Key: CT = control theory, TTM = transtheoretical model.
  2. *coded using CALO-RE taxonomy [23]; **Number of intervention techniques used consistent with control theory (out of the following four intervention techniques: prompt specific goal setting, prompt review of behavioural goals, prompt self monitoring of behaviour and provide feedback on performance); ***4 techniques used if participant was overweight, otherwise three techniques.