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Table 5 Matrix of strategies, theory-based methods, practical applications of changing unhealthy diet: examples

From: Development of interventions for an intelligent and individualized mobile health care system to promote healthy diet and physical activity: using an intervention mapping framework

Phases of change POs Mediators Moderators PPOs Strategies Theory-based Methods IF AND THEN: Practical applications Mode
Precontemplation PO1 Motivation Risk Perception PPO1 Dynamic monitoring and individualized, immediate feedback Monitor and provide feedback on performance (e.g. salt intake) of the behavior. Monitor and provide feedback on the outcome (e.g. blood pressure) of the behavior. Salt intake >5 g/d Cooked soil intake < 25 g/d Mr. Wang, we found that you have very good control of your lipid and cholesterol levels, which is good for your health. Your health would improve if you decreased your sodium intake, because a salty diet may increase the risk of developing hypertension. Text- messaging with trend graph
Contemplation PO2 Motivation Action Planning PPO13 Personalized action plan Provide a personalized action plan based on the patient’s health condition and preferences. Patient can modify the action plan if they disagree with the plan. Salt intake >5 g/d and Cooked oil intake > 25 g/d Have an intention to change Mr. Wang, here is the action plan we recommend for you to maintain a healthy diet. What do you think of it? If you accept it, please click the accept button. If not, you can click the edit button to change the plan and then submit it. Text-messaging with a link to review action plan
Action PO3 Volition Self-Efficacy PPO17 Psychological cues Psychometric tests: To uncover the obstacles in the maintenance of healthy behavior change and to provide tailored feedbacks and suggestions. Salt intake >5 g/d and Soil intake > 25 g/d Action plan has been made If you have a dietary action plan, but you can’t stick to it, please complete this questionnaire to tell us your experience. Text-messaging with a link to Psychological test
Maintenance PO3 Volition Social Support PPO23 Role model Patients who maintain healthy behavior for more than 6 months, will serve as role models. Regular group discussions will be facilitated by the role models for other patients who encounter difficulties in the process of behavior change to help them learn coping strategies Salt intake >5 g/d and Soil intake > 25 g/d Maintaining healthy diet for 6 months or above The topics of the group discussions are: (1) experiences shared by the role model, and (2) the role model answering the questions from other patients. Group discussion in the app
  1. PO: Performance Objectives; PO1: Building intention to change; PO2: Building and enhancing motivation of action taking; PO3: Building and enhancing volition of action maintaining; PPO: Proximal performance objectives; PPO1: Promoting patients to identify CHD risk factors; PPO13: Making a specific and individualized action planning of diet and physical activity changes for patients, and make sure patients confirm and accept it; PPO17: Helping patients to uncover the barriers in maintaining healthy diet and regular physical activity; PPO23: Increasing peer-support
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