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Theory, evidence and Intervention Mapping to improve behavior nutrition and physical activity interventions
Johannes Brug, Anke Oenema, Isabel Ferreira
International Journal of Behavioral Nutrition and Physical Activity , 2005, DOI: 10.1186/1479-5868-2-2
Abstract: Since behavior theory is a reflection of the compiled evidence of behavior research, theory is the only foothold we have for the development of behavioral nutrition and physical activity interventions. Application of theory should improve the effectiveness of interventions. However, some of the theories we use lack a strong empirical foundation, and the available theories are not always used in the most effective way. Furthermore, many of the commonly-used theories provide at best information on what needs to be changed to promote healthy behavior, but not on how changes can be induced. Finally, many theories explain behavioral intentions or motivation rather well, but are less well-suited to explaining or predicting actual behavior or behavior change.For more effective interventions, behavior change theory needs to be further developed in stronger research designs and such change-theory should especially focus on how to promote action rather than mere motivation. Since voluntary behavior change requires motivation, ability as well as the opportunity to change, further development of behavior change theory should incorporate environmental change strategies.Intervention Mapping may help to further improve the application of theories in nutrition and physical activity behavior change.Is there "nothing more practical than a good theory" in improving behavioral nutrition and physical activity interventions? And which theories are indeed good enough to help us improve the practice of encouraging people to adopt healthier diets and physical activity patterns? The International Journal of Behavioral Nutrition and Physical Activity (IJBNPA) recognized the importance of this issue and encouraged a 'theory debate' [1]. Jeffery started the debate by sharing his experiences with and views on applying theories in weight management and weight loss interventions [2]. His conclusion is that we focussed too much on social cognition models and that these models proved to be not very
Nutrition intervention in scholars  [PDF]
Carolina Anzolin,Camila Marcon Ouriques,Doroteia Aparecida H?felmann,Tatiana Mezadri
Revista Brasileira em Promo??o da Saúde , 2010,
Abstract: Objective: To verify the effectiveness of nutrition intervention in changing dietary intake among school children aged 6 to 10 years old in private school, in the city of Itajaí - SC, Brazil. Methods: A non-randomized and uncontrolled intervention study, carried through four educational activities in the period from August to November, 2008 and food intake reassessed at the end. We evaluated the nutritional status by means of body mass index for age and sex, and waist circumference. The frequency of consumption before and after intervention was compared using the paired Student t test. Results: Joined in the survey 93 students (69.92%) of whom 48 children (54.5%) were normal weight, while 36 (40.9%) were overweight or presented obesity. The most consumed food groups, before and after intervention were: crackers and pasta; rice and fruit juice. The average frequency of sweets intake decreased after the intervention (0.54 to 0.24 times per day, p <0.001), however increased the intake of fried potatoes (0.25 to 0.65, p <0.001), pizza and hamburger (0.30 to 0.46, p = 0.028). Among girls, the intake of sweets decreased after the educational activities (0.58 to 0.12, p <0.001). Conclusions: Nutritional interventions, despite the short period of time, were effective in changing the consumption of certain foods / food groups. The results reinforce the need to carry out interventions more often and for longer periods, to promote effective changes in food consumption.
Nutrition interventions in the workplace: Evidence of best practice
NP Steyn, W Parker, EV Lambert, Z Mchiza
South African Journal of Clinical Nutrition , 2009,
Abstract: Aim: The aim of this desktop study was to review all workplace interventions having a nutrition component, published in peer-reviewed literature between 1995 and 2006 by WHO, and to document activities that were successful, as well as possible barriers to their success. Methodology: A systematic review of workplace studies revealed 41 interventions, of which 30 complied with the predetermined search criteria. The following outcome measures were considered in the evaluation of the interventions: (i) changes in nutritional knowledge, attitudes, self-efficacy, intentions and stage of change; (ii) changes in dietary behaviours; (iii) changes in clinical/physical markers, such as: body weight or body-mass index (BMI), blood pressure (BP) or serum cholesterol concentrations; and (iv) process and/or policy outcomes. Results: A large number of diverse workplace interventions were successful in changing outcomes positively in the interventions evaluated. The following were key success factors: i) there was a nutrition and physical activity component; ii) dietitians were involved in nutrition education; iii) changes occurred in the cafeteria/canteen, which increased the availability of healthy food options and advertised them accordingly; iv) tailored feedback on diet (and clinical values) was given to subjects; v) employees were involved in planning and managing programmes; vi) the reduced prices (of healthy food items) in vending machines encouraged employees to buy healthier options; and vii) the stages of change theory was most commonly associated with best practice outcomes. Conclusions: Numerous workplace interventions have shown significant improvements in employees’ health and behaviours. However, it is necessary to plan intervention programmes based on the existing evidence of best practice.
Evaluation of the effectiveness of a nutrition education intervention performed by primary school teachers
Erminia Agozzino,Umberto Del Prete,Chiara Leone,Elisabetta Manzi
Italian Journal of Public Health , 2007, DOI: 10.2427/5865
Abstract: Background: Long-term interventions based on the active involvement of students, carried out by properly prepared staff using didactic support material (brochures, games etc.) including the participation/involvement of mothers or associates in community interventions; seem to be the most effective ones. This study evaluates the effectiveness of nutrition education interventions carried out by teachers with active didactic methodologies. Methods: The research was carried out by administering a frequency of food intake questionnaire, before and after the intervention. To compare the answers given before and after the educational intervention the Wilcoxon-test was applied to dependent data discriminating the group with “sufficient implementation” of the project versus “insufficient implementation”. Results: Our data demonstrates that a substantial percentage of children do not report an adequate nutritional intake, making education interventions not only opportune but necessary. In both groups there was an increase in the number of subjects having breakfast, particularly in terms of bread and biscuits intake. In the group with “sufficient implementation” there was an increase in the intake of all kinds of food with respect to the previous day’s intake and a decrease in the intake of meat, fish and legumes consumed during the previous week; in the group with “insufficient implementation” only fish intake increased significantly while vegetable intake decreased in a non-significant way. So this educational intervention appears to have been particularly effective in modifying breakfast habits and reducing snack.
A review of school nutrition interventions globally as an evidence base for the development of the HealthKick programme in the Western Cape, South Africa
NP Steyn, EV Lambert, W Parker, Z Mchiza, A De Villiers
South African Journal of Clinical Nutrition , 2009,
Abstract: Aim: The aim of this study was to review all school interventions having a nutrition component, published in peer-reviewed literature between 1995 and 2006, and to document activities that were successful as well as those that were possible barriers in order to develop a best practice school intervention for the Western Cape Province, South Africa. Methodology: A systematic review of school studies revealed 85 interventions that complied with the predetermined search criteria. The following outcome measures were considered in the evaluation of the interventions: (i) changes in nutritional knowledge, attitudes and selfefficacy and stage of change; (ii) changes in dietary behaviours; (iii) changes in clinical/physical markers such as body weight or body mass index, blood pressure or serum cholesterol concentrations; and (iv) process and/or policy outcomes. Results: Key success factors of school-based interventions appeared to be the following: A nutrition-based curriculum offered at school by trained teachers generally improved behavioural outcomes. A physical activity programme and parental component were associated with most of the best practice clinical and behavioural outcomes. Furthermore, all best practice studies were grounded on a firm theory of behaviour, such as social cognitive, social marketing or stages of change. Most of the interventions that included a food service component had best practice behavioural outcomes. Conclusions: Numerous school-based nutrition interventions have shown significant improvements in children’s nutritional behaviours. Consequently, it is necessary to plan programmes based on existing evidence of best practice. The lessons learnt from this review have been applied in the development of the HealthKick programme initiated in schools in the Western Cape in 2007.
Explaining the effects of a point-of-purchase nutrition-information intervention in university canteens: a structural equation modelling analysis  [cached]
Hoefkens Christine,Pieniak Zuzanna,Van Camp John,Verbeke Wim
International Journal of Behavioral Nutrition and Physical Activity , 2012, DOI: 10.1186/1479-5868-9-111
Abstract: Background The importance of canteen meals in the diet of many university students makes the provision of simple point-of-purchase (POP) nutrition information in university canteens a potentially effective way to promote healthier diets in an important group of young adults. However, modifications to environments such as the posting of POP nutrition information in canteens may not cause an immediate change in meal choices and nutrient intakes. The present study aimed at understanding the process by which the POP nutrition information achieved its effects on the meal choice and energy intake, and whether the information was more effective in changing the meal choice of subgroups of university canteen customers. Methods The POP nutrition-information intervention used a one-group pretest-posttest design. A sample of 224 customers of two university canteens completed the baseline and 6-months follow-up surveys. A multi-group structural equation modelling analysis was used to test mediation effects of individual difference variables (liking, understanding and use of the information, subjective knowledge and attitude) on the energy intake from canteen meals, moderated by the objective nutrition knowledge and motivation to change diet. Results Significant relations were identified between liking of the information and its use on one hand and a positive effect in attitude towards healthy canteen meals on the other hand. Motivation to change diet and sufficient objective nutrition knowledge were required to maintain a recommended energy intake from canteen meals or to lead to a decrease in energy intake. Participants with greater objective nutrition knowledge had a greater understanding of the POP nutrition information which also resulted in a more effective use of the information. Conclusions The results suggest that nutrition-information interventions may be more effective when using nutrition information that is generally liked by the target population in combination with an educational intervention to increase objective nutrition knowledge. Trial registration NCT01249508
Demonstration of an E-mailed Worksite Nutrition Intervention Program
Gladys Block,Torin Block,Patricia Wakimoto,Clifford H. Block
Preventing Chronic Disease , 2004,
Abstract: Introduction Dietary fat and low fruit and vegetable intake are linked to many chronic diseases, and U.S. population intake does not meet recommendations. Interventions are needed that incorporate effective behavior-change principles and that can be delivered inexpensively to large segments of the population. Methods Employees at a corporate worksite were invited to participate in a program, delivered entirely by e-mail, to reduce dietary fat and increase fruit and vegetable intake. Behavior-change principles underlying the intervention included tailoring to the participant s dietary lifestyle, baseline assessment and feedback about dietary intake, family participation, and goal setting. Assessment, tailoring, and delivery was fully automated. The program was delivered weekly to participants e-mail inboxes for 12 weeks. Each e-mail included information on nutrition or on the relationship between diet and health, dietary tips tailored to the individual, and small goals to try for the next week. In this nonrandomized pilot study, we assessed technical feasibility, acceptability to employees, improvement in Stage of Change, increase in fruit and vegetable consumption, and decrease in fat intake. Results Approximately one third (n = 84) of employees who were offered the 12-week program signed up for it, and satisfaction was high. There was significant improvement in Stage of Change: 74% of those not already at the top had forward movement (P < .001). In addition, results suggest significant increase in fruit and vegetable consumption (0.73 times/day, P < .001) and significant decrease in intake of fat sources (-0.39 times/day, P < .001). Conclusion This inexpensive program is feasible and appears to be effective. A randomized controlled trial is needed.
Optimal intervention in the foreign exchange market when interventions affect market dynamics  [PDF]
Alec N. Kercheval,Juan F. Moreno
Quantitative Finance , 2009,
Abstract: We address the problem of optimal Central Bank intervention in the exchange rate market when interventions create feedback in the rate dynamics. In particular, we extend the work done on optimal impulse control by Cadenillas and Zapatero to incorporate temporary market reactions, of random duration and level, to Bank interventions, and to establish results for more general rate processes. We obtain new explicit optimal impulse control strategies that account for these market reactions, and show that they cannot be obtained simply by adjusting the intervention cost in a model without market reactions.
Directable Needle Guide: Efficacy for Image-Guided Percutaneous Interventions  [PDF]
Hiroshi Ishizaka
ISRN Radiology , 2013, DOI: 10.5402/2013/516941
Abstract: Diagnostic and therapeutic image-guided percutaneous interventions have become increasingly important in the clinical management of various conditions. Though precise needle placement via a safe route is essential for successful percutaneous interventions, it is often difficult in cases of deeply situated, small lesions. The present paper describes the efficacy of the directable needle guide (DNG), which allows manipulation of the direction of a fine needle within organs. The DNG was used in patients for needle biopsy of hepatic ( ) and splenic ( ) lesions and for percutaneous ethanol injection therapy for liver tumors ( ) under sonographic or computed tomography guidance. The DNG enabled the direction of a 21- or 22-gauge needle to be successfully changed during needle advancement in all cases, allowing adjustment of the location of the needle tip or needle access root to avoid vessels, the gallbladder, and the lungs. We conclude that DNG increases the safety and ease of percutaneous interventions. 1. Introduction Image-guided percutaneous interventions with a fine needle are used for various clinical purposes, including biopsies, antitumor therapy with ethanol injection, laser thermal ablation, gene-technology implants, and nerve blocks [1–4]. Though precise needle placement passing through a safe root is essential for percutaneous interventions, it is often difficult due to needle deflection and patients’ respiratory or postural variations during the procedure and also because of intervening vital structures on the root. When a thin beveled needle is inserted into any organ, the tip of the needle has a tendency to curve toward the side when advancing, due to its flexibility. However, when a beveled needle is inserted with a twisting motion, it advances in a straight path. This phenomenon was applied to create a directable needle guide (DNG) that could be used to steer a needle within organs. The present paper describes the utility of the DNG in our clinical experience. 2. Subjects and Methods The DNG was used in patients undergoing both needle biopsy of hepatic ( ) or splenic ( ) lesions and percutaneous ethanol injection therapy for liver tumors ( ). Sonography and computed tomography (CT) images were used for imaging guidance in 43 and 17 lesions, respectively. The DNG (0.018 inches in diameter; 250?mm long) with a flattened segment (0.010 inches in thickness) on the distal portion of the beveled side of the tip (Leadway, Hakko, Tokyo, Japan, a prototype not commercially available at present) (Figures 1(a) and 1(b)) was used to direct the needle
A new intervention in the Nursing Interventions Classification: “Mechanical Ventilation: Noninvasive”
Joaquín Jesús Blanca Gutiérrez,Rafael Mu?oz Segura
NURE Investigación , 2008,
Abstract: With the term of noninvasive mechanical ventilation we refer to any type of ventilatory support that it doesn′t invade the airway to ventilate the patient. The advantage that this contributes is unquestionable, diminishing the rate of infections and other complications associated to the tracheal intubation. In the Nursing Interventions Classification (NIC) we find a very much related intervention, the intervention 3300, with the label of “Mechanical ventilation". If we read the activities included in this intervention, we observe that they are derived cares of the invasive mechanical ventilation, activities includes in the care of intubated patients. With our work, we have produced a new Intervention, its label is “Mechanical Ventilation: Noninvasive”, and we have already revised the existent intervention named as “Mechanical Ventilation”. Both proposals have been evaluated and accepted for their inclusion in the NIC fifth edition. Methodology: bibliographical revision in CUIDEN PLUS, MEDLINE, CINAHL and LILACS. Results: We present the double proposal, including labels, definitions and activities. Conclusion: the Intervention with code 3300 changes their current label of “Mechanical Ventilation”, for the label of “Mechanical Ventilation: Invasive”, also changing their definition. A totally new Intervention is included with the label of “Mechanical Ventilation: Noninvasive”.
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