Effects of a Workplace mHealth Intervention for Smoking Behaviour: A Quasi Experimental Study Protocol

@#Introduction: Tobacco smoking causes various chronic diseases and adds costs to healthcare systems. The current smoking cessation interventions mostly target smokers who are ready to quit and are reactive in recruitment. Recently, mobile phones have become a new tool for promoting smoking cessation. The aim of this paper is to present a study protocol on a quasi-experimental study investigating the effects of a workplace mHealth intervention for smoking behaviour. Methods: A quasi-experimental study will be conducted among employees in an academic institution in Malaysia. The intervention group will receive a theory based WhaSTOP module via WhatsApp and will be compared with the control group (receive usual care). The primary outcomes are stage movement and the number of cigarettes per day. The secondary outcomes include knowledge of smoking, quit attempt, nicotine dependence, 7-day point prevalence of smoking abstinence, and the Transtheoretical Model constructs. A generalised estimating equation analysis will be performed to determine the effects of the intervention. Discussion: This protocol will provide a novel method to proactively approach smokers regardless of readiness to quit and to guide them through the stages of change so that they will be ready to take action to quit. This research will also provide insight into whether the intervention can be utilised as an additional tool for smokers at the workplace to quit smoking. Trial Registration: The trial was registered with the Iranian Registry of Clinical Trials (Registry Number IRCT20220415054539N1).

Stages of change in the purchase of ultra-processed snacks among university students after the implementation of the chilean food law; a multi-center study

The Objective is to determine the stages of change in the behavior of university students regarding the purchase of ultra-processed snacks consumed. Multi-center study (14 Chilean universities). The participants (4,807 students)evaluated were applied a survey to determine the stage of change of behavior regarding the purchase of foods with warning signs. The students were evaluated and classified as (a) Nutrition Students, (b) Healthcare-related Students and (c) Other degree Students. More than 90% of the students were aware of the food regulation and knew the warning signs. More than 60% of Healthcare-related and Other degree students are in the stage of pre-contemplation or contemplation regarding purchase intent of sugary drinks, juices, cookies, sweet snacks and potato chips; this value is twice the percentage of Nutrition students in this stages ( Chi2, p<0.001). In conclusion there is a high proportion of pre-contemplation and contemplation with respect to purchase intent among the students(AU)

Determinar las etapas de cambio en el comportamiento de los estudiantes universitarios con respecto a la compra de colaciones ultraprocesadas. Estudio Multicéntrico (14 universidades chilenas). A los participantes (4.807 estudiantes) se les aplicó una encuesta para determinar el cambio en el comportamiento con respecto a la compra de alimentos con sellos de advertencia. Los estudiantes se clasificaron como (a) estudiantes de nutrición, (b) estudiantes del área de la salud y (c) estudiantes de otras carreras. Se evaluaron. Más del 90% de los estudiantes conocían la regulación alimentaria y conocían las señales de advertencia. Más del 60% de los estudiantes de la salud y de otras carreras se encuentran en la etapa de pre-contemplación o contemplación con respecto a la intención de compra de bebidas azucaradas, jugos, galletas, bocadillos dulces y papas fritas; Este valor es el doble del porcentaje de estudiantes de nutrición en estas etapas ( Chi2, p <0,001). Se concluye que existe una alta proporción de pre-contemplación y contemplación con respecto a la intención de compra entre los estudiantes universitarios(AU)

Effect of health literacy interventions with the stages of change on Kazakh-Chinese hypertension pa-tients / 中华行为医学与脑科学杂志

Objective To evaluate the effect of the intervention combined the high blood pressure health literacy(HBP-HL) with the stages of change on waist circumference( WC),body mass index( BMI) and physiological-biochemical indexes among the Kazakh-Chinese hypertensive patients. Methods The in-terventional plan was built based on the " Stages of Change of Transtheoretical Model" . This randomized con-trolled trial study was carried out from July 2014 to January 2016,and Kazakh hypertension patients from" qianjin" and " small canal" pastoral areas were sampled using stratified cluster sampling method,with 74 patients from each place. The general health management combined with " High Blood Pressure Health Edu-cation" handbook was applied in the control group. The intervention group was given the 12-month interven-tion combined the HBP-HL with the stages of change based on the control group. Meanwhile,WC,BMI and other data were collected at the first,twelfth and eighteenth months. Results Repeated variance analysis showed interaction effects between time and group (F=14. 396,15. 214,P<0. 05),indicating that the effect of intervention factors on WC and BMI would increase over time when intervention existed. The total choles-terol ((5. 69±0. 93)mol/L),low density lipoprotein ((3. 74±0. 86)mol/L) and serum creatinine ((65. 46 ±13. 45)mol/L) of hypertension patients in intervention group were lower than those before intervention (t=3. 998,4. 581,2. 574,P<0. 05). After intervention,the scores of total health literacy ( t=5. 157) ,under-standing ability (t=6. 504),the latest vital signs (t=11. 583) and avoiding food allergy ( t=3. 778) of the intervention group were higher than those of the control group,and the differences were statistically significant (P<0. 05). Conclusions The intervention strategy of " health literacy-behavioral change stage" is feasible and effective. It can significantly reduce WC,BMI,total cholesterol,low density lipoprotein and serum creati-nine in Kazakh hypertension patients in pastoral areas,and the short-term maintenance effect of the interven-tion is acceptable.

Application of nursing intervention based on transtheoretical model and stages of change in breastfeeding for primiparas / 中国实用护理杂志

Objective To explore the effect of nursing intervention based on the transtheoretical model and stages of change on breastfeeding knowledge, self-efficacy, and duration of breastfeeding in newly born pregnant women, aimed to provide reference for breastfeeding behavior health education model for pregnant women. Methods The 130 primiparas who came to the hospital graded a class- three of Shanxi Province for perinatal examination were selected as the research subjects from May to June in 2017 , they were divided into test group and control group by random digits table method. In the control group, the normal breastfeeding health guidance was carried out in the three stages of prenatal, hospitalized and after discharge. The test group divided the primipara from the beginning of pregnancy to 6th months postpartum period into 5 stages according to transtheoretical model and stages of change. The new strategy of breastfeeding should be formulated and implemented according to different stages and behavior changing processes. Results The total score of breastfeeding knowledge of primipara were (8.76±1.14), (8.92±1.21), (9.90±1.27), (9.94±1.29) points in control group before intervention, the 3rd day, the 42nd day and the 6th month after delivery, and they were (9.11 ± 1.42), (12.02 ± 1.64), (13.04 ± 1.67), (15.00±1.83) points respectively in test group, the differences were statistically significant(Ftime= 51.823, Fgroup=10.406, Finteractive=56.641, all P < 0.05). The total scores of breastfeeding self-efficacy of primipara were (84.62 ± 1.14), (88.96 ± 1.41), (86.65 ± 1.47), (84.31 ± 1.57) points respectively in control group before intervention, the 3rd day, the 42nd day and the 6th month after delivery, while in test group they were (84.98 ± 1.20), (104.02 ± 1.42), (111.00 ± 1.45), (120.04 ± 1.40) points, the differences were statistically significan (Ftime=12.592, Fgroup=229.674, Finteractive=79.955, all P<0.05). The pure breastfeeding rates of primipara were 60.0％(33/55) , 41.8％(23/55), 21.8％(12/55) in control group on the 3rd day, the 42nd day and the 6th month after delivery, they were 84.7％(50/59), 76.3％(45/59) , 49.2％(29/59) in the test group. The differences was statistically significant (χ2=8.804, 14.038, 9.235, all P <0.01). Conclusion Breastfeeding intervention based on the theory of behavioral staged transition can help primipara to improve breastfeeding knowledge and self-efficacy, and improve breastfeeding status.

Factors affecting vegetable preference in adolescents: stages of change and social cognitive theory

BACKGROUND/OBJECTIVES: Despite the importance of consuming sufficient amounts of vegetables, daily vegetable intake among adolescents in Korea is lower than the current dietary recommendation. The objective of this study was to examine determinants affecting vegetable preference in order to suggest a stage-tailored education strategy that can promote vegetable consumption in adolescents. SUBJECTS/METHODS: Adolescents (n = 400, aged 16-17 years) from two high schools participated in a cross-sectional study. Survey variables were vegetable preference, the social cognitive theory (SCT) and stages of change (SOC) constructs. Based on vegetable preference, subjects were classified into two groups: a low-preference group (LPG) and a high-preference group (HPG). SOC was subdivided into pre-action and action/maintenance stages. To compare SCT components and SOC related to vegetable preference, chi-squared and t-tests, along with stepwise multiple-regression analysis, were applied. RESULTS: In the LPG, a similar number of subjects were classified into each stage. Significant differences in self-efficacy, affective attitudes, and vegetable accessibility at home and school were detected among the stages. Subjects in the HPG were mainly at the maintenance stage (81%), and there were significant differences among the stages regarding self-efficacy, affective attitudes, and parenting practice. In the predictions of vegetable preference, self-efficacy and parenting practice had a significant effect in the “pre-action” stage. In the action/maintenance stage, outcome expectation, affective attitudes, and vegetable accessibility at school had significant predictive value. In predicting the vegetable preference for all subjects, 42.8% of the predictive variance was accounted for by affective attitudes, self-efficacy, and vegetable accessibility at school. CONCLUSION: The study revealed that different determinants affect adolescent vegetable preference in each stage. Self-efficacy and affective attitudes are important determinants affecting vegetable preference. Additionally, school-based nutrition intervention that focuses on enhancing affective attitudes, self-efficacy, and vegetable exposure may constitute an effective education strategy for promoting vegetable consumption among adolescents.

Consejeria en alimentación, actividad fÍsica y tabaco: Instrumento fundamental en la practica profesional / Counseling in feeding, physical activity and tobacco: Basic instrument in professional practice

The aim of this article was to present an update of the theorical and methodological foundations of counseling and evidence of their effectiveness, relating to the practice of health teams and analyzing future challenges. It is described, the theorical basis, the policy directions of the Chilean Ministry of Health, the international recommended strategies and the contributions of the participants in a training program conducted by INTA with 312 professionals (nutritionists, physiotherapists and dentists mostly). The analysis of the conditions in the Primary Health Care, to implement systematically nutrition, physical activity and tobacco counseling is presented. The need to improve the practice and its contribution to a preventive approach to serious problems of physical inactivity, obesity and smoking in the Chilean population is discussed.

El objetivo de este artículo es presentar una actualización de los fundamentos teóricos y metodológicos de la consejería y la evidencia sobre su eficacia, relacionándola con la práctica de los equipos de salud y analizando los desafíos futuros. Se describen las bases teóricas, las orientaciones de política del Ministerio de Salud de Chile, las estrategias recomendadas a nivel internacional y los aportes de los participantes de un programa de capacitación realizado por el INTA con 312 profesionales (nutricionistas, kinesiólogos y odontólogos en su mayoría). Se presenta el análisis de las condiciones en la Atención Primaria de Salud para implementar la consejería en alimentación, actividad física y tabaco en forma sistemática. Se discute la necesidad de adoptar medidas para el mejoramiento de la práctica y su contribución a un abordaje preventivo de los graves problemas de sedentarismo, obesidad y tabaquismo en la población chilena.

Impact of Having Action Plan and Self Efficacy Score on Physical Activity Action Change after One Year / 日本プライマリ・ケア連合学会誌

<b>Introduction</b>: The present study was conducted to identify the influence of self-efficacy score and having an action plan on “stages of change” for exercise after one year.<br><b>Methods</b>: Physical functions and psychological factors at baseline and after one year in 105 elderly individuals who participated in a preventive care program. The subjects were classified into four groups by using the stages of change scale for physical activity.<br>The cause related to impact on physical activity and action stage change (stage) after one year later with having or not having action plan for preventive care program in elderly at home in community as well as sense of self efficacy was investigated.<br><b>Results</b>: Self-efficacy scored significantly higher in the usual activity group with continuity of stage activity both at baseline and one year later. The relative risk of having an action plan at baseline for exercise after one year was 2 . 90 (95% CI: 1.52-5.55). This value significantly influenced the maintenance of physical activity after one year.<br><b>Conclusion</b>: The results of this study suggest that showing an action plan was effective in maintenance of physical activity.

Intervention of empowerment with multi-stage change theory on diet behavior for the influence of metabolic indices in patients with diabetes / 重庆医学

Objective To investigate the influence of different educational methods on the metabolic indices in patients with diabetes .Methods A total of 218 patients with diabetes in the First Affiliated Hospital of Guangxi Medical University were ran-domized divided into two groups .Different intervention ways were used :patients in the control group received conventional educa-tional methods ,while patients in experiment group received the educational methods combined with empowerment and multi-stage theory of change .The C-DES-SF scale scores and the HbA1c ,FPG ,2 h PG ,TC ,TG ,LDL ,HDL indices was compared between the two groups .Results Indices and empowered ability of HbA1c ,FPG ,2 h PG ,TC ,LDL were changed in accordance with time .As compared with control group ,the educational method in intervention group had better change of FPG ,2 h PG ,TC ,LDL(P< 0 .05) . Indices and empowered ability of HbA1c ,FPG ,2 h PG ,TC ,LDL had inter-action with time ,and indexes in intervention group were better than those in the control group(P< 0 .05) .At the 3rd and 6th month after invention in the intervention group ,patients in movement stage and movement maintaining stage were higher than those in control group(P< 0 .05) .Conclusion Well correction of bad diet behaviors by application of educational methods of combined with empowerment and multi-stage theory of change for the type 2 diabetes patients would help the patients to improve the ability of self-care and control the level of metabolic indices .

Consejería breve en tabaquismo / Brief counseling in smoking

La consejería breve o intervenciones breves, son un conjunto de estrategias efectivas para la cesación, que actúan a nivel conductual y que pueden ser brindadas por cualquier profesional de la salud y que demandan poco tiempo de la práctica clínica asistencial, están basadas en la mejor calidad de evidencia, se encuentran ampliamente difundidas y son recomendadas por numerosas guías de práctica clínica de todo el mundo, su duración estimada es de 2 a 5 minutos por consulta. Puede utilizarse con toda la población fumadora independientemente del sexo, edad, raza y nivel de adicción a la nicotina. Las intervenciones breves están constituidas por 5 componentes fundamentales: 1. Conocer el estatus de fumador, registrarlo en ficha clínica y actualizarlo en cada consulta.2. Realizar consejo anti tabáquico claro.3. Evaluar el nivel de motivación (o etapa de cambio de la dependencia). 4. Elaborar un programa de tratamiento: Fecha de abandono Intervención psicosocial. 5. Seguimiento....

Brief advice or brief interventions are a set of effective strategies for smoking cessation, and acting to behavioral level that can be provided by any health professional and requires little time from the clinical practice. They are based on quality evidence, widely known and recommended by numerous clinical guidelines throughout the world. It should take from 2 to 5 minutes per visit. It can be used with the whole smoking population, regardless their gender, age, race or level of nicotine addiction. Brief interventions consist of 5 fundamental components: 1. Knowing the smoking status, record it on the medical records and update it on every visit. 2. Make a clear advice on smoking cessation 3. Assess the level of motivation (or stage of change of dependency) 4. Design a treatment program: - Date of quitting - Psychosocial intervention 5. Follow up...

Research on effect of the transtheoretical model and stages of change in maintenance hemodialysis patients / 中国实用护理杂志

Objective To investigate effect of the transtheoretical model and stages of change (TTM) on self-management paradigm,serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis (MHD).Methods Total 140 MHD patients were separated into two groups as the intervention group (65 of 70 cases completed with TTM) and the control group (63 of 70 cases completed with routine nursing care) by random number table.Data obtained by using hyperphosphatemia related knowledge questionnaires and Self-management Rating Scale before and after intervention.The levels of serum calcium and phosphorus between the above groups were compared.Results The scores of self-management behavior were higher in control group after 3 months intervention,the differences was statistically significant (P ＜ 0.05),in which the scores of problem solving (2.97 ± 0.28),self care activities (2.99±0.28),relationships (3.13±0.35) and emotional treatment (2.80 ± 0.32) in experimental group was apparently higher than control group at the same time,the scores were (2.63±0.32),(2.67±0.38),(2.76±0.42),(2.44±0.36) respectively in conrtol group,t values were-0.907,-7.68,-6.03 and-8.43,respectively.And also,there was statistically significant difference between the two groups in serum phosphorus level [(1.81±0.49) mmol/L vs.(2.56±0.69) mmol/L],the product of calcium and phosphorus [(55.33±14.45) mg2/dl2 vs.(72.35±20.94) mg2/dl2],serum parathyroid hormone [238.00 (130.35,413.85) ng/L vs.297.75 (155.02,760.37) ng/L] (t=11.01,8.43,Z=-2.09,P＜0.05).Conclusions TTM is conducive to promote behavior change,improve self-management conduct,and also reduce serum phosphorus level in MHD patients.

Nutrition knowledge, eating attitudes, nutrition behavior, self-efficacy of childcare center foodservice employees by stages of behavioral change in reducing sodium intake / 한국영양학회지

PURPOSE: The purpose of this study was to examine sodium-related nutrition knowledge, eating attitudes, eating behaviors, and self-efficacy by stages of behavioral change in reducing sodium intake among childcare center foodservice employees. METHODS: Subjects (n = 333) were categorized according to two groups based on the stages of change; Pre-action stage (PA group: precontemplation/contemplation/preparation stage), Action stage (A group: action/maintenance stage). RESULTS: A major source of sodium-related nutrition information was TV/radio (56.6%) and only 166 people (49.8%) have experienced nutrition education specific to sodium. Although the A group showed slightly higher scores for nutrition knowledge than the PA group, the difference was not significant. The percentages of correct answers for 'daily goal of sodium intake for adults (27.0%)', 'calculation of sodium content in nutrition labeling (30.3%)' were low for both groups. The A group (total score: 40.3) had more desirable eating attitudes regarding reducing sodium intake than the PA group (36.6, p < 0.001). The total score for eating behaviors was slightly higher in the A group (49.6) than in the PA group (48.5), but without statistical significance. The A group (total score: 58.2) also received higher scores for self-efficacy regarding reducing sodium intake than the PA group (52.5, p < 0.001). CONCLUSION: This study suggests that nutrition education for childcare center foodservice employees should be expanded and customized education should be implemented according to the stages in reducing sodium intake. It is also suggested that food companies make efforts to develop low-sodium products.

Niveles y estados de cambio de la actividad física en una comunidad universitaria de Medellín-Colombia / Níveis e estados de alteração da atividade física em uma comunidade universitária de Medellín-Colômbia / Physical activity levels and stages of change of a university community in Medellín-Colombia

Este estudio se plante¢ como objetivos determinar los niveles y los estados de cambio frente a la actividad f¡sica en la comunidad universitaria del campus “Ciudadela de Robledo” de la Universidad de Antioquia, Medell¡n, Colombia. Participaron de manera voluntaria 92 estudiantes, 72 docentes y 45 empleados; utilizando un muestreo aleatorio simple para cada grupo. Se emple¢ el Cuestionario Global de Actividad F¡sica (GPAQ) para identificar los niveles de actividad f¡sica, y el Sample Physical Activity Questionnaire para los estados de cambio; las encuestas fueron recolectadas durante el segundo semestre del a¤o 2012. Se manej¢ el programa estad¡stico SPSS versi¢n 21 para el an lisis de los datos, utilizando t‚cnicas de distribuci¢n de frecuencias para realizar el an lisis descriptivo; las variables cualitativas fueron analizadas de acuerdo al v¡nculo con la universidad y al sexo, utilizando a prueba de X2 para comparar las proporciones. Pudo identificarse que el 51,1% de los estudiantes, el 48,6% de los docentes y el 46,7% de los empleados presentan niveles altos de AF. La mayor proporci¢n encontrada para los estados de cambio de acuerdo al v¡nculo, la obtuvo el estado de mantenimiento, 47,2% para los docentes, 28,9% para los empleados y 26,1% para los estudiantes. Los resultados del presente estudio podr¡an servir como insumos para la creaci¢n de estrategias que permitan mejorar los programas deportivos y de AF del campus universitario, y busquen incrementar los niveles de AF de la poblaci¢n.

Tra‡ou-se como objetivo principal deste estudo determinar os n¡veis e os estados de altera‡Æo frente … atividade f¡sica na comunidade universit ria do campus “Ciudadela de Robledo” da Universidade de Antioquia, Medell¡n, Col“mbia. Participaram de maneira volunt ria 92 estudantes, 72 docentes e 45 empregados; utilizando uma amostragem aleat¢ria simples para cada grupo. Se empregou o Question rio Global de Atividade F¡sica (GPAQ) para identificar os n¡veis de atividade f¡sica, e o Sample Physical Activity Questionnaire para os estados de altera‡Æo; as enquetes foram coletadas durante o segundo semestre do ano de 2012. Empregou-se o programa estat¡stico SPSS versÆo 21 para a an lise dos dados, utilizando t‚cnicas de distribui‡Æo de frequˆncias para realizar a an lise descritiva; as vari veis qualitativas foram analisadas de acordo com o v¡nculo com a universidade e com o sexo, utilizando a prova de X2 para comparar as propor‡ães. P“de-se identificar que 51,1% dos estudantes, 48,6% dos docentes e 46,7% dos empregados apresentam n¡veis altos de AF. A maior propor‡Æo encontrada para os estados de altera‡Æo de acordo com o v¡nculo foi obtida pelo estado de manuten‡Æo, 47,2% para os docentes, 28,9% para os empregados e 26,1% para os estudantes. Os resultados do presente estudo poderiam servir como insumos para a cria‡Æo de estrat‚gias que permitam melhorar os programas esportivos e de AF do campus universit rio, e busquem incrementar os n¡veis de AF da popula‡Æo.

The main goal of this study was to determine the levels of physical activity and stages of change related to it in the “Ciudadela de Robledo” campus of the University of Antioquia, Medellin, Colombia. A total of 92 students, 72 faculty’s members and 45 employees voluntarily participated in this study. The Global Physical Activity Questionnaire (GPAQ) was used to identify the physical activity levels and the Sample Physical Activity Questionnaire to determine the stages of change. The surveys were collected during the second semester of 2012. The data was handled and analyzed using SPSS version 21(Statistical program) applying frequency distribution techniques to develop the descriptive analysis; the qualitative variables were analyzed according to the university nexus and gender using the X2 test to compare the proportions. The results evinced the 51.1% of students, 48.6% of professors, and 46.7% of employees presented high PA levels. The biggest proportion for the stages of change according to the nexus was obtained by the maintenance stage 47.2% for professors, 28.9% for employees, and 26.1% for students. The results from this study could serve as a basis to create strategies that allow the improvement of sportive and PA programs inside the campus in order to increase the PA level among the campus population.

Study on relationship between physical activity and characteristics of exercise behaviour among college students / 中华行为医学与脑科学杂志

Objective To explore the relationship between physical activity ( PA) in college students and self?efficacy,and provide guarantee for improving health education in colleges. Methods International physical ac?tivity questionnaire( IPAQ) ,scales of physical behavior,scales of stage of change in physical exercise behavior,and scales of self?efficacy were used to test 504 students from some of colleges in Zhejiang province. Results Signifi?cantly more males (38.52%) than females (27.27%) were in the high activity tertile (P<0.01); the amount of PA per week in males and females were (4608±872.07)MET and(4361±674.03)MET(P<0.01); the scores of males and females were (3.32±0.44) and(3.04±0.36),(P<0.01). The number of males (35.5%) in maintenance period and period of action is greater than that of females (28.9%). Males had higher self?efficacy and more scores of behavior than females (P<0.05) . There were significant characteristics of PA in their self?efficacy,score of be?havior and stages of change( F=18.38, F=15.08, F=34.71, P<0.01),and a significant correlation between PA and self?efficacy,stages of change and physical exercise behavior ( r=0.336, r=0.36, r=0.46, P<0.01).Conclu?sion Self?efficacy may have important effect on the level of PA. Stages of change and scores of behavior may ex?plain difference of PA between males and females.

Stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake and related psychosocial factors

BACKGROUND/OBJECTIVES: Understanding individual's intention, action and maintenance to increase fruit and vegetable intake is an initial step in designing nutrition or health promotion programs. This study aimed to determine stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake, self-efficacy, perceived benefits and perceived barriers. SUBJECTS/METHODS: This cross-sectional study was conducted among 348 public university staff in Universiti Putra Malaysia. A pre-tested self-administered questionnaire and two days 24-hour diet recall were used. RESULTS: Half of the respondents (50%) were in preparation stage, followed by 43% in action/maintenance, 7% in pre-contemplation/contemplation stages. Respondents in action/maintenance stages had significantly higher self-efficacy (F = 9.17, P < 0.001) and perceived benefits (F = 5.07, P < 0.01) while respondents in pre-contemplation/contemplation and preparation stages had significantly higher perceived barriers (F = 4.83, P < 0.05). Perceived benefits tend to outweigh perceived barriers pre-ceding to taking action. Self-efficacy is important in motivating individuals to increase fruit and vegetable intake as self-efficacy and perceived barriers crossed over between preparation and action/maintenance. Respondents in action/maintenance stages had the highest adjusted mean serving of fruit and vegetable intake (F = 4.52, P < 0.05) but the intake did not meet recommendation. CONCLUSION: Intervention strategies should emphasize on increasing perceived benefits and building self-efficacy by providing knowledge and skills to consume a diet high in fruits and vegetables in order to promote healthy changes in having high fruit and vegetable intake.

Autoeficácia para redução de gordura nas dietas e estágios de mudança de comportamento para perda de peso entre funcionários de escolas viçosenses / Self-efficacy for fat reduction in diets and stages of change in behavior for weight loss among school employees in Viçosa, Brazil

In this study, we aimed to evaluate self-efficacy in a diet with reduced fat and identify stages of change in behavior for weight loss in employees of two schools in the municipality of Viçosa, Minas Gerais state. It is a cross-sectional study with a sample of 21 subjects, 95% females. Weight and height were self-reported and nutritional status was obtained by the body mass index (BMI). We applied a questionnaire containing Likert Scale from 0 to 100 points to measure self-efficacy in following a diet with reduced fat. We calculated the average value of each individual: the score 0 classifies the individual as "not confident", 50 as "moderately confident", and 100 as "very confiden". Algorithm was also used to identify the stages of change in behavior. Body weight was 60.75±12.73kg. Overweight and obesity accounted for 21.1% and 15.7% of the subjects analyzed, respectively. We verified that 50% of individuals did not maintain their desired weight for more than six months and that 50% actively attempted to lose weight in the last month; of these, 40% were aimed atweight loss in the following six months. Regarding stage changes, 50% of subjects were in the pre-contemplation stage; 30%, 5%, and 15% werein the preparation, action, and maintenance stages, respectively. Results showed that the individuals studied were moderately confident in following a diet with reduced fat, mean score of 40.68±21.96, and that most of them were in their pre-action stages. It is suggested that interventions be accomplished with school officials, among individuals who are in the stages of preparation and maintenance, to promote body weight reduction besides encouraging self-efficacy among the less confident.

El presente estudio tuvo como objetivo evaluar la auto-confianza para seguir una dieta reducida en grasa e identificar las etapas de cambio de comportamiento para la pérdida de peso entre el personal de dos escuelas en Viçosa/MG. Se trata de un estudio transversal con una muestra de 21 individuos, 95% mujeres. El peso y la altura se obtuvieron a través del relato de las participantes y el estado nutricional se obtuvo por el índice de masa corporal-IMC. Se aplicó un cuestionario con la Escala Likert de 0 a 100 puntos para medir la auto-confianza en consumir alimentos con bajo contenido de grasa y se calculó el valor medio de cada individuo,siendo que el puntaje "0" clasifica al individuo como "no confiante", 50 como "moderadamente confiante" y 100 como "muy confiante", también se utilizó un algoritmo para identificar las etapas de cambio de comportamiento. El peso promedio fue de 60,75±12,73kg. El sobrepeso y la obesidad representaron el 21,1% y el 15,7% de los pacientes, respectivamente. El 50% de los sujetos no mantuvo el peso deseado durante más de seis meses, y el 50% trató activamente de perder peso en el último mes. De ésos, el 40% tuvo por objetivo la pérdida de peso dentro de los seis meses. En cuanto a las etapas de cambios, 50% de los sujetos se encontraba en la fase de pre-contemplación, 30% estaba en la etapa de preparación, 5% en la de acción y 15%,en la de mantenimiento. Los sujetos estudiados fueron moderadamente confiantes en seguir una dieta con menor cantidad de grasa, con una puntuación media de 40,68±21,96, y la mayoría estaba en la etapa de pre-acción. Se sugiere que se lleven a cabo intervenciones con los funcionarios escolares, en particular con aquellos que se encuentren en lasetapas de preparación y mantenimiento, con el objetivo de promover la reducción del peso corporal e incentivar la auto-confianza.

O presente estudo teve como objetivo avaliar a autoeficácia para uma alimentação com reduzida quantidade de gordura, além de identificar estágios de mudança de comportamento para a perda de peso em funcionários de duas escolas do município de Viçosa-MG. O estudo é transversal, com amostra de 21 indivíduos, sendo 95% do gênero feminino. Peso e estatura foram autorrelata dose o estado nutricional foi obtido pelo Índice de Massa Corporal - IMC. Aplicou-se questionário contendo Escala Likert de zero a 100 pontos, par amensurar a autoeficácia em consumir uma alimentação com reduzida quantidade de gordura; calculou-se o valor médio de cada indivíduo: o escore zero classifica o indivíduo como "nada confiante"; 50, como "moderadamente confiante";100, "muito confiante". Utilizou-se também algoritmo para identificar os estágios de mudanças de comportamento. A média de peso corporal encontrada foi de 60,75±12,73kg. Sobrepeso e obesidade representaram 21,1% e 15,7% dos indivíduos, respectivamente. Verificou-se que 50%dos indivíduos não mantiveram seu peso desejado por mais de seis meses e que 50% tentaram,ativamente, perder peso no último mês anterior à pesquisa. Destes, 40% objetivavam a perda de peso nos seis meses seguintes. Quanto aos estágios de mudanças, 50% dos indivíduos estavam na fase de pré-contemplação, 30%, 5% e 15%encontravam-se no estágio de preparação, ação e manutenção, respectivamente. Os indivíduos analisados foram moderadamente confiantes em seguir uma alimentação com reduzida quantidade gordura, com escore médio de 40,68±21,96, e a maioria encontrava-se nos estágios pré-ação.Sugere-se que sejam realizadas intervenções com os funcionários das escolas, entre os indivíduos que se encontravam nos estágios de preparação e manutenção, visando a promover a redução do peso corporal e a incentivar a autoeficácia entre os menos confiantes.

Etapas de cambio y niveles de actividad física en estudiantes universitarios de Cartagena (Colombia) / Stages of change and levels of phusucal activity in university students of Cartagena (Colombia)

Objetivo: Estimar las etapas de cambio en relación con la actividad física en población universitaria de ambos sexos. Métodos: Estudio transversal en 301 estudiantes de una universidad privada de la ciudad de Cartagena. Los niveles de actividad física se estimaron a partir del gasto energético en MET, usando la versión corta del Cuestionario Internacional de Actividad Física (IPAQ). Las etapas de cambio mediante una encuesta que consideró seis etapas: precontemplación, contemplación, preparación, acción, mantenimiento y recaída. Las diferencias entre los grupos se determinaron mediante la prueba Chi2. Resultados: El 60% de los encuestados se encuentran en las tres primeras etapas de cambio y sólo el 44% son físicamente activos. Los estudiantes categorizados en las etapas precontemplación, contemplación y preparación presentaron un menor gasto energético (MET); mientras que los sujetos clasificados en las etapas de acción y mantenimiento mostraron mayores consumos. Conclusiones: Existe una relación significativa entre el gasto energético (METs) y los estados de cambio para la actividad física. Se sugiere que las intervenciones para fomentar la actividad física deben considerar cada etapa de cambio.

Objective: Estimating the stages of change in relation to physical activity in young uni-versity people of both sexes. Methods: Cross-sectional study on 301 students of a private University in the city of Cartagena. Physical activity levels were estimated from the energy expenditure in METs, using the short version of the International physical activity Questionnaire (IPAQ). The stages of change through a survey that found six stages: precontemplación, contemplation, preparation, action, maintenance and relapse. The differences between the groups identi-fied by Chi2 test. Results: 60% of respondents are in the first three stages of change and only 44%t are physically active. Students categorized in stages precontemplatión, contemplation and preparation presented lower energy expenditure (EMT); while subjects in action and maintenance stages showed greater consumption. Conclusions: There is a significant relationship between energy expenditure (METs) and the stages of change for physical activity. It is suggested that interventions to promote physical activity should consider each stage of change.

Perfil sociodemográfico, nutricional e psicossocial dos usuários dos restaurantes e refeitórios populares de Belo Horizonte-MG: fundamento para a elaboração de uma interveção educativa alimentar e nutricional / Determination of the profile of users of the popular restaurants and DinnigHallin Belo Horizonte on healty eating and the preparation of an Educational Approach based on Social Representations and Processes of the Transtheoretical Model on the adopti

Introdução: O Programa Restaurante Popular preconiza que estes estabelecimentos funcionem como espaços para o desenvolvimento da educação alimentar e nutricional, a fim deestimular práticas alimentares saudáveis e contribuir para a prevenção de doenças e apromoção da saúde. As práticas de educação alimentar e nutricional atuais pautam-se na transmissão de informações, e não favorecem a criação de novos sentidos para o ato de comere a ressignificação de práticas que conduzam ao desenvolvimento autônomo de estratégias para a aquisição de uma alimentação saudável. Observa-se que é necessário, além da busca pela construção do conhecimento, considerar a dimensão subjetiva do comportamento alimentar bem como as teorias cognitivas-sociais, e os fatores sóciodemográficos enutricionais. Objetivo: Determinar o perfil sociodemográfico, nutricional e psicossocial dos usuários dos restaurantes e refeitório populares de Belo Horizonte-MG e elaborar uma intervenção educativa alimentar e nutricional pautada nestes perfis e nos processos do modelo transteórico. Método: Estudo transversal descritivo, de abordagem quanti-qualitativa, com 1656 usuários de quatro restaurantes e um refeitório populares de Belo Horizonte-MG. A amostra foicalculada após aferição do fluxo de usuários em cada estabelecimento segundo sexo, idade etipo de refeição (desjejum, almoço e jantar). A coleta de dados foi feita por cotas segundo sexo,idade e refeições realizadas por estabelecimento. Por meio de um questionário estruturado, determinou-se o perfil sóciodemográfico, nutricional e os estágios e fases de mudança de comportamento dos usuários. Para a identificação das suas representações sociais foi utilizado um questionário semi-estruturado. A análise dos dados foi realizada com o emprego de análises descritivas, por meio do SPSS 19.0. Utilizou-se também, como estratégia, a análise de discurso do sujeito coletivo. Com estes dados identificados, elaborou-se uma intervenção...

Introduction: Low Cost Restaurant Program recommends that these establishments functionas spaces for the dissemination and implementation of food and nutrition education, to encourage the practice of healthy eating habits and contribute to disease prevention and health promotion. The practices of food and nutrition education today are driven in the transmission of information, and do not favor the creation of new meanings for the act of eating and there definition of practices that lead to the autonomous development of strategies for the acquisition of a healthy diet. It is observed that is necessary, beyond the quest for knowledge construction, consider the subjective dimension of eating behavior and the social-cognitive theories, and socio-demographic factors and nutritional. Objective: To determine the demographic, nutritional and psychosocial profile of users of the low cost restaurants and canteen of Belo Horizonte-MG, and develop a food and nutrition education intervention based on this profiles and the processes of the transtheoretical model. Method: This is a crosssectional study of quantitative and qualitative approach with 1656 users of four low cost restaurants and one canteen in Belo Horizonte-MG.The sample was calculated after measuringthe flow of users in each establishment according to gender, age and type of meals (breakfast,lunch and dinner ). Data were collected by quotas according to gender, age and meals made byestablishment. It was determined the sociodemographic and nutrition profiles and the stagesand phases of change in the behavior of users, through a structured questionnaire. It was useda semi-structured questionnaire to identify the social representations. Data analysis wasperformed with the use of descriptive statistics, using the SPSS version 19.0. There was also the use of discourse analysis of the collective subject. With these data identified, it was conducted an educational intervention...

The effects of food safety education on adolescents' hand hygiene behavior: an analysis of stages of change

The hand hygiene behavior of 400 middle school students (grades 1-3) in Seoul and Gyeonggi-Do was studied to determine how stages of change were affected by food safety education, focusing on hand hygiene and general food safety. Subjects were 51.3% male and 44.3% of study subjects were first graders of middle school. Approximately 40% of subjects were at the stage of action, 42.7% were at the stage of contemplation, and 16.4% were at pre-contemplation. The most important factor that influenced proper hand washing was self efficacy (P < 0.001). Proper hand washing was also correlated significantly with positive belief (P < 0.01) and stages of change (P < 0.01). After food safety education by high-school mentors, middle-school students who were in the stages of pre-contemplation (11.1%) and contemplation (88.9%) showed significant progression toward the action stage (P < 0.001). Proper hand washing (P < 0.01) and food safety knowledge (P < 0.05) were also significantly increased after educational intervention.

Beliefs Regarding Vegetable Consumption, Self-Efficacy and Eating Behaviors according to the Stages of Change in Vegetable Consumption among College Students / 대한지역사회영양학회지

The purpose of this study was to examine beliefs, self-efficacy and eating behaviors by the stages of change in vegetable consumption among college students (n = 297). A survey was conducted to examine study variables, and subjects were categorized into three groups based on the stages of change: precontemplation/contemplation stage (PC/C), preparation stage (P), action/maintenance stage (A/M). Subjects had 3.7 servings of vegetables a day, and vegetable consumption was significantly different by stages of change (p < 0.001). The A/M group showed higher score on beliefs regarding vegetable consumption (p < 0.001) than the other groups, and perceived benefits of vegetable consumption (e.g. cancer prevention) more strongly (p < 0.05). The PC/C group felt more barriers than the A/M group, such as disliking cooking methods, texture of vegetables (p < 0.001), bad taste and bad experience of eating vegetables (p < 0.05). Self-efficacy score was 27.2, with decreasing self-efficacy from A/M to P, PC/C (p < 0.001). The A/M group showed more confidence in nine behaviors such as "eating vegetables during meals" and "replacing menu at home with more vegetable dishes" (p < 0.001) than the other groups. The A/M group had more desirable eating behaviors (e.g, having a variety of foods, eating regularly, consumption of food groups). This study suggests that target population for education and educational strategies be different based on the stages of change. For those in the PC/C stage, education might focus on reducing barriers and increasing self-efficacy. For those in the A/M stage, it is necessary to use strategies to maintain and reinforce behaviors for enough vegetable consumption.

Consejería para uso de condón basada en etapas del cambio en un centro de atención a adolescentes / Counseling on condom use based on stages of change in an adolescent care center

Los y las adolescentes están iniciando relaciones sexuales cada vez más temprano, muchas veces sin las medidas necesarias para prevenir embarazos no deseados o infecciones de transmisión sexual (ITS), observándose un bajo uso del condón. La consejería basada en el Modelo Transteórico del Cambio (MTTC), se plantea como una estrategia efectiva para la promoción del uso del condón. El objetivo de este estudio es explorar las etapas del cambio en las cuales se encuentran las adolescentes describiendo la consejería basada en MTTC para el uso del condón. El método consistió en aplicar un test diagnóstico previo y posterior a la realización de las sesiones de consejería, recogiendo la información de forma cualitativa. Los resultados muestran que las adolescentes se encuentran en etapas tempranas del cambio, usando el condón principalmente como anticonceptivo, posterior a la intervención, algunas adolescentes avanzaron en las etapas del cambio. Es necesario llevar a cabo más estudios con una mayor muestra para evaluar el impacto de la consejería en el uso del condón.

Male and female adolescents are initiating sexual intercourse earlier than in past years, often without the necessary measures to prevent unwanted pregnancies or sexually transmitted infections (STIs), with a low use of condoms to prevent STI/AIDS. Counseling based in Transtheoretical Model of Change (TMC), is proponed as an effective strategy for promoting condom use. The aim of this study is to identify the stage of change in which female adolescents are and to describe counseling based on TMC applied for the use of condoms. The method consisted in applying a diagnostic test before and after the execution of the counseling sessions, gathering information qualitatively. The results show that female adolescents are in early stages of change, especially using condoms as a contraceptive. It is necessary to carry out further studies with larger samples to evaluate the impact of counseling in condom use.