Training dietitians in basic motivational interviewing skills results in changes in their counseling style and in lower saturated fat intakes in their patients.

OBJECTIVE: To test if basic training for dietitians in motivational interviewing (MI) resulted in changes in dietitians' counseling style and improvements in their patients' diet and risk parameters. DESIGN: A randomized controlled trial. SETTING: 9 home-care organizations in the Netherlands. PARTICIPANTS: 37 dietitians, 209 baseline patients, and 142 follow-up diabetes patients. INTERVENTION: Dietitians were randomly allocated to receive basic training in motivational interviewing (MI dietitians, n=18) or not (control dietitians, n=19). MAIN OUTCOME MEASURES: Counseling style of dietitians; total self-reported saturated fat, fruit, and vegetable intake, measured body mass index (BMI), waist circumference, and glycated hemoglobin (Hemoglobin A(1c), HbA(1c)) of patients. ANALYSIS: Analyses of variance and multiple linear regression analyses. Alpha = .05 RESULTS: MI dietitians were significantly more empathetic, more often showed reflection during consultations, and were more likely than control dietitians to let their patients talk for the majority of the consultation. Patients of MI dietitians had significantly lower saturated fat intake levels at posttest compared to patients of control dietitians. No effects on HbA(1c), BMI, and waist circumference were found. CONCLUSIONS AND IMPLICATIONS: Basic training in MI changed the dietitians' counseling style and resulted in lower saturated fat intakes in their patients.

The 'balance intervention' for promoting caloric compensatory behaviours in response to overeating: a formative evaluation.

To help people prevent weight gain, the Netherlands Nutrition Centre initiated the 'balance intervention', which promotes moderation of food intake and/or increased physical activity in response to occasions of overeating. The aim of this study was to determine whether intervention materials were appreciated, encouraged information seeking and increased motivation and caloric compensatory behaviours. A three-group randomized trial with pre-intervention measures (n = 963, response 86%) and post-intervention measures (n = 857) using electronic questionnaires was conducted among participants aged 25-40 years, recruited from an Internet research panel. The first group received a printed brochure and electronic newsletters (print group), the second group was exposed to radio advertisements (radio group) and the third group was the control group. Multiple regression analyses were used to investigate the impact of the materials on self-reported prevalence of overeating, attitudes, perceived behavioural control, intentions and compensatory behaviours. At follow-up, we found significantly more positive attitudes, intentions and dietary action in the print and radio groups. However, participants who received the radio advertisement had a significantly lower perceived behavioural control. No effects were found on the prevalence of overeating. The results indicate that the intervention materials have potential for increasing people's attitudes, motivation and self-reported behaviour actions, with a possible negative side-effect on perceived behavioural control.

The impact of a national mass media campaign in The Netherlands on the prevention of weight gain.

OBJECTIVE: A 5-year nationwide mass media campaign aimed at prevention of overweight was organised from 2002 onwards. The present study evaluates the first campaign, which was aimed primarily at increasing awareness of weight gain. DESIGN AND SUBJECTS: Data were collected by telephone interview in four independent cross-sectional surveys among non-obese Dutch adults aged 25-35 years (total n = 1,949) for statistical analyses. Awareness of personal body-weight status, overweight-related risk perceptions, attitudes towards weight-gain prevention, motivation to prevent weight gain and self-reported body mass index (BMI) were measured in each survey. Campaign exposure was assessed in the post-intervention surveys. To identify intervention effects over time multiple linear and logistic regression analyses were used, adjusted for secular time effects and age. RESULTS: After the campaign about 65% of the respondents knew about the campaign. The campaign was associated with more positive attitudes towards the prevention of weight gain (beta = 0.16; P < 0.01) and higher self-reported BMI (beta = 0.14; P < 0.01). CONCLUSIONS: The results suggest that the first campaign reached a large proportion of the population and initiated some positive change in attitudes, but did not achieve significant improvements in other determinants of weight-gain prevention among non-obese young adults.

Correlates of motivation to prevent weight gain: a cross sectional survey.

BACKGROUND: This study is an application of the theory of planned behaviour (TPB) with additional variables to predict the motivations to prevent weight gain. In addition, variations in measures across individuals classified into Precaution Adoption Process stages (PAPM-stages) of behaviour change were investigated. METHODS: A cross-sectional survey among 979 non-obese Dutch adults aged 25-35 years was conducted. Multiple binary logistic regression analysis was conducted to assess the associations of Body Mass Index (BMI), demographic factors and psychosocial variables from the TPB with the intention to prevent weight gain. Differences in BMI, demographic and psychosocial factors between PAPM-stages were explored using one-way analysis of variance and chi-square tests. RESULTS: Eighty-five percent of respondents intended to prevent weight gain. Age, attitudes and risk perceptions related to weight gain were the strongest correlates of intention (age: OR = 1.12, 95%CI: 1.04-1.20; attitude OR = 7.91, 95%CI: 5.33-11.74; risk perception OR = 1.24, 95%CI: 1.11-1.38). Significant differences were detected between the PAPM-stages in almost all variables. Notably, perceived behavioural control was lowest among people who had decided to prevent weight gain. CONCLUSION: Messages to influence attitudes towards the prevention of weight gain and risk perception may affect people who are not yet motivated to prevent weight gain. Interventions increasing people's perceived behavioural control in overcoming barriers to prevent weight gain may help people to act on their intentions.