How Can Stages of Change be Best Used in Dietary Interventions?
Section snippets
Definition and Classification of Stages of Change for Adopting Healthful Diets
Algorithms that unambiguously classify people into a stage of dietary change are required to apply the stages of change construct to dietary behavior. Researchers have developed algorithms for assigning stages of change for 3 dietary constructs: low-fat diets, high-fiber diets, and diets high in fruits and vegetables. We focus our discussion and give examples from studies on adoption of low-fat diets, but the issues are similar for these 3 dietary constructs.
Most strategies used to categorize
Dietary Interventions and Movement Through Stages of Dietary Change
An effective dietary intervention should accelerate movement from pre-action stages into the action and maintenance stages. To our knowledge, only 3 studies have reported how dietary interventions affect transition through stages of change. Greene and Rossi (9) reported percentages of participants moving from pre-action stages into action or maintenance at 6, 12, and 18 months after randomization. The proportions of respondents moving into action and maintenance increased steadily over the
Nutrient Intake and Movement Through Stages of Dietary Change
People moving through stages of change should make predictable changes in their dietary behavior. A straightforward interpretation of stages of change leads us to expect that dietary change will be largest among people moving from a pre-action stage into maintenance, intermediate among those moving from a pre-action stage into action or from action into maintenance, and small among those not changing stage. We know of only 2 studies that have examined dietary change as a function of movement
Interpreting the Stages of Change Construct in the Context of Dietary Change
Dietary behavior is fundamentally different from behaviors such as smoking and using drugs. Thus, creative interpretation of the stages of change construct is required in reference to diet. We always need to eat. Preferences for foods with fat, sugar, and salt and dislike of foods that are bitter can be modified, but they cannot be eliminated (16). We eat a healthful diet by maintaining cognitive vigilance about how we purchase, prepare, and select foods. Diets vary over time, because the food
Conclusions and Recommendations
Table 3 offers general guidelines for nutritionists who wish to incorporate the stages of change construct into their practice. It is fast and simple to assess stages of change as part of a personal interview (Figure 1), and information about stages of change can be used to develop a personalized intervention program. These guidelines can be useful in a range of dietary change interventions. For most interventions, the behavioral targets will be a combination of specific changes (eg, using skim
References (17)
- et al.
Stages of change in dietary fat reductionsocial psychological correlates
J Nutr Educ.
(1995) - et al.
Self-rated dietary fat intakeassociations with objectively assessed intake, psychosocial factors and intention to change
J Nutr Educ.
(1994) - et al.
Stages of change for reducing dietary fat intake over 18 months
J Am Diet Assoc.
(1998) - et al.
The Transtheoretical Model of Health Behavior Change
Am J Health Promot.
(1997) - et al.
An application of the stage model of behavior change to dietary fat reduction
Health Educ Res.
(1992) - et al.
Stages of change for reducing dietary fat to 30% of energy or less
J Am Diet Assoc.
(1994) - et al.
Stages of change in adopting healthy dietsfat, fiber, and correlates of nutrient intake
Health Educ Q.
(1994) - et al.
Improving dietary behaviorthe effectiveness of tailored messages in primary care settings
Am J Public Health.
(1994)
Cited by (129)
Reducing meat consumption in meat-loving Denmark: Exploring willingness, behavior, barriers and drivers
2021, Food Quality and PreferenceCitation Excerpt :The response options were: no plan to reduce in the next six months (pre-contemplation stage), planning to reduce within the next six months (contemplation stage), planning to reduce within the next month (preparation stage), already reduced within the last six months (action stage), or reduced for longer than six months (maintenance stage). As the time-frame definitions of the stages have been criticized (e.g. West, 2005), we employed time-frames used in previous studies (Hoek et al., 2011; Kristal et al., 1999). We also included a response option asking whether the respondent planned to increase, or had increased, their meat consumption (which we classified within the pre-contemplation stage).