Stage-based analysis of an adaptive worksite intervention trial for diabetes prevention

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling Pub Date : 2025-01-20 DOI:10.1016/j.pec.2025.108671

Carla K. Miller , Danielle King , Kentaro Fujita , Jennifer Cheavens

{"title":"Stage-based analysis of an adaptive worksite intervention trial for diabetes prevention","authors":"Carla K. Miller , Danielle King , Kentaro Fujita , Jennifer Cheavens","doi":"10.1016/j.pec.2025.108671","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>Stage-based models of change posit stage specific factors to promote motivation and intention formation for those not ready to change and volitional action strategies for others. The impact of two interventions on energy restriction and weight change among adults with prediabetes (n = 190) was examined by baseline stage.</div></div><div><h3>Methods</h3><div>Stage classification included: Pre-intenders had no intention to change; Intenders set an intention but were not acting; and Actors reported eating a low-fat diet at baseline. Intervention impact on intention formation, planning, self-efficacy, energy intake, and weight change was evaluated. Structural equation modeling identified mechanisms of change.</div></div><div><h3>Results</h3><div>At baseline, Pre-intenders (28.3 %) and Actors (41.7 %) significantly differed in action self-efficacy, planning, and energy intake. Post-intervention, 91.7 % of the sample remained Actors or progressed in stage placement; intention to consume a low-fat diet increased for Pre-intenders. An increase in action self-efficacy strengthened intention formation for Intenders/Actors. Model fit for post-intentional factors was unsatisfactory, but dietary planning may promote energy restriction.</div></div><div><h3>Conclusions</h3><div>The lifestyle interventions promoted stage progression. Whether post-intentional mechanisms of change differ for Pre-intenders compared to Intenders/Actors requires further research.</div></div><div><h3>Practice implications</h3><div>Classifying participants by intention and tailoring interventions to stage may promote greater intention formation and reduction in energy intake.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108671"},"PeriodicalIF":2.9000,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Patient Education and Counseling","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0738399125000382","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

Stage-based models of change posit stage specific factors to promote motivation and intention formation for those not ready to change and volitional action strategies for others. The impact of two interventions on energy restriction and weight change among adults with prediabetes (n = 190) was examined by baseline stage.

Methods

Stage classification included: Pre-intenders had no intention to change; Intenders set an intention but were not acting; and Actors reported eating a low-fat diet at baseline. Intervention impact on intention formation, planning, self-efficacy, energy intake, and weight change was evaluated. Structural equation modeling identified mechanisms of change.

Results

At baseline, Pre-intenders (28.3 %) and Actors (41.7 %) significantly differed in action self-efficacy, planning, and energy intake. Post-intervention, 91.7 % of the sample remained Actors or progressed in stage placement; intention to consume a low-fat diet increased for Pre-intenders. An increase in action self-efficacy strengthened intention formation for Intenders/Actors. Model fit for post-intentional factors was unsatisfactory, but dietary planning may promote energy restriction.

Conclusions

The lifestyle interventions promoted stage progression. Whether post-intentional mechanisms of change differ for Pre-intenders compared to Intenders/Actors requires further research.

Practice implications

Classifying participants by intention and tailoring interventions to stage may promote greater intention formation and reduction in energy intake.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.