评估营养师营养教育决策与行为改变理论的一致性

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Nutrition Education and Behavior Pub Date : 2025-08-01 DOI:10.1016/j.jneb.2025.05.035

Dagny Larson MS, RD, LD, Tvisha Karumuri n/a, Marissa Burgermaster PhD

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引用次数: 0

摘要

背景：以理论为基础的营养教育可以增加成功的饮食行为改变。通过利用基于理论的工具，如营养教育设计程序（DESIGN），营养教育者可以识别相关的行为决定因素，并针对这些决定因素实施行为改变策略。然而，研究表明，营养教育的主要提供者营养师在行为改变理论方面可能没有得到足够的培训。目的探讨营养师如何将行为改变理论纳入营养教育。研究设计、环境、参与者我们对26名营养师进行了定性访谈，了解他们如何调整教育以满足患者的需求。两名编码员审查了抄本，以：1)确定营养师向患者提供教育活动的目标，2)对这些摘录进行编码，以确定DESIGN营养教育综合模型中行为决定因素的存在。七名参与者被明确询问了他们在教育决策中使用理论的情况。可测量的结果/分析对营养师所描述的目标和行为改变内容的存在进行专题分析。结果7名参与者中有3人在做出教育决策时考虑了变化阶段（跨理论模型）；参与者没有提到其他理论。尽管如此，我们确定了与营养师教育目标相关的5个主题，这些主题与基于理论的决定因素有重叠。1)原因——患者必须理解改变的目的和重要性（可感知的风险，可感知的益处）。2)压倒——教育应该使饮食改变变得容易和现实（自我效能，感知障碍）。3)控制——患者应自主选择饮食改变（感知行为控制）。4)指导——患者存在阻碍改变的知识缺口（知识和认知技能）。5)打破神话——患者带着对健康和糖尿病友好饮食的错误信息和误解（态度、自我效能、感知益处、知识和认知技能）来就诊。结论营养师在有意识地选择教育目标时很少运用行为改变理论。然而，在他们陈述的目标和基于理论的营养教育中使用的共同行为决定因素之间存在重叠。未来的研究需要确定如何在营养师的营养教育决策中增加对理论的考虑。FundingNone

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Evaluating Alignment of Dietitian’s Nutrition Education Decisions with Behavior Change Theory

Background

Theory-based nutrition education can increase successful dietary behavior change. By leveraging theory-based tools such as the Nutrition Education DESIGN procedure (DESIGN), nutrition educators can identify relevant behavioral determinants and implement behavior change strategies targeted for those determinants. However, research suggests that dietitians, key providers of nutrition education, may have insufficient training in behavior change theory.

Objective

To investigate how dietitians incorporate behavior change theory in nutrition education.

Study Design, Settings, Participants

We conducted qualitative interviews with 26 dietitians about how they adapt education to meet patient needs. Two coders reviewed transcripts to: 1) identify dietitians’ objectives for the educational activities they deliver to patients, and 2) code these excerpts for the presence of behavioral determinants from the DESIGN’s integrated model for nutrition education. Seven participants were asked explicitly about their use of theory in education decisions.

Measurable Outcome/Analysis

A thematic analysis of dietitians’ described objectives and the presence of behavior change content.

Results

Three of 7 participants considered Stages of Change (Transtheoretical Model) when making education decisions; no other theories were mentioned by participants. Despite this, we identified 5 themes related to dietitians’ education objectives, which had overlap with theory-based determinants. 1) The Why – patients must understand purpose and importance of change (perceived risk, perceived benefits). 2) Overwhelm – education should make diet changes easy and realistic (self-efficacy, perceived barriers). 3) Control – patients should have autonomy and choice around diet changes (perceived behavioral control). 4) Guidance – patients have knowledge gaps that prevent change (knowledge and cognitive skills). 5) Myth Busting – patients come in with misinformation and misperceptions of what a healthy and diabetes-friendly diet is (attitudes, self-efficacy, perceived benefits, knowledge and cognitive skills).

Conclusions

Dietitians are infrequently utilizing behavior change theory in their conscious selection of educational objectives. However, there is overlap between their stated objectives and common behavioral determinants used in theory-based nutrition education. Future research is needed to identify how to increase consideration of theory in dietitians’ nutrition education decisions.

Funding

None

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来源期刊

Journal of Nutrition Education and Behavior 医学-学科教育

CiteScore

4.20

自引率

11.50%

发文量

379

审稿时长

44 days

期刊介绍： The Journal of Nutrition Education and Behavior (JNEB), the official journal of the Society for Nutrition Education and Behavior, is a refereed, scientific periodical that serves as a global resource for all professionals with an interest in nutrition education; nutrition and physical activity behavior theories and intervention outcomes; complementary and alternative medicine related to nutrition behaviors; food environment; food, nutrition, and physical activity communication strategies including technology; nutrition-related economics; food safety education; and scholarship of learning related to these areas. The purpose of JNEB is to document and disseminate original research and emerging issues and practices relevant to these areas worldwide. The Journal of Nutrition Education and Behavior welcomes evidence-based manuscripts that provide new insights and useful findings related to nutrition education research, practice and policy. The content areas of JNEB reflect the diverse interests in nutrition and physical activity related to public health, nutritional sciences, education, behavioral economics, family and consumer sciences, and eHealth, including the interests of community-based nutrition-practitioners. As the Society''s official journal, JNEB also includes policy statements, issue perspectives, position papers, and member communications.