Journal Article

Development of a peer support intervention to encourage dietary behaviour change towards a Mediterranean diet in adults at high cardiovascular risk

Woodside, Jayne V., Erwin, Christina, Kee, Frank, Prior, Lindsay, Young, Ian S., McEvoy, Claire T., Cupples, Margaret E., McKinley, Michelle C., Moore, Sarah E., Appleton, Katherine M.

2018

Overview

Background Mediterranean diet (MD) interventions are demonstrated to significantly reduce cardiovascular disease (CVD) risk but are typically resource intensive and delivered by health professionals. There is considerable interest to develop interventions that target sustained dietary behaviour change and that are feasible to scale-up for wider public health benefit. The aim of this paper is to describe the process used to develop a peer support intervention to encourage dietary behaviour change towards a MD in non-Mediterranean adults at high CVD risk. Methods The Medical Research Council (MRC) and Behaviour Change Wheel (BCW) frameworks and the COM-B (Capability, Opportunity, Motivation, Behaviour) theoretical model were used to guide the intervention development process. We used a combination of evidence synthesis and qualitative research with the target population, health professionals, and community health personnel to develop the intervention over three main stages: (1) we identified the evidence base and selected dietary behaviours that needed to change, (2) we developed a theoretical basis for how the intervention might encourage behaviour change towards a MD and selected intervention functions that could drive the desired MD behaviour change, and (3) we defined the intervention content and modelled outcomes. Results A theory-based, culturally tailored, peer support intervention was developed to specifically target behaviour change towards a MD in the target population. The intervention was a group-based program delivered by trained peer volunteers over 12-months, and incorporated strategies to enhance social support, self-efficacy, problem-solving, knowledge, and attitudes to address identified barriers to adopting a MD from the COM-B analysis. Conclusions The MRC and BCW frameworks provided a systematic and complementary process for development of a theory-based peer support intervention to encourage dietary behaviour change towards a MD in non-Mediterranean adults at high CVD risk. The next step is to evaluate feasibility, acceptability, and diet behaviour change outcomes in response to the peer support intervention (change towards a MD and nutrient biomarkers) using a randomized controlled trial design.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Addictive behaviors / Adult / Adults / Behavior / behaviour change wheel / Biomarkers / Biostatistics / Cardiovascular disease / Cardiovascular diseases / Cardiovascular Diseases - prevention & control / Clinical outcomes / Diabetes / Diet / Diet - psychology / Diet, Mediterranean / Environmental Health / Epidemiology / Feasibility studies / Female / Health aspects / Health Behavior / Health Promotion - organization & administration / health promotion and society / Health risks / Humans / Intervention / interventiondevelopment / Male / Management / Medical personnel / Medical research / Medicine / Medicine & Public Health / Mediterranean diet / Nutrition research / Peer Group / peer support / Peer tutoring / Prevention / Problem solving / Professionals / Public Health / Qualitative Research / Research Article / Risk / Risk Assessment / Social interactions / Social Support / Systematic review / Theory / Vaccine