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Who benefits from a dietary online intervention? Evidence from Italy, Spain and Greece

  • Ralf Schwarzer (a1), Lena Fleig (a1), Lisa M Warner (a1), Maryam Gholami (a1), Lluis Serra-Majem (a2) (a3) (a4), Joy Ngo (a2), Blanca Roman-Viñas (a2) (a3), Lourdes Ribas-Barba (a2) (a3), Alessandro Distante (a5), Evangelia Ntzani (a6) (a7), George Giannakis (a8) and Maria L Brandi (a9)...
Abstract
Abstract Objective

The traditional Mediterranean diet includes high consumption of fruits, vegetables, olive oil, legumes, cereals and nuts, moderate to high intake of fish and dairy products, and low consumption of meat products. Intervention effects to improve adoption of this diet may vary in terms of individuals’ motivational or volitional prerequisites. In the context of a three-country research collaboration, intervention effects on these psychological constructs for increasing adoption of the Mediterranean diet were examined.

Design

An intervention was conducted to improve Mediterranean diet consumption with a two-month follow-up. Linear multiple-level models examined which psychological constructs (outcome expectancies, planning, action control and stage of change) were associated with changes in diet scores.

Setting

Web-based intervention in Italy, Spain and Greece.

Subjects

Adults (n 454; mean age 42·2 (sd 10·4) years, range 18–65 years; n 112 at follow-up).

Results

Analyses yielded an overall increase in the Mediterranean diet scores. Moreover, there were interactions between time and all four psychological constructs on these changes. Participants with lower levels of baseline outcome expectancies, planning, action control and stage of change were found to show steeper slopes, thus greater behavioural adoption, than those who started out with higher levels.

Conclusions

The intervention produced overall improvements in Mediterranean diet consumption, with outcome expectancies, planning, action control and stage of change operating as moderators, indicating that those with lower motivational or volitional prerequisites gained more from the online intervention. Individual differences in participants’ readiness for change need to be taken into account to gauge who would benefit most from the given treatment.

Copyright
Corresponding author
* Corresponding author: Email ralf.schwarzer@fu-berlin.de
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Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
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