Effects of a behavioural approach on lifestyle habits in a healthy Italian population: a before-after interventional study
Keywords:
Empowerment, Education, Nutrition, Public Health, PreventionAbstract
Background. The study aimed to assess the effectiveness of an educational intervention promoting adherence to healthy diet and physical activity.
Study design. Before-after interventional study.
Methods. Participants were healthy volunteers, 18-70 y old, from Bologna. They followed a training course consisting of seven meetings and signed a contract to comply with the promoted habits, verified through questionnaires at the engagement phase (T0), three months later (T1) and one year later (T2).
Results. One hundred, fifty-three subjects were involved, 75.8% were evaluated at T1 and 41.2% at T2. More than 80% of the subjects involved at T1 achieved an improvement of planned goals. Moreover, 77% of T1 compliants retained healthy eating and physical activity at T2.
Conclusions. The proposed pathway of empowerment positively affected nutrition and promotion of physical activity at 3 months after the intervention (T1) and were maintained even after a year. The results appear to be promising for primary prevention across the spectrum of a healthy lifestyle educational approach.
References
1. World Health Organization (WHO). Preventing chronic diseases: a vital investment: WHO global report. Geneva, Switzerland: World Health Organization, 2005. ISBN 9241563001.
2. World Health Organization (WHO). The global burden of disease: 2004 update. Geneva, Switzerland: World Health Organization, 2008. ISBN 9789241563710.
3. World Health Organization (WHO). Global health risks: mortality and burden of disease attributable to selected major risks. Geneva, Switzerland: World Health Organization, 2009 Dec. ISBN 9789241563871.
4. World Cancer Research Fund / American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. Washington, DC: AICR, 2007.
5. Maresso KC, Hawk E. Cancer Prevention Recommendations: Impact of Adherence. Semin Oncol Nurs 2016; 32(3): 306-13. doi: 10.1016/j. soncn.2016.05.010.
6. Kirkegaard H, Johnsen NF, Christensen J, Frederiksen K, Overvad K, Tjønneland A. Association of adherence to lifestyle recommendations and risk of colorectal cancer: a prospective Danish cohort study. BMJ 2010; 341: c5504. doi: 10.1136/bmj.c5504.
7. Vergnaud AC, Romaguera D, Peeters PH, et al. Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study. Am J Clin Nutr 2013; 97(5): 1107-20. doi: 10.3945/ ajcn.112.049569.
8. Jankovic N, Geelen A, Winkels RM, et al; Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). Adherence to the WCRF/AICR Dietary Recommendations for Cancer Prevention and Risk of Cancer in Elderly from Europe and the United States: A Meta-Analysis within the CHANCES Project - Cancer Epidemiol Biomarkers Prev 2017; 26(1): 136-44. doi: 10.1158/1055-9965.EPI-16-0428.
9. World Cancer Research Fund/American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: A Global Perspective. Continuous Update Project Expert Report 2018. Available on: dietandcancerreport.org [Last accessed: 2020, Oct 8].
10. Romano-Spica V, Parlato A, Palumbo D, et al. Health promotion through physical activity: territorial models and experiences. Ann Ig 2008; 20(3): 297-311.
11. Liguori G, Gallè F, Valeriani F, Romano Spica V. The role of the hygienist in prevention and health promotion through physical activity: the contribute of the Working Group “Movement Sciences for Health” of the Italian Society of Hygiene. Ann Ig 2015; 27(1): 11-5. doi: 10.7416/ai.2015.2018.
12. Gallè F, Di Onofrio V, Barcone F, et al. Investi-gating the Role of Physical Education in Physical Activity Promotion: An Italian Multicenter Study. J Phys Act Health 2016; 13(8): 854-60. doi: 10.1123/jpah.2015-0452.
13. Panunzio MF, Caporizzi R, Antoniciello A, et al. Nutrition prevention intervention for cancers: “Med-Food Anticancer Program”. Ann Ig 2011; 23(6): 519-25. PMID: 22509621.
14. Rubak S, Sandbaek A, Lauritzen T, Christensen B. Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract 2005; 55(513): 305-12. PMID: 15826439.
15. Pace BT, Dembe A, Soma CS, Baldwin SA,
Atkins DC, Imel ZE. A Multivariate MetaAnalysis of Motivational Interviewing Process and Outcome. Psychol Addict Behav 2017; 31(5): 524-33. doi: 10.1037/adb0000280.
16. Morgenstern J, Kuerbis A, Amrhein P, Hail L, Lynch K, McKay JR. Motivational Interviewing: A Pilot Test of Active Ingredients and Mechanisms of Change. Psychol Addict Behav 2012; 26(4): 859-69. doi: 10.1037/a0029674.
17. Christie D, Channon S. The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical review. Diabetes Obes Metab 2014; 16(5): 381-7. doi:
10.1111/dom.12195.
18. McDonald HP, Garg AX, Haynes R. Interventions to enhance patient adherence to medication prescriptions: Scientific review. JAMA 2002; 28(22): 2868-79. doi: 10.1001/ jama.288.22.2868.
19. Sabaté E, Ed. Adherence to long-term therapies: evidence for action. Geneva, Switzerland: World Health Organization, 2003. ISBN 9241545992.
20. Ashfield-Watt PA, Welch AA, Day NE, Bingham SA. Is ‘five-a-day’ an effective way of increasing fruit and vegetable intakes? Public Health Nutr 2004; 7(2): 257-61. doi: 10.1079/ PHN2003524.
21. World Health Organization, Food and Agriculture Organization of the United Nations. Report of a Joint FAO/WHO Expert Consultation. Rome, 14-18 April 1997 - M-86. ISBN 9251041148.
22. Carlsen MH, Halvorsen BL, Holte K, et al. The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide. Nutr J 2010; 9: 3. doi:
10.1186/1475-2891-9-3.
23. World Health Organization (WHO). Global Recommendations on Physical Activity for Health. Geneva, Switzerland: World Health Organization, 2010. ISBN 9789241599979.
24. World Health Organization (WHO). Physical Status: The Use and Interpretation of Anthropometry: Report of a World Health Organization (WHO) Expert Committee. Geneva, Switzerland: World Health Organization, 1995. ISBN 9241208546.
25. World Health Organization (WHO). Waist circumference and waist–hip ratio: report of a WHO expert consultation. Geneva, Switzerland, 8-11 December 2008. ISBN 9789241501491.
26. Lara J, Evans EH, O’Brien N, et al. Association of behaviour change techniques with effectiveness of dietary interventions among adults of retirement age: a systematic review and metaanalysis of randomised controlled trials. BMC Med 2014; 12: 177. doi: 10.1186/s12916-0140177-3.
27. Schneider JK, Wong-Anuchit C, Stallings D, Krieger MM. Motivational Interviewing and Fruit/Vegetable Consumption in Older Adults.
Clin Nurs Res 2017; 26(6): 731-46. doi: 10.1177/1054773816673634.
28. Cutler L, King B, McCarthy N, Hamilton G, Cook L. Appetite for life: an evaluation of a primary care lifestyle programme. J Prim Health Care 2010; 2(4): 281-7. PMID: 21125068.
29. French DP, Olander EK, Chisholm A, Mc Sharry J. Which behaviour change techniques are most effective at increasing older adults’ self-efficacy and physical activity behaviour? A systematic review. Ann Behav Med 2014; 48(2): 225-34. doi: 10.1007/s12160-014-9593-z.
30. Richards EA, Cai Y. Integrative Review of Nurse-Delivered Physical Activity Interventions in Primary Care. West J Nurs Res 2016; 38(4): 484-507. doi: 10.1177/0193945915581861.
31. Swift DL, McGee JE, Earnest CP, Carlisle E, Nygard M, Johannsen NM. The Effects of Exercise and Physical Activity on Weight Loss and Maintenance. Prog Cardiovasc Dis 2018; 61(2): 206-13. doi: 10.1016/j.pcad.2018.07.014.
32. Armstrong MJ, Mottershead TA, Ronksley PE, Sigal RJ, Campbell TS, Hemmelgarn BR. Motivational interviewing to improve weight loss in overweight and/or obese patients: a systematic review and meta-analysis of randomized controlled trials. Obes Rev 2011; 12(9): 709-23. doi: 10.1111/j.1467-789X.2011.00892.x.
33. Greaves CJ, Middlebrooke A, O’Loughlin L, et al. Motivational interviewing for modifying diabetes risk: a randomised controlled trial. Br J Gen Pract 2008; 58(553): 535-40. doi: 10.3399/ bjgp08X319648.
34. Spencer JC, Wheeler SB. A systematic review of Motivational Interviewing interventions in cancer patients and survivors. Patient Educ Couns 2016; 99(7): 1099-105. doi: 10.1016/j. pec.2016.02.003.
35. Christie D, Channon S. The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical review. Diabetes Obes Metab 2014; 16(5): 381-7. doi: 10.1111/dom.12195.
36. Concert CM, Burke RE, Eusebio AM, Slavin EA, Shortridge-Baggett LM. The Effectiveness of Motivational Interviewing on Glycemic Control for Adults with Type 2 Diabetes Mellitus (DM2): A Systematic Review. JBI Libr Syst Rev 2012; 10(42 Suppl): 1-17. doi: 10.11124/ jbisrir-2012-246.
37. O’Halloran PD, Blackstock F, Shields N, et al.
Motivational interviewing to increase physical activity in people with chronic health conditions: a systematic review and meta-analysis. Clin Rehabil 2014; 28(12): 1159-71. doi:
10.1177/0269215514536210.
38. Alperstein D, Sharpe L. The Efficacy of Motivational Interviewing in Adults with Chronic Pain: A Meta-Analysis and Systematic Review.
J Pain 2016; 17(4): 393-403. doi: 10.1016/j. jpain.2015.10.021.
39. Zomahoun HTV, Guénette L, Grégoire JP, et al. Effectiveness of motivational interviewing interventions on medication adherence in adults with chronic diseases: a systematic review and meta-analysis. Int J Epidemiol 2017; 46(2): 589602. doi: 10.1093/ije/dyw273.
40. Buratta L, Reginato E, Ranucci C, et al. Stage of Change and Motivation to a Healthier Lifestyle before and after an Intensive Lifestyle Intervention. J Obes 2016; 2016: 6421265. doi:
10.1155/2016/6421265.
41. Samdal GB, Eide GE, Barth T, Williams G, Meland E. Effective behaviour change techniques for physical activity and healthy eating in overweight and obese adults; systematic review and meta-regression analyses. Int J Behav Nutr Phys Act 2017; 14(1): 42. doi: 10.1186/s12966-017-0494-y.
42. Stonerock GL, Blumenthal JA. Role of Counseling to Promote Adherence in Healthy Lifestyle Medicine: Strategies to Improve Exercise Adherence and Enhance Physical Activity. Prog Cardiovasc Dis 2017; 59(5): 455-62. doi: 10.1016/j.pcad.2016.09.003.
43. Scatigna M, D’Eugenio S, Cesarini V, et al. Physical activity as a key issue for promoting human health on a local and global scale: evidences and perspectives. Ann Ig 2019; 31(6): 595-613. doi: 10.7416/ai.2019.2320.
Downloads
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.