López-Azpiazu I, Martinez-González M A, León-Mateos A, Kearney J, Gibney M, Martínez J A
Department of Physiology and Nutrition, University of Navarra, Pamplona, Spain.
Public Health. 2000 May;114(3):183-9.
A national survey was developed in a representative sample of the Spanish population (15 years old and upwards). This study belongs to a partnership in a pan-European survey about stages of dietary change where subjects were classified into six different categories according to their readiness for dietary change: precontemplation (not considering any changes), contemplation (considering changes), decision (making plans to change), action (carrying out the changes), maintenance (maintaining changes for more than six months) and relapse stage (reverting back to eating less healthily). The main objective was to investigate the distribution of the different stages of change concerning dietary habits across strata of socio-demographic variables (sex, age, educational level, socioeconomic level). Also, this study was conducted to assess the relationships between stages of dietary change and the influences on food choice as well as the definitions used to describe healthy eating. The survey was carried out, according to an established protocol, on a representative sample of 1009 Spanish subjects selected by an at random multistage procedure. Subjects completed a face-to-face interview-assisted questionnaire. To ensure representativeness data were weighted by population size, by sex, age and regional distribution. The proportion of subjects in precontemplation (56.0%) and maintenance (28.3%) stages was substantially larger than in the other stages of dietary change. More males (59.7%) and subjects from the oldest age groups (65.8%) were classified as belonging to the precontemplation stage, while more females (30.2%) and subjects between 25-34 years of age (34.5%) were in the maintenance stage. 'Trying to eat healthy' as an influence on food choice was more frequently mentioned by those in the dynamic and maintenance stages, while a high percentage of subjects from the precontemplation and relapse stages (61.1%) agreed they did not need to make changes to their diets because their diet was already sufficiently healthy. A very high proportion of the Spanish adult population do not contemplate a change in their dietary habits. Intervention strategies in health promotion programs should be available for people at the various stages of change. It would be more effective to attempt to increase people's awareness and personal concerns about nutrition and health, before introducing action strategies.
The adult population can be classified into different stages of dietary change, so the stages of change model may be applied to future nutrition interventions. This approach will help to focus more accurately strategies of nutrition education.
在西班牙有代表性的人口样本（15岁及以上）中开展了一项全国性调查。本研究是一项泛欧饮食变化阶段调查合作项目的一部分，在该项目中，受试者根据其饮食变化的准备程度被分为六个不同类别：未考虑阶段（不考虑任何变化）、考虑阶段（考虑变化）、决定阶段（制定改变计划）、行动阶段（实施改变）、维持阶段（保持改变超过六个月）和复发阶段（恢复到不太健康的饮食）。主要目的是调查社会人口统计学变量（性别、年龄、教育水平、社会经济水平）各阶层中饮食习惯变化不同阶段的分布情况。此外，开展本研究是为了评估饮食变化阶段之间的关系以及对食物选择的影响，还有用于描述健康饮食的定义。根据既定方案，对通过随机多阶段程序选取的1009名西班牙受试者的代表性样本进行了调查。受试者完成了一份由面对面访谈辅助的问卷。为确保代表性，数据按人口规模、性别、年龄和地区分布进行了加权。处于未考虑阶段（56.0%）和维持阶段（28.3%）的受试者比例明显高于饮食变化的其他阶段。更多男性（59.7%）和年龄最大的年龄组的受试者（65.8%）被归类为处于未考虑阶段，而更多女性（30.2%）和25 - 34岁的受试者（34.5%）处于维持阶段。处于动态和维持阶段的人更频繁地提到“尝试健康饮食”对食物选择的影响，而处于未考虑和复发阶段的受试者中很大比例（61.1%）认为他们不需要改变饮食，因为他们的饮食已经足够健康。很大比例的西班牙成年人口没有考虑改变饮食习惯。健康促进项目中的干预策略应适用于处于不同变化阶段的人群。在引入行动策略之前尝试提高人们对营养和健康的认识及个人关注可能会更有效。
成年人口可分为饮食变化的不同阶段，因此变化阶段模型可应用于未来的营养干预。这种方法将有助于更准确地聚焦营养教育策略。
