Department of Family Medicine, University of Rochester School of Medicine and Dentistry, 777 South Clinton Avenue, Rochester, NY 14620, USA.
Fam Pract. 2013 Aug;30(4):452-8. doi: 10.1093/fampra/cmt009. Epub 2013 Mar 20.
Health behavioural change is complex, especially for underserved patients who have higher rates of obesity and physical inactivity. Behavioural change interventions that show high efficacy in clinical trials may be difficult to disseminate and may not be effective in the office.
We sought to identify factors that facilitate or hinder behavioural change among past participants of a healthy lifestyle intervention in an urban underserved health centre.
Between March and October 2011, we conducted five focus group sessions with a total of 23 past participants. The focus group transcripts were analysed with a framework approach using the Social Ecological Model as a coding structure.
We found four interconnected levels of social contexts: individual, interpersonal, programmatic and community levels. Themes of social support and the importance of relationships for making and maintaining behavioural changes were found at all levels.
Social support and relatedness were key facilitators of healthy lifestyle changes and influenced individual motivation and perseverance. Harnessing the power of social support and motivation may be a way for future behavioural change interventions to bridge the gap between efficacy and effectiveness.
健康行为改变是复杂的，尤其是在服务不足的患者中，他们的肥胖和身体活动不足的比率更高。在临床试验中显示出高疗效的行为改变干预措施可能难以传播，并且在办公室中可能无效。
我们试图确定在城市服务不足的健康中心中，过去参加健康生活方式干预的参与者中促进或阻碍行为改变的因素。
在 2011 年 3 月至 10 月期间，我们对 23 名过去的参与者进行了五次焦点小组会议。使用框架方法对焦点小组的转录进行了分析，使用社会生态模型作为编码结构。
我们发现了四个相互关联的社会环境层次：个人、人际、项目和社区层次。在所有层次上都发现了社会支持和关系对做出和维持行为改变的重要性的主题。
社会支持和关联性是健康生活方式改变的关键促进因素，并影响个人的动机和毅力。利用社会支持和动机的力量可能是未来行为改变干预措施弥合疗效和有效性之间差距的一种方式。
