School of Psychology, Ulster University, Coleraine, UK.
Faculty of Science, Sligo Institute of Technology, Sligo, UK.
BMC Public Health. 2020 Dec 3;20(1):1857. doi: 10.1186/s12889-020-09985-8.
The term 'whole dietary pattern' can be defined as the quantity, frequency, variety and combination of different foods and drinks typically consumed and a growing body of research supports the role of whole dietary patterns in influencing the risk of non-communicable diseases. For example, the 'Mediterranean diet', which compared to the typical Western diet is rich in fruits and vegetables, whole grains, and oily fish, is associated with reduced risk of cardiovascular disease and cancer. Social Cognition Models provide a basis for understanding the determinants of behaviour and are made up of behavioural constructs that interventions target to change dietary behaviour. The aim of this systematic review was to provide a comprehensive assessment of the effectiveness and use of psychological theory in dietary interventions that promote a whole dietary pattern.
We undertook a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis to synthesize quantitative research studies found in Embase, Medline, PsycInfo, CINAHL and Web of Science. The studies included were randomised and non-randomised trials published in English, involving the implementation of a whole dietary pattern using a Social Cognition Model to facilitate this. Two independent reviewers searched the articles and extracted data from the articles. The quality of the articles was evaluated using Black and Down quality checklist and Theory Coding Scheme.
Nine intervention studies met the criteria for inclusion. Data from studies reporting on individual food group scores indicated that dietary scores improved for at least one food group. Overall, studies reported a moderate application of the theory coding scheme, with poor reporting on fidelity.
To our knowledge, this is the first review to investigate psychological theory driven interventions to promote whole dietary patterns. This review found mixed results for the effectiveness of using psychological theory to promote whole dietary pattern consumption. However, the studies in this review scored mostly moderate on the theory coding scheme suggesting studies are not rigorously applying theory to intervention design. Few studies reported high on treatment fidelity, therefore, translation of research interventions into practice may further impact on effectiveness of intervention. Further research is needed to identify which behaviour change theory and techniques are most salient in dietary interventions.
“整体饮食模式”一词可定义为通常摄入的不同食物和饮料的数量、频率、种类和组合，越来越多的研究支持整体饮食模式在影响非传染性疾病风险方面的作用。例如，与典型的西方饮食相比，富含水果、蔬菜、全谷物和油性鱼类的“地中海饮食”与降低心血管疾病和癌症风险有关。社会认知模型为理解行为的决定因素提供了基础，它由行为结构组成，干预措施旨在改变饮食行为。本系统评价的目的是全面评估促进整体饮食模式的饮食干预措施中使用心理理论的有效性和实用性。
我们使用系统评价和荟萃分析的首选报告项目进行了系统评价，以综合 Embase、Medline、PsycInfo、CINAHL 和 Web of Science 中发现的定量研究。纳入的研究是使用社会认知模型实施整体饮食模式以促进这种模式的随机和非随机试验，发表在英语中。两名独立的评审员搜索文章并从文章中提取数据。使用 Black 和 Down 质量清单和理论编码方案评估文章的质量。
有 9 项干预研究符合纳入标准。报告个别食物组分数的研究数据表明，至少有一种食物组的饮食分数有所提高。总体而言，研究报告了理论编码方案的中等应用，对保真度的报告较差。
据我们所知，这是第一项调查促进整体饮食模式的心理理论驱动干预措施的综述。本综述发现，使用心理理论促进整体饮食模式消费的效果好坏参半。然而，本综述中的研究在理论编码方案上大多得分为中等，这表明研究并未严格将理论应用于干预设计。很少有研究报告高保真度，因此，将研究干预措施转化为实践可能会进一步影响干预效果。需要进一步研究以确定哪些行为改变理论和技术在饮食干预中最为重要。
