Yiga Peter, Van Lippevelde Wendy, Seghers Jan, Ogwok Patrick, Tafiire Henry, Muluuta Susan Nakaayi, Matthys Christophe
Department of Food Technology, Kyambogo University, Kampala, Uganda.
Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.
BMC Public Health. 2022 Feb 18;22(1):351. doi: 10.1186/s12889-022-12740-w.
Metabolic health of urban Ugandans, mostly women, has increasingly become sub-optimal. As women are strategic for family behavioral change and do not meet WHO recommendations regarding dietary and physical activity (PA), there is an urgent need for science-based interventions to tackle unhealthy dietary and PA behaviors.
To develop a food literacy and PA promotion intervention to optimise metabolic health among women of reproductive age in urban Uganda.
Steps 1- 6 of the Intervention Mapping protocol were used to design the intervention.
Notable determinants from Step 1 were health/beauty paradox, nonfactual nutrition information, socio-cultural misconceptions around moderate PA, fruits, and vegetables. Others included gaps in food/PA knowledge, skills, and self-efficacy. We hypothesised that changing the overall existing behaviours in one intervention may meet strong resistance. Thus, we decided to go for gradual stepwise changes. Hence in step 2, three behavioural intervention objectives were formulated; (1) women evaluate the accuracy of nutrition and PA information., (2) engage in moderate intensity PA for at least 150 min a week, and (3) consume at least one portion of vegetables and one portion of fruit every day. Based on the food literacy model, intervention objectives were formulated into performance objectives and matrices of change objectives. In step 3 a combination of eleven behavioural change techniques were selected and translated into practical strategies to effect changes in determinants. In step 4, intervention components and materials were developed. The intervention consists of five interactive group sessions, 150 min each. Infographics on benefits/recommendations, vegetable recipes, and practical tips to eat more fruits, vegetables, and to engage more in PA are included. Personalised goals and action plans tailored to personal metabolic health and lifestyle needs, and environmental opportunities form the basis of the intervention. A randomized controlled trial is being conducted to evaluate the intervention ( https://clinicaltrials.gov/ct2/show/NCT04635332 ).
The intervention is novel, based on a holistic food literacy model. The intervention is built on determinants specific to urban Uganda, evidence based behavioural change theoretical models and techniques, detailing the hypothesised behavioural change mechanism. If effective, an evidence-based intervention will become available for reference in urban Uganda.
乌干达城市居民（大多数为女性）的代谢健康状况越来越不理想。由于女性对于家庭行为改变具有关键作用，且未达到世界卫生组织关于饮食和身体活动（PA）的建议，因此迫切需要基于科学的干预措施来解决不健康的饮食和身体活动行为。
制定一项食品素养和身体活动促进干预措施，以优化乌干达城市育龄妇女的代谢健康。
采用干预映射协议的第1至6步来设计干预措施。
第1步中值得注意的决定因素包括健康/美容悖论、不实的营养信息、围绕适度身体活动、水果和蔬菜的社会文化误解。其他因素包括食品/身体活动知识、技能和自我效能方面的差距。我们假设在一次干预中改变现有的整体行为可能会遇到强烈阻力。因此，我们决定采取逐步渐进的改变。于是在第2步中，制定了三个行为干预目标；（1）女性评估营养和身体活动信息的准确性。（2）每周进行至少150分钟的中等强度身体活动。（3）每天至少食用一份蔬菜和一份水果。基于食品素养模型，将干预目标转化为绩效目标和变革目标矩阵。在第3步中，选择了十一种行为改变技术并转化为实际策略，以影响决定因素的变化。在第4步中，开发了干预组件和材料。该干预措施包括五个互动小组会议，每次150分钟。其中包括关于益处/建议的信息图表、蔬菜食谱以及多吃水果、蔬菜和增加身体活动的实用小贴士。根据个人代谢健康和生活方式需求以及环境机会量身定制的个性化目标和行动计划构成了干预的基础。目前正在进行一项随机对照试验以评估该干预措施（https://clinicaltrials.gov/ct2/show/NCT04635332）。
该干预措施新颖，基于整体食品素养模型。它基于乌干达城市特有的决定因素、循证行为改变理论模型和技术构建，详细阐述了假设的行为改变机制。如果有效，将为乌干达城市提供一项可供参考的循证干预措施。
