Worthington Anna, Coffey Taylor, Gillies Katie, Roy Rajshri, Braakhuis Andrea
Discipline of Nutrition, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Health Services Research Unit, Health Sciences Building, University of Aberdeen, Aberdeen, United Kingdom.
Front Nutr. 2024 Dec 17;11:1457708. doi: 10.3389/fnut.2024.1457708. eCollection 2024.
Nutrition trials are important for informing dietary and clinical guidelines. Central to the success of these trials is participant adherence to dietary behaviors. However, trials commonly experience poor adherence. This study seeks to understand if and how researchers consider supporting participant adherence to dietary behaviors and their relationship to using behavior change science when designing trials.
A mapping exercise was undertaken to create matrices that describe the landscape of current nutrition trials. A total of 12 researchers participated in semi-structured, one-on-one interviews. Transcripts were analyzed using (i) the theoretical domains framework (TDF) to identify themes in current practice and beliefs, and (ii) the capability, opportunity, motivation, and behavior model to identify barriers and enablers to using behavior change science in the design of nutrition trials.
Twenty-two belief statements were identified across all 14 TDF domains and were conceptualized as 5 key themes with respect to designing nutrition trials to improve participant adherence: (i) what was done, (ii) how it was done, (iii) why it was done, (iv) adherence challenges, and (v) conflicting beliefs. Regarding using behavior change science when designing trials, some researchers felt this would be beneficial but lacked the knowledge and skills to do so, while others were skeptical of its value over the current experience-based practice.
Researchers are motivated to encourage participant adherence to dietary behaviors, and, consciously and subconsciously, implement a range of strategies through non-systematic methods in their trials. Future publications would benefit from the explicit documentation of levels of adherence to dietary behaviors and strategies implemented to improve adherence.
营养试验对于制定饮食和临床指南至关重要。这些试验成功的关键在于参与者对饮食行为的坚持。然而，试验中普遍存在依从性差的问题。本研究旨在了解研究人员在设计试验时是否以及如何考虑支持参与者坚持饮食行为，以及这与运用行为改变科学之间的关系。
开展了一项映射活动，以创建描述当前营养试验情况的矩阵。共有12名研究人员参与了半结构化的一对一访谈。对访谈记录进行了分析，（i）使用理论领域框架（TDF）来确定当前实践和信念中的主题，（ii）使用能力、机会、动机和行为模型来确定在营养试验设计中运用行为改变科学的障碍和促进因素。
在所有14个TDF领域中确定了22条信念陈述，并将其概念化为设计营养试验以提高参与者依从性的5个关键主题：（i）做了什么，（ii）如何做的，（iii）为什么这样做，（iv）依从性挑战，以及（v）相互冲突的信念。关于在设计试验时运用行为改变科学，一些研究人员认为这会有帮助，但缺乏相关知识和技能，而另一些人则对其相对于当前基于经验的实践的价值表示怀疑。
研究人员有动力鼓励参与者坚持饮食行为，并在试验中通过非系统的方法有意识和下意识地实施一系列策略。未来的出版物若能明确记录饮食行为的依从水平以及为提高依从性而实施的策略，将会从中受益。
