Interventions to improve nutritional status
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Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults (Review)
Desroches S, Lapointe A, Ratté S, Gravel K, Légaré F, Turcotte S
Desroches S, Lapointe A, Ratté S, Gravel K, Légaré F, Turcotte S. Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD008722. DOI: 10.1002/14651858.CD008722.pub2.
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Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults (Review)
Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
https://doi.org/10.1002%2F14651858.CD008722.pub2
https://www.cochranelibrary.com
Cochrane Library
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Cochrane Database of Systematic Reviews
T A B L E O F C O N T E N T S HEADER………………………………………………………………………………………………………………………………………………………………………………… 1 ABSTRACT…………………………………………………………………………………………………………………………………………………………………………….. 1 PLAIN LANGUAGE SUMMARY………………………………………………………………………………………………………………………………………………….. 2 BACKGROUND………………………………………………………………………………………………………………………………………………………………………. 3 OBJECTIVES………………………………………………………………………………………………………………………………………………………………………….. 4 METHODS…………………………………………………………………………………………………………………………………………………………………………….. 4 RESULTS……………………………………………………………………………………………………………………………………………………………………………….. 7
Figure 1………………………………………………………………………………………………………………………………………………………………………….. 8 Figure 2………………………………………………………………………………………………………………………………………………………………………….. 12 Figure 3………………………………………………………………………………………………………………………………………………………………………….. 16 Figure 4………………………………………………………………………………………………………………………………………………………………………….. 17 Figure 5………………………………………………………………………………………………………………………………………………………………………….. 18
DISCUSSION………………………………………………………………………………………………………………………………………………………………………….. 24 AUTHORS’ CONCLUSIONS……………………………………………………………………………………………………………………………………………………… 26 ACKNOWLEDGEMENTS………………………………………………………………………………………………………………………………………………………….. 27 REFERENCES………………………………………………………………………………………………………………………………………………………………………… 28 CHARACTERISTICS OF STUDIES……………………………………………………………………………………………………………………………………………… 43 DATA AND ANALYSES……………………………………………………………………………………………………………………………………………………………… 109
Analysis 1.1. Comparison 1 Nutritional tools versus control in diet adherence, Outcome 1 Continuous data………………………….. 110 Analysis 2.1. Comparison 2 Multiple interventions versus control in diet adherence, Outcome 1 Continuous data…………………. 113 Analysis 2.2. Comparison 2 Multiple interventions versus control in diet adherence, Outcome 2 Dichotomous data………………. 114
ADDITIONAL TABLES……………………………………………………………………………………………………………………………………………………………… 115 APPENDICES…………………………………………………………………………………………………………………………………………………………………………. 134 CONTRIBUTIONS OF AUTHORS………………………………………………………………………………………………………………………………………………. 137 DECLARATIONS OF INTEREST………………………………………………………………………………………………………………………………………………… 137 SOURCES OF SUPPORT…………………………………………………………………………………………………………………………………………………………. 137 DIFFERENCES BETWEEN PROTOCOL AND REVIEW…………………………………………………………………………………………………………………… 138 INDEX TERMS……………………………………………………………………………………………………………………………………………………………………….. 138
Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults (Review) Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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[Intervention Review]
Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults
Sophie Desroches1,2, Annie Lapointe1,2, Stéphane Ratté1, Karine Gravel2, France Légaré3, Stéphane Turcotte1
1Centre de recherche du Centre hospitalier universitaire de Québec (CHUQ), St-François d’Assise Hôpital, Québec, Canada. 2Département des sciences des aliments et de nutrition, Université Laval, Québec, Canada. 3Département de médecine familiale et d’urgence, Université Laval, Québec, Canada
Contact address: Sophie Desroches, Centre de recherche du Centre hospitalier universitaire de Québec (CHUQ), St-François d’Assise Hôpital, 10 Rue de l’Espinay, OGice D6-740, Québec, Québec, G1L 3L5, Canada. sophie.desroches@fsaa.ulaval.ca.
Editorial group: Cochrane Consumers and Communication Group Publication status and date: New, published in Issue 2, 2013.
Citation: Desroches S, Lapointe A, Ratté S, Gravel K, Légaré F, Turcotte S. Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD008722. DOI: 10.1002/14651858.CD008722.pub2.
Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
A B S T R A C T
Background
It has been recognized that poor adherence can be a serious risk to the health and wellbeing of patients, and greater adherence to dietary advice is a critical component in preventing and managing chronic diseases.
Objectives
To assess the eGects of interventions for enhancing adherence to dietary advice for preventing and managing chronic diseases in adults.
Search methods
We searched the following electronic databases up to 29 September 2010: The Cochrane Library (issue 9 2010), PubMed, EMBASE (Embase.com), CINAHL (Ebsco) and PsycINFO (PsycNET) with no language restrictions. We also reviewed: a) recent years of relevant conferences, symposium and colloquium proceedings and abstracts; b) web-based registries of clinical trials; and c) the bibliographies of included studies.
Selection criteria
We included randomized controlled trials that evaluated interventions enhancing adherence to dietary advice for preventing and managing chronic diseases in adults. Studies were eligible if the primary outcome was the client’s adherence to dietary advice. We defined ‘client’ as an adult participating in a chronic disease prevention or chronic disease management study involving dietary advice.
Data collection and analysis
Two review authors independently assessed the eligibility of the studies. They also assessed the risk of bias and extracted data using a modified version of the Cochrane Consumers and Communication Review Group data extraction template. Any discrepancies in judgement were resolved by discussion and consensus, or with a third review author. Because the studies diGered widely with respect to interventions, measures of diet adherence, dietary advice, nature of the chronic diseases and duration of interventions and follow-up, we conducted a qualitative analysis. We classified included studies according to the function of the intervention and present results in a narrative table using vote counting for each category of intervention.
Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults (Review) Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
1
mailto:sophie.desroches@fsaa.ulaval.ca
https://doi.org/10.1002%2F14651858.CD008722.pub2
Cochrane Library
Trusted evidence. Informed decisions. Better health.
Cochrane Database of Systematic Reviews
Main results
We included 38 studies involving 9445 participants. Among studies that measured diet adherence outcomes between an intervention group and a control/usual care group, 32 out of 123 diet adherence outcomes favoured the intervention group, 4 favoured the control group whereas 62 had no significant diGerence between groups (assessment was impossible for 25 diet adherence outcomes since data and/or statistical analyses needed for comparison between groups were not provided). Interventions shown to improve at least one diet adherence outcome are: telephone follow-up, video, contract, feedback, nutritional tools and more complex interventions including multiple interventions. However, these interventions also shown no diGerence in some diet adherence outcomes compared to a control/ usual care group making inconclusive results about the most eGective intervention to enhance dietary advice. The majority of studies reporting a diet adherence outcome favouring the intervention group compared to the control/usual care group in the short-term also reported no significant eGect at later time points. Studies investigating interventions such as a group session, individual session, reminders, restriction and behaviour change techniques reported no diet adherence outcome showing a statistically significant diGerence favouring the intervention group. Finally, studies were generally of short duration and low quality, and adherence measures varied widely.
Authors’ conclusions
There is a need for further, long-term, good-quality studies using more standardized and validated measures of adherence to identify the interventions that should be used in practice to enhance adherence to dietary advice in the context of a variety of chronic diseases.
P L A I N L A N G U A G E S U M M A R Y
Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults
Chronic diseases are the leading cause of mortality worldwide. Although the adoption of a healthy diet is recognized as an important component for their prevention and management, many individuals at risk of or having chronic diseases do not adhere to recommended dietary advice. The methods used to facilitate changes in dietary habits through dietary advice (defined in this review as ‘interventions’) could improve adherence of clients to dietary advice. Therefore, we reviewed trials of interventions aiming to enhance adherence to dietary advice for preventing and managing chronic diseases in adults.
We identified 38 studies involving 9445 participants examining several types of interventions for enhancing…
