Volume 11, Issue 3 (2023)
Health Educ Health Promot 2023, 11(3): 485-492 |
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Ghanbari M, Rajati F, Salehi L. Fiber Consumption in Constipated Older Adults; a Theory-Based Interventional Study. Health Educ Health Promot 2023; 11 (3) :485-492
URL: http://hehp.modares.ac.ir/article-5-57834-en.html
URL: http://hehp.modares.ac.ir/article-5-57834-en.html
1- Department of Health Education and Health Promotion, School of Health, Alborz University of Medical Sciences, Karaj, Iran
2- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
3- Research Center for Health, Safety and Environment, Health Education and Promotion, Alborz University of Medical Sciences, Karaj, Iran
2- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
3- Research Center for Health, Safety and Environment, Health Education and Promotion, Alborz University of Medical Sciences, Karaj, Iran
Abstract: (411 Views)
Aims: This study aimed to assess the effectiveness of an intervention on fiber consumption, self-efficacy, perceived benefit, and barriers among the elderly using the Trans-theoretical Model (TTM).
Materials & Methods: This quasi-experimental study was developed among constipated elderly people aged ≥60 in Karaj, Iran, between 2019 and 2021. Constipated participants were randomly assigned to the intervention (n=66) or the control (n=64) groups. Before and after four educational sessions, demographic information, participants’ stages of change for diet, self-efficacy, decisional balance, and daily amount of fiber consumption were evaluated. An analysis was performed to assess any differences in the stages of change (posttest vs. baseline).
Findings: The perceived barriers and self-efficacy were statistically significant after intervention (p<0.001) in the intervention group compared to the control group (p>0.001). In both groups, perceived benefits changed statistically significantly (p<0.001). Pearson correlation also showed a significant correlation between stages of change and benefits, barriers, self-efficacy, and fiber consumption. The analysis of variance adjusting for covariates also indicated significant differences between intervention and control groups.
Conclusion: The TTM is a useful model that can be applied to dietary behavior change, specifically fruit and vegetable consumption among elderly populations.
Materials & Methods: This quasi-experimental study was developed among constipated elderly people aged ≥60 in Karaj, Iran, between 2019 and 2021. Constipated participants were randomly assigned to the intervention (n=66) or the control (n=64) groups. Before and after four educational sessions, demographic information, participants’ stages of change for diet, self-efficacy, decisional balance, and daily amount of fiber consumption were evaluated. An analysis was performed to assess any differences in the stages of change (posttest vs. baseline).
Findings: The perceived barriers and self-efficacy were statistically significant after intervention (p<0.001) in the intervention group compared to the control group (p>0.001). In both groups, perceived benefits changed statistically significantly (p<0.001). Pearson correlation also showed a significant correlation between stages of change and benefits, barriers, self-efficacy, and fiber consumption. The analysis of variance adjusting for covariates also indicated significant differences between intervention and control groups.
Conclusion: The TTM is a useful model that can be applied to dietary behavior change, specifically fruit and vegetable consumption among elderly populations.
Keywords: Aged [MeSH], Constipation [MeSH], Dietary Fiber [MeSH], Health Education [MeSH], Transtheoretical Model [MeSH]
Article Type: Original Research |
Subject:
Health Education and Health Behavior
Received: 2023/06/5 | Accepted: 2023/07/8 | Published: 2023/08/28
Received: 2023/06/5 | Accepted: 2023/07/8 | Published: 2023/08/28
References
1. Guiné R, Martinho C, Barroca MJ, Viseu C. Knowledge and attitudes regarding dietaryfibres: A consumer survey in portuguese population. J Basic Appl Res Int. 2014;1:1-12. [Link]
2. Kim Y, Je Y. Dietary fiber intake and total mortality: A meta-analysis of prospective cohort studies. Am J Epidemiol. 2014;180(6):565-73. [Link] [DOI:10.1093/aje/kwu174]
3. Miller KB. Review of whole grain and dietary fiber recommendations and intake levels in different countries. Nutr Rev. 2020;78(Suppl 1):29-36. [Link] [DOI:10.1093/nutrit/nuz052]
4. Stephen AM, Champ MMJ, Cloran SJ, Fleith M, van Lieshout L, Mejborn H, et al. Dietary fibre in Europe: Current state of knowledge on definitions, sources, recommendations, intakes and relationships to health. Nutr Res Rev. 2017;30(2):149-90. [Link] [DOI:10.1017/S095442241700004X]
5. Donini LM, Savina C, Cannella C. Nutrition in the elderly: role of fiber. Arch Gerontol Geriatr. 2009;49:61-9. [Link] [DOI:10.1016/j.archger.2009.09.013]
6. Anderson JW, Baird P, Davis RH, Ferreri S, Knudtson M, Koraym A, et al. Health benefits of dietary fiber. Nutr Rev. 2009;67(4):188-205. [Link] [DOI:10.1111/j.1753-4887.2009.00189.x]
7. Salehi L, Eftekhar H, Mohammad K, Tavafian SS, Jazayery A, Montazeri A. Consumption of fruit and vegetables among elderly people: A cross sectional study from Iran. Nutr J. 2010;9:2. [Link] [DOI:10.1186/1475-2891-9-2]
8. Fathi E. The phenomenon of population aging in Iran. Iran J Off Statistics Stud. 2020;30(2):387-413. [Persian] [Link]
9. Macêdo MIP, Albuquerque M de FM, Tahan S, Morais MB de. Is there any association between overweight, physical activity, fat and fiber intake with functional constipation in adolescents?. Scand J Gastroenterol. 2020;55(4):414-20. [Link] [DOI:10.1080/00365521.2020.1749878]
10. Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: Systematic review and meta-analysis. Am J Gastroenterol. 2011;106(9):1582-91. [Link] [DOI:10.1038/ajg.2011.164]
11. Yang J, Wang HP, Zhou L, Xu CF. Effect of dietary fiber on constipation: A meta analysis. World J Gastroenterol. 2012;18(48):7378-83. [Link] [DOI:10.3748/wjg.v18.i48.7378]
12. Liu LWC. Chronic constipation: current treatment options. Can J Gastroenterol. 2011;25(Suppl B):22B-8. [Link] [DOI:10.1155/2011/930108]
13. Nour-Eldein H, Salama HM, Abdulmajeed AA, Heissam KS. The effect of lifestyle modification on the severity of constipation and quality of life of elders in nursing homes at Ismailia city, Egypt. J Family Community Med. 2014;21(2):100. [Link] [DOI:10.4103/2230-8229.134766]
14. Woodward S. Assessment and management of constipation in older people: Sue Woodward examines the causes and symptoms of this disorder and the role nurses can play in promoting healthy bowel habits. Nurs Older People. 2012;24(5):21-6. [Link] [DOI:10.7748/nop2012.06.24.5.21.c9115]
15. Davis R, Campbell R, Hildon Z, Hobbs L, Michie S. Theories of behavior and behavior change across the social and behavioral sciences: A scoping review. Health Psychol Rev. 2015;9(3):323-44. [Link] [DOI:10.1080/17437199.2014.941722]
16. Soltani R, Torabi A, Hasanzadeh A, Sharifirad G. Factors behind fruit and vegetable consumption among the elderly with functional constipation: A study based on the health belief model. Modern Care J. 2017;14(1):e63387. [Persian] [Link] [DOI:10.5812/modernc.63387]
17. Horwath CC, Schembre SM, Motl RW, Dishman RK, Nigg CR. Does the transtheoretical model of behavior change provide a useful basis for interventions to promote fruit and vegetable consumption?. Am J Health Promot. 2013;27(6):351-7. [Link] [DOI:10.4278/ajhp.110516-QUAN-201]
18. Menezes MC de, Mendonça R de D, Ferreira NL, Guimarães LMF, Lopes ACS. Promoting fruit and vegetable consumption: Methodological protocol of a randomized controlled community trial. Contemporary Clin Trial Communications. 2018;10:131-6. [Link] [DOI:10.1016/j.conctc.2018.04.003]
19. Vilamala-Orra M, Vaqué-Crusellas C, Foguet-Boreu Q, Guimerà Gallent M, del Río Sáez R. Applying the stages of change model in a nutrition education programme for the promotion of fruit and vegetable consumption among people with severe mental disorders (Dietment). Nutrients. 2021;13(6):2105. [Link] [DOI:10.3390/nu13062105]
20. Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38-48. [Link] [DOI:10.4278/0890-1171-12.1.38]
21. Yusufov M, Paiva AL, Redding CA, Lipschitz JM, Gokbayrak NS, Greene G, et al. Fat reduction efforts: A 24-month longitudinal comparison of a large sample of maintainers, relapsers, and non-changers. Health Promot Pract. 2016;17(1):116-26. [Link] [DOI:10.1177/1524839915606423]
22. Cook AS, O'Leary F, Allman-Farinelli M. The relationship between process use and stage of change for sugary drinks. J Hum Nutr Diet. 2018;31(5):697-703. [Link] [DOI:10.1111/jhn.12548]
23. de Freitas PP, de Menezes MC, Dos Santos LC, Pimenta AM, Ferreira AVM, Lopes ACS. The transtheoretical model is an effective weight management intervention: a randomized controlled trial. BMC Public Health. 2020;20(1):1-12. [Link] [DOI:10.1186/s12889-020-08796-1]
24. Sutton K, Logue E, Jarjoura D, Baughman K, Smucker W, Capers C. Assessing dietary and exercise stage of change to optimize weight loss interventions. Obes Res. 2003;11(5):641-52. [Link] [DOI:10.1038/oby.2003.92]
25. Nakabayashi J, Melo GR, Toral N. Transtheoretical model-based nutritional interventions in adolescents: A systematic review. BMC Public Health. 2020;20(1):1-14. [Link] [DOI:10.1186/s12889-020-09643-z]
26. Keshteli AH, Esmaillzadeh A, Rajaie S, Askari G, Feinle-Bisset C, Adibi P. A dish-based semi-quantitative food frequency questionnaire for assessment of dietary intakes in epidemiologic studies in Iran: Design and development. Int J Prev Med. 2014;5(1):29. [Link]
27. Keshani P, Tavousi M, Montazeri A, Farvid MS. Perceived benefits and barriers of increased dietary fiber consumption: Validation of a decisional balance scale. J Nutr Sci Diet. 2016;2(1):15-23. [Link]
28. Diclemente CC. A premature obituary for the transtheoretical model: A response to West (2005). Addiction. 2005;100(8):1046-8. [Link] [DOI:10.1111/j.1360-0443.2005.01138.x]
29. de Vet E, de Nooijer J, de Vries NK, Brug J. Stages of change in fruit intake: A longitudinal examination of stability, stage transitions and transition profiles. Psychol Health. 2005;20(4):415-28. [Link] [DOI:10.1080/14768320500051425]
30. Johnson DB, Beaudoin S, Smith LT, Beresford SAA, LoGerfo JP. Increasing fruit and vegetable intake in homebound elders: The Seattle senior farmers' market nutrition pilot program. Prev Chronic Dis. 2004;1(1):A03. [Link]
31. Brewer D, Dickens E, Humphrey A, Stephenson T. Increased fruit and vegetable intake among older adults participating in Kentucky's congregate meal site program. Educ Gerontol. 2016;42(11):771-84. [Link] [DOI:10.1080/03601277.2016.1231511]
32. Steptoe A. Behavioural counselling to increase consumption of fruit and vegetables in low income adults: Randomised trial. BMJ. 2003;326(7394):855. [Link] [DOI:10.1136/bmj.326.7394.855]
33. de Vet E, de Nooijer J, de Vries NK, Brug J. Testing the transtheoretical model for fruit intake: comparing web-based tailored stage-matched and stage-mismatched feedback. Health Educ Res. 2007;23(2):218-27. [Link] [DOI:10.1093/her/cym019]
34. Carvalho de Menezes M. Interventions directed at eating habits and physical activity using the Transtheoretical Model: A systematic review. Nutr Hosp. 2016;33(5):586. [Link] [DOI:10.20960/nh.586]
35. Lattimer JM, Haub MD. Effects of dietary fiber and its components on metabolic health. Nutrients. 2010;2(12):1266-89. [Link] [DOI:10.3390/nu2121266]
36. Zavarmoghadam M, Farmanbar R. The application of transtheoretical model to identify metabolic control and fruit and vegetable consumption in patients with type 2 diabetes. Caspian J Health Res. 2018;3(1):10-4. [Persian] [Link] [DOI:10.29252/cjhr.3.1.10]
37. Mastellos N, Gunn LH, Felix LM, Car J, Majeed A. Transtheoretical model stages of change for dietary and physical exercise modification in weight loss management for overweight and obese adults. Cochrane Database Syst Rev. 2014;2014(2):CD008066. [Link] [DOI:10.1002/14651858.CD008066.pub3]
38. Wolf RL, Lepore SJ, Vandergrift JL, Wetmore-Arkader L, McGinty E, Pietrzak G, et al. Knowledge, barriers, and stage of change as correlates of fruit and vegetable consumption among urban and mostly immigrant black men. J Am Diet Assoc. 2008;108(8):1315-22. [Link] [DOI:10.1016/j.jada.2008.05.011]
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