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Multiple behavior changes in diet and activity

Spring, B., Schneider, K., McFadden, G., Vaughn, J., Kozak, A.T., Smith, M., ... Lloyd-Jones, D.M. (2012). Multiple behavior changes in diet and activity. Archives of Internal Medicine 172

Background: Many patients exhibit multiple chronic disease risk behaviors. Research provides little information about advice that can maximize simultaneous health behavior changes.

Methods: To test which combination of diet and activity advice maximizes healthy change, we randomized 204 adults with elevated saturated fat and low fruit and vegetable intake, high sedentary leisure time, and low physical activity to 1 of 4 treatments: increase fruit/vegetable intake and physical activity, decrease fat and sedentary leisure, decrease fat and increase physical activity, and increase fruit/vegetable intake and decrease sedentary leisure. Treatments provided 3 weeks of remote coaching supported by mobile decision support technology and financial incentives. During treatment, incentives were contingent on using the mobile device to self-monitor and attain behavioral targets; during follow-up, incentives were contingent only on recording. The outcome was standardized, composite improvement on the 4 diet and activity behaviors at the end of treatment and at 5-month follow-up.

Conclusions: Remote coaching supported by mobile technology and financial incentives holds promise to improve diet and activity. Targeting fruits/vegetables and sedentary leisure together maximizes overall adoption and maintenance of multiple healthy behavior changes.

Uitgever(s): American Medical Association,


Multiple behavior changes in diet and activity

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Bonny Spring
Kristin Schneider
Gene McFadden
Jocelyn Vaughn
Andrea Kozak
Malaina Smith
Arlen Moller
Leonard Epstein
Andrew DeMott
Donald Hedeker
Juned Siddique
Donald Lloyd-Jones

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