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Development of a Tool to Stage Households' Readiness to Change Dietary Behaviours in Kerala, India
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics. Sree Chitra Tirunal Inst Med Sci & Technol, Achutha Menon Ctr Hlth Sci Studies, Thiruvananthapuram 695011, Kerala, India.;Karolinska Inst, Dept Publ Hlth Sci Global Hlth, Tomtebodavagen 18A, S-17177 Stockholm, Sweden..
Sree Chitra Tirunal Inst Med Sci & Technol, Achutha Menon Ctr Hlth Sci Studies, Thiruvananthapuram 695011, Kerala, India..
Sree Chitra Tirunal Inst Med Sci & Technol, Achutha Menon Ctr Hlth Sci Studies, Thiruvananthapuram 695011, Kerala, India..
Sree Chitra Tirunal Inst Med Sci & Technol, Achutha Menon Ctr Hlth Sci Studies, Thiruvananthapuram 695011, Kerala, India..
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2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 11, article id e0165599Article in journal (Refereed) Published
Abstract [en]

Dietary interventions and existing health behaviour theories are centred on individuals; therefore, none of the available tools are applicable to households for changing dietary behaviour. The objective of this pilot study was to develop a practical tool that could be administered by community volunteers to stage households in rural Kerala based on readiness to change dietary behaviour. Such a staging tool, comprising a questionnaire and its algorithm, focusing five dietary components (fruits, vegetables, salt, sugar and oil) and households (rather than individuals), was finalised through three consecutive pilot validation sessions, conducted over a four-month period. Each revised version was tested with a total of 80 households (n = 30, 35 and 15 respectively in the three sessions). The tool and its comparator, Motivational Interviewing (MI), assessed the stage-of-change for a household pertaining to their: 1) fruit and vegetable consumption behaviour; 2) salt, sugar and oil consumption behaviour; 3) overall readiness to change. The level of agreement between the two was tested using Kappa statistics to assess concurrent validity. A value of 0.7 or above was considered as good agreement. The final version was found to have good face and content validity, and also a high level of agreement with MI (87%; weighted kappa statistic: 0.85). Internal consistency testing was performed using Cronbach's Alpha, with a value between 0.80 and 0.90 considered to be good. The instrument had good correlation between the items in each section (Cronbach's Alpha: 0.84 (fruit and vegetables), 0.85 (salt, sugar and oil) and 0.83 (Overall)). Pre-contemplation was the most difficult stage to identify; for which efficacy and perceived cooperation at the household level were important. To the best of our knowledge, this is the first staging tool for households. This tool represents a new concept in community-based dietary interventions. The tool can be easily administered by lay community workers and can therefore be used in large population-based studies. A more robust validation process with a larger sample is needed before it can be widely used.

Place, publisher, year, edition, pages
2016. Vol. 11, no 11, article id e0165599
National Category
Nutrition and Dietetics Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Nutrition
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URN: urn:nbn:se:uu:diva-311190DOI: 10.1371/journal.pone.0165599ISI: 000388350300010PubMedID: 27861500OAI: oai:DiVA.org:uu-311190DiVA, id: diva2:1059225
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BID study
Available from: 2016-12-22 Created: 2016-12-22 Last updated: 2017-11-29Bibliographically approved

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