Most preventive interventions require that an individual carry out specific behavioral prescriptions including the adoption and maintenance of new behaviors and the decrease or elimination of other ones. With regard to diet behaviors, dietary changes are feasible but inconsistently maintained. Although a number of theories and models have been proposed to explain behavior change and adherence behavior, some of them overlap and most fail to be comprehensive enough to include many factor known to influence health behaviors. Each theory or model addresses only a specific and limited aspect of behavior change and adherence to such change. For example, the health belief model fails to explain risk behaviors which have habitual component (such as smoking), health behaviors an individual engages in for non-health reasons (i.e., dieting to appear more attractive), and environmental factors which prevent an individual to engage in a particular health behavior (ie, limited budget for health food choices). Another problem in understanding adherence is that much of the current research on adherence is only loosely tied to theories and models of adherence behavior, perhaps because of the overlap among them and the limited efforts to integrate the various theories and models into a cohesive and heuristic framework. The objectives of this proposed study are: 1) to conduct formative research in order to construct a broad conceptual framework to explain dietary adherence; 2) in utilizing the constructed framework, to conduct a prospective study to investigate factors which are related to adherence to DM by WHI participants; and 3) to develop and pilot-test an adherence assessment and intervention algorithm to be sued by WHI nutritionists with women presenting with adherence problems. Ad additional objective of this proposal is to provide the applicant with opportunities to enhance her research skills, training and development as outlined in this five-year proposal. The proposed award period will provide the applicant with mentored research experience and expertise in areas of specific interest to her -- namely, adherence, nutrition interventions, and women's health.
|Kearney, Margaret H; Rosal, Milagros C; Ockene, Judith K et al. (2002) Influences on older women's adherence to a low-fat diet in the Women's Health Initiative. Psychosom Med 64:450-7|