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A Tailored Behavioral Intervention to Promote Adherence to the DASH Diet

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Objectives: In this study, we evaluated the effects of a Transtheoretical model (TTM)-based tailored behavioral intervention (TBI), a non-tailored intervention (NTI) or usual care (UC) on: (1) the Dietary Approaches to Stop Hypertension (DASH) dietary pattern in 533 individuals with uncontrolled hypertension; and (2) the change from baseline to 6 months in proportion of participants in action or maintenance stages of change (SOC). Methods: This was a randomized clinical trial. Diet was evaluated using the validated Harvard DASH score calculated from Willett Food Frequency Questionnaires (range 8-40). The randomized groups were compared using the Wilcoxon rank-sum test, with adjustment for clustering by physician and baseline DASH scores. Results: At 6 months, compared to UC, TBI had a 1.28 point increase in DASH score (p ≤ .01) while NTI was not significant. At 6-month follow-up, TBI was more effective in advancing dietary SOC when compared to UC (56% vs 43%, p < .01) and NTI was not effective (46% vs 43%, p = .64). Conclusions: A phone-delivered tailored TTM-based intervention achieved greater improvement in DASH score and dietary SOC, suggesting that TTM-based tailored interventions can increase patients' dietary adherence.
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Keywords: ADHERENCE; DIETARY APPROACHES TO STOP HYPERTENSION (DASH) DIET; HYPERTENSION; TELEMEDICINE; TRANSTHEORETICAL MODEL OF BEHAVIOR CHANGE

Document Type: Research Article

Affiliations: 1: Health Science Specialist, VA New York Harbor Healthcare System, New York, NY 2: Women Veteran Program Manager, VA New York Harbor Healthcare System, New York, NY 3: Assistant Professor, NYU School of Medicine, New York, NY 4: Division Head, Division of Health Promotion and Nutrition Research, Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY 5: Staff Physician, VA New York Harbor Healthcare System, New York, NY;, Email: [email protected]

Publication date: July 1, 2019

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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