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Effect of the web-based intervention MyPlan 1.0 on self-reported fruit and vegetable intake in adults who visit general practice : a quasi-experimental trial

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Abstract
BACKGROUND: Web-based interventions typically have small intervention effects on adults' health behavior because they primarily target processes leading to an intention to change leaving individuals in an intention-behavior gap, they often occur without contact with health care providers, and a limited amount of feedback is provided only at the beginning of these interventions, but not further on in the behavior change process. Therefore, we developed a Web-based intervention ("MyPlan 1.0") to promote healthy behavior in adults. The intervention was based on a self-regulation perspective that also targets postintentional processes and guides individuals during all phases of behavior change. OBJECTIVE: The study investigated the effectiveness of MyPlan1.0 on fruit and vegetable intake of Flemish adults visiting general practice (3 groups: control group, intervention group recruited by researchers, and intervention group recruited and guided by general practitioners [GPs]). Second, it examined whether there was a larger intervention effect for the intervention group guided by GPs compared to the intervention group recruited by researchers. METHODS: Adults (≥18 years) were recruited in 19 Flemish general practices. In each general practice, patients were systematically allocated by a researcher either for the intervention group (researchers' intervention group) or the waiting-list control group that received general advice. In a third group, the GP recruited adults for the intervention (GPs intervention group). The two intervention groups filled in evaluation questionnaires and received MyPlan 1.0 for a behavior of choice (fruit, vegetable, or physical activity). The waiting-list control group filled in the evaluation questionnaires and received only general information. Self-reported fruit and vegetable intake were assessed at baseline (T0), 1 week (T1), and 1 month (T2) postbaseline. Three-level (general practice, adults, time) linear regression models were conducted in MLwiN. RESULTS: A total of 426 adults initially agreed to participate (control group: n=149; GPs' intervention group: n=41; researchers' intervention group: n=236). A high attrition rate was observed in both intervention groups (71.8%, 199/277) and in the control group (59.1%, 88/149). In comparison to no change in the control group, both the GPs' intervention group (fruit: χ(2)1=10.9, P=.004; vegetable: χ(2)1=5.3, P=.02) and the researchers' intervention group (fruit: χ(2)1=18.0, P=.001; vegetable: χ(2)1=12.8, P<.001) increased their intake of fruit and vegetables. CONCLUSIONS: A greater increase in fruit and vegetable intake was found when the Web-based intervention MyPlan 1.0 was used compared to usual care of health promotion in general practice (ie, flyers with general information). However, further investigation on which (or combinations of which) behavior change techniques are effective, how to increase response rates, and the influence of delivery mode in routine practice is required.
Keywords
primary prevention, health promotion, Web-based intervention, eHealth, dietary interventions, fruit and vegetable intake, general practice, self-regulation, PHYSICAL-ACTIVITY INTERVENTION, RANDOMIZED CONTROLLED-TRIALS, 12-MONTH FOLLOW-UP, LIFE-STYLE, PRIMARY-CARE, SMOKING-CESSATION, HEALTH-PROMOTION, BEHAVIOR-CHANGE, DIETARY, PRACTITIONERS

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Chicago
Plaete, Jolien, Geert Crombez, Celien Van der Mispel, Maïté Verloigne, Vicky Van Stappen, and Ilse De Bourdeaudhuij. 2016. “Effect of the Web-based Intervention MyPlan 1.0 on Self-reported Fruit and Vegetable Intake in Adults Who Visit General Practice : a Quasi-experimental Trial.” Journal of Medical Internet Research 18 (2).
APA
Plaete, J., Crombez, G., Van der Mispel, C., Verloigne, M., Van Stappen, V., & De Bourdeaudhuij, I. (2016). Effect of the web-based intervention MyPlan 1.0 on self-reported fruit and vegetable intake in adults who visit general practice : a quasi-experimental trial. JOURNAL OF MEDICAL INTERNET RESEARCH, 18(2).
Vancouver
1.
Plaete J, Crombez G, Van der Mispel C, Verloigne M, Van Stappen V, De Bourdeaudhuij I. Effect of the web-based intervention MyPlan 1.0 on self-reported fruit and vegetable intake in adults who visit general practice : a quasi-experimental trial. JOURNAL OF MEDICAL INTERNET RESEARCH. 2016;18(2).
MLA
Plaete, Jolien, Geert Crombez, Celien Van der Mispel, et al. “Effect of the Web-based Intervention MyPlan 1.0 on Self-reported Fruit and Vegetable Intake in Adults Who Visit General Practice : a Quasi-experimental Trial.” JOURNAL OF MEDICAL INTERNET RESEARCH 18.2 (2016): n. pag. Print.
@article{7056999,
  abstract     = {BACKGROUND: Web-based interventions typically have small intervention effects on adults' health behavior because they primarily target processes leading to an intention to change leaving individuals in an intention-behavior gap, they often occur without contact with health care providers, and a limited amount of feedback is provided only at the beginning of these interventions, but not further on in the behavior change process. Therefore, we developed a Web-based intervention ({\textacutedbl}MyPlan 1.0{\textacutedbl}) to promote healthy behavior in adults. The intervention was based on a self-regulation perspective that also targets postintentional processes and guides individuals during all phases of behavior change.
OBJECTIVE: The study investigated the effectiveness of MyPlan1.0 on fruit and vegetable intake of Flemish adults visiting general practice (3 groups: control group, intervention group recruited by researchers, and intervention group recruited and guided by general practitioners [GPs]). Second, it examined whether there was a larger intervention effect for the intervention group guided by GPs compared to the intervention group recruited by researchers.
METHODS: Adults (\ensuremath{\geq}18 years) were recruited in 19 Flemish general practices. In each general practice, patients were systematically allocated by a researcher either for the intervention group (researchers' intervention group) or the waiting-list control group that received general advice. In a third group, the GP recruited adults for the intervention (GPs intervention group). The two intervention groups filled in evaluation questionnaires and received MyPlan 1.0 for a behavior of choice (fruit, vegetable, or physical activity). The waiting-list control group filled in the evaluation questionnaires and received only general information. Self-reported fruit and vegetable intake were assessed at baseline (T0), 1 week (T1), and 1 month (T2) postbaseline. Three-level (general practice, adults, time) linear regression models were conducted in MLwiN.
RESULTS: A total of 426 adults initially agreed to participate (control group: n=149; GPs' intervention group: n=41; researchers' intervention group: n=236). A high attrition rate was observed in both intervention groups (71.8\%, 199/277) and in the control group (59.1\%, 88/149). In comparison to no change in the control group, both the GPs' intervention group (fruit: \ensuremath{\chi}(2)1=10.9, P=.004; vegetable: \ensuremath{\chi}(2)1=5.3, P=.02) and the researchers' intervention group (fruit: \ensuremath{\chi}(2)1=18.0, P=.001; vegetable: \ensuremath{\chi}(2)1=12.8, P{\textlangle}.001) increased their intake of fruit and vegetables.
CONCLUSIONS: A greater increase in fruit and vegetable intake was found when the Web-based intervention MyPlan 1.0 was used compared to usual care of health promotion in general practice (ie, flyers with general information). However, further investigation on which (or combinations of which) behavior change techniques are effective, how to increase response rates, and the influence of delivery mode in routine practice is required.},
  articleno    = {e47},
  author       = {Plaete, Jolien and Crombez, Geert and Van der Mispel, Celien and Verloigne, Ma{\"i}t{\'e} and Van Stappen, Vicky and De Bourdeaudhuij, Ilse},
  issn         = {1438-8871},
  journal      = {JOURNAL OF MEDICAL INTERNET RESEARCH},
  keyword      = {primary prevention,health promotion,Web-based intervention,eHealth,dietary interventions,fruit and vegetable intake,general practice,self-regulation,PHYSICAL-ACTIVITY INTERVENTION,RANDOMIZED CONTROLLED-TRIALS,12-MONTH FOLLOW-UP,LIFE-STYLE,PRIMARY-CARE,SMOKING-CESSATION,HEALTH-PROMOTION,BEHAVIOR-CHANGE,DIETARY,PRACTITIONERS},
  language     = {eng},
  number       = {2},
  pages        = {14},
  title        = {Effect of the web-based intervention MyPlan 1.0 on self-reported fruit and vegetable intake in adults who visit general practice : a quasi-experimental trial},
  url          = {http://dx.doi.org/10.2196/jmir.5252},
  volume       = {18},
  year         = {2016},
}

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