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The conceptual framework for a combined food literacy and physical activity intervention to optimize metabolic health among women of reproductive age in urban Uganda

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Abstract
Background: Metabolic health of urban Ugandans, mostly women, has increasingly become sub-optimal. As women are strategic for family behavioral change and do not meet WHO recommendations regarding dietary and physical activity (PA), there is an urgent need for science-based interventions to tackle unhealthy dietary and PA behaviors. Objective: To develop a food literacy and PA promotion intervention to optimise metabolic health among women of reproductive age in urban Uganda. Methodology: Steps 1- 6 of the Intervention Mapping protocol were used to design the intervention. Results: Notable determinants from Step 1 were health/beauty paradox, nonfactual nutrition information, socio-cultural misconceptions around moderate PA, fruits, and vegetables. Others included gaps in food/PA knowledge, skills, and self-efficacy. We hypothesised that changing the overall existing behaviours in one intervention may meet strong resistance. Thus, we decided to go for gradual stepwise changes. Hence in step 2, three behavioural intervention objectives were formulated; (1) women evaluate the accuracy of nutrition and PA information., (2) engage in moderate intensity PA for at least 150 min a week, and (3) consume at least one portion of vegetables and one portion of fruit every day. Based on the food literacy model, intervention objectives were formulated into performance objectives and matrices of change objectives. In step 3 a combination of eleven behavioural change techniques were selected and translated into practical strategies to effect changes in determinants. In step 4, intervention components and materials were developed. The intervention consists of five interactive group sessions, 150 min each. Infographics on benefits/recommendations, vegetable recipes, and practical tips to eat more fruits, vegetables, and to engage more in PA are included. Personalised goals and action plans tailored to personal metabolic health and lifestyle needs, and environmental opportunities form the basis of the intervention. A randomized controlled trial is being conducted to evaluate the intervention (https://clinicaltrials.gov/ct2/show/NCT04635332). Conclusions: The intervention is novel, based on a holistic food literacy model. The intervention is built on determinants specific to urban Uganda, evidence based behavioural change theoretical models and techniques, detailing the hypothesised behavioural change mechanism. If effective, an evidence-based intervention will become available for reference in urban Uganda.
Keywords
GESTATIONAL WEIGHT-GAIN, CHRONIC DISEASES, SEVERELY OBESE, BEHAVIOR, METAANALYSIS, DIET, Food literacy, Physical activity, Metabolic health, Women of, reproductive age, Intervention mapping protocol

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MLA
Yiga, Peter, et al. “The Conceptual Framework for a Combined Food Literacy and Physical Activity Intervention to Optimize Metabolic Health among Women of Reproductive Age in Urban Uganda.” BMC PUBLIC HEALTH, vol. 22, no. 1, 2022, doi:10.1186/s12889-022-12740-w.
APA
Yiga, P., Van Lippevelde, W., Seghers, J., Ogwok, P., Tafiire, H., Muluuta, S. N., & Matthys, C. (2022). The conceptual framework for a combined food literacy and physical activity intervention to optimize metabolic health among women of reproductive age in urban Uganda. BMC PUBLIC HEALTH, 22(1). https://doi.org/10.1186/s12889-022-12740-w
Chicago author-date
Yiga, Peter, Wendy Van Lippevelde, Jan Seghers, Patrick Ogwok, Henry Tafiire, Susan Nakaayi Muluuta, and Christophe Matthys. 2022. “The Conceptual Framework for a Combined Food Literacy and Physical Activity Intervention to Optimize Metabolic Health among Women of Reproductive Age in Urban Uganda.” BMC PUBLIC HEALTH 22 (1). https://doi.org/10.1186/s12889-022-12740-w.
Chicago author-date (all authors)
Yiga, Peter, Wendy Van Lippevelde, Jan Seghers, Patrick Ogwok, Henry Tafiire, Susan Nakaayi Muluuta, and Christophe Matthys. 2022. “The Conceptual Framework for a Combined Food Literacy and Physical Activity Intervention to Optimize Metabolic Health among Women of Reproductive Age in Urban Uganda.” BMC PUBLIC HEALTH 22 (1). doi:10.1186/s12889-022-12740-w.
Vancouver
1.
Yiga P, Van Lippevelde W, Seghers J, Ogwok P, Tafiire H, Muluuta SN, et al. The conceptual framework for a combined food literacy and physical activity intervention to optimize metabolic health among women of reproductive age in urban Uganda. BMC PUBLIC HEALTH. 2022;22(1).
IEEE
[1]
P. Yiga et al., “The conceptual framework for a combined food literacy and physical activity intervention to optimize metabolic health among women of reproductive age in urban Uganda,” BMC PUBLIC HEALTH, vol. 22, no. 1, 2022.
@article{8745132,
  abstract     = {{Background: Metabolic health of urban Ugandans, mostly women, has increasingly become sub-optimal. As women are strategic for family behavioral change and do not meet WHO recommendations regarding dietary and physical activity (PA), there is an urgent need for science-based interventions to tackle unhealthy dietary and PA behaviors. Objective: To develop a food literacy and PA promotion intervention to optimise metabolic health among women of reproductive age in urban Uganda. Methodology: Steps 1- 6 of the Intervention Mapping protocol were used to design the intervention. Results: Notable determinants from Step 1 were health/beauty paradox, nonfactual nutrition information, socio-cultural misconceptions around moderate PA, fruits, and vegetables. Others included gaps in food/PA knowledge, skills, and self-efficacy. We hypothesised that changing the overall existing behaviours in one intervention may meet strong resistance. Thus, we decided to go for gradual stepwise changes. Hence in step 2, three behavioural intervention objectives were formulated; (1) women evaluate the accuracy of nutrition and PA information., (2) engage in moderate intensity PA for at least 150 min a week, and (3) consume at least one portion of vegetables and one portion of fruit every day. Based on the food literacy model, intervention objectives were formulated into performance objectives and matrices of change objectives. In step 3 a combination of eleven behavioural change techniques were selected and translated into practical strategies to effect changes in determinants. In step 4, intervention components and materials were developed. The intervention consists of five interactive group sessions, 150 min each. Infographics on benefits/recommendations, vegetable recipes, and practical tips to eat more fruits, vegetables, and to engage more in PA are included. Personalised goals and action plans tailored to personal metabolic health and lifestyle needs, and environmental opportunities form the basis of the intervention. A randomized controlled trial is being conducted to evaluate the intervention (https://clinicaltrials.gov/ct2/show/NCT04635332). Conclusions: The intervention is novel, based on a holistic food literacy model. The intervention is built on determinants specific to urban Uganda, evidence based behavioural change theoretical models and techniques, detailing the hypothesised behavioural change mechanism. If effective, an evidence-based intervention will become available for reference in urban Uganda.}},
  articleno    = {{351}},
  author       = {{Yiga, Peter and Van Lippevelde, Wendy and Seghers, Jan and Ogwok, Patrick and Tafiire, Henry and Muluuta, Susan Nakaayi and Matthys, Christophe}},
  issn         = {{1471-2458}},
  journal      = {{BMC PUBLIC HEALTH}},
  keywords     = {{GESTATIONAL WEIGHT-GAIN,CHRONIC DISEASES,SEVERELY OBESE,BEHAVIOR,METAANALYSIS,DIET,Food literacy,Physical activity,Metabolic health,Women of,reproductive age,Intervention mapping protocol}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{14}},
  title        = {{The conceptual framework for a combined food literacy and physical activity intervention to optimize metabolic health among women of reproductive age in urban Uganda}},
  url          = {{http://doi.org/10.1186/s12889-022-12740-w}},
  volume       = {{22}},
  year         = {{2022}},
}

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