Implementing Nutrition Intervention: Nutrition Education and Nutrition Counseling


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Box 5.1 (cont.) Theory-Based Approaches and Models for Designing or Implementing an Intervention10,11


Social learning theory


Emphasizes the importance of observing


and modeling behaviors, attitudes, and emo- tional reactions of others. Determinants of behavior


include goals, outcome expec-


tations, and self-efficacy. Reinforcements increase or decrease the likelihood that the behavior will be repeated.


Transtheoretical model (stages of change)


Describes behavior change not as a discrete event but as something that occurs in five stages over time:


1. Precontemplation: no recognition of need for change; no intention to take action within the next 6 months. Suggested inter- ventions: personalize risk factors; discuss health concern and its implications.


2. Contemplation: recognition of need to change; intention to take action within the next 6 months. Suggested interventions: provide basic information; help the client to see that the pros of change outweigh the cons.


3. Preparation: intends to take action in the next 30 days and has taken some behav- ioral steps in that direction. Suggested interventions: set date to start; teach spe- cific “how-to” skills.


4. Action: has made changes in target behav- ior for less than 6 months. Suggested interventions: implement counseling strat- egies; continue to reinforce and support decision to change; discuss the differences between lapse vs relapse.


5. Maintenance: has changed target behav- ior for more than 6 months. Suggested interventions: provide support; encourage behavior maintenance strategies; continue relapse prevention counseling.


a PA = physical activity


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