Comparison of barriers and facilitators of MIND diet uptake among adults from Northern Ireland and Italy

Abstract

Background The aim of the study was to identify and compare components of the COM-B (capability, opportunity, motivation and behaviour) model, that influences behaviour to modify dietary patterns in 40–55-year olds living in Northern Ireland (NI) and Italy, in order to reduce the risk of cognitive decline in later life. Methods This was a qualitative study examining factors influencing Mediterranean-DASH (Dietary Approaches to Stop Hypertension) Intervention for Neurodegenerative Delay (MIND) diet behaviour. This study further elaborated the COM-B components into the 14 domains of the Theoretical Domains Framework to further understand behaviour. Twenty-five Northern Irish and Italian participants were recruited onto the study, to take part in either a focus group or an interview. Participants were both male and female aged between 40 and 55 years. Results Thematic analysis revealed that the main barriers to the uptake of the MIND diet were; time, work environment (opportunity), taste preference and convenience (motivation). Culture (motivation), seasonal foods and lack of family support (opportunity) to be a barrier to the Italian sample only. The main facilitators reported were; improved health, memory, planning and organisation (motivation) and access to good quality food (opportunity). Cooking skills, knowledge (capability) and heathy work lunch (opportunity) reported as a facilitator to the Italian sample only. Conclusions Cross-cultural differences in relation to psychosocial barriers and facilitators were found in both samples. More barriers than facilitators towards uptake of the MIND diet were found. There is a need for interventions that increase capability, opportunity, and motivation to aid behaviour change. The findings from this study will be used to design a behaviour change intervention using the subsequent steps from the Behaviour Change Wheel.

Gait and/or balance disturbances associated with Alzheimer's dementia among older adults with amnestic mild cognitive impairment: A longitudinal observational study

“…In addition, although improving gait and/or balance disturbances may not directly result in better cognitive health, options to mitigate these disturbances, such as healthy nutrition and physical activity, are clinical recommendations that can be provided. Education on various cooking techniques and recipes and modes of physical activity may help overcome barriers to these healthy behaviours (e.g., lack of knowledge on how to meet taste preferences or become physically active) (Chong et al, 2020; Timlin et al, 2021). Synchronous group videoconferencing educational sessions can be considered because these improve accessibility, provide supervision/feedback, and allow interactions with peer participants (Ahn et al, 2022; Ptomey et al, 2020).…”

A peer support dietary change intervention for encouraging adoption and maintenance of the Mediterranean diet in a non-Mediterranean population (TEAM-MED): lessons learned and suggested improvements

“…The peer supporters also recognised their own increased difficulties with small groups, negative impacts on their enthusiasm as a result of low attendance and the negative impacts of a lack of social activities within the sessions. The impacts of both positive and negative social support at the personal level are often recognised within dietary interventions (24)(25)(26)(27) , but comments related to sharing and swapping demonstrate an additional value to the peer support group, and a different type of 'communal support' that may be gained based on shared experiences, vicarious learning, commonality and a shared identity, with resultant increases in selfefficacy, confidence and coping (31)(32)(33)(34)(35)(36)(37)45,46) . This communal support is also notably different from that that may be gained from health professionals, where the provision of accurate, credible information and good role modelling is anticipated (20,45,46) .…”

“…Important barriers, as reported in Australian ( 26 ) , UK ( 20 , 22 , 23 , 25 ) and US ( 21 ) populations, are knowledge of the required foods ( 20 – 23 , 26 ) ; access to and affordability of these foods ( 22 , 23 , 25 , 26 ) ; the acceptability of these foods and the acceptability of a diet with only minimal consumption of certain other foods, such as red meat ( 20 – 22 , 25 , 26 ) ; the time and skills required for food shopping, preparation and organisation ( 21 – 23 , 25 , 26 ) ; and motivation to maintain the diet within a physical, social or cultural environment that may not provide good support ( 20 , 22 , 23 , 25 , 26 ) . In the Northern Irish population specifically, we ( 24 ) and others ( 27 ) found similar concerns based on the acceptability, including the healthiness, of certain foods, the cost and availability of relevant foods, the knowledge, time or cooking skills that may be required, the suitability of the MD ( 24 ) or a MD-style intervention ( 27 ) for the Northern Irish climate, culture and dietary traditions and the challenge of changing established eating patterns ( 24 , 27 ) . In non-Mediterranean populations, olive oil and legume consumption is often low, and meat consumption is often higher than recommended for the MD ( 18 , 19 , 28 ) .…”

“…However, the transferability and acceptance of MD to populations outside of the Mediterranean region may remain a challenge (2,6,7,11,18,19) . Several studies point to numerous barriers to adopting and adhering to the MD in these populations (20)(21)(22)(23)(24)(25)(26)(27) . Important barriers, as reported in Australian (26) , UK (20,22,23,25) and US (21) populations, are knowledge of the required foods (20)(21)(22)(23)26) ; access to and affordability of these foods (22,23,25,26) ; the acceptability of these foods and the acceptability of a diet with only minimal consumption of certain other foods, such as red meat (20)(21)(22)25,26) ; the time and skills required for food shopping, preparation and organisation (21)(22)(23)25,26) ; and motivation to maintain the diet within a physical, social or cultural environment that may not provide good support (20,22,23,25,26) .…”

Identifying Targets for Interventions to Increase Uptake and Use of Hearing Protection in Noisy Recreational Settings

“…Other potential avenues for change may have presented themselves through the low scoring recorded for physical and social opportunities. In order to address these gaps, further explorative research is required, potentially achieved through qualitative fact-finding informed by the COM-B model itself, similar to that seen within the fields of dietary patterns [23,24] and cancer research [25]. Such research could bolster the current evidence base for future interventions.…”