Development of an Evidence-Informed Blog to Promote Healthy Eating Among Mothers: Use of the Intervention Mapping Protocol

Abstract

BackgroundLow adherence to dietary guidelines and a concurrent rise of obesity-related chronic diseases emphasize the need for effective interventions to promote healthy eating. There is growing recognition that behavior change interventions should draw on theories of behavior change. Online interventions grounded in theory lead to increased effectiveness for health behavior change; however, few theory-driven social media-based health promotion interventions have been described in the literature.ObjectiveThe objective of this study was to describe the application of the Intervention Mapping (IM) protocol to develop an evidence-informed blog to promote healthy eating among French-Canadian mothers of preschool and school-aged children.MethodsThe following six steps of the IM protocol were performed. In Step 1, a preliminary needs assessment included a literature search on theoretical domains predicting Vegetables and Fruits intakes and Milk and Alternatives intakes in adults (ie, knowledge, beliefs about capabilities, beliefs about consequences, intention/goals) and a qualitative study including focus groups to identify female Internet users’ perceptions of their use of healthy eating blogs. In Step 2, two behavioral outcomes were selected (ie, increase daily intakes of Vegetables and Fruits and Milk and Alternatives of mothers to reach Canadian dietary recommendations) and subsequently divided into six performance objectives inspired by national and international dietary recommendations such as planning for healthy meals. A matrix of change objectives was then created by crossing performance objectives with theoretical domains predicting Vegetables and Fruits intakes and Milk and Alternatives intakes in adults. Step 3 consisted of selecting theory-based intervention methods (eg, modeling and goal setting) and translating them into practical applications for the context of a dietary intervention delivered through a blog. A 6-month intervention was developed in Step 4 in which we aimed to address one performance objective per month in weekly blog publications written by a registered dietitian. For Step 5, we sought to include engagement-promoting methods (eg, peer and counselor support) to promote mothers’ use of the blog and adherence to the intervention. Finally in Step 6, a randomized controlled trial has been launched to evaluate the effects of the blog on dietary behaviors of French-Canadian mothers.ResultsThe intervention study is expected to be completed in March 2018.ConclusionsAn intervention mapping protocol allowed for effective decision making in the development of a novel knowledge translation tool to increase adherence to dietary recommendations among mothers of preschool and school-aged children.

Users, Uses, and Effects of Social Media in Dietetic Practice: Scoping Review of the Quantitative and Qualitative Evidence

“…The majority of intervention studies targeted adult populations (26/34, 76%) [ 18 , 41 - 44 , 48 , 50 , 52 , 54 - 56 , 58 - 60 , 66 , 72 , 75 , 77 , 79 , 82 - 84 , 87 , 88 , 92 , 93 ]. Among them, specific populations of users were adult women [ 18 , 50 , 66 , 84 , 88 ], young adults aged 18-35 years [ 55 , 56 , 72 ], pregnant adult women [ 79 , 92 ], and collegiate athletes [ 58 ]. RDs were the main users of social media in 2 intervention studies [ 47 , 78 ].…”

“…Intervention studies covered a limited range of health conditions, with most users of social media being overweight and obese (15/34, 44%) [ 41 , 44 , 52 , 54 - 56 , 59 , 60 , 72 , 75 , 82 - 84 , 88 , 92 ] or obese (3/34, 9%) [ 63 , 87 , 93 ]. In total, 8 intervention studies targeted healthy users (8/34, 24%) [ 18 , 43 , 50 , 58 , 66 , 76 , 79 , 80 ]. Other health conditions included patients with type 1 diabetes [ 64 ] (1/34, 3%), patients with type 2 diabetes [ 77 ] (1/34, 3%), patients with polycystic ovary syndrome (1/34, 3%) [ 84 ], and patients with metabolic syndrome (1/34, 3%) [ 42 ].…”

“…We identified 7 single-component intervention studies. Those studies, evaluated the effects of a blog for healthy eating behavior change among adult women [ 18 , 50 ], a closed Facebook group for diabetes management among adolescents with type 1 diabetes [ 64 ], a discussion forum for the delivery of online journal clubs among RDs [ 78 ], the virtual world Second Life for weight management among overweight or obese adults [ 82 ] and as a training tool for RDs to perform the subjective global assessment [ 47 ], and a wiki to disseminate evidence-based practice guidelines for the nutritional management of patients with head and neck cancer [ 40 ].…”

Long‐term effects of a healthy eating blog in mothers and children

“…During a 6‐month intervention period conducted from January 2016 to September 2017, an RD blogger published one new blog post each week in which positive, nonrestrictive messages integrated theory‐based intervention methods (e.g., modelling, goal setting, and provision of feedback on performance) selected from evidence‐based taxonomies (Kok et al, ; S. Michie et al, ). Theory‐based intervention methods were selected on the basis of their effectiveness to promote changes in the theoretical constructs predicting the consumption of vegetables and fruit and milk and alternatives in adults (i.e., knowledge, beliefs about consequences [e.g., perceptions of advantages/disadvantages], beliefs about capabilities [e.g., perceptions of barriers/facilitators], and intention and goals; Brewer, Blake, Rankin, & Douglass, ; Guillaumie, Godin, & Vezina‐Im, ; Kim, Reicks, & Sjoberg, ; Park & Ureda, ; Wheeler & Chapman‐Novakofski, ) and in light of their feasibility of delivery using a blog, as described elsewhere (Dumas et al, ). Blog messages also aimed to promote healthy food changes in the home environment and encourage involvement of children in family meal planning and preparation, which, in turn, aimed to improve the quality of children's diet.…”

Career Crafting Training Intervention for Physicians: Protocol for a Randomized Controlled Trial

“…The intervention was developed in a systematic way, using elements of the intervention mapping (IM) protocol. IM is a widely accepted methodology for planning theory-based and evidence-based health promotion programs [ 34 ] and has been used in numerous studies, eg [ 35 ], [ 36 ]. IM consists of six steps: (1) needs assessment, (2) definition of program objectives, (3) methods and practical applications, (4) intervention program development and pilot test, (5) adoption and implementation, and (6) evaluation.…”