Implementing a dietary intervention in primary care practice: a process evaluation.
OBJECTIVE
Physicians acknowledge the need to advise their patients about dietary habits, but they may not have the training or tools to do this efficiently. In the context of a randomized trial, we investigated the feasibility of enlisting physicians to implement a dietary intervention in the primary care setting.


METHODS
Physicians from 14 primary care practices were assigned via randomization to introduce a self-help booklet to promote dietary change at routine appointments. Delivery of the booklet was recorded by these intervention physicians at the clinic appointment; intervention participants were asked 3 months later in a telephone interview about whether they received and used the booklet.


RESULTS
According to physician documentation, 95% of intervention participants who kept an appointment (n = 935) received the booklet; among participants completing a 3-month interview (n = 890), 96% reported the same. However, only about 50% of participants reported receiving the booklet from their physician; the remainder received the booklet from other clinic staff. Overall, 93% reported reading at least part of the booklet. Use of the booklet varied little whether it was delivered by a physician or staff person, but it was more likely to be read as time spent discussing the booklet increased.


CONCLUSIONS
Physician cooperation and evidence of intervention effectiveness support the use of primary care for the delivery of interventions to change diet; training the entire health team and repeating dietary advice at subsequent visits may improve the success of such interventions.
Lazovich
D
D
Division of Epidemiology, University of Minnesota, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454, USA.
Curry
S J
SJ
Beresford
S A
SA
Kristal
A R
AR
Wagner
E H
EH
D004034:Diet Surveys; D005194:Family Practice / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D008297:Male; D052756:Nutritional Sciences / Q000193:education*; D010174:Pamphlets; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D017064:Process Assessment, Health Care; D015397:Program Evaluation; D013664:Teaching Materials; D014861:Washington