title: Improving adherence to a cholesterol-lowering diet: a behavioral intervention study.
abstract: Less than 50% of US adults follow dietary recommendations. Despite these figures, little research has focused on improving adherence to a therapeutic eating plan. The research utilizing self-efficacy theory has shown promise for improving behavior change and treatment adherence. This study evaluated the efficacy of a telephone-delivered, self-efficacy based intervention designed to improve adherence to a cholesterol-lowering diet among those self-reporting nonadherence. Sixty-five men and women diagnosed with hypercholesterolemia were randomized to usual care or treatment, which consisted of six intervention sessions delivered every 2 weeks by telephone and focused on how to manage eating behavior in challenging situations. There were significant between group differences post intervention in the consumption of saturated fat (P < .001) and cholesterol (P = .040) with the intervention group improving their dietary adherence. Significant change (P = .013) occurred over time in low-density lipoprotein-cholesterol (LDL-C) in the intervention group. No changes were observed in self-efficacy between groups, suggesting that self-efficacy was not a mediator of the improved adherence. The study's findings confirm that the telephone is a useful tool to deliver adherence-enhancing interventions.
authors.affiliation: University of Pittsburgh School of Nursing, 415 Victoria Building, Pittsburgh, PA 15261, USA. lbu100@pitt.edu
authors.forename: Lora E
authors.initials: LE
authors.lastname: Burke
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Dunbar-Jacob
authors.forename: Trevor J
authors.initials: TJ
authors.lastname: Orchard
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sereika
mesh_terms: D000223:Adaptation, Psychological; D002791:Cholesterol, Dietary; D008078:Cholesterol, LDL / Q000097:blood; D018752:Diet, Fat-Restricted / Q000523:psychology*; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000178:diet therapy* / Q000451:nursing* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009042:Motivation; D015403:Nursing Evaluation Research; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic / Q000458:organization & administration*; D015397:Program Evaluation; D011582:Psychological Theory; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires; D013689:Telephone
chemical_list: D002791:Cholesterol, Dietary; D008078:Cholesterol, LDL