title: Timing of dietary change in response to a telephone counseling intervention: evidence from the WHEL study.
abstract: OBJECTIVE
  Little is known about temporal patterns of diet change within interventions, nor about predictors of early and sustained successful change. Social-cognitive theory asserts that early successes in achieving behavior change increase self-efficacy, leading to longer-term success.
  
  
  METHODS
  The authors conducted exploratory cluster analyses using dietary data from the first month of the telephone counseling intervention of the Women's Healthy Eating and Living (WHEL) Study.
  
  
  METHODS
  Change in dietary pattern at three early intervention timepoints.
  
  
  RESULTS
  Three clusters were identified: Cluster 1 (25%) was close to meeting study goals at baseline, but still made major changes; Cluster 2 (49%) and Cluster 3 (26%) were not achieving study goals at baseline, but Cluster 2 made substantial immediate changes, while Cluster 3 changed their diet more gradually. Baseline demographic and behavioral variables were associated with cluster membership; however, the strongest predictors of cluster were self-efficacy, motivation, and approaches to study goals. Cluster membership predicted dietary pattern at 12 months.
  
  
  CONCLUSIONS
  These data suggest that a one-on-one telephone counseling intervention that is intensive in the early weeks may maximize the level of change achieved in a study.
authors.affiliation: Department of Family and Preventive Medicine, University of California, California, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Madlensky
authors.forename: Loki
authors.initials: L
authors.lastname: Natarajan
authors.forename: Shirley W
authors.initials: SW
authors.lastname: Flatt
authors.forename: Susan
authors.initials: S
authors.lastname: Faerber
authors.forename: Vicky A
authors.initials: VA
authors.lastname: Newman
authors.forename: John P
authors.initials: JP
authors.lastname: Pierce
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000517:prevention & control; D002338:Carotenoids / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D003376:Counseling; D004035:Diet Therapy; D004043:Dietary Fiber; D005260:Female; D006801:Humans; D008875:Middle Aged; D011582:Psychological Theory; D020377:Self Efficacy; D017741:Survivors / Q000706:statistics & numerical data; D013689:Telephone; D013997:Time Factors
chemical_list: D004043:Dietary Fiber; D002338:Carotenoids