Dietitians' Perspectives on Interventions to Enhance Adherence to Dietary Advice for Chronic Diseases in Adults.
OBJECTIVE
To assess dietitians' perspectives on the importance and applicability of interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults in the Canadian context.


METHODS
Based on a Cochrane systematic review, we identified 8 promising interventions for enhancing adherence to dietary advice: behavioural contracts, exchange lists, feedback based on self-monitoring, individualized menu suggestions, multiple interventions, portion size awareness, telephone follow-up, and videos. Thirty-two dietitians then completed a 3-round Delphi study by responding to an electronic questionnaire asking them to rate the importance and applicability in their practice of the 8 interventions on a 7-point Likert scale.


RESULTS
Using a ≥75% level of agreement, 4 interventions showed strong consensus: multiple interventions, feedback based on self-monitoring, portion size awareness, and videos. Among these, the most significant were (means ± SD for importance and applicability, respectively) feedback based on self-monitoring (6.97 ± 0.18 and 6.72 ± 0.46), portion size awareness (6.69 ± 0.54 and 6.75 ± 0.51), and multiple interventions (6.94 ± 0.25 and 6.81 ± 0.40).


CONCLUSIONS
These findings can guide the development of educational training sessions for dietitians to help them provide practice-relevant interventions that will increase the likelihood that patients adhere to their advice regarding prevention and management of chronic diseases.
a CHUQ Research Center, Centre Hospitalier Universitaire de Québec, Hôpital St-François d'Assise, Laval University, Quebec, QC.|b Institute of Nutrition and Functional Foods, Laval University, Quebec, QC.
Sophie
S
Desroches
b Institute of Nutrition and Functional Foods, Laval University, Quebec, QC.
Annie
A
Lapointe
b Institute of Nutrition and Functional Foods, Laval University, Quebec, QC.
Sarah-Maude
SM
Deschênes
b Institute of Nutrition and Functional Foods, Laval University, Quebec, QC.
Véronique
V
Bissonnette-Maheux
b Institute of Nutrition and Functional Foods, Laval University, Quebec, QC.
Karine
K
Gravel
c Practice-based Evidence in Nutrition, Dietitians of Canada, Calgary, AB.
Jayne
J
Thirsk
a CHUQ Research Center, Centre Hospitalier Universitaire de Québec, Hôpital St-François d'Assise, Laval University, Quebec, QC.|d Department of Family Medicine and Emergency Medicine, Laval University, Quebec, QC.
France
F
Légaré
D002170:Canada; D002908:Chronic Disease / Q000517:prevention & control* / Q000628:therapy*; D003376:Counseling; D004032:Diet; D004035:Diet Therapy / Q000379:methods*; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D064686:Nutritionists; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D064787:Portion Size; D057566:Self Report; D011795:Surveys and Questionnaires; D014743:Videotape Recording