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Health Education Research Advance Access published online on April 11, 2008
Health Education Research, doi:10.1093/her/cyn015
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© 2008 The Author(s).
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Transtheoretical model-based dietary interventions in primary care: a review of the evidence in diabetes

Sanna Salmela1,*, Marita Poskiparta1, Kirsti Kasila2, Kati Vähäsarja1 and Mauno Vanhala3

1 Research Centre for Health Promotion, Faculty of Sport Sciences, Department of Health Sciences, University of Jyväskylä, PO Box 35 (L), FIN-40014, Finland
2 Health Care and Social Services, University of Applied Sciences, Raastuvankatu 31–33, FIN-65100 Vaasa, Finland
3 Central Finland Central Hospital, Keskussairaalantie 19, FIN-40620 Jyväskylä, Finland

Correspondence to: * Correspondence to: S. Salmela. E-mail: sanna.salmela{at}sport.jyu.fi

The objective of this study was to review the evidence concerning stage-based dietary interventions in primary care among persons with diabetes or an elevated diabetes risk. Search strategies were electronic databases and manual search. Selection criteria were randomized controlled studies with stage-based dietary intervention, conducted in primary care with at least 6 months of follow-up, and participants with either type 2 diabetes or with an elevated risk. The researchers evaluated trials for inclusion, extracted data and assessed study quality. Seven articles, based on five data sets, were included. These studies concentrated on cardiovascular diseases and being overweight, not diabetes. The quality of the studies was moderate to weak. Inadequacies in the reporting often involved unspecific information on the training of health care providers. Long-term positive outcomes (compared with controls) were found in total and monounsaturated fat intake, diastolic blood pressure, health status and well-being. The existing data are insufficient for drawing conclusions on the benefits of the transtheoretical model. More high-quality studies focusing on diabetes are needed, with greater attention to the training of providers and process evaluation. There is a need for a standardized appraisal tool for study evaluation, focusing separately on education interventions for patients and providers.


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