Health Education Research, Vol. 14, No. 3, 399-410,
June 1999
© 1999 Oxford University Press
A brief motivational intervention to improve dietary adherence in adolescents
for the Dietary Intervention Study in Children (DISC) Research Group
1 Kaiser Permanente Center for Health Research, Portland, OR 97227-1098,
2 Maryland Medical Research Institute, Baltimore, MD 21210,
3 Department of Preventive Medicine, Northwestern University Medical School, Chicago, IL 60611,
4 Department of Medicine, New Jersey Medical School, Newark, NJ 07107 and
5 Department of Pediatric Cardiology, University of Iowa, Iowa City, IA 52242-1100, USA
Motivational interviewing offers health care professionals a potentially effective strategy for increasing a patient's readiness to change health behaviors. Recently, elements of motivational interviewing and the stages of change model have been simplified and adapted for use with patients in brief clinical encounters. This paper describes in detail a brief motivational intervention model to improve and renew dietary adherence with adolescents in the Dietary Intervention Study in Children (DISC). DISC is a randomized, multi-center clinical trial assessing the efficacy and safety of lowering dietary fat to decrease low-density lipoprotein cholesterol in high-risk children. In the first 3 years of follow-up covering ages 8–13, intervention participants (n = 334) were exposed to a family-based group intervention approach to change dietary choices. To address adherence and retention obstacles as participants moved into adolescence (age 13–17), an individual-level motivational intervention was implemented. The DISC motivational intervention integrates several intervention models: stages of change, motivational interviewing, brief negotiation and behavioral self-management. A preliminary test of the intervention model suggests that it was acceptable to the participants, popular with interventionists and appeared to be an age-appropriate shift from a family-based intervention model.
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