AbstractBackground: Despite decades

Abstract
Background: Despite decades of nutrition education, the prevalence of unhealthy dietary patterns is still high and
inequalities in intake between high and low socioeconomic groups still exist. Therefore, it is important to innovate
and improve existing nutrition education interventions. This paper describes the development, design and evaluation
protocol of a web-based computer-tailored nutrition education intervention for adults targeting fruit, vegetable,
high-energy snack and fat intake. This intervention innovates existing computer-tailored interventions by not only
targeting motivational factors, but also volitional and self-regulation processes and environmental-level factors.
Methods/design: The intervention development was guided by the Intervention Mapping protocol, ensuring a
theory-informed and evidence-based intervention. Two versions of the intervention were developed: a basic version
targeting knowledge, awareness, attitude, self-efficacy and volitional and self-regulation processes, and a plus
version additionally addressing the home environment arrangement and the availability and price of healthy food
products in supermarkets. Both versions consist of four modules: one for each dietary behavior, i.e. fruit, vegetables,
high-energy snacks and fat. Based on the self-regulation phases, each module is divided into three sessions. In the
first session, feedback on dietary behavior is provided to increase awareness, feedback on attitude and self-efficacy
is provided and goals and action plans are stated. In the second session goal achievement is evaluated, reasons for
failure are explored, coping plans are stated and goals can be adapted. In the third session, participants can again
evaluate their behavioral change and tips for maintenance are provided. Both versions will be evaluated in a
three-group randomized controlled trial with measurements at baseline, 1-month, 4-months and 9-months
post-intervention, using online questionnaires. Both versions will be compared with a generic nutrition information
control condition. The primary outcomes are fruit, vegetable, high-energy snack and fat intake.
Discussion: The evaluation study will provide insight into the short- and long-term efficacy of both intervention versions
in adults. Additionally, differences in the efficacy among high- and low-educated people will be examined. If these
interventions are effective, two well-developed interventions will become available for the implementation and
promotion of healthy dietary patterns among both high- and low-educated adults in the Netherlands.
Trial registration: Dutch Trial Registry NTR3396.
Keywords: Environmental feedback, Self-regulation, Computer tailoring, Nutrition education, Fruit intake, Vegetable
intake, Fat intake, Snack intake

結果 (中文) 1:

摘要背景 ︰ 尽管几十年的营养教育，不健康的饮食模式的流行是仍然很高，摄入量高、 低社会经济群体之间的不平等依然存在。因此，它是重要的创新和改善现有营养教育干预措施。本文介绍了开发、 设计和评价协议的成年人针对水果，基于 web 的计算机量身定制营养教育干预蔬菜，高能小吃和脂肪摄入量。这种干预创新不仅现有计算机量身定做的干预目标激励的因素，但也意志和自我调节过程和环境层面的因素。方法/设计 ︰ 干预映射协议，确保遵循干预发展通知理论和基于证据的干预。被开发了干预的两个版本 ︰ 一个基本的版本针对了解、 认识、 态度、 自我效能感与意志和自我调节的过程和一个加号另外解决家庭环境安排和可用性和健康食品价格的版本在超市的产品。两个版本都由四个模块组成 ︰ 一个用于每个饮食行为，如水果、 蔬菜、高能量的零食和脂肪。基于自律阶段，每个模块分为三届会议。在第一届会议，对饮食行为的反馈提供提高认识，态度和自我效能感的反馈提供并阐述了目标和行动计划。在第二届会议目标成就进行了评价理由失败探讨，阐述应对计划和目标可以适应。在第三届会议，与会者可以再一次评价其行为的改变和提供维修技巧。这两个版本将在评估在基线、 1 月、 4 月和 9 个月测量三组随机对照的试验干预后，使用在线问卷调查。这两个版本将与通用营养信息比较控制条件。主要结局是水果、 蔬菜、 高能的小吃和脂肪的摄入量。讨论 ︰ 评价研究将提供两个版本都干预的短期和长期疗效的洞察在成人。此外，在高和低学历人群疗效差异会加以说明。如果这些干预措施是有效的两个发达的干预将成为可用于执行和促进健康饮食模式荷兰两高和低学历人群。试验注册 ︰ 荷兰审判注册表 NTR3396。关键词 ︰ 环境反馈，自我调节、 剪裁、 营养教育、 计算机蔬菜水果摄入摄入，脂肪摄入量，零食的摄入量