Aims To describe how the Transtheoretical Model (TTM) was applied to nutritional interventions for adolescents.
Methods The development of this work followed The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) directions, therefore it is registered on PROSPERO Website (#CRD42018096819). Databases searched were Adolec, Google Scholar, LILACS, PsycINFO, PubMed, Science Direct and Web of Science. Only randomized controlled trials and quasi-experimental designs written in English, Spanish and Portuguese that applied the TTM to nutritional interventions targeting adolescents were included, without restrictions to time of publication. Data extraction occurred through the usage of a table based on instructions of Centre for Reviews and Dissemination for Undertaking Reviews in Healthcare. Assessment of quality and risk of bias were made through the Effective Public Health Practice Project Quality Assessment Tool.
Results The initial search in seven databases yielded 3779 results, from which 10 papers were included. Adolescents were mostly recruited from schools, and the duration of the studies ranged from a month to three years. The sample size varied from 50 to 4158 participants. The model was used individually or combined with other behaviour of change theories. The majority of the interventions had a computer component. All studies assessed stages of change, except for one. Seven studies included measures for decisional balance, five of them measured self-efficacy and only one study measured processes of change. Eight interventions had positive results regarding improvements in dietary behaviours or TTM’s measurements, with significant differences from the control group.
Conclusion According to this review, the Stages of Change are the most used TTM’s construct, whereas the processes of change seem to be less explored. It is suggested that future studies consider comparing usage of behavioural change theories so that the effectiveness of the MTT can be more evidenced regarding this age group.
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