Table 2

Recommendations for practice

A1

Interventions should aim to promote changes in both diet and physical activity


A

Interventions should use established, well defined behaviour change techniques (e.g. Specific goal-setting, relapse prevention, self-monitoring, see Table 1)


A

Interventions should encourage participants to engage social support in planned behaviour change (i.e. engage others who are important such as family, friends, and colleagues)


A

Interventions may be delivered by a wide range of people/professions, subject to appropriate training. There are examples of successful physical activity and/or dietary interventions delivered by doctors, nurses, dieticians/nutritionists, exercise specialists and lay people, often working within a multi-disciplinary team


A

Interventions may be delivered in a wide range of settings. There are examples of successful physical activity and/or dietary interventions delivered in healthcare settings, the workplace, the home, and in the community


A

Interventions may be delivered using group, individual or mixed modes (individual and group). There are examples of successful physical activity and/or dietary interventions using each of these delivery modes


A

Interventions should include a strong focus on maintenance. It is not clear how best to achieve behaviour maintenance but behaviour change techniques designed to address maintenance include: self-monitoring of progress, providing feedback, reviewing of goals, engaging social support, use of relapse management techniques and providing follow-up prompts


B

Interventions should maximise the frequency or number of contacts with participants


C

Interventions may consider building on a coherent set of "self-regulation" techniques, which have been associated with increased effectiveness (Specific goal setting; Prompting self-monitoring; Providing feedback on performance; Review of behavioural goals) as a starting point for intervention design. However, this is not the only approach available


C

No specific intervention adaptations are recommended for men or women, although it may be important to take steps to increase engagement and recruitment of men


D

If using established behaviour change techniques, a clear plan of intervention should be developed, based on a systematic analysis of factors preceding, enabling and supporting behaviour change in the social/organisational context in which the intervention is to be delivered. The plan should identify the processes of change and the specific techniques and method of delivery designed to achieve these processes. Such planning should ensure that the behaviour change techniques and strategies used are mutually compatible and well-adapted to the local delivery context. Following the procedures of the PRECEDE-PROCEED model [62], Intervention Mapping [61], or a similar intervention-design procedure is recommended


D

People planning and delivering interventions should consider whether adaptations are needed for different ethnic groups (particularly with regard to culturally-specific dietary advice), people with physical limitations and people with mental health problems


1Key to grades of recommendations:

A: At least one meta-analysis, systematic review, or RCT rated as 1++ and directly applicable to the target population; or A body of evidence

consisting principally of studies rated as 1+, directly applicable to the target population, and demonstrating overall consistency of results

B: A body of evidence including studies rated as 2++, directly applicable to the target population, and demonstrating overall consistency of

results; or Extrapolated evidence from studies rated as 1++ or 1+

C: A body of evidence including studies rated as 2+, directly applicable to the target population and demonstrating overall consistency of results;

or Extrapolated evidence from studies rated as 2++

D: Evidence level 3 or 4 (non-analytic studies or expert opinion); or Extrapolated evidence from studies rated as 2+

Greaves et al. BMC Public Health 2011 11:119   doi:10.1186/1471-2458-11-119

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