Study On Applying Stage Of Change Model To Nutritional Intervention In Farmers

Objective To improve the healthy awareness of eating more vegetables and fruits, eating less salts, doing more exercises etc, and to promote the change of healthy behavior. Moreover, to decrease the risk factors of chronic diseases, increase the healthy level of farmers; Learning the methods of applying Stage of Change Model to conduct nutritional intervention and to evaluate the effect of nutrition intervention; Explore the scientific and effective intervention patterns by all kinds of intervention activities and health education.Methods 500 farmers were selected randomly in Jinnan and Wuqing district respectively as trial and control group from Nov 2007 to Jan 2009. The questionnaires were used to do baseline and twice evaluation surveys on Dec 2007, Jun 2008, Dec 2008 respectively. According to baseline data to apply the stage of change model to divide the subjects into five stages, the intervention ways were used in trial group, such as holding lectures, posting pasters, sending out healthy materals, quizzs with prizes, recommending salts low in sodium to each family, training of making healthy foods by the chef, competetion of doing dumpling with vegetables and handing out the related healthy materials to five stages people respectively, but there were nothing any measures in control group.Results There were statistical significance on proportion of behavioral stages between before intervention and after intervention in trial group(P<0.05):the upgrade of behavior stages has been gained, the proportion of preparation,action, maintenance increased by 15.1%,20.7%and 16.1%for eating more vegetables and fruits, and 17.8%,21.2%and 9.8%for doing more exercises respectively; Healthy awareness and attitude on nutrition, exercises and chronic diseases had increased and related attitude had improved(P<0.05); The average daily intake of vegetables, fruits have increased from 206,150 grams to 251,168 grams respectively, but average daily intake of cooking oils and salts have decreased from 48,10 grams to 42,8 grams respectively(P<0.05). Meanwhile, with change of diet patterns on farms, the average daily intake of nutrients have changed:diet fiber, vitaminC, potassium have increased and sodium has decreased; exercise time has increased(P<0.05); There were good improvement on healthy and biochemical factors index after intervention(P<0.05): BMI, blood pressure, total cholesterol, homocysteine and urine sodium levels have decreased, folic acid, urine potassium have increased after intervention. Moreover, these change have already appeared after half of a year intervention. In trial group, with the rise of behavioral stage, the awareness rates of healthy knowledge, the average daily intake of vegetables and fruits, exercise time every time, folic acid and urine potassium levels have rised, and the average daily intake of salts, diastolic pressure, homocysteine and urine sodium levels have reduced increasingly(P<0.05). The best way to gain helthy knowledge for farmers was TV, and the brochures, posting pasters, experts lectures were also better ways, the brochures was the favorite ways for precontemplation, preparation, action, maintenance, posting pasters for contemplation; The majority of farmers in trial groups thought that the nutritional knowledge was easy to understand; The degree of siatisfactions for intervention content and intervention ways were all 100%, and the participation rate of farmers for intervention activitives was 97.7%; The nearly 100%farmers had received the salts low in sodium, salt spoons, brochures, and nearly 50%famers had watched the pasters.Conclusions 1.After intervention, through applying SOC model to analyse and show that the proportion of behavioral stages about eating more vegetables and fruits, doing more exercises on farmers have changed from precontemplation to action and maintenance, the upgrade of behavior stages has been gained, the intervention measures are good for farmers on promoting their healthy behaviors to the higher stages; 2.The awareness and attitudes of healthy knowledge have improved; The farmers have start-ed to increase the average daily intake of vegetables and fruits, to decrease the cooking oils and salts intake, Meanwhile, with the change of diet patterns on farmers, the average daily nutrients have changed, for example, diet fiber, vitaminC, potassium have increased and sodium has decreased. All these results have shown that farmers have increasingly built up the conceptions and behaviors on eating more vegetables and fruits, eating less salts; 3.So the risk factors levels of chonic diseases have decreased such as BMI, blood pressure, total cholesterol, homocysteine and urine sodium levels, protective factors levels have increased such as folic acid and urine potassium levels, so health level has improved; 4.The higher stages farmers have higher levels of heathy knowledge, more positive healthy belief and attitude, lower risk factors of chronic diseases than the lower stages farmers; 5.The favorate intervention ways for all farmers and different stages farmers in trial group have been found; The nutritional knowledge is easy to understand for a large majority of farmers, which is helpful to ensure farmers are willing to receive the nutritional interventions and healthy knowledge so as to improve intervention effect; 6.Exploring out the scientific and effecitive nutritional intervention patterns for farmers by means of all kinds of interventiona activities and health education.