Randomized trial of planning tools to reduce unhealthy snacking: Implications for health literacy.

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  • Author(s): Ayre J;Ayre J; Bonner C; Bonner C; Cvejic E; Cvejic E; McCaffery K; McCaffery K
  • Source:
    PloS one [PLoS One] 2019 Jan 17; Vol. 14 (1), pp. e0209863. Date of Electronic Publication: 2019 Jan 17 (Print Publication: 2019).
  • Publication Type:
    Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
    • Abstract:
      Objective: Guidance to address health literacy often focuses on health education rather than tools to facilitate action, despite action being important for self-management. This study evaluated an online intervention informed by health literate design principles and behavior change theory to reduce unhealthy snacking.
      Methods: 440 participants were recruited online and randomized to an intervention: 1) Health-literate action plan (guided implementation intention); 2) Standard action plan (self-guided implementation intention); 3) Education (healthy snacking fact-sheet). The primary outcome was self-reported unhealthy snacking. Follow-up was at 1 month.
      Results: 373 participants (84.8%) completed follow-up. Half the sample had adequate health literacy (52%), and the other half had low (24%) or possibly low (25%) health literacy, as measured by Newest Vital Sign (NVS). At follow-up, lower health literacy was associated with more unhealthy snacks and there was no overall difference between intervention groups. However, participants with lower health literacy who used the health-literate action plan reported less unhealthy snacking compared to the standard action plan; the reverse was true for those with higher health literacy scores (b = 1.7, p = 0.03). People scoring 2 points below the mean NVS (M = 3.4, SD = 2.0) using the health-literate action plan reported eating 8 fewer serves of unhealthy snacks, whereas people scoring 2 points above the mean NVS reported eating 6 more serves of unhealthy snacks using the same tool.
      Conclusions: These findings suggest that the universal precautions approach currently recommended for health information may be less effective for facilitating action than tailoring to health literacy level.
      Trial Registration: ANZCTR identifier: ACTRN12617001194358.
      Competing Interests: The authors have declared that no competing interests exist.
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    • Molecular Sequence:
      ANZCTR ACTRN12617001194358
    • Publication Date:
      Date Created: 20190118 Date Completed: 20191104 Latest Revision: 20200309
    • Publication Date:
      20240105
    • Accession Number:
      PMC6336265
    • Accession Number:
      10.1371/journal.pone.0209863
    • Accession Number:
      30653531