Phase | Finding | Explanation / interpretation | Opportunity for intervention refinement |
---|---|---|---|
Motivation(planning change) | ‘I already meet the standards’ and ‘I’m satisfied with my health/ behavior’ are important motivational barriers | Inclusion of participants with a relatively healthy lifestyle, limiting motivation to change [10, 19] | Increase FINDRISC-value for participant inclusion or additional evaluation of lifestyle prior to invitation |
Inability of participants to correctly interpret their lifestyle | Better inform participants about the standards reflecting healthy lifestyle | ||
Introduction of tools for (self)-monitoring of health and lifestyle [21] | |||
Motivation-Action Gap (initiating change) | Significant differences in the number of initiators between study groups for nearly all objectives | The intervention seems to help participants bridge the gap between motivation and action [8, 22] | Continue to stimulate participants to set goals and to develop concrete action plans [8, 14, 22] |
A substantial part of the planners do not put their plans into action | Lack of action self-efficacy of non-initiators [23] | Underline the small-step approach of the intervention [15] | |
Action (achieving change) | A majority of initiators reports to have achieved change for diet and physical activity, AND Large numbers of initiators reported no difficulties achieving change, BUT Modest risk factor reductions [25] | Too optimistic perceptions of participants of lifestyle change success. | Introduction of tools for (self)-monitoring for parti-cipants to reflect on behavior change progress [21] |
Guard participant progress towards achieving the project objectives | |||
Provide GPs and nurse practitioners with tools for monitoring participant progress | |||
Continuity (maintaining a new habit on the longer term) is an important barrier for losing weight and increasing physical activity. | Tendency of participants to make too drastic alterations in the lifestyle, easily resulting in relapse [15]. | Following the small-step approach: stimulate participants to set intermediate goals [15] | |
Keep a goal and performance logbook to facilitate continuous evaluation of participant progress [21] | |||
Resisting temptation to snack is an often-mentioned difficulty for the weight loss and dietary objectives. | Participants may have difficulties to control internal and external stimuli [27] | Encourage to avoid cues [27] | |
Support participants to monitor circumstances of habitual behavior to identify future high-risk situations and beforehand develop strategies [21] |