social cognition models and dietary behaviour: What is the Latest?
The Question
How effective are interventions using social cognition models in bringing about positive change in dietary behaviour?
The Recommendation
Different theoretical frameworks have been used to develop different types of dietary interventions. Research is mixed as to whether interventions based on social cognition models (e.g. Stages of Change/Transtheoretical Model (SOC/TTM), Health Belief Model (HBM), Health Action Approach (HAA)) are more effective in promoting dietary change than nontheory-based dietary interventions in adults. Although some RCTs have reported small to modest positive results, design flaws, high risk of bias and methodological inconsistencies limit the reliability of these findings. The specific theoretical evidence associated with the type of intervention should be considered when evaluating the effectiveness of a dietary intervention.
The Evidence
A 2020 systematic review examining the effect of using a behaviour change theoretical framework to change dietary patterns in adults found that although theory-based interventions were generally effective in achieving dietary change, uneven theory application and lack of treatment fidelity made the authors hesitant to confirm a relationship between behaviour change theories and successful dietary interventions. The authors recommended interpreting their results with caution.
A 2016 systematic review of 18 interventions concluded that TTM interventions led to positive changes in nutrition behaviours, although the authors noted that their results should be interpreted with caution due to methodological concerns in the evidence base.
A 2021 systematic review and meta-analysis of 58 RCTs and 15 quasi-RCTs concluded that interventions based on the Self-determination Theory (SDT) were modestly associated with the SDT constructs of need support, autonomy, competence need satisfaction and autonomous motivation. The strength of these associations waned but remained significant as time elapsed from the end of the intervention. Health behaviours were also modestly improved by SDT interventions, although the type of health behaviour (e.g. dietary, physical activity) was not specified.
Michie et al.’s Behaviour Change Wheel, based on the authors’ COM-B model, has been proven to be a reliable tool to characterize behaviour change interventions and policies. National policies, such as behaviour change intervention guidelines in the U.K., are underpinned by these theories.
Grade of Evidence C
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March 2022 ·
Volume 12
(3)