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      Translation and application of an obesity behavior change technique training in a Spanish nursing undergraduate setting Translated title: Traducción y aplicación de un programa de cambio de conducta en obesidad, en estudiantes españoles de enfermería

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          Abstract

          Abstract Background The TEnT PEGS framework is a behavior change communication toolkit which has been shown to be useful in increasing health professional trainees’ skills and knowledge about obesity-related behavior change techniques. There is no version of the behavioral change intervention toolkit in Spanish. Therefore, the objectives of this study were 1) to translate the TEnT PEGS framework into Spanish and apply it to a Spanish nursing student population; 2) To analyze whether training with the Spanish toolkit (DEPREMIO) had a positive impact on students’ skills in encouraging obesity-related behavioral change. Methods First year nursing students (n=95) attended two face-to-face (2 hours per session) obesity management training sessions. A specifically designed pre-post test was carried out. Data were collected using an ad-hoc questionnaire of fourteen items, ten of them evaluated the student’s knowledge and attitude about behavior change techniques, and four evaluated the student’s perception of their skills in developing different strategies. Results Training significantly increased most students’ knowledge and attitudes with a 0.05 level of significance and effect sizes were between 0.36 and 0.77. It also increased students’ skills, although not to any significant extent. Conclusion The DEPREMIO toolkit helped nursing students to acquire more knowledge, attitudes and skills in obesity management. It therefore seems that this adaptation is an acceptable and feasible training tool for the Spanish nursing student population.

          Translated abstract

          Resumen Fundamento El programa TEnT PEGS es un conjunto de herramientas de comunicación para el cambio de comportamiento que se ha demostrado útil para aumentar las habilidades y conocimiento de los profesionales de la salud sobre técnicas de cambio de comportamiento relacionadas con la obesidad. No existe ningún manual de intervención para cambiar la conducta en español. Por lo tanto, los objetivos de este estudio fueron 1) traducir TEnT PEGS al español y aplicarlo en una población de estudiantes de enfermería españoles; 2) Analizar si este programa en español (DEPREMIO) tuvo un impacto positivo en las habilidades de los estudiantes para fomentar el cambio de comportamiento relacionado con la obesidad. Metodología Los estudiantes de primer año de enfermería (n = 95) asistieron a dos sesiones presenciales (2 horas por sesión) de control de la obesidad. Se utilizó un diseño pre-post. Los datos se recogieron a través de un cuestionario ad-hoc de catorce ítems, diez de ellos evaluaban los conocimientos y actitudes de los estudiantes sobre técnicas de cambio de conducta y cuatro evaluaban la percepción de los estudiantes sobre sus habilidades para desarrollar diferentes técnicas. Resultados La intervención aumentó significativamente la mayoría de los conocimientos y actitudes de los estudiantes con un nivel de significación de 0,05 y tamaños de efecto entre 0,36 y 0,77. También aumentaron las habilidades de los estudiantes, aunque no significativamente. Conclusión La herramienta DEPREMIO ayudó a los estudiantes de enfermería a alcanzar mayores habilidades y actitudes en el manejo de la obesidad, por lo que sería una intervención aceptable y factible para la población española de estos estudiantes.

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          Most cited references29

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          The theory of planned behavior

          Icek Ajzen (1991)
          Organizational Behavior and Human Decision Processes, 50(2), 179-211
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            A taxonomy of behavior change techniques used in interventions.

            Without standardized definitions of the techniques included in behavior change interventions, it is difficult to faithfully replicate effective interventions and challenging to identify techniques contributing to effectiveness across interventions. This research aimed to develop and test a theory-linked taxonomy of generally applicable behavior change techniques (BCTs). Twenty-six BCTs were defined. Two psychologists used a 5-page coding manual to independently judge the presence or absence of each technique in published intervention descriptions and in intervention manuals. Three systematic reviews yielded 195 published descriptions. Across 78 reliability tests (i.e., 26 techniques applied to 3 reviews), the average kappa per technique was 0.79, with 93% of judgments being agreements. Interventions were found to vary widely in the range and type of techniques used, even when targeting the same behavior among similar participants. The average agreement for intervention manuals was 85%, and a comparison of BCTs identified in 13 manuals and 13 published articles describing the same interventions generated a technique correspondence rate of 74%, with most mismatches (73%) arising from identification of a technique in the manual but not in the article. These findings demonstrate the feasibility of developing standardized definitions of BCTs included in behavioral interventions and highlight problematic variability in the reporting of intervention content.
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              What are the most effective techniques in changing obese individuals’ physical activity self-efficacy and behaviour: a systematic review and meta-analysis

              Increasing self-efficacy is generally considered to be an important mediator of the effects of physical activity interventions. A previous review identified which behaviour change techniques (BCTs) were associated with increases in self-efficacy and physical activity for healthy non-obese adults. The aim of the current review was to identify which BCTs increase the self-efficacy and physical activity behaviour of obese adults. A systematic search identified 61 comparisons with obese adults reporting changes in self-efficacy towards engaging in physical activity following interventions. Of those comparisons, 42 also reported changes in physical activity behaviour. All intervention descriptions were coded using Michie et al’s (2011) 40 item CALO-RE taxonomy of BCTs. Meta-analysis was conducted with moderator analyses to examine the association between whether or not each BCT was included in interventions, and size of changes in both self-efficacy and physical activity behaviour. Overall, a small effect of the interventions was found on self-efficacy (d = 0.23, 95% confidence interval (CI): 0.16-0.29, p < 0.001) and a medium sized effect on physical activity behaviour (d = 0.50, 95% CI 0.38-0.63, p < 0.001). Four BCTs were significantly associated with positive changes in self-efficacy; ‘action planning’, ‘time management’, ‘prompt self-monitoring of behavioural outcome’ and ‘plan social support/social change’. These latter two BCTs were also associated with positive changes in physical activity. An additional 19 BCTs were associated with positive changes in physical activity. The largest effects for physical activity were found where interventions contained ‘teach to use prompts/cues’, ‘prompt practice’ or ‘prompt rewards contingent on effort or progress towards behaviour’. Overall, a non-significant relationship was found between change in self-efficacy and change in physical activity (Spearman’s Rho = −0.18 p = 0.72). In summary, the majority of techniques increased physical activity behaviour, without having discernible effects on self-efficacy. Only two BCTs were associated with positive changes in both physical activity self-efficacy and behaviour. This is in contrast to the earlier review which found a strong relationship between changes in physical activity self-efficacy and behaviour. Mechanisms other than self-efficacy may be more important for increasing the physical activity of obese individuals compared with non-obese individuals.
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                Author and article information

                Journal
                asisna
                Anales del Sistema Sanitario de Navarra
                Anales Sis San Navarra
                Gobierno de Navarra. Departamento de Salud (Pamplona, Navarra, Spain )
                1137-6627
                April 2021
                : 44
                : 1
                : 51-59
                Affiliations
                [2] Madrid orgnameUniversidad CEU Cardenal Herrera orgdiv1Department of Nursing Spain
                [3] Liverpool orgnameUniversity of Liverpool orgdiv1Institute of Psychology. Health and Society United Kingdom
                [4] Manchester orgnameThe University of Manchester orgdiv1School of Health Sciences orgdiv2Manchester Centre for Health Psychology United Kingdom
                [5] Manchester orgnameThe University of Manchester orgdiv1School of Medical Sciences orgdiv2Division of Medical Education United Kingdom
                [1] Elche Valencia orgnameUniversidad Miguel Hernández de Elche orgdiv1Department of Health Psychology Spain
                Article
                S1137-66272021000100005 S1137-6627(21)04400100005
                10.23938/assn.0938
                33853227
                e76b727a-f143-4554-984c-c14ce225a8a8

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 09 December 2020
                : 11 September 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 29, Pages: 9
                Product

                SciELO Spain

                Categories
                Original Articles

                Técnicas de cambio de comportamiento,Obesity,Spanish adaptation,Behavioral change technique,Nursing students,Obesidad,Adaptación española,Estudiantes de Enfermería

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