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Table 3 Details of the interventions

From: Primary health care-level interventions targeting health literacy and their effect on weight loss: a systematic review

Study (Year)

Intervention period (months)

Sessions (number)

Duration of each session (hours)

Mode of administration and frequency

Intervention component

Intervention providersϪ

Intervention intensity score*

Randomised controlled trials

Barclay 2008 [21]

6

6

1.5

Group sessions. First four held weekly, the fifth in week 12 and sixth in week 26

Nutrition education, PA sessions, group motivational discussions, completion of food diary and its analysis accompanied with brief written comments.

Nutritional scientist@, psychologist@, aerobics instructor@

3

Bo 2007 [23]

12

5

1

1-1 and group sessions

Group sessions sensitive to cultural differences and patient expectations. Individualised verbal and written recommendations and group sessions covering diet, PA and behaviour modification.

Nutritionists@, specialists in endocrinology@, internal medicine@

2

Greaves 2008 [25]

6

Up to 11

~0.5

1-1 (median 8) and telephone contacts (median 1.5)

Action plans made and assessed at subsequent contacts using relapse-management/relapse-prevention techniques and targets increased gradually to build/reinforce confidence over time. 1–1 motivational interviewing and diet and PA assessment, recommendations and target setting. Participants encouraged to self-monitor weight, PA and energy levels and to develop sustainable cognitive and behavioural skills for managing diet and PA.

Health promotion counsellors&

2/3

Kulzer 2009 [26]

4

12

~1.5

Group sessions. First eight, 1/w; last four, bimonthly

Intervention based on self-management theory. Verbal and written information on diabetes prevention and resources and worksheets on diet and PA.

Diabetes educators#, psychologists#

4

McConnon 2007 [28]

12

52

NR

Internet. Participants asked to log on to the intervention website at least once/w

Personalised and generic advice on diet and PA and behaviour therapy and tools and information to support dietary and PA behaviour change. Website designed to enable patients in self-management and to vary frequency of use according to own needs. Motivational statements generated.

Website&

4

Tsai 2010 [30]

6

8

1/4 -1/3

1-1. At weeks 0, 2, 4, 8, 12, 16, 20, and 24

Visits using handouts. Recommendations on dietary and PA behaviour, completion of food diary and review of food and PA records at each visit.

Medical assistants&

1/2

Whittemore 2009 [31]

6

11

NR

1-1 and telephone sessions

Culturally relevant education on nutrition, PA, and diabetes prevention, behavioural support in collaboratively identifying lifestyle change goals and problem-solving barriers to change, and motivational interviewing when participants were unable to achieve lifestyle goals.

Nurse practitioners&

2/3

Non-Equivalent Groups Design trials

Bjorkelund 1991 [22]

3

12

Diet: 3 PA: 1

Group sessions. Separate diet and PA sessions once every 2nd w

Food education, cooking activities and PA sessions.

Dietician@, physical training instructors@

4

Rohrer 2008 [29]

12

104

Group: 1.5 Phone and 1–1: NR

Weekly 1–1 and group sessions. Midweek telephone follow-ups

Behavioural classes focussing on lifestyle change and meal replacements including record keeping, goal setting, planning, problem solving, environmental control, and PA.

Nurses@, health educators@

4

Single group pre-post trials

Absetz 2007 [19]

8

6

2

Group sessions. First five at 2w intervals, last at 8 m

A group-based, task-oriented counselling model base on the Health Action Process Approach (HAPA). The program emphasised the participants’ possibilities to make informed choices and his/her role as an independent decision-maker. Information provision, group discussions, behaviour self-monitoring, dietary counselling, diet and PA goal setting, planning, and motivation for life-style changes that would result in the diet and PA goals accomplishment.

Dietitian^%, public health nurses*, physiotherapist$, municipal sports officers%

4

Arrebola 2011 [20]

5.5

11

NR

One 1–1 and group sessions. Group sessions every 2w

Nutrition education, PA recommendations and psychological support.

Dietician ~#, nurse#, doctor#

2/3

Gilis-Januszewska 2011 [24]

10

18

NR

Group sessions, telephone, and letters. Intensive phase (4 m): 10 sessions. Continuous phase (6 m): 6 telephone sessions and 2 letters

Intervention based on reinforced behaviour modification. Social support emphasised by the group setting and participants encouraged to involve their own social environment in the lifestyle changes. Group sessions on lifestyle changes and diet and PA education using printed resources. PA sessions.

Nurses&

4

Laatikainen 2007 [27]

8

6

1.5

Group sessions. First five at 2w intervals, last session at 8 m

Intervention model used the HAPA. Regular self-assessment used to empower participants to take responsibility for own decisions and make informed choices. Social support enhanced by the group setting and encouraging participants to seek support from their own social networks. Goal setting used to motivate individuals to progress from intention to actual behaviour change. Education on diet and PA.

Dietitians@, nurses@, physiotherapists@

3

  1. *Intervention intensity score.
  2. 1: Low - ≤4 hours of contact or 6 points of contact.
  3. 2: Medium - >4 hours and <8 hours of contact or 10 points of contact.
  4. 3: High - ≥8 hours and <12 hours or 12 points of contact.
  5. 4: Very high - ≥12 hours of contact or 14 points of contact.
  6. Ϫ Provider.
  7. ^: Supervised/supported the main intervention provider.
  8. #: One or the other.
  9. *: Main intervention provider.
  10. @: All delivered.
  11. $: Helped the main intervention provider.
  12. %: delivered 1 session only.
  13. &: Sole deliverer.
  14. ~: Solely delivered instructions on diet and PA during a 1–1 session.