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. 2018 Nov 9;10(11):1717.
doi: 10.3390/nu10111717.

A Process Evaluation of a Multi-Component Intervention in Dutch Dietetic Treatment to Improve Portion Control Behavior and Decrease Body Mass Index in Overweight and Obese Patients

Willemieke Kroeze  1   2 , Frédérique Rongen  3 , Michelle Eykelenboom  4 , Wieke Heideman  5 , Claudia Bolleurs  6 , Ellen Govers  7 , Ingrid Steenhuis  8
Affiliations

A Process Evaluation of a Multi-Component Intervention in Dutch Dietetic Treatment to Improve Portion Control Behavior and Decrease Body Mass Index in Overweight and Obese Patients

Willemieke Kroeze et al. Nutrients. .

Abstract

The SMARTsize intervention embeds an evidence-based portion control intervention in regular dietetic care. This intervention was evaluated to explore (1) which patients participated, (2) the implementation process, and (3) the outcomes of the intervention. The intervention was evaluated with an observational study design including measures at baseline, and three, six, and nine months after the start of the program. Data concerning the process (participation, dose delivered, dose received, satisfaction) and the outcomes (self-efficacy, intention, portion control strategies, and Body Mass Index (BMI) were collected with forms and questionnaires filled out by dietitians and patients. Descriptive analyses, comparison analyses, and cluster analyses were performed. Patients were mainly obese, moderately to highly educated women of Dutch ethnicity. Use of the intervention components varied from 50% to 100% and satisfaction with the SMARTsize intervention was sufficient to good (grades 7.2⁻8.0). Statistically significant (p < 0.001) improvements were observed for self-efficacy (+0.5), portion control strategies (+0.7), and BMI (-2.2 kg/m²), with no significant differences between patients with or without counselling. Three clusters of patients with different levels of success were identified. To conclude, implementing an evidence-based portion control intervention in real-life dietetic practice is feasible and likely to result in weight loss.

Keywords: dietitians; multicomponent intervention; portion control strategies; portion size; process evaluation; weight management.

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Conflict of interest statement

Ingrid Steenhuis is the co-owner of Brickhouse Academy, a company with the aim of translating scientific knowledge into practice. In this respect, she trains dietitians and other paramedics based on the educational book that was part of the SMARTsize intervention. She has received royalties from Scriptum Publishers for the book. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Patterns of weight change over nine months identified by cluster analysis. T0 = baseline measurement; T1 = three-month follow-up; T3 = nine-month follow-up. * p < 0.001.
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