A stage-of-change classification system based on actions and beliefs regarding dietary fat and fiber

Purpose. The objectives of this study were to develop a stnge-of-change classification system and to determine the degree to which various adult subgroups have adopted the behavioral changes necessary to achieve a low-fat and/or high-fiber diet as recommended by the Dietary Guidelines for Americans. Design. The study used a mail survey randomly sent to 7110 adults. Setting. The survey was conducted in II states and the District of Columbia. Subjects. The random sample included males and females over age 18. Of the eligible respondents, 3198 (51.5%) were included in this analysis, with 2004 and 2066 unambiguously classified into stages of change for fat and fiber, respectively. Measures. Stage of change was defined by an algorithm based on self-reported intent and behaviors to limit fat and/or increase fiber. Results. 45 % of the respondents were classified as being in action/maintenance for fat and 38 % for fiber. Women, older adults, individuals with advanced education, persons with diet-related chronic disease, people with higher levels of relevant nutrition knowledge and attitudes, and persons who indicated that health concerns were a primary influence on their diet were more likely to be in action/maintenance than other respondents. Conclusions. The algorithm in this study presents a model that more closely reflects the proportions of the adult population that have achieved low-fat diets and classifies a greater proportion in the preparation stage than classification systems in previous studies.