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Choosing coaching frameworks for promoting diet modifications

12 December 2019
9 min read
Volume 28 · Issue 22


Theoretical frameworks have successfully guided researchers in implementing coaching interventions to effect dietary changes in adults for both prevention and management of chronic diseases. Three such frameworks include the Transtheoretical Model (TTM), Social Cognitive Theory (SCT), and the Theory of Integrative Nurse Coaching (TINC). This article introduces each theory, followed by an overview of the coaching interventions used to effect dietary behaviour changes within each theory. A condensed version of Turner's synthesis methodology is used to determine if a conceptual connection exists among the three models/theories. The condensed version includes synthesis preparation, synthesis (comparison of converging and diverging components), synthesis refinement (conceptual connection), and a concluding discussion of all three theories related to nursing practice. This synthesis will inform the focus of interventions that aim to promote dietary changes in adults at risk of developing sarcopenia.

By 2030, the older adult population (age 65+) will represent 21% of the total US population (US Census Bureau, 2018). Yet with aging and increased longevity, organ systems decline. The results of poor lifestyle choices further negatively impact the body's systems, and risks for chronic diseases rise (Hung et al, 2011). Diet represents a lifestyle factor that is linked to multiple chronic health conditions, including sarcopenia, type 2 diabetes, hypertension, heart disease, some cancers, and osteoporosis (Greene et al, 2004; Alemán-Mateo et al, 2014; Loenneke et al, 2016; Chanet et al, 2017; Norton et al, 2017). One suggested intervention for helping individuals to improve their health, via changes in diet, is health coaching (Olsen and Nesbitt, 2010). Research using behaviour change theories in conjunction with coaching interventions has provided successful strategies to support behaviour changes. It has been shown that dietary modifications can prolong or prevent the onset of chronic disease including, for example, increasing protein intake to reduce the risk of sarcopenia (Alemán-Mateo et al, 2014; Chanet et al, 2017; Kim et al, 2015).

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