Article

Starting the Conversation: Performance of a brief dietary assessment and intervention tool for health professionals

Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 27599-7426, USA.
American journal of preventive medicine (Impact Factor: 4.53). 01/2011; 40(1):67-71. DOI: 10.1016/j.amepre.2010.10.009
Source: PubMed

ABSTRACT

For chronic disease prevention and management, brief but valid dietary assessment tools are needed to determine risk, guide counseling, and monitor progress in a variety of settings. Starting The Conversation (STC) is an eight-item simplified food frequency instrument designed for use in primary care and health-promotion settings.
This report investigates the feasibility, validity, and sensitivity to change of the STC tool, a simplified screener instrument for assessment and counseling.
Data from an ongoing practical efficacy study of type 2 diabetes patients in a diverse population (N=463) were used to document STC validity, robustness, stability, and sensitivity to change from baseline to 4 months. Data were collected from 2008 to 2010, and they were analyzed for this report in 2010.
The eight STC items and summary score performed well. STC items and the summary score were moderately intercorrelated (r =0.39-0.59, p<0.05). The STC summary score was significantly correlated with the NCI fat screener at baseline (r =0.39, p<0.05), and change in the STC summary score correlated with reduction in percentage of calories from fat (r =0.22, p<0.05) from baseline to 4 months. The STC was sensitive to the intervention, with intervention participants improving significantly more than controls on the summary score (M=1.16 vs 0.46, p<0.05).
The brief STC is a relatively simple, valid, and efficient tool for dietary assessment and intervention in the clinical setting. It is available in English and Spanish and is in the public domain. Researchers and practitioners are encouraged to assess its utility in other settings and with other dietary interventions.

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Available from: Deborah J Toobert, Jul 30, 2014
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    • "Some tools have been developed for PC (Gans et al., 2003). The majority of these tools have focused on specific nutrients (e.g., fat, salt), foods (e.g., fruit and vegetables), or meal patterns (e.g., regular meals) (Hark &amp; Deen, 1999;Paxton, Strycker, Toobert, Ammerman, &amp; Glasgow, 2011); however, some of these questionnaires take 10–15 minutes to complete, which is not realistic given that physicians conduct most DA in a couple of minutes (Eaton et al., 2002). Given the complexity of diet, different tools may make more sense in screening for different diet problems, followed by more in-depth assessment by a relevant member of the team. "
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    • "To encourage responses, initial mailings included a $10 gift card and nonrespondents received 2 follow-up reminders. The questionnaire included measures on patient experiences with clinicians, exercise behavior, patient activation measures (using the Patient Activation Measure-13) (Hibbard et al., 2005), general health (using the Medical Outcomes Study 12-item Short Form Version 2) (Frosch et al., 2010), diet using questions from the " Starting the Conversation " measure (Paxton et al., 2011), self-reported chronic conditions, and demographics. "
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    • "The presence and severity of depressive symptoms at baseline is measured using the Patient Health Questionnaire (PHQ-8), [47] which is re-administered during the 30-day follow up interview, as both prevalent and incident depression are common in this setting and impact multiple outcomes [48]. Other health behaviors, such as tobacco/alcohol use, diet, and exercise are measured using the Centers for Disease Control (CDC) Behavioral Risk Factor Surveillance System (BRFSS), [49] the Starting the Conversation (STC) scale, [50] and the Exercise Vital sign, [51] respectively. Post-discharge stress is assessed as well (Table 1). "
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