Focus Groups Matched to Stage of Change for Dietary Fat Reduction

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Five focus groups, matched by Stage of Change, explored subjects perceptions about dietary fat reduction as well as strategies to limit fat intake. Subjects were recruited by telephone after an 18-month study of dietary change. Stage was determined by intention to change as well as fat intake (Maintenance ≤30% energy from fat). Subjects received individualized feedback prior to the groups either listing behavior changes calculated to reduce their fat to ≤30% energy or providing reinforcement for a low fat intake. Perceptions and strategies varied by stage of change. For example, Precontemplators (N = 14) did not see themselves at risk of disease associated with fat intake and did not think they were consuming excessive fat. They felt their diet was healthy because they ate a variety of foods and avoided "unnatural" low-fat food products. In contrast, subjects in Preparation (N = 17) recognized the health risks of dietary fat. They tried to avoid eating high-fat foods but didn't like low-fat substitutes and didn't limit fat when eating out. Maintainers (N = 18) were committed to low-fat eating habits. They perceived themselves as needing to avoid fat for specific health problems or weight concerns. They regularly avoided high-fat foods and used low-fat food substitutes. They were more concerned with avoiding fat than balance, variety, or moderation. These findings reinforce the need to tailor interventions to an individual's Stage of Change. In addition, they raise interesting questions about perceptions of healthy eating and the complex relationship between level of fat intake and unhealthy eating patterns. © 1995 American Dietetic Association.

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Journal of the American Dietetic Association