The efficacy of nationally distributed Smart Family - lifestyle counselling method

Abstract

Background: In Finland maternity and child welfare clinics reach 98% of their target group. Smart Family is a lifestyle counselling method coordinated by Finnish Heart Association and applied in 110/320 municipalities. Smart Family method is based on self-monitoring and motivational interviewing. The aim in this study was to investigate if clients who received Smart Family lifestyle counselling perceived more autonomy support (AS) and had higher self-efficacy for healthy diet. Methods: Nurses who delivered intervention were educated for the Smart Family method. Parents completed questionnaires after a visit at maternity or child welfare clinic (T1: n = 210 Smart Family, n = 152 control) and after next visit 6 -25 weeks (T2: n = 126 intervention; n = 104 control; expected end of data collection 4/2016). Findings: There were no significant changes in AS [F(1,218) = .53, p = .468] or self-efficacy for healthy diet [F(1,219) = .28, p = .596] between T1 and T2. Although the direction of the means favored Smart Family, the repeated measures ANOVA showed that the groups did not differ either in AS [F(1,218) = 2.54, p = .113] or in self-efficacy for healthy diet [F(1,219) = .17, p = .684]. In the multiple regression model neither AS (β = .13, SE =.042, p = .057) nor study arm (β = .06, SE =.050, p = .350) predicted change in self-efficacy for healthy diet (R2adj. = .013). Discussion: Possible explanations including dose of lifestyle counselling in health care and fidelity of the intervention will be discussed.