• Raquel de Deus Mendonça, Larissa Morelli Ferraz Guimarães, Suely Aparecida Mingoti, Kelly Alves Magalhães, and Aline Cristine Souza Lopes.
• Nutrition Department, Federal University of Minas Gerais, Belo Horizonte, Brazil.
• Nutrition. 2019 Nov 1; 67-68: 110568.

ObjectivesThe aim of this study was to investigate the barriers and facilitators for the adherence of participants to a nutritional intervention.MethodsA randomized controlled trial was carried out with participants from the Health Academy Program in Belo Horizonte, MG, Brazil. The intervention (7 mo) was based on the Transtheoretical Model and on Paulo Freire's pedagogy and offered 12 education activities with the purpose of promoting the consumption of fruits and vegetables. Adherene was determined by calculating the participation percentage (attendance at activities/number of activities).ResultsIn all, 1483 individuals participated and the average adherence was 58.3%. Low adherence was demonstrated by 24.3%, medium adherence by 26.5%, and high adherence by 49.2% of the participants. Adherence was associated with aging (odds ratio [OR], 1.97; 95% CI, 1.33-2.94), being unemployed (OR, 0.75; 95% CI, 0.58-0.95), not being under psychiatric treatment (OR, 0.77; 95% CI, 0.63-0.95), participant body satisfaction (OR, 1.27; 95% CI, 1.02-1.58) and participant attendance at the Health Academy Program for >1 y (OR, 2.78; 95% CI, 2.17-3.56). The qualitative analysis revealed the following facilitators for adherence: service structure, intervention methodology, bond-building among users and professionals, family support, and patient-associated aspects. The barriers to adherence included work, self-care, and care for another.ConclusionAdherence to the intervention was high, and the patient-associated aspects, the logistics of the Health Academy Program, and the methodology appeared to contribute to adherence. However, the timetable was a barrier for those who were working and for those who support their families.Copyright © 2019. Published by Elsevier Inc.

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