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        Exploring preferred methods of peer support approaches to encourage adherence to a Mediterranean Diet in a Northern European population at high risk of Cardiovascular Disease
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        Exploring preferred methods of peer support approaches to encourage adherence to a Mediterranean Diet in a Northern European population at high risk of Cardiovascular Disease
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There is a clear pattern of increasing incidence of chronic diseases in western civilization, which is beginning to establish in developing countries( 1 ). Epidemiological studies have demonstrated that a two point increase in adherence to a Mediterranean Diet (MD) is associated with an 8 % reduction in all-cause mortality, particularly from chronic diseases such as cardiovascular disease (CVD)( 2 ). Peer support has been suggested as a possible cost-effective method to encourage adoption and maintenance of the MD in at risk populations. However development of such a programme has not been fully explored in the literature. The aim of this study was to use a mixed methods approach to determine the preferred approach for a peer-support intervention to encourage adoption of the MD. This work represents the first stage of the TEAM-MED feasibility study.

Qualitative (focus groups) and quantitative methods (questionnaire and preference scoring sheet) were used to determine preferred methods of peer support. A total of 67 participants at high risk of CVD took part in 12 focus groups; 27 males and 40 females with a mean age of 63. Discussions were stimulated using vignettes to contextualise the different concepts and facilitate understanding. Focus group data was transcribed under pseudonyms, coded using Nvivo 10 and thematically analysed. Quantitative data was analysed using IBM SPSS 11.

Group peer support was qualitatively and quantitatively the most preferred method. The mean preference score (1 being most preferred and 5 being least preferred) for group support was 1·5, compared to 3·4 for peer mentorship, 4·0 for telephone support and 4·0 for internet support. Thematic analysis of the focus groups produced themes 1 and 2; that elucidate reasons for the group support preference, and 3; which proposes that a combination of methods may be most effective in encouraging behavioural change (see table).

It is useful to understand how participants conceptualise group peer support and their views are imperative to improve future models to assist in behavioural change.

1. Lopez, AD, Mathers, CD, Ezzati, M, Jamison, DT, Murray, CJ (2006) Lancet 367, 1747–57.
2. Sofi, F, Macchi, C, Abbate, R, Gensini, GF, Casini, A. (2014 Dec) Public Health Nutr. 17(12), 2769–82.