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Mobile application-based dietary sugar intake reduction intervention study according to the stages of behavior change in female college students

모바일 어플리케이션 기반 당류 저감화 중재 프로그램의 행동변화단계에 따른 효과 분석 : 일부 여대생 대상 연구

  • Choi, Yunjung (Department of Food and Nutrition, Sookmyung Women's University) ;
  • Kim, Hyun-Sook (Department of Food and Nutrition, Sookmyung Women's University)
  • 최윤정 (숙명여자대학교 생활과학대학 식품영양학과) ;
  • 김현숙 (숙명여자대학교 생활과학대학 식품영양학과)
  • Received : 2019.09.02
  • Accepted : 2019.10.18
  • Published : 2019.10.31

Abstract

Purpose: This study examined the effects of a mobile app-based program to reduce the dietary sugar intake according to the stages of the behavioral change in dietary sugar reduction in female college students. Methods: The program used in this study can monitor the dietary sugar intake after recording the dietary intake and provide education message for the reduction of dietary sugar intake. In an eight-week pre-post intervention study, 68 female college students were instructed to record all the food they consumed daily and received weekly education information. At pre-post intervention, the subjects were asked to answer the questionnaire about sugar-related nutrition knowledge, sugar-intake behavior, and sugar-intake frequency. For statistical analysis, ANOVA and a paired t-test were used for comparative analysis according Precontemplation (PC), Contemplation Preparation (C P), and A M (Action Maintenance) stage. Results: Significant differences were observed in the frequency of snacking, experience of nutrition education, and preference for sweetness according to the stages of behavior change in dietary sugar reduction. After finishing an intervention, the sugar-related nutrition knowledge score was increased significantly in the stages of Precontemplation (PC) and Contemplation Preparation (C P). The score of the sugar intake behavior increased significantly in all stages. The intake frequency of chocolate, muffins or cakes, and drinking yogurt decreased significantly in the PC stage and the intake frequency of biscuits, carbonated beverages, and fruit juice decreased significantly in the C P stage. Subjects in the PC and C P stages had an undesirable propensity in nutrition knowledge, sugar-intake behavior, and sugar-intake frequency compared to the A M stage, but this intervention improved significantly their nutrition knowledge, sugar-intake behavior, and sugar-intake frequency. Conclusion: This program can be an effective educational tool in the stages of PC and C P, and is expected to further increase the usability and sustainability of mobile application if supplemented appropriately to a health platform program.

서울시에 거주하는 여대생 68명을 대상으로 본 연구에서는 모바일 앱 기반 당류 저감화 프로그램을 개발한 후, 개발된 프로그램을 활용하여 당류 저감화 행동변화단계에 따른 중재효과를 분석 비교하였다. 하루 간식섭취횟수, 당류교육경험여부, 단맛에 대한 기호도에서 행동변화단계에 따른 유의한 차이가 있었다. 당류에 관한 영양 지식 점수는 프로그램 중재 전에 행동 유지단계 대상자들이 고려전단계 대상자들에 비해 영양 지식 점수가 유의하게 높았으며 프로그램 중재 후에는 고려전단계와 고려 준비단계에서 영양 지식 점수가 유의적으로 상승하였고, 행동 유지단계도 점수가 상승하였지만 유의적이지는 않았다. 당류 섭취에 관한 식행동 점수는 프로그램 중재 전 행동 유지단계 대상자들이 고려전단계 대상자들에 비해 유의적으로 높았으며, 행동 유지단계 대상자들의 점수가 모든 식행동 항목에서 가장 높았다. 연구 결과 프로그램 중재 후 모든 행동변화단계에서 당류 섭취에 관한 식행동 점수는 유의적으로 상승하였다. 프로그램 중재 전 당류 섭취빈도는 음료류 중 '탄산음료', '과실주스'에서 고려 준비단계와 행동 유지단계에 따른 차이가 유의적이었고, 우유 및 유제품, 아이스크림 제품류 중 '액상 요구르트'는 고려전단계와 행동 유지단계에서 유의적인 차이가 있었다. 행동 유지 단계에서는 '비스킷'과 '단맛씨리얼'을 제외한 모든 항목의 섭취 빈도가 고려전단계, 고려 준비단계와 비교하여 가장 낮았다. 프로그램 중재 후에는 고려전단계에서 '초콜릿', '머핀케익류', '액상 요구르트'의 섭취 빈도가 유의적으로 감소하였고, 고려 준비단계에서는 '비스킷', '탄산음료', '과실주스', '가공우유'의 섭취 빈도가 유의적으로 감소하였다. 행동 유지단계 대상자들에서는 대부분의 항목에서 섭취 빈도가 감소하였지만 유의한 개선은 없었다. 당류 저감화를 실천하는 행동 유지단계 대상자들에 비해 고려전, 고려준비 단계 대상자들은 영양지식, 식행동, 섭취빈도가 바람직하지 않은 방향이었으나 모바일 앱 기반 당류 저감화 프로그램에 의해 고려전, 고려준비단계에서 영양지식, 식행동, 섭취빈도가 개선되었다. 당류에 관한 쉽고 정확한 교육정보를 제공함과 동시에 사용자 스스로 식이모니터링을 할 수 있도록 고안된 본 연구의 모바일 앱 기반 당류 저감화 프로그램은 고려전, 고려준비단계에 있는 대상자들의 당류 저감화 효과를 창출할 수 있는 효과적인 교육 도구이다. 본 프로그램은 시간과 장소에 구애받지 않고 사용 가능하므로 당류 교육 참여가 어려운 청년층을 위해 유용하게 활용될 수 있을 것이다. 또한 여러 연령층으로 확대가 가능하며 행동변화단계별로 세분화하여 적용한다면 당류 섭취 저감화에 효과적으로 기여 할 것으로 사료된다. 본 연구의 앱 기반 당류 저감화 프로그램에 건강 플랫폼에서 활용하고 있는 게이미피케이션 (gamification) 기법을 사용하여 흥미가 추가되도록 보완하면, 수용성 및 지속가능성이 더욱 증가할 것으로 기대된다.

Keywords

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