# A Stage of Change Theory–Based, Stage-Matched Intervention for Healthy Dietary Intake Among Office Workers in a Low- to Middle-Income Country: Protocol for a Cluster Randomized Trial

## TL;DR

This study tests a diet intervention for office workers in Sri Lanka, using a theory-based approach to encourage healthier eating habits.

## Contribution

The study introduces a stage-matched dietary intervention based on stage of change theory in a low- to middle-income country context.

## Key findings

- The intervention was implemented in 20 office clusters with sedentary workers.
- Participants received tailored interventions based on their stage of change, including awareness-raising and goal-setting.
- Dietary intake and stage of change were assessed using a staging algorithm and 24-hour dietary recall.

## Abstract

An unhealthy diet is a well-established risk factor for the development of noncommunicable diseases, and office workers are at a higher risk of noncommunicable diseases due to their sedentary work style. Stage of change (SOC) theory–based and stage-matched interventions effectively influence dietary and behavior changes. The effectiveness of such interventions in the context of low- and middle-income countries is yet to be assessed.

This protocol describes a cluster randomized trial planned to evaluate the effectiveness of an intervention for changing dietary behavior among government office workers in the Galle district in Sri Lanka.

A cluster randomized trial was conducted in 20 clusters divided into intervention and control arms. A cluster was an office with 30 clerical-type workers who were sedentary at work. A stage-matched intervention based on behavior change processes was implemented in the intervention clusters for 3 months. Participants were provided with an intervention matched to their SOC at baseline. Precontemplators and contemplators received awareness-raising and emotional arousal interventions. Others received goal setting and self-monitoring interventions. The SOC and dietary intake were assessed at baseline and the postintervention stage through a staging algorithm, and 24-hour dietary recall was supplemented with a picture guide and computer software. Adherence to the intervention was assessed monthly. We hypothesized that participants would achieve a progressive change in the SOC and healthy dietary intake in the intervention clusters compared to the control clusters.

By December 2024, the planned intervention was completed. Data analysis on the effectiveness of the intervention is to be completed and published in 2025.

This protocol reports a stage-matched intervention based on SOC theory, enriching the current knowledge base with new evidence from office workers in a low- to middle-income country.

Sri Lanka Clinical Trials Registry SLCTR/2020/025; https://slctr.lk/trials/slctr-2020-025

DERR1-10.2196/70293