FACTORS ASSOCIATED WITH ADHERENCE TO THE DIETARY-PROTEIN INTERVENTIONIN THE MODIFICATION OF DIET IN RENAL-DISEASE STUDY

Objective To determine the characteristics and behaviors associated wi th adherence to dietary protein interventions among participants with chronic renal disease in the Modification of Diet in Renal Disease ((M DRD) Study. Design Participants were categorized as consistent adherer s or nonadherers on the basis of urinary urea nitrogen excretion and d ietary protein intake data from self-reports. Psychosocial and behavio ral factors were compared between groups. Subjects Subgroups of consis tently adherent and nonadherent participants in the MDRD Study. Settin g 15 clinical centers in the United States. Intervention In the nutrit ion intervention program, participants were assigned randomly to a usu al-, low-, or very-low-protein diet group. Each eating pattern also sp ecified a phosphorus goal. Statistical analysis Analysis of variance. Result Psychosocial factors significantly related to adherence include d participant knowledge, attitude, support, satisfaction, and self-per ception of success. Behavioral strategies including participant self-m onitoring of protein intake and the provision of feedback by the dieti tian were also significantly related to adherence. Application Nutriti on interventions for patients with renal disease should focus on psych osocial factors and behavioral approaches. Such approaches can be succ essfully incorporated into treatment programs and will assist the diet itian in promoting adherence to usual-, low-, and very-low-protein eat ing patterns.