{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T07:31:38Z","timestamp":1793259098258,"version":"4.5.0"},"reference-count":23,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Nutr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Poor nutrition and HIV disease progression form a vicious cycle. Nutrition education interventions based on behavioural theories may improve dietary practices among people living with HIV\/AIDS (PLWHA). This study examined the effects of a Health Belief Model (HBM)-based nutrition education intervention on dietary diversity practices among adults on antiretroviral treatment (ART) in the Ilu Abbabor Zone, southwestern Ethiopia. A facility-based quasi-experimental study with a control group was conducted from September 2019 to May 2020. A total of 384 adult PLWHA (192 intervention, 192 control) were recruited from six health facilities selected by simple random sampling. The intervention group received HBM-based nutrition education every 15 days for 4 months (8 sessions total), while the control group received standard education at baseline only. Dietary diversity was assessed using the FAO\/FANTA Individual Dietary Diversity Score (IDDS). Difference-in-differences (DID) regression estimated the intervention effect while controlling for baseline demographic differences. At baseline, good dietary diversity was similar between groups (37\u00b75 %\n                    <jats:italic>v<\/jats:italic>\n                    . 39 %,\n                    <jats:italic>P<\/jats:italic>\n                    = 0\u00b7375). After the intervention, good dietary diversity increased to 66 % in the intervention group\n                    <jats:italic>v<\/jats:italic>\n                    . 53 % in the control group (\n                    <jats:italic>P<\/jats:italic>\n                    = 0\u00b7004). The DID estimate was 9 % (95 % CI: 0\u00b705 to 0\u00b713;\n                    <jats:italic>\u03b2<\/jats:italic>\n                    = 0\u00b709;\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0\u00b7001), indicating a significant intervention effect. All HBM constructs except perceived self-efficacy showed significant correlations with dietary diversity practices, with perceived barriers negatively correlated. HBM-based nutrition education significantly improved dietary diversity among adults on ART. Incorporating behavioural models such as HBM into routine nutritional counselling may strengthen HIV care and support nutritional science-informed practice in resource-limited settings.\n                  <\/jats:p>","DOI":"10.1017\/s0007114526108666","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T07:03:26Z","timestamp":1791788606000},"page":"1-6","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Effect of a health belief model-based nutrition education intervention on dietary diversity among adults on antiretroviral treatment in Ilu Abbabor Zone, Southwestern Ethiopia"],"prefix":"10.1017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2093-1120","authenticated-orcid":false,"given":"Ebissa","family":"Gemechu","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05eer8g02","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute of Health, Jimma University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tefera","family":"Lemma","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05eer8g02","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute of Health, Jimma University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalkidan","family":"Abate","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05eer8g02","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute of Health, Jimma University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"S0007114526108666_ref5","volume-title":"Food and Nutrition Implications of Antiretroviral Therapy in Resource-Limited Settings","year":"2016"},{"key":"S0007114526108666_ref2","volume-title":"Report on the Nutrition Challenge in Sub-Saharan Africa","author":"Johnson","year":"2012"},{"key":"S0007114526108666_ref16","first-page":"218","article-title":"Dietary intake adequacy of people living with HIV\/AIDS in rural communities of Imo State, Nigeria","volume":"21","author":"Akwivu","year":"2017","journal-title":"J Agric Ext"},{"key":"S0007114526108666_ref14","first-page":"451","article-title":"Economic growth is necessary but not sufficient to reduce hunger and malnutrition","volume":"4","author":"Smith","year":"2013","journal-title":"Adv Nutr"},{"key":"S0007114526108666_ref13","unstructured":"13. Catholic Relief Services (2007) A practical guide to nutrition for people living with HIV. Baltimore, MD, USA."},{"key":"S0007114526108666_ref8","volume-title":"Defining nutrition assessment, counseling, and support (NACS)","year":"2012"},{"key":"S0007114526108666_ref21","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/6731815"},{"key":"S0007114526108666_ref19","first-page":"7162310","article-title":"Dietary diversity and associated factors among HIV positive adults in Northwest Ethiopia","volume":"2018","author":"Tadesse","year":"2018","journal-title":"Adv Public Health"},{"key":"S0007114526108666_ref9","volume-title":"Ethiopian Demographic and Health Survey 2019","year":"2020"},{"key":"S0007114526108666_ref23","first-page":"151","article-title":"Effectiveness of nutrition education based on health belief model","volume":"2","author":"Sharifirad","year":"2013","journal-title":"J Educ Health Promot"},{"key":"S0007114526108666_ref20","first-page":"8","article-title":"Factors associated with dietary diversity among HIV positive adults in Northwest Ethiopia","volume":"6","author":"Worku","year":"2015","journal-title":"J AIDS Clin Res"},{"key":"S0007114526108666_ref3","volume-title":"The State of Food Insecurity in the World: Strengthening the Enabling Environment for Food Security and Nutrition","year":"2016"},{"key":"S0007114526108666_ref4","doi-asserted-by":"publisher","DOI":"10.1086\/605573"},{"key":"S0007114526108666_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-008-9042-y"},{"key":"S0007114526108666_ref12","volume-title":"Global AIDS Update","year":"2016"},{"key":"S0007114526108666_ref10","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.012809.103604"},{"key":"S0007114526108666_ref1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2010.28608D"},{"key":"S0007114526108666_ref6","doi-asserted-by":"publisher","DOI":"10.1086\/367558"},{"key":"S0007114526108666_ref7","volume-title":"Krause\u2019s Food and Nutrition Therapy","author":"Mahan","year":"2008"},{"key":"S0007114526108666_ref17","unstructured":"17. Nanziri, C (2010) Factors associated with dietary intake among HIV positive adults at Mildmay Centre Kampala, Uganda."},{"key":"S0007114526108666_ref18","first-page":"10","article-title":"Factors affecting dietary intake and diversity among adults living with HIV in Kenya","volume":"7","author":"Mbithe","year":"2018","journal-title":"J Nurs Health Sci"},{"key":"S0007114526108666_ref22","doi-asserted-by":"publisher","DOI":"10.5812\/ircmj.23584"},{"key":"S0007114526108666_ref15","first-page":"63","article-title":"Dietary diversity and associated factors among HIV positive adults attending ART clinics in eastern Ethiopia","volume":"10","author":"Weldegebreal","year":"2018","journal-title":"HIV AIDS (Auckl)"}],"updated-by":[{"DOI":"10.1017\/s0007114526109520","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000}}],"container-title":["British Journal of Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007114526108666","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T07:03:29Z","timestamp":1791788609000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007114526108666\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":23,"alternative-id":["S0007114526108666"],"URL":"https:\/\/doi.org\/10.1017\/s0007114526108666","relation":{},"ISSN":["0007-1145","1475-2662"],"issn-type":[{"value":"0007-1145","type":"print"},{"value":"1475-2662","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of The Nutrition Society","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}