{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:56:17Z","timestamp":1790034977194,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Human Nutrition Diet"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify the key behavioural determinants that influence dietary self\u2010management among adults with CKD, using the Theoretical Domains Framework and Behaviour Change Wheel to guide development of practical dietary interventions for clinical practice and research trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A theory\u2010informed secondary analysis of a published qualitative meta\u2010synthesis that included 92 studies and 2924 adults with CKD from 23 countries. Themes from the meta\u2010synthesis were mapped to Theoretical Domains Framework (v2) and linked to Behaviour Change Wheel intervention functions and behaviour change techniques. Potential behaviour change intervention strategies were then evaluated using the APEASE criteria (Affordability, Practicability, Effectiveness\/Cost\u2010effectiveness, Acceptability, Side\u2010effects\/Safety, Equity).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve of the 14 Theoretical Domains Framework (v2) domains were identified, indicating that dietary self\u2010management in CKD is influenced by a broad range of cognitive, emotional, social, and environmental factors. Key barriers included inconsistent or conflicting dietary advice (Knowledge; Environmental Context and Resources), limited practical guidance (Skills; Behavioural Regulation), and emotional distress and social disruption associated with dietary change (Emotion; Social Influences). Trust in healthcare professionals and experiential learning also shaped adherence (Beliefs about Capabilities and Consequences). Optimism and Intentions domains were not evident. Mapping to the Behaviour Change Wheel identified Education, Enablement, Environmental Restructuring, Training, Persuasion, Incentivisation, and Modelling as relevant intervention functions. APEASE assessment suggested that Education and Enablement were the most feasible, acceptable, and scalable approaches for clinical implementation, while more complex components requiring additional resources or coordination (e.g., training and system\u2010level changes) were comparatively less practical.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dietary self\u2010management in CKD is influenced by multiple behavioural determinants beyond knowledge alone. Interventions should therefore integrate education with skills training, confidence building, social support, and environmental adaptation. Embedding these multi\u2010component strategies within clinical nutrition practice and research may enhance self\u2010management and improve patient engagement across the CKD care pathway.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jhn.70295","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:30:14Z","timestamp":1783053014000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Behavioural Determinants of Dietary Self\u2010Management in Chronic Kidney Disease: A Theory\u2010Informed Analysis to Inform Dietetic Interventions"],"prefix":"10.1111","volume":"39","author":[{"given":"Andrew","family":"Morris","sequence":"first","affiliation":[{"name":"Health and Community Wellbeing Research Centre Coventry University  Coventry UK"},{"name":"Dietetic Department, Worcestershire Acute Hospitals NHS Trust Charles Hastings Way  Worcester UK"},{"name":"Renal Delivery Network, NIHR West Midlands Regional Research Delivery Network, The Royal Wolverhampton Trust New Cross Hospital, Wednesfield  Wolverhampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Lycett","sequence":"additional","affiliation":[{"name":"Health and Community Wellbeing Research Centre Coventry University  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riya","family":"Patel","sequence":"additional","affiliation":[{"name":"Diabetes Research Department, NIHR East Midlands Applied Research Centre Leicester General Hospital  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group","year":"2024","journal-title":"Kidney International"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.05.006"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2013.147"},{"key":"e_1_2_11_5_1","unstructured":"National Institute for Health and Care Excellence (NICE). 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