Assessing dietary and exercise stage of change to optimize weight loss interventions
assessment; behaviors; diet and exercise; Endocrinology & Metabolism; expert-system intervention; fat; minority women; model; nutrient database; Nutrition & Dietetics; obesity; older-adults; physical-activity; population; smoking cessation; stage of change; Transtheoretical; weight loss intervention
Objective: According to the Transtheoretical Model (TM), tailoring interventions to patients' readiness to change can enhance patient progress and help patients use therapeutic resources more effectively. However, tailoring an intervention depends on accurate assessment of patients' stage of change (SOC). This study describes a multi-item algorithm of SOC (M-SOC) for weight loss-related behaviors that attempts to overcome some of the conceptual and methodological difficulties encountered in previously SOC assessments. Research Methods: Data were collected from participants randomly assigned to the treatment arm of a clinical trial comparing a TM-based, cognitive-behavioral intervention with enhanced usual care for weight loss. Results: The stair-step relationships hypothesized by the TM between assessed SOC and key behavioral measures were found for all algorithms (p < 0.05), indicating that the M-SOC algorithm performs as well as single item algorithms. However, 50% fewer patients were classified in action or maintenance for dietary fat intake and portion control (p < 0.05) by the multiple-item algorithms, providing staging more consistent with the clinical presentation of obese individuals. In addition, logistic regression analyses indicated that the single-item algorithms were not sufficient predictors of these behavioral domains. Discussion: To the extent that treatment is guided by assessed SOC, there is potential for a considerable variability in interventions with different approaches to staging. For weight-loss interventions that target portion control and decreased fat intake, the multi-item SOC algorithms seem to be better guides for matching treatments to SOC.
Sutton K; Logue E; Jarjoura D; Baughman K; Smucker W; Capers C
Obesity Research
2003
2003-05
Journal Article
<a href="http://doi.org/10.1038/oby.2003.92" target="_blank" rel="noreferrer noopener">10.1038/oby.2003.92</a>
Obesity treatment: Broadening our perspective
body-mass index; Cardiovascular disease; dietary behaviors; dietary fiber; Environmental & Occupational Health; food-intake; glycemic index; low-fat; night-eating syndrome; obesity; patterns; Public; randomized controlled-trial; weight management; weight-loss
Objective: To selectively review the dietary literature to broaden perspectives on energy restriction as the primary determinant of successful obesity treatment. Methods: Forty-five articles describing novel dietary behaviors and nutrient intakes that may impact obesity treatment are examined. Results: Two areas of promising research were identified: (a) Dietary behaviors and patterns - eating frequency, meal timing, specific dietary pattern and (b) Nutritional factors - fat, fiber, glycemic load, carbohydrate. Conclusions: Caloric restriction leads to weight loss. However, promotion of dietary behaviors that focus primarily on cutting calories needs evaluation. There may be many dietary behaviors and patterns that promote weight loss and maintenance, making it essential to consider new nutritional approaches for obesity treatment.
Taylor E; Missik E; Hurley R; Hudak S; Logue E
American Journal of Health Behavior
2004
2004-05
Journal Article
<a href="http://doi.org/10.5993/ajhb.28.3.5" target="_blank" rel="noreferrer noopener">10.5993/ajhb.28.3.5</a>
HIGH NORMAL SERUM POTASSIUM PREDICTS MORTALITY
Urology & Nephrology
Silver M R; Vo T T; Logue E; McCord G
Journal of the American Society of Nephrology
1994
1994-09
Journal Article
n/a