Longitudinal Relationship Between Elapsed Time In The Action Stages Of Change And Weight Loss
balance; decisional; Endocrinology & Metabolism; exercise; health behaviors; longitudinal study; Nutrition & Dietetics; obesity; physical-activity; primary care; primary care; reducing dietary-fat; self-efficacy; transtheoretical model; weight loss; women
Objective: The objective of this study was to examine the longitudinal relationship between the elapsed time in the action and maintenance stages of change for multiple target behaviors and weight loss or gain. Research Methods and Procedures: The research design was a prospective cohort study of overweight and obese primary care patients randomized to an obesity management intervention based on the Transtheoretical Model and a chronic disease paradigm. The target behaviors included increased planned exercise and usual physical activity, decreased dietary fat, increased fruit and vegetable consumption, and increased dietary portion control. The participants were 329 middle-aged men and women with elevated body mass indices recruited from 15 primary care practices in Northeastern Ohio; 28% of the participants were African Americans. The main outcomes were weight loss (5% or more) or weight gain (5% or more) after 18 or 24 months of follow-up. Results: There were significant (p < 0.05) longitudinal relationships between the number of periods (0 to 4) in action or maintenance for each of the five target behaviors, or a composite score taken across the five target behaviors, and weight loss. In all cases, there was a significant (p < 0.05) stepped (graded) relationship between the time in action or maintenance and weight loss (or gain). Discussion: The data support the concept of applying the Transtheoretical Model to the problem of managing obesity in primary care settings. The remaining challenge is to identify those factors that reliably move patients into the action and maintenance stages for long periods.
Logue E E; Jarjoura D G; Sutton K S; Smucker W D; Baughman K R; Capers C F
Obesity Research
2004
2004-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1038/oby.2004.187" target="_blank" rel="noreferrer noopener">10.1038/oby.2004.187</a>
Biopsychosocial characteristics of overweight and obese primary care patients: do psychosocial and behavior factors mediate sociodemographic effects?
intervention; social support; obesity; self-efficacy; exercise; balance; primary care; General & Internal Medicine; Environmental & Occupational Health; Public; Health; women; behavior; body-mass index; body-mass index; physical-activity; weight management; 7-day recall; decisional; energy intake; energy intake; motivational readiness; physical-activity
Background. The increasing prevalence of obesity and obesity-related conditions in primary care settings challenges the health care system. Thus. we used available baseline data from an on-going clinical trial to examine the biopsychosocial characteristics of overweight and obese primary care patients. The primary research objective was to ascertain whether theoretically important psychosocial and behavioral variables mediate the empirical relationships between sociodemographic factors and body mass index (BMI). Methods. Overweight or obese primary care patients (n = 665) enrolled in an on-going trial of a cognitive-behavioral obesity intervention provided baseline sociodemographic, psychosocial, nutritional, physical activity, and anthropometric data that were analyzed via multiple regression. Results. Lower educational attainment was associated with a higher BMI after controlling for decisional balance, social support, self-efficacy, energy intake, and energy expenditure (P < 0.05). In contrast, ethnicity was not associated with BMI after controlling for the psychosocial and behavioral variables. Decisional balance and social support variables were associated with BMI and energy intake, but the directions of some of the associations were not consistent with a priori expectations. Conclusions. Overall, we found some evidence of mediation by the psychosocial and behavioral variables of the relationship between ethnicity and BMI, but not for the relationship between education and BMI. In addition, some of the relationships between the psychosocial variables and BMI were opposite of our expectations. (C) 2003 American Health Foundation and Elsevier Science (USA). All rights reserved.
Baughman K; Logue E E; Sutton K; Capers C; Jarjoura D; Smucker W
Preventive Medicine
2003
2003-08
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/s0091-7435(03)00095-1" target="_blank" rel="noreferrer noopener">10.1016/s0091-7435(03)00095-1</a>