Abstract
Objective
To examine whether baseline behavior-specific cognitions moderated the effects of
2 Web-based interventions with enhanced features on weight loss success in rural women.
Design
Secondary analysis of behavior-specific cognition data from a community-based, randomized
controlled trial, as potential moderators of weight loss over 30 months.
Participants
Women, overweight or obese, from rural communities, aged 40–69 years (n = 200).
Interventions
Theory-based Web interventions, with enhanced features of either peer-led Web discussion
or professional e-mail counseling.
Main Outcome Measures
Benefits and barriers to healthy eating and activity; self-efficacy and interpersonal
support for healthy eating and activity using validated surveys; and weight.
Analysis
Longitudinal multilevel models.
Results
Women in the professional e-mail counseling group were more likely to lose weight
if they perceived fewer barriers to and higher self-efficacy for healthy eating and
activity. Greater weight loss in the peer-led discussion group was observed for women
with lower self-efficacy and higher perceptions of barriers. Interpersonal support
did not moderate the effects of the interventions.
Conclusions and Implications
Although women in 2 different Web-enhanced interventions achieved similar weight loss,
their baseline perceptions of behavior-specific cognitions moderated their relationship
with the type of intervention and weight loss success. These findings, although exploratory,
may assist in matching women to Web interventions that would best maximize weight
loss success. Further research is needed.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessSNEB Member Login
SNEB Members, full access to the journal is a member benefit. Login via the SNEB Website to access all journal content and features.Subscribe:
Subscribe to Journal of Nutrition Education and BehaviorAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Web-based interventions for weight loss or weight loss maintenance in overweight and obese people: a systematic review of systematic reviews.J Med Internet Res. 2017; 19: e229
- Effectiveness of web-based interventions in achieving weight loss and weight loss maintenance in overweight and obese adults: a systematic review with meta-analysis.Obes Rev. 2010; 11: 306-321
- Web-based interventions alone or supplemented with peer-led support or professional email counseling for weight loss and weight maintenance in women from rural communities: results of a clinical trial.J Obes. 2017; 20171602627
- Interactive computer‐based interventions for weight loss or weight maintenance in overweight or obese people.Cochrane Database Syst Rev. 2012; 8CD007675
- Efficacy of standard versus enhanced features in a web-based commercial weight-loss program for obese adults, part 2: randomized controlled trial.J Med Internet Res. 2013; 15: e140
- Internet-based weight control: the relationship between web features and weight loss.Telemed J E Health. 2008; 14: 775-782
- Features predicting weight loss in overweight or obese participants in a Web-based intervention: randomized trial.J Med Internet Res. 2012; 14: e173
- A review of efficacious technology-based weight-loss interventions: five key components.Telemed J E Health. 2010; 16: 931-938
- A randomized comparison of two motivationally enhanced Internet behavioral weight loss programs.Behav Res Ther. 2008; 46: 1090-1095
- Health Promotion in Nursing Practice.6th ed. Pearson, Upper Saddle River, NJ2011
- Values, expectations, and the prediction of social action: an expectancy-valence analysis.Motiv Emot. 1982; 6: 217-244
- Self-efficacy: toward a unifying theory of behavioral change.Psychol Rev. 1977; 84: 191-215
- Assessment of psychological predictors of weight loss: how and what for?.World J Psychiatry. 2015; 5: 56-67
- Dietary and physical activity behaviors among adults successful at weight loss maintenance.Int J Behav Nutr Phys Act. 2006; 3: 17
- Determinants of weight loss maintenance: a systematic review.Obes Rev. 2018; 20: 171-211
- Psychosocial pretreatment predictors of weight control: a systematic review update.Obes Facts. 2018; 11: 67-82
- Past, present, and future of eHealth and mHealth research to improve physical activity and dietary behaviors.J Nutr Educ Behav. 2016; 48: 219-228.e1
- NIH working group report: innovative research to improve maintenance of weight loss.Obesity. 2014; 23: 7-15
- Syme S; Committee on Capitalizing on Social Science and Behavioral Research to Improve the Public's Health. Promoting health: intervention strategies from social and behavioral research.Am J Health Promot. 2001; 15: 149-166
- Reducing cardiovascular disease risk factors in rural sedentary, overweight, and obese midlife and older women.Am J Public Health. 2009; 99: 1271-1277
- Developing a research agenda for cardiovascular disease prevention in high-risk rural communities.Am J Public Health. 2013; 103: 1011-1021
- Web-based interventions for weight loss and weight maintenance among rural midlife and older women: protocol for a randomized controlled trial.BMC Public Health. 2011; 11: 521
- Dietary Guidelines for Americans, 2010.7th ed. US Government Printing Office, Washington, DC2011
US Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. Washington, DC: US Department of Health and Human Services; 2019. https://health.gov/sites/default/files/2019-09/paguide.pdf. Accessed January 20, 2020.
- Determinants of older rural women's activity and eating.West J Nurs Res. 2006; 28: 449-468
- What is coefficient alpha? An examination of theory and applications.J Appl Psychol. 1993; 78: 98-104
- Development and psychometric evaluation of the exercise benefits/barriers scale.Res Nurs Health. 1987; 10: 357-365
- The development of self-efficacy scales for healthrelated diet and exercise behaviors.Health Educ Res. 1988; 3: 283-292
- Mediators of change in physical activity following an intervention in primary care: PACE.Prev Med. 1997; 26: 297-304
- The development of scales to measure social support for diet and exercise behaviors.Prev Med. 1987; 16: 825-836
- The effective sample size and an alternative small-sample degrees-of-freedom method.Ann Stat. 2009; 63: 389-399
- Technology-assisted weight loss interventions in primary care: a systematic review.J Gen Intern Med. 2014; 30: 107-117
- A systematic review of peer-supported interventions for health promotion and disease prevention.Prev Med. 2017; 101: 156-170
- Effect of Internet support on the long-term maintenance of weight loss.Obes Res. 2004; 12: 320-329
- Systematic review and meta-analysis of internet-delivered interventions providing personalized feedback for weight loss in overweight and obese adults.Obes Rev. 2016; 17: 541-551
- U.S. Health professionals’ views on obesity care, training, and self-efficacy.Am J Prev Med. 2015; 48: 411-418
Article info
Publication history
Published online: March 06, 2020
Accepted:
February 6,
2020
Footnotes
Conflict of Interest Disclosure: C. H. Pullen and P. A. Hageman declare a patent copyright on the DVD Banding Together for Strength used in the intervention component of the clinical trial. The other authors have not stated any conflicts of interest.
Identification
Copyright
Published by Elsevier Inc. on behalf of Society for Nutrition Education and Behavior.
