Article

Social support for healthy behaviors: Scale psychometrics and prediction of weight loss among women in a behavioral program

Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
Obesity (Impact Factor: 4.39). 10/2011; 20(4):756-64. DOI: 10.1038/oby.2011.293
Source: PubMed

ABSTRACT Social support could be a powerful weight-loss treatment moderator or mediator but is rarely assessed. We assessed the psychometric properties, initial levels, and predictive validity of a measure of perceived social support and sabotage from friends and family for healthy eating and physical activity (eight subscales). Overweight/obese women randomized to one of two 6-month, group-based behavioral weight-loss programs (N = 267; mean BMI 32.1 ± 3.5; 66.3% White) completed subscales at baseline, and weight loss was assessed at 6 months. Internal consistency, discriminant validity, and content validity were excellent for support subscales and adequate for sabotage subscales; qualitative responses revealed novel deliberate instances not reflected in current sabotage items. Most women (>75%) "never" or "rarely" experienced support from friends or family. Using nonparametric classification methods, we identified two subscales-support from friends for healthy eating and support from family for physical activity-that predicted three clinically meaningful subgroups who ranged in likelihood of losing ≥5% of initial weight at 6 months. Women who "never" experienced family support were least likely to lose weight (45.7% lost weight) whereas women who experienced both frequent friend and family support were more likely to lose weight (71.6% lost weight). Paradoxically, women who "never" experienced friend support were most likely to lose weight (80.0% lost weight), perhaps because the group-based programs provided support lacking from friendships. Psychometrics for support subscales were excellent; initial support was rare; and the differential roles of friend vs. family support could inform future targeted weight-loss interventions to subgroups at risk.

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Available from: Michael G Perri, Nov 13, 2014
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    • "One factor within an individual's social environment that may play an important role in health and behavior change is social support. In both cross sectional and longitudinal studies, social support is associated with improved lifestyle changes and weight loss [12] [13] [14] [15] [16], but less is known about how social and mobile media can be used to promote weight loss via social support. There is some evidence that online support groups [17] and web chats [18] improve weight-related outcomes, and studies that compared weight loss between an Internet-based intervention group and a therapist-led group found that weight loss was similar between the two groups [19] [20]. "
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    ABSTRACT: To describe the theoretical rationale, intervention design, and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media. A total of 404 overweight or obese college students from three Southern California universities (Mage=22(+4) years; MBMI=29(+2.8); 70% female) were randomized to participate in the intervention or to receive an informational web-based weight loss program. The intervention is based on behavioral theory and integrates intervention elements across multiple touch points, including Facebook, SMS, smartphone applications, blogs, and e-mail. Participants are encouraged to seek social support among their friends, self-monitor their weight weekly, post their health behaviors on Facebook, and e-mail their weight loss questions/concerns to a health coach. The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback. Measures of body mass index, waist circumference, physical activity (PA), sedentary behavior (SED), diet, weight management practices, smoking, alcohol, sleep, body image, self-esteem, and depression occur at 6, 12, 18, and 24months. Currently, all participants have been recruited, and all are in the final year of the trial. Theory-driven, evidence-based strategies for PA, SED, and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults.
    Contemporary clinical trials 11/2013; 37(1). DOI:10.1016/j.cct.2013.11.001 · 1.99 Impact Factor
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    • "Social support Peer group setting incorporating self-management programs, establishing peer support networks; information, shared experiences, and outside interaction — Theory of planned behaviour Individual Channel Kiernan et al., 2012 [42] Social support Friend and family support for healthy eating and PA Support subscales and sabotage subscales; general supportive and strained interactions with family and friends subscales; qualitative question on social support Social support measurement Individual Resource Kalodner and DeLucia, 1999 [43] Social support Classmate interaction to facilitate social cohesion and support — Behaviour change Individual Resource Table 1: Continued. "
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    ABSTRACT: Background. Recent research has shown the importance of networks in the spread of obesity. Yet, the translation of research on social networks and obesity into health promotion practice has been slow. Objectives. To review the types of obesity interventions targeting social relational factors. Methods. Six databases were searched in January 2013. A Boolean search was employed with the following sets of terms: (1) social dimensions: social capital, cohesion, collective efficacy, support, social networks, or trust; (2) intervention type: intervention, experiment, program, trial, or policy; and (3) obesity in the title or abstract. Titles and abstracts were reviewed. Articles were included if they described an obesity intervention with the social relational component central. Articles were assessed on the social relational factor(s) addressed, social ecological level(s) targeted, the intervention's theoretical approach, and the conceptual placement of the social relational component in the intervention. Results. Database searches and final article screening yielded 30 articles. Findings suggested that (1) social support was most often targeted; (2) few interventions were beyond the individual level; (3) most interventions were framed on behaviour change theories; and (4) the social relational component tended to be conceptually ancillary to the intervention. Conclusions. Theoretically and practically, social networks remain marginal to current interventions addressing obesity.
    Journal of obesity 08/2013; 2013:348249. DOI:10.1155/2013/348249
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    • "Both approaches have had limited success, and no trials have evaluated whether the proposed mediator, social support for diet and activity from friends, actually increases, and whether it differentially predicts weight outcomes compared with a relevant control group. However, new components could be developed.20 As we propose in the paper,20 one component could encourage participants to develop new friendships around healthy behaviors, in part, by accessing new social networks in which social support for diet or physical activity behaviors is already high, such as joining hiking or walking clubs.20 Another component could encourage participants to foster greater reliance on themselves rather than on others, that is, increasing self-determination. "
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    ABSTRACT: In light of the limited long-term success of obesity treatments, it is tempting to consider the elusive goal of ‘treatment matching’, in which characteristics of individuals are optimally matched to targeted treatments to improve success. Previous frameworks for treatment matching in obesity have primarily focused on basic physiological characteristics, such as initial degree of overweight, and on treatment intensity, such as stepped-care alternatives (self-help manuals, group support, medication and surgery). Few studies have empirically evaluated the success of these frameworks. Given recent advances in genomics, neuroscience and other fields, both the breadth of domains and combinations of individuals’ characteristics that could be used for treatment matching have increased markedly. Although the obesity field seems poised to build on these advances, a crucial challenge remains regarding the treatments themselves. Ultimately, the success of treatment matching will rely on identifying treatment intervention components with well-differentiated and empirically supported mediators, that is, clear insights into how intervention components work. Here we examine the scope of this challenge specifically for the design of efficacious psychosocial and behavioral intervention components, and identify areas for future research.
    07/2012; 2(Suppl 1):S23-S25. DOI:10.1038/ijosup.2012.6
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