Mediators of Weight Loss in a Family-Based Intervention Presented over the Internet

Louisiana State University, Baton Rouge, Louisiana, United States
Obesity research (Impact Factor: 4.95). 08/2004; 12(7):1050-9. DOI: 10.1038/oby.2004.132
Source: PubMed


To assess the process variables involved in a weight loss program for African-American adolescent girls. Several process variables have been identified as affecting success in in vivo weight loss programs for adults and children, including program adherence, self-efficacy, and social support. The current study sought to broaden the understanding of these process variables as they pertain to an intervention program that is presented using the Internet. It was hypothesized that variables such as program adherence, dietary self-efficacy, psychological factors, and family environment factors would mediate the effect of the experimental condition on weight loss.
Participants were 57 adolescent African-American girls who joined the program with one obese parent; family pairs were randomized to either a behavioral or control condition in an Internet-based weight loss program. Outcome data (weight loss) are reported for the first 6 months of the intervention.
Results partially supported the hypotheses. For weight loss among adolescents, parent variables pertaining to life and family satisfaction were the strongest mediating variables. For parental weight loss, changes in dietary practices over the course of 6 months were the strongest mediators.
The identification of factors that enhance or impede weight loss for adolescents is an important step in improving weight loss programs for this group. The current findings suggest that family/parental variables exert a strong influence on weight loss efforts for adolescents and should be considered in developing future programs.

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Available from: Emily York, Oct 02, 2015
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    • "This research provides important evidence that web-based programs may lead to improved health behaviors among adolescents, including underserved adolescents. However, to date, few previous randomized controlled trials have been conducted to test the efficacy of on-line web-based interventions on reducing obesity in overweight African American adolescent and their parents [54]. A preliminary study by our group that evaluated a similar on-line web-based program was rated as well-liked and easy to use by African American parents [55]. "
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    ABSTRACT: The Families Improving Together (FIT) randomized controlled trial tests the efficacy of integrating cultural tailoring, positive parenting, and motivational strategies into a comprehensive curriculum for weight loss in African American adolescents. The overall goal of the FIT trial is to test the effects of an integrated intervention curriculum and the added effects of a tailored web-based intervention on reducing z-BMI in overweight African American adolescents. The FIT trial is a randomized group cohort design the will involve 520 African American families with an overweight adolescent between the ages of 11-16 years. The trial tests the efficacy of an 8-week face-to-face group randomized program comparing M+FWL (Motivational Family Weight Loss) to a comprehensive health education program (CHE) and re-randomizes participants to either an 8-week on-line tailored intervention or control on-line program resulting in a 2 (M+FWL vs. CHE group) x 2 (on-line intervention vs. control on-line program) factorial design to test the effects of the intervention on reducing z-BMI at post-treatment and at 6-month follow-up. The interventions for this trial are based on a theoretical framework that is novel and integrates elements from cultural tailoring, Family Systems Theory, Self-Determination Theory and Social Cognitive Theory. The intervention targets positive parenting skills (parenting style, monitoring, communication); cultural values; teaching parents to increase youth motivation by encouraging youth to have input and choice (autonomy-support); and provides a framework for building skills and self-efficacy through developing weight loss action plans that target goal setting, monitoring, and positive feedback. Copyright © 2015. Published by Elsevier Inc.
    Contemporary clinical trials 03/2015; 42. DOI:10.1016/j.cct.2015.03.009 · 1.94 Impact Factor
    • "For example, some research shows that greater health-related self-efficacy is associated with successful health maintenance attempts (Henry et al., 2006; Hagler et al., 2007; Bui et al., 2011), and self-efficacy has a strong correlation with overall intentions as it represents internal motivations (Zhou et al., 2013). However, other research suggests that high self-efficacy is not related to greater weight loss results (Linde et al., 2004; White et al., 2004). Martin et al. (2003) suggest that high self-efficacy in the initial stages could signify inexperience or overconfidence with weight loss attempts to explain the negative self-efficacy and behavioural intention relationship. "
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    ABSTRACT: This research takes a new look at individuals' attitudes and intentions towards losing weight. Study 1 examines the relationship among those interested in losing weight and individual self-evaluative ambivalence on attitude towards trying to achieve a weight loss goal and the intentions to achieve the weight loss goal. For Study 2, a between-subjects experimental design, where attitudinal ambivalence and prior outcome feedback were manipulated and self-efficacy was measured, is conducted to examine attitude towards eating healthier and intention to change eating behaviours. Findings across the two studies show that attitudinal ambivalence about the self and the individual's abilities and motivation to change the health behaviour produces a negative relationship between health-related attitudes and intentions. We provide implications of how self-efficacy and the provision of outcome feedback can alleviate the negative effect and improve the individuals' intentions to try to achieve a weight loss goal. Copyright © 2014 John Wiley & Sons, Ltd.
    Journal of Consumer Behaviour 03/2014; 13(4). DOI:10.1002/cb.1475 · 0.75 Impact Factor
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    • "Although the field of obesity research has traditionally focused on parenting behaviors related to physical activity and nutrition (Davison & Birch, 2001), Rhee et al. (2006) noted that a warm and supportive parenting style may have a greater impact on childhood and adolescent obesity. Indeed, variables related to family functioning (e.g., parental acceptance and support) have been linked to successful treatment outcomes in clinical studies (Stein, Epstein, Raynor, Kilanowksi, & Paluch, 2005; White et al., 2004). Likewise, epidemiological research has found that family factors, such as parent–youth relationship quality, are important to controlling adolescent weight (Mellin, Neumark-Sztainer, Story, Ireland, & Resnick, 2002). "
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    ABSTRACT: We explored family processes in adolescence that may influence the likelihood of obesity in early adulthood using a randomized trial of a family-based intervention (the Family Check-Up, or FCU). The FCU has been shown to reduce escalations in antisocial behavior and depression in adolescence by supporting positive family management practices, but no research has examined the mechanisms by which the FCU could influence health-related attitudes and behaviors linked to obesity. Participants were 998 adolescents (n = 526 male; n = 423 European American; M age 12.21 years) and their families, recruited in 6th grade from 3 middle schools in the Pacific Northwest. We used structural equation modeling (SEM) and an Intent-To-Treat (ITT) design to evaluate the direct and indirect effects of the FCU on parent-youth relationship quality (ages 12-15), healthy lifestyle behaviors, eating attitudes, depressive symptoms (all measured at age 17), and obesity (age 22). We found that the FCU led to greater parent-youth relationship quality, which predicted enhanced health-related behaviors, reduced maladaptive eating attitudes, and reduced depression. In turn, reduced maladaptive eating attitudes predicted reduced odds of obesity. The indirect effect of the FCU on obesity by way of parent-youth relationship quality and eating attitudes was significant. Our findings illustrate how family processes may influence adolescent health and suggest that family functioning may be an additional factor to consider when developing intervention programs for obesity. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
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