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: 3.73). 10/2011; 20(4):756-64. DOI: 10.1038/oby.2011.293
Source: PubMed


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
    • "Online questionnaires allowed us to limit volunteer burden and recruit participants across Greece. We used a validated instrument to assess perceived support (Kiernan et al., 2012), and additionally analyzed the individual questions, an approach that allowed for some explanatory observations. Moving on to the limitations, it appears that the scales used do not discriminate between types of ''support''. "
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    ABSTRACT: The role of social support in weight management is not fully understood, as more support has been linked to both favorable and unfavorable outcomes. We examined social support in relation to weight loss maintenance, comparing between maintainers and regainers of weight loss. The MedWeight study is a Greek registry of people who have intentionally lost ≥10 % of their weight and are either maintaining this loss for over a year (maintainers), or have regained weight (regainers). Demographics and lifestyle habits questionnaires are completed online. Dietary assessment is carried out by two telephone 24 h recalls. Perceived social support was assessed by validated scales examining support from family and friends regarding healthy eating and exercise. 289 maintainers and 122 regainers participated. Regainers received more support compared to maintainers. However, maintainers reported receiving compliments and active participation, whereas regainers receiving verbal instructions and encouragements. Maintainers who received diet support displayed improved dietary intakes, such as lower energy intake; regainers’ diet was unaffected by support. Positive, rather than instructive, support appears beneficial in weight loss maintenance.
    No preview · Article · Jan 2016 · Journal of Behavioral Medicine
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    • "To the extent that you are locked in a social circle that strongly reinforces unhealthy habits, you will have great difficulty consistently living a healthy lifestyle. " The experiments of Kiernan et al. (2012), Gorin et al. (2005), and Shoham et al. (2012) involving multiple roles of concerned persons (e.g. family members, friends, and neighbors) revealed mixed results. "
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    ABSTRACT: Purpose-The purpose of this paper is to propose a new approach recommending friends to social networking users who are also using weight loss app in the context of social networks. Design/methodology/approach-Social network has been recognized as an effective way to enhance overweight and obesity interventions in past studies. However, effective measures integrating social network with weight loss are very limited in the healthcare area. To bridge this gap, this study develops a measure for friend recommendation using the data obtained by weight loss apps; designs methods to model weight-gain-related behaviors (WGRB); constructs a novel "behavior network;" and develops two measurements in experiments to examine the proposed approach. Findings-The approach for friend recommendation is based on Friend Recommendation for Health Weight (FRHW) algorithm. By running this algorithm on a real data set, the experiment results show that the algorithm can recommend a friend who has a healthy lifestyle to a target user. The advantages of the proposed mechanism have been well justified via comparisons with popular friend recommenders in past studies. Originality/value-The conventional methods for friend recommenders in social networks are only concerned with similarities of pairs rather than interactions between people. The system cannot account for the potential influences among people. The method pioneers to model a WGRB as recommendation mechanismthat allow recommended friends to simultaneously fulfill two criteria. They are: first, similarity to the target person; and second, ensuring the positive influence toward weight loss. The second criterion is obviously important in practice and thus the approach is valuable to the literature.
    Full-text · Article · Aug 2015 · Industrial Management & Data Systems
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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.
    Full-text · Article · Nov 2013 · Contemporary clinical trials
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