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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    • "Most report on relationships between self-efficacy and overall weightloss (e.g., Annesi, 2007; Byrne et al., 2012; Palmeira et al., 2007), though some focus on self-efficacy domains and behavior with congruent focal points (e.g., the relationship between diet selfefficacy and change in fruit and vegetable consumption; Van Duyn et al., 2001), or incongruent focal points (e.g., the relationship between self-efficacy for exercise and change in dietary behaviors; Linde et al., 2006). Furthermore, self-efficacy has been included as a predictor (e.g., Linde et al., 2006), outcome (e.g., Plotnikoff et al., 2005), or mediator (e.g., White et al., 2004) in weight-loss trials. Despite differences in the behavioral domain of interest and the range of applications of self-efficacy in relation to various behavioral outcomes observed in the literature, no surveys are currently available that measure self-efficacy for more than one behavioral domain related to weight-loss (e.g., physical activity, healthful eating). "
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    ABSTRACT: Self-efficacy is a commonly included cognitive variable in weight-loss trials, but there is little uniformity in its measurement. Weight-loss trials frequently focus on physical activity (PA) and eating habits, as well as weight loss, but no survey is available that offers reliable measurement of self-efficacy as it relates to each of these targeted outcomes. The purpose of this study was to test the psychometric properties of brief, pragmatic self-efficacy scales specific to PA, healthful eating and weight-loss (4 items each). An adult sample (n=1790) from 28 worksites enrolled in a worksite weight-loss program completed the self-efficacy scale, as well as measures of PA, dietary fat intake, and weight, at baseline, 6-, and 12-months. The hypothesized factor structure was tested through confirmatory factor analysis, which supported the expected factor structure for three latent self-efficacy factors, specific to PA, healthful eating, and weight-loss. Measurement equivalence/invariance between relevant demographic groups, and over time was also supported. Parallel growth processes in self-efficacy factors and outcomes (PA, fat intake, and weight) support the predictive validity of score interpretations. Overall, these analyses support the interpretation that scores on these scales reflect self-efficacy for PA, healthful eating, and weight-loss. Further use of this instrument in large-scale weight-loss trials is encouraged.
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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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    Full-text · Article · Mar 2015 · Contemporary clinical trials
    • "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.
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