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Pänkäläinen M, Fogelholm M, Valve R, Kampman O, Kauppi M, Lappalainen E, Hintikka J. Pessimism, diet, and the ability to improve dietary habits: a three-year follow-up study among middle-aged and older Finnish men and women. Nutr J 2018; 17:92. [PMID: 30322387 PMCID: PMC6190558 DOI: 10.1186/s12937-018-0400-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 10/01/2018] [Indexed: 01/12/2023] Open
Abstract
Background Dietary habits have a great influence on physiological health. Even though this fact is generally recognized, people do not eat as healthily as they know they should. The factors that support a healthy diet, on the other hand, are not well known. It is supposed that there is a link between personal traits and dietary habits. Personal traits may also partially explain why some people manage to make healthy dietary changes while some fail to do so or are not able to try to make changes even when they desire to do so. There is some information suggesting that dispositional optimism plays a role in succeeding in improving dietary habits. The aim of this study was to determine the role of optimism and pessimism in the process of dietary changes. Methods Dispositional optimism and pessimism were determined using the revised Life Orientation Test in 2815 individuals (aged 52–76 years) participating in the GOAL study in the region of Lahti, Finland. The dietary habits of the study subjects were analysed. After 3 years, the subjects’ dietary habits and their possible improvements were registered. The associations between dispositional optimism and pessimism, dietary habits at baseline, and possible changes in dietary habits during the follow-up were studied with logistic regression. We also studied if the dietary habits or certain lifestyle factors (e.g. physical exercising and smoking) at baseline predicted success in improving the diet. Results Pessimism seemed to correlate clearly negatively with the healthiness of the dietary habits at baseline – i.e. the higher the level of pessimism, the unhealthier the diet. Optimism also showed a correlation with dietary habits at baseline, although to a lesser extent. Those who managed to improve their dietary habits during follow-up or regarded their dietary habits as healthy enough even without a change were less pessimistic at baseline than those who failed in their attempts to improve their diet or did not even try, even when they recognized the need for a change. Conclusions Pessimistic people are more likely to eat an unhealthy diet than others. Pessimism reduces independently the possibilities to improve dietary patterns.
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Affiliation(s)
- Mikko Pänkäläinen
- Department of Psychiatry, Päijät-Häme Central Hospital, Keskussairaalankatu 7, FI-15850, Lahti, Finland.
| | - Mikael Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Raisa Valve
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Olli Kampman
- Department of Psychiatry, Seinäjoki Hospital District, Seinäjoki, Finland.,School of Medicine, University of Tampere, Tampere, Finland
| | - Markku Kauppi
- School of Medicine, University of Tampere, Tampere, Finland.,Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland
| | - Erja Lappalainen
- Department of Psychiatry, Päijät-Häme Central Hospital, Keskussairaalankatu 7, FI-15850, Lahti, Finland
| | - Jukka Hintikka
- Department of Psychiatry, Päijät-Häme Central Hospital, Keskussairaalankatu 7, FI-15850, Lahti, Finland.,School of Medicine, University of Tampere, Tampere, Finland
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Churchill S, Pavey L, Sparks P. The Impact of Autonomy-Framed and Control-Framed Implementation Intentions on Snacking Behaviour: The Moderating Effect of Eating Self-Efficacy. Appl Psychol Health Well Being 2018; 11:42-58. [PMID: 30302915 DOI: 10.1111/aphw.12142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Autonomy-supportive implementation intention exercises have been shown to facilitate goal-directed behaviour (Koestner et al., ). The current study explored whether eating self-efficacy moderated the impact of autonomy-framed versus control-framed implementation intentions to reduce high-calorie snack intake. METHODS The study employed a randomised prospective design, involving two waves of data collection conducted in 2016. At Time 1, UK participants (N = 300) completed an online questionnaire which asked them to report their snacking behaviour over the previous 7 days. Participants were subsequently asked to form either an autonomy-framed implementation intention or a control-framed implementation intention. Seven days later, participants reported their consumption of high-calorie snacks and completed a measure of eating self-efficacy. RESULTS Hierarchical multiple regression analysis revealed that eating self-efficacy moderated the effects of implementation intention framing. Autonomy-framed implementation intentions had a greater impact on the avoidance of snacking for high eating self-efficacy participants than did control-framed implementation intentions. In contrast, for low eating self-efficacy participants, control-framed implementation intentions had more impact than did autonomy-framed implementation intentions. CONCLUSIONS The results suggest that if implementation intentions to promote healthy diet are to be effective, the role of eating self-efficacy should be considered, and the design of interventions adapted accordingly.
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Kegler MC, Haardörfer R, Alcantara IC, Gazmararian JA, Veluswamy JK, Hodge TL, Addison AR, Hotz JA. Impact of Improving Home Environments on Energy Intake and Physical Activity: A Randomized Controlled Trial. Am J Public Health 2016; 106:143-52. [PMID: 26696290 DOI: 10.2105/ajph.2015.302942] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed the effectiveness of an intervention targeting home food and activity environments to reduce energy intake and increase physical activity among overweight and obese patients from 3 community health centers in rural Georgia. METHODS We conducted a randomized controlled trial (n = 349) from 2011 to 2013, with follow-up at 6 and 12 months. Health coaches delivered the 16-week intervention by using tailored home environment profiles showing areas in need of improvement and positive aspects of the home environment, behavioral contracts for healthy actions, and mailed support materials. RESULTS Participants were mostly African American women (84.8%), with a mean age of 50.2 years and a mean body mass index (weight in kilograms divided by the square of height in meters) of 38.3. Daily energy intake decreased more for the intervention than control group at 6 (-274 vs -69 kcal) and 12 months (-195 vs -76 kcal). We observed no change for either objective or self-reported physical activity. At 12 months, 82.6% of intervention participants had not gained weight compared with 71.4% of control participants. CONCLUSIONS The intervention was effective in changing home environments and reducing energy intake.
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Affiliation(s)
- Michelle C Kegler
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - Regine Haardörfer
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - Iris C Alcantara
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - Julie A Gazmararian
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - J K Veluswamy
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - Tarccara L Hodge
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - Ann R Addison
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
| | - James A Hotz
- Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany
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Kegler MC, Alcantara I, Haardörfer R, Gazmararian JA, Ballard D, Sabbs D. The influence of home food environments on eating behaviors of overweight and obese women. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2014; 46:188-196. [PMID: 24809866 DOI: 10.1016/j.jneb.2014.01.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Revised: 12/21/2013] [Accepted: 01/02/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To describe home food environments and examine which aspects are associated with fruit and vegetable intake and percent calories from fat among overweight and obese women. DESIGN Baseline data from a weight gain prevention trial collected through telephone interviews. SETTING Participants were recruited from 3 federally qualified health centers in rural Georgia. PARTICIPANTS Overweight and obese patients (n = 319) were referred by their providers if they had a body mass index (BMI) > 25 and lived with at least 1 other person. Participants were primarily African American (83.7%), with a mean BMI of 38.4. MAIN OUTCOME MEASURES Fruit and vegetable intake and percent calories from fat. ANALYSIS Descriptive statistics and multiple regression. RESULTS Participants reported a large variety of both fruits and vegetables and unhealthy foods in their homes, and an average of 2.6 family meals from non-home sources per week. Eating family meals with the television on was common. Availability of fruits and vegetables in the home (P < .001) and frequency of fruit shopping (P = .01) were associated with fruit and vegetable intake. The number of unhealthy foods in the home (P = .01) and food preparation methods (P = .01) were associated with percent calories from fat. CONCLUSIONS AND IMPLICATIONS Home food environments may be effective intervention targets for nutrition programs designed for overweight and obese women.
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Affiliation(s)
- Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA.
| | - Iris Alcantara
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, Emory University, Atlanta, GA
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Julie A Gazmararian
- Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Denise Ballard
- Cancer Prevention and Control, Cancer Coalition of South Georgia, Albany, GA
| | - Darrell Sabbs
- Community Benefits, Phoebe Putney Memorial Hospital, Albany, GA
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Noordman J, van der Weijden T, van Dulmen S. Communication-related behavior change techniques used in face-to-face lifestyle interventions in primary care: a systematic review of the literature. PATIENT EDUCATION AND COUNSELING 2012; 89:227-244. [PMID: 22878028 DOI: 10.1016/j.pec.2012.07.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 04/23/2012] [Accepted: 07/10/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To systematically review the literature on the relative effectiveness of face-to-face communication-related behavior change techniques (BCTs) provided in primary care by either physicians or nurses to intervene on patients' lifestyle behavior. METHODS PubMed, EMBASE, PsychINFO, CINAHL and The Cochrane Library were searched for studies published before October 2010. Fifty studies were included and assessed on methodological quality. RESULTS Twenty-eight studies reported significantly favorable health outcomes following communication-related BCTs. In these studies, 'behavioral counseling' was most frequently used (15 times), followed by motivational interviewing (eight times), education and advice (both seven times). Physicians and nurses seem equally capable of providing face-to-face communication-related BCTs in primary care. CONCLUSION Behavioral counseling, motivational interviewing, education and advice all seem effective communication-related BCTs. However, BCTs were also found in less successful studies. Furthermore, based on existing literature, one primary care profession does not seem better equipped than the other to provide face-to-face communication-related BCTs. PRACTICE IMPLICATIONS There is evidence that behavioral counseling, motivational interviewing, education and advice can be used as effective communication-related BCTs by physicians and nurses. However, further research is needed to examine the underlying working mechanisms of communication-related BCTs, and whether they meet the requirements of patients and primary care providers.
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Affiliation(s)
- Janneke Noordman
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
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Artinian NT, Fletcher GF, Mozaffarian D, Kris-Etherton P, Van Horn L, Lichtenstein AH, Kumanyika S, Kraus WE, Fleg JL, Redeker NS, Meininger JC, Banks J, Stuart-Shor EM, Fletcher BJ, Miller TD, Hughes S, Braun LT, Kopin LA, Berra K, Hayman LL, Ewing LJ, Ades PA, Durstine JL, Houston-Miller N, Burke LE. Interventions to promote physical activity and dietary lifestyle changes for cardiovascular risk factor reduction in adults: a scientific statement from the American Heart Association. Circulation 2010; 122:406-41. [PMID: 20625115 PMCID: PMC6893884 DOI: 10.1161/cir.0b013e3181e8edf1] [Citation(s) in RCA: 668] [Impact Index Per Article: 47.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Moser SE, Aiken LS. Cognitive and emotional factors associated with elective breast augmentation among young women. Psychol Health 2010. [DOI: 10.1080/08870440903207635] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Stephanie E. Moser
- a Department of Psychology , Arizona State University , P.O. Box 871104, Tempe, AZ 85287-1104, USA
| | - Leona S. Aiken
- a Department of Psychology , Arizona State University , P.O. Box 871104, Tempe, AZ 85287-1104, USA
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Kalavana TV, Maes S, De Gucht V. Interpersonal and Self-regulation Determinants of Healthy and Unhealthy Eating Behavior in Adolescents. J Health Psychol 2010; 15:44-52. [DOI: 10.1177/1359105309345168] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this study was to investigate the influence of interpersonal and personal factors on (un)healthy eating in adolescents. The study sample consisted of 473 adolescents. Regression analyses were conducted to examine the effect of family climate, peer influence and self-regulation cognitions (goal commitment, efficacy and ownership) on healthy and unhealthy eating. Self-regulation cognitions are positively related to healthy eating and negatively to unhealthy eating. We conclude that different aspects of family climate and peer influence are significantly related to both healthy and unhealthy eating. Interventions should be directed at self-regulation cognitions as well as at family and peer influence.
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Grandes G, Sanchez A, Cortada JM, Balague L, Calderon C, Arrazola A, Vergara I, Millan E. Is integration of healthy lifestyle promotion into primary care feasible? Discussion and consensus sessions between clinicians and researchers. BMC Health Serv Res 2008; 8:213. [PMID: 18854033 PMCID: PMC2577098 DOI: 10.1186/1472-6963-8-213] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Accepted: 10/14/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The adoption of a healthy lifestyle, including physical activity, a healthy diet, moderate alcohol consumption and abstinence from smoking, is associated with a major decrease in the incidence of chronic diseases and mortality. Primary health-care (PHC) services therefore attempt, with rather limited success, to promote such lifestyles in their patients. The objective of the present study is to ascertain the perceptions of clinicians and researchers within the Basque Health System of the factors that hinder or facilitate the integration of healthy lifestyle promotion in routine PHC setting. METHODS Formative research based on five consensus meetings held by an expert panel of 12 PHC professionals with clinical and research experience in health promotion, supplied with selected bibliographic material. These meetings were recorded, summarized and the provisional findings were returned to participants in order to improve their validity. RESULTS The Health Belief Model, the Theory of Planned Action, the Social Learning Theory, "stages of change" models and integrative models were considered the most useful by the expert panel. Effective intervention strategies, such as the "5 A's" strategy (assess, advise, agree, assist and arrange) are also available. However, none of these can be directly implemented or continuously maintained under current PHC conditions. These strategies should therefore be redesigned by adjusting the intervention objectives and contents to the operation of primary care centres and, in turn, altering the organisation of the centres where they are to be implemented. CONCLUSION It is recommended to address optimisation of health promotion in PHC from a research perspective in which PHC professionals, researchers and managers of these services cooperate in designing and evaluating innovative programs. Future strategies should adopt a socio-ecological approach in which the health system plays an essential role but which nevertheless complements other individual, cultural and social factors that condition health. These initiatives require an adequate theoretical and methodological framework for designing and evaluating complex interventions.
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Affiliation(s)
- Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Basque Health Service (Osakidetza), Bilbao, Spain
| | - Alvaro Sanchez
- Primary Care Research Unit of Bizkaia, Basque Health Service (Osakidetza), Bilbao, Spain
| | - Josep M Cortada
- Deusto Health Centre, Basque Health Service (Osakidetza), Bilbao, Spain
| | - Laura Balague
- Renteria Health Centre, Basque Health Service (Osakidetza), Renteria, Spain
| | - Carlos Calderon
- Alza Health Centre, Basque Health Service (Osakidetza), Donostia-San Sebastian, Spain
| | - Arantza Arrazola
- Health Plan Service in Gipuzkoa. Department of Health of the Basque Government
| | - Itziar Vergara
- O+berri Institute, Basque Foundation for Health Innovation and Research, Sondika, Spain
| | - Eduardo Millan
- Cruces Hospital, Basque Health Service (Osakidetza), Barakaldo, Spain
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Burke V, Beilin LJ, Cutt HE, Mansour J, Mori TA. Moderators and mediators of behaviour change in a lifestyle program for treated hypertensives: a randomized controlled trial (ADAPT). HEALTH EDUCATION RESEARCH 2008; 23:583-91. [PMID: 17890759 DOI: 10.1093/her/cym047] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
We aimed to examine moderators and mediators of behaviour change in a cognitive lifestyle program for drug-treated overweight hypertensives in Perth, Australia. We collected data at baseline, 4 months (post-intervention) and 1-year follow-up in a randomized controlled trial of a program that focused on weight loss, diet, and exercise. Mediation analysis used regression models that estimate indirect effects with bootstrapped confidence limits. Outcomes examined were saturated fat intake (% energy) and physical activity (hours per week). In total, 90/118 individuals randomized to usual care and 102/123 to the program-completed follow-up. Sex was a moderator of response post-intervention for diet and physical activity, with a greater response among women with usual care and among men with the program. Change in self-efficacy was a mediator of dietary change post-intervention [effect size (ES) -0.055, 95% confidence interval (CI) -0.125, -0.005] and at follow-up (ES 0.054, 95% CI -0.127, -0.005), and in physical activity post-intervention (ES 0.059, 95% CI 0.003, 0.147). These findings highlight different responses of men and women to the program, and the importance of self-efficacy as a mediator. Mediators for physical activity in the longer term should be investigated in other models, with appropriate cognitive measurements, in future trials.
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Affiliation(s)
- Valerie Burke
- School of Medicine.harmacology, University of Western Australia, Royal Perth Hospital Unit, the Cardiovascular Research Centre and West Australian Institute for Medical Research, Perth, WA 6847, Australia.
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Chang MW, Brown RL, Baumann LJ, Nitzke SA. Self-efficacy and dietary fat reduction behaviors in obese African-American and white mothers. Obesity (Silver Spring) 2008; 16:992-1001. [PMID: 18292751 DOI: 10.1038/oby.2008.20] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined the influence of weight management and education on five types of fat reduction behaviors mediated through three task-specific domains of self-efficacy among young, low-income obese African-American and white mothers. It also investigated interaction of race with the relationships between weight management, education, self-efficacy, and fat reduction behaviors. A sample of obese African-American and white mothers was recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Wisconsin. Participants reported their weight management status, education, self-efficacy for eating low-fat food, and fat reduction behaviors. For both racial groups, weight management status predicted low-fat food substitution and meat modification behaviors; education predicted meat modification behavior. Three task-specific domains of self-efficacy (negative mood, positive mood, and food availability) predicted different types of fat reduction behaviors and differed by race. Weight management influenced behaviors of low-fat food substitution, meat modification, and fried-food avoidance, mediated partially through self-efficacies of negative mood (African Americans), positive mood (African Americans, whites), and food availability (African Americans). Race affected the relationships between weight management, education, three task-specific domains of self-efficacy, and five types of fat reduction behaviors. Self-efficacies operated differentially for African Americans and whites. Thus, strategies to address specific fat reduction behaviors have the potential to be more effective when tailored to specific individual characteristics such as racial background, history of weight management strategies and task-specific domains of self-efficacy.
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Affiliation(s)
- Mei-Wei Chang
- Michigan State University College of Nursing, East Lansing, Michigan, USA.
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Warziski MT, Sereika SM, Styn MA, Music E, Burke LE. Changes in self-efficacy and dietary adherence: the impact on weight loss in the PREFER study. J Behav Med 2007; 31:81-92. [DOI: 10.1007/s10865-007-9135-2] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Accepted: 09/28/2007] [Indexed: 01/22/2023]
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13
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Tinker LF, Rosal MC, Young AF, Perri MG, Patterson RE, Van Horn L, Assaf AR, Bowen DJ, Ockene J, Hays J, Wu L. Predictors of dietary change and maintenance in the Women's Health Initiative Dietary Modification Trial. ACTA ACUST UNITED AC 2007; 107:1155-66. [PMID: 17604744 DOI: 10.1016/j.jada.2007.04.010] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2005] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To identify predictors of dietary change to and maintenance of a low-fat eating pattern (<20% energy from fat, > or = 5 servings fruits/vegetables daily, and > or = 6 servings grains daily) among a cohort of postmenopausal women. Candidate predictors included intrapersonal, interpersonal, intervention program characteristics, and clinical center. DESIGN Longitudinal study within the Women's Health Initiative Dietary Modification Trial. Dietary change was evaluated after 1 year of participation in the Women's Health Initiative Dietary Modification Trial, and dietary maintenance after 3 years. SUBJECTS Postmenopausal women aged 50 to 79 years at baseline who were randomized to the intervention arm of the Women's Health Initiative Dietary Modification Trial (n=19,541). STATISTICAL ANALYSIS Univariate and multivariate linear regression analysis was performed and associations evaluated between candidate predictors and each of the three dietary goals: percent energy from fat, fruit/vegetable servings, and grain servings. RESULTS Year 1 (change) predictors of percent energy from fat (P<0.005) included being younger (beta=2.12; 70 to 79 years vs 50 to 59 years), more educated (beta=-.69; college vs high school), more optimistic (beta=-.07), attending more sessions (beta=-.69), and submitting more self-monitoring records (beta=-.74). At year 3 (maintenance), the predictors of percent energy from fat (P<0.005) included attending more sessions (beta=-.65) and submitting more self-monitoring scores (beta=-.71). The analytic model predicted 22% of the variance in fat intake at year 1 and 27% at year 3 (P<0.01). CONCLUSIONS The strongest predictors of dietary change and maintenance were attending intervention sessions and self-monitoring dietary intake. Novel was the finding that optimism predicted dietary change.
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Affiliation(s)
- Lesley F Tinker
- Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
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Bhargava A. Socio-economic and behavioural factors are predictors of food use in the National Food Stamp Program Survey. Br J Nutr 2007; 92:497-506. [PMID: 15469654 DOI: 10.1079/bjn20041210] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The unhealthy dietary patterns in the USA especially among low-income households demand complex strategies for health promotion. The present paper analysed the proximate determinants of 7 d food use by 919 participants in the National Food Stamp Program Survey conducted in 1996. The households' consumption of dietary energy, carbohydrate, protein, fibre, saturated, monounsaturated and polyunsaturated fats, Ca, Fe, β-carotene and vitamin C were explained by background, socio-economic and behavioural factors. Certain methodological issues arising in modelling food use data were addressed. The results showed that the subjects' knowledge of the US Department of Agriculture food pyramid, reading nutrition labels, adopting a low-fat diet, selecting fruits and vegetables, saving money at grocery stores and frequency of shopping trips were often significantly associated (P>0·05) with the densities of nutrient use. The results identified certain aspects of nutrition education programmes that deserve greater emphasis for improving diet quality. The model for energy intake indicated that disbursing half the food stamp benefits on a 2-week basis and better shopping practices can enhance food availability.
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Affiliation(s)
- Alok Bhargava
- Department of Economics, University of Houston, Texas, USA.
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Orbell S, Hagger M. Temporal framing and the decision to take part in type 2 diabetes screening: Effects of individual differences in consideration of future consequences on persuasion. Health Psychol 2006; 25:537-48. [PMID: 16846330 DOI: 10.1037/0278-6133.25.4.537] [Citation(s) in RCA: 150] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Reliable individual differences in the extent to which people consider the long- and short-term consequences of their own behaviors are hypothesized to influence the impact of a persuasive communication. In a field experiment, the time frame of occurrence of positive and negative consequences of taking part in a proposed Type 2 diabetes screening program was manipulated in a sample of 210 adults with a mean age of 53 years. Individual differences in consideration of future consequences (CFC; A. Strathman, F. Gleicher, D. S. Boninger, & C. S. Edwards, 1994) moderated (a) the generation of positive and negative thoughts and (b) the persuasive impact of the different communications. Low-CFC individuals were more persuaded when positive consequences were short term and negative consequences were long term. The opposite was true of high-CFC individuals. Path analyses show that net positive thoughts generated mediated the effect of the CFC x Time Frame manipulations on behavioral intentions.
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Affiliation(s)
- Sheina Orbell
- Department of Psychology, University of Essex, Colchester, United Kingdom.
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Murphy BM, Worcester MUC, Elliott PC, Le Grande MR, Higgins RO, Goble AJ. Change in women's dietary fat intake following an acute cardiac event: Extent, predictors and comparison with non-cardiac Australian women and older adults. Eur J Cardiovasc Nurs 2006; 5:206-13. [PMID: 16481218 DOI: 10.1016/j.ejcnurse.2006.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2005] [Revised: 12/22/2005] [Accepted: 01/05/2006] [Indexed: 10/25/2022]
Abstract
BACKGROUND Cardiac patients are encouraged to reduce their dietary fat intake, yet few studies have assessed fat intake in female cardiac patients. AIM We assessed changes in fat intake for female cardiac patients at four occasions during the first year following their event, and compared it with fat intake for a non-cardiac sample. METHODS The Short Fat Questionnaire (SFQ) was administered to 239 women aged 36 to 84 years consecutively admitted to four hospitals at the time of an acute event. Mplus was used to analyse change over time in SFQ scores and to identify predictors of change. Mean SFQ scores were compared with those for a sample of randomly selected Australian women and older adults. RESULTS Mean SFQ scores decreased substantially during the first two months (t(139) = 8.374, p < 0.001), then increased over the subsequent 10 months (t(146) = 4.656, p < 0.001). By 12 months, SFQ scores remained significantly lower than at baseline. Older women and those with hypertension showed less reduction in fat intake. At all four time-points, mean SFQ scores were significantly lower than those reported for other Australian women and older adults. CONCLUSION Even prior to their event, female cardiac patients reported lower fat intake than other Australian women and older adults, but showed partial deterioration in adherence following convalescence. Future studies could investigate options for assisting patients to sustain dietary changes, with attention to older patients and those with hypertension.
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Affiliation(s)
- Barbara Mary Murphy
- Heart Research Centre, Box 2137 Post Office, Royal Melbourne Hospital, Victoria 3050 Australia.
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Steptoe A, Perkins-Porras L, Rink E, Hilton S, Cappuccio FP. Psychological and social predictors of changes in fruit and vegetable consumption over 12 months following behavioral and nutrition education counseling. Health Psychol 2005; 23:574-81. [PMID: 15546225 DOI: 10.1037/0278-6133.23.6.574] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study assessed psychological and social factors predicting 12-month changes in fruit and vegetable consumption achieved by 271 men and women from a low-income population randomized to brief behavioral and nutrition education counseling. Greater increases in fruit and vegetable intake were achieved in the behavioral than in the nutrition education condition (1.49 vs. 0.87 portions per day, p=.021). Increases were predicted by baseline social support for dietary change but not by baseline psychological measures. However, short-term (8-week) changes in dietary self-efficacy, encouragement, anticipated regret, perceived benefits, and knowledge of recommended intake predicted 12-month changes in fruit and vegetable consumption independently of gender, age, ethnicity, income, and baseline intake. These factors accounted for 51% of the superiority of behavioral counseling over nutrition education.
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Affiliation(s)
- Andrew Steptoe
- University College London, Department of Epidemiology and Public Health, London, England.
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Bhargava A, Hays J. Behavioral variables and education are predictors of dietary change in the Women's Health Trial: Feasibility Study in Minority Populations. Prev Med 2004; 38:442-51. [PMID: 15020177 DOI: 10.1016/j.ypmed.2003.11.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Reducing the intakes of fats and increasing consumption of fruits and vegetables are an important goal for improving population health. Analyzing the effects of nutrition education programs on subjects' dietary intakes incorporating factors such as habit persistence in diets, unhealthy eating habits, perceptions of health risks, participation motivation, and expectancies can yield useful insights. METHODS A Food Frequency Questionnaire (FFQ) was used to measure intakes at baseline, 6 and 12 months, by 318 and 548 postmenopausal women in, respectively, the Control and Intervention groups of the Women's Health Trial: Feasibility Study in Minority Populations (WHTFSMP). Information on background, behavioral, and anthropometric variables was collected. The Intervention group met in classes led by nutritionists. Dynamic random effects models were estimated for the two groups using the data at baseline, 6 and 12 months on the intakes of carbohydrate, saturated, monounsaturated, and polyunsaturated fats, fiber, beta-carotene, ascorbic acid, and calcium. RESULTS The nutrition education program lowered the intakes of fats while increasing fiber, beta-carotene, and ascorbic acid intakes especially in subjects scoring high on indices reflecting concerns about health, desirability of change, and participation motivation. In addition, subjects' education was a predictor of dietary intakes in the Intervention group. CONCLUSIONS Nutrition education can be an effective tool for improving diets, but behavioral characteristics deserve greater attention in helping to design the most effective approaches for various target groups.
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Affiliation(s)
- Alok Bhargava
- Department of Economics, University of Houston, Houston, TX 77204-5019, USA.
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Baughman K, Logue E, Sutton K, Capers C, Jarjoura D, Smucker W. Biopsychosocial characteristics of overweight and obese primary care patients: do psychosocial and behavior factors mediate sociodemographic effects? Prev Med 2003; 37:129-37. [PMID: 12855212 DOI: 10.1016/s0091-7435(03)00095-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The increasing prevalence of obesity and obesity-related conditions in primary care settings challenges the health care system. Thus, we used available baseline data from an on-going clinical trial to examine the biopsychosocial characteristics of overweight and obese primary care patients. The primary research objective was to ascertain whether theoretically important psychosocial and behavioral variables mediate the empirical relationships between sociodemographic factors and body mass index (BMI). METHODS Overweight or obese primary care patients (n=665) enrolled in an on-going trial of a cognitive-behavioral obesity intervention provided baseline sociodemographic, psychosocial, nutritional, physical activity, and anthropometric data that were analyzed via multiple regression. RESULTS Lower educational attainment was associated with a higher BMI after controlling for decisional balance, social support, self-efficacy, energy intake, and energy expenditure (P<0.05). In contrast, ethnicity was not associated with BMI after controlling for the psychosocial and behavioral variables. Decisional balance and social support variables were associated with BMI and energy intake, but the directions of some of the associations were not consistent with a priori expectations. CONCLUSIONS Overall, we found some evidence of mediation by the psychosocial and behavioral variables of the relationship between ethnicity and BMI, but not for the relationship between education and BMI. In addition, some of the relationships between the psychosocial variables and BMI were opposite of our expectations.
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Affiliation(s)
- Kristin Baughman
- Department of Family Practice, Summa Health System, Akron, OH 44304-2090, USA.
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Steptoe A, Perkins-Porras L, McKay C, Rink E, Hilton S, Cappuccio FP. Psychological factors associated with fruit and vegetable intake and with biomarkers in adults from a low-income neighborhood. Health Psychol 2003. [DOI: 10.1037/0278-6133.22.2.148] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Changing dietary behaviors to prevent chronic disease has been an important research focus for the last 25 years. Here we present a review of published articles on the results of research to identify methods to change key dietary habits: fat intake, fiber intake, and consumption of fruits and vegetables. We divided the research reviewed into sections, based on the channel through which the intervention activities were delivered. We conclude that the field is making progress in identifying successful dietary change strategies, but that more can be learned. Particularly, we need to transfer some of the knowledge from the individual-based trials to community-level interventions. Also, more research with rigorous methodology must be done to test current and future intervention options.
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Affiliation(s)
- Deborah J Bowen
- Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, MP 900, Seattle, Washington 98109-1024, USA.
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Cota D, Vicennati V, Ceroni L, Morselli-Labate AM, Pasquali R. Relationship between socio-economic and cultural status, psychological factors and body fat distribution in middle-aged women living in Northern Italy. Eat Weight Disord 2001; 6:205-13. [PMID: 11808816 DOI: 10.1007/bf03339744] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
This study analyses the relationships between body fat distribution and socioeconomic and psychological factors in a cohort of 426 healthy middle-aged women living in Virgilio, Mantua (Northern Italy). The information concerning their occupational, social and psychological conditions and smoking habits were obtained by means of questionnaires. Psychological factors were investigated using the Italian version of the Illness Behaviour Questionnaire and the Symptom Questionnaire. Anthropometric measurements, body mass index (BMI) (kg/m2), waist/hip ratio (WHR) and clinical/hormonal menopausal status were also collected for each subject. The women reported significantly higher or lower psychological factor scores (symptoms of conversion: p=0.005; perception of disease: p=-0.018; denial: p=0.021; hostility: p=0.57; and laxity: p=0.047) as their WHR increased, thus indicating some concern about their health. In a multiple regression model, their WHR and waist circumference (W) significantly correlated with symptoms of conversion (p=0.005 and p=0.029), and W was also significantly related to the perception of disease (p=0.043). There was a significant inverse correlation between the WHR and educational level (p<0.001). The prevalence of partners who were entrepreneurs or self-employed also decreased as WHR increased (p<0.001). Furthermore, the number of women living in the centre of town significantly diminished, whereas those living in the suburbs or in the country significantly increased (p=0.005). However, using age, BMI and menopausal status as covariates, only the partner's work significantly and negatively correlated with the WHR (p=0.029). These results are consistent with the hypothesis that psychological and socio-economic handicaps are associated with a higher prevalence of abdominal fatness in middle-aged women living in Northern Italy
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Affiliation(s)
- D Cota
- Department of Internal Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Italy
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