Transtheoretical Model-based Multiple Behavior Intervention for Weight Management: Effectiveness on a Population Basis

Overview

Journal Prev Med

Specialty Public Health

Date 2007 Dec 7

PMID 18055007

Citations 87

Authors

Sara S Johnson

Andrea L Paiva

Carol O Cummins

Janet L Johnson

Sharon J Dyment

Julie A Wright

James O Prochaska

Janice M Prochaska

Karen Sherman

Affiliations

Soon will be listed here.

Abstract

Background: The increasing prevalence of overweight and obesity underscores the need for evidence-based, easily disseminable interventions for weight management that can be delivered on a population basis. The Transtheoretical Model (TTM) offers a promising theoretical framework for multiple behavior weight management interventions.

Methods: Overweight or obese adults (BMI 25-39.9; n=1277) were randomized to no-treatment control or home-based, stage-matched multiple behavior interventions for up to three behaviors related to weight management at 0, 3, 6, and 9 months. All participants were re-assessed at 6, 12, and 24 months.

Results: Significant treatment effects were found for healthy eating (47.5% versus 34.3%), exercise (44.90% versus 38.10%), managing emotional distress (49.7% versus 30.30%), and untreated fruit and vegetable intake (48.5% versus 39.0%) progressing to Action/Maintenance at 24 months. The groups differed on weight lost at 24 months. Co-variation of behavior change occurred and was much more pronounced in the treatment group, where individuals progressing to Action/Maintenance for a single behavior were 2.5-5 times more likely to make progress on another behavior. The impact of the multiple behavior intervention was more than three times that of single behavior interventions.

Conclusions: This study demonstrates the ability of TTM-based tailored feedback to improve healthy eating, exercise, managing emotional distress, and weight on a population basis. The treatment produced a high level of population impact that future multiple behavior interventions can seek to surpass.

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References

Zeger S, Liang K . Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986; 42(1):121-30. View

Tate D, Wing R, Winett R . Using Internet technology to deliver a behavioral weight loss program. JAMA. 2001; 285(9):1172-7. DOI: 10.1001/jama.285.9.1172. View

Tate D, Jackvony E, Wing R . Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. JAMA. 2003; 289(14):1833-6. DOI: 10.1001/jama.289.14.1833. View

Flegal K, Carroll M, Ogden C, Johnson C . Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002; 288(14):1723-7. DOI: 10.1001/jama.288.14.1723. View

Prochaska J, Velicer W, Prochaska J, Delucchi K, Hall S . Comparing intervention outcomes in smokers treated for single versus multiple behavioral risks. Health Psychol. 2006; 25(3):380-8. DOI: 10.1037/0278-6133.25.3.380. View

Evers K, Prochaska J, Johnson J, Mauriello L, Padula J, Prochaska J . A randomized clinical trial of a population- and transtheoretical model-based stress-management intervention. Health Psychol. 2006; 25(4):521-9. DOI: 10.1037/0278-6133.25.4.521. View

Harel O, Zhou X . Multiple imputation: review of theory, implementation and software. Stat Med. 2007; 26(16):3057-77. DOI: 10.1002/sim.2787. View

Glasgow R, Goldstein M, Ockene J, Pronk N . Translating what we have learned into practice. Principles and hypotheses for interventions addressing multiple behaviors in primary care. Am J Prev Med. 2004; 27(2 Suppl):88-101. DOI: 10.1016/j.amepre.2004.04.019. View

Wing R, Koeske R, Epstein L, Nowalk M, Gooding W, Becker D . Long-term effects of modest weight loss in type II diabetic patients. Arch Intern Med. 1987; 147(10):1749-53. View

10.

Heshka S, Anderson J, Atkinson R, Greenway F, Hill J, Phinney S . Weight loss with self-help compared with a structured commercial program: a randomized trial. JAMA. 2003; 289(14):1792-8. DOI: 10.1001/jama.289.14.1792. View

11.

Blue C, Black D . Synthesis of intervention research to modify physical activity and dietary behaviors. Res Theory Nurs Pract. 2005; 19(1):25-61. DOI: 10.1891/rtnp.19.1.25.66333. View

12.

. The Diabetes Prevention Program. Design and methods for a clinical trial in the prevention of type 2 diabetes. Diabetes Care. 1999; 22(4):623-34. PMC: 1351026. DOI: 10.2337/diacare.22.4.623. View

13.

Velicer W, Prochaska J . An expert system intervention for smoking cessation. Patient Educ Couns. 1999; 36(2):119-29. DOI: 10.1016/s0738-3991(98)00129-3. View

14.

Prochaska J, Velicer W, Redding C, Rossi J, Goldstein M, Depue J . Stage-based expert systems to guide a population of primary care patients to quit smoking, eat healthier, prevent skin cancer, and receive regular mammograms. Prev Med. 2005; 41(2):406-16. DOI: 10.1016/j.ypmed.2004.09.050. View

15.

Schafer J, Graham J . Missing data: our view of the state of the art. Psychol Methods. 2002; 7(2):147-77. View

16.

Johnson S, Driskell M, Johnson J, Dyment S, Prochaska J, Prochaska J . Transtheoretical model intervention for adherence to lipid-lowering drugs. Dis Manag. 2006; 9(2):102-14. DOI: 10.1089/dis.2006.9.102. View

17.

Godin G, Shephard R . A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985; 10(3):141-6. View

18.

Ware J . Interpreting incomplete data in studies of diet and weight loss. N Engl J Med. 2003; 348(21):2136-7. DOI: 10.1056/NEJMe030054. View

19.

Jones H, Edwards L, Michael Vallis T, Ruggiero L, Rossi S, Rossi J . Changes in diabetes self-care behaviors make a difference in glycemic control: the Diabetes Stages of Change (DiSC) study. Diabetes Care. 2003; 26(3):732-7. DOI: 10.2337/diacare.26.3.732. View

20.

Riebe D, Blissmer B, Greene G, Caldwell M, Ruggiero L, Stillwell K . Long-term maintenance of exercise and healthy eating behaviors in overweight adults. Prev Med. 2005; 40(6):769-78. DOI: 10.1016/j.ypmed.2004.09.023. View