Social Cognitive Changes Following Weight Loss and Physical Activity Interventions in Obese, Older Adults in Poor Cardiovascular Health

Abstract

Background The study objectives were to determine (a) the effects of group-mediated cognitive–behavioral interventions on change in performance self-efficacy, satisfaction with function, and with appearance among older, overweight/obese adults in poor cardiovascular health and (b) whether self-efficacy mediated change in 400-m walk time. Methods This translational, randomized controlled trial of physical activity and weight loss was conducted within community Cooperative Extension Centers. Participants were randomized to three intervention arms: Physical Activity, Weight Loss+ Physical Activity, or a Successful Aging education control. Results Across 18 months, the Weight Loss+Physical Activity intervention demonstrated greater improvements in self-efficacy, satisfaction with function, and appearance versus other trial arms. Physical Activity intervention participants also experienced significant improvements in self-efficacy and satisfaction with function versus those in Successful Aging. Self-efficacy mediated 400-m walk time at 18 months. Conclusions Both group-mediated cognitive–behavioral interventions yielded desirable improvements in social cognitions and preserved mobility improvements post-intervention.

Effects of the Addition ofT'ai Chito a Dietary Weight Loss Program on Lipoprotein Atherogenicity in Obese Older Women

“…In addition, combined interventions, such as diet and exercise, have better outcomes than single interventions. 58,59 Triacylglycerol significantly increased as HDL-C decreased in both groups, an outcome seen previously with the DASH diet. 19 In addition, percentage calories from carbohydrate significantly increased from baseline to postintervention in the diet education group and increased nonsignificantly in the diet education plus TC group.…”

The MAT-sf: Clinical Relevance and Validity

“…In both analyses, performance on the 400-m walk and a related measure of self-efficacy shared significant variance with both outcomes; the magnitude of the effects for both variables were comparable. It is important to reemphasize that the self-report of mobility is far more than merely a surrogate for objective measures in that it taps into perceptions that are central in understanding older adults' willingness to engage in mobility-related activities (9), has been found to mediate improvements in mobility observed in physical activity interventions (17,18), and has been linked to survival in older patients with chronic obstructive pulmonary disease (19). In fact, in a prospective epidemiological study, we found that decline in timed stair climb performance over a 30-month period among older adults with knee pain, who had low leg strength, was dramatically more pronounced among those whose baseline confidence in their ability to climb stairs was low compared with high (20).…”

Promoting physical activity for elders with compromised function: the Lifestyle Interventions and Independence for Elders (LIFE) Study physical activity intervention

“…Specifically, participants are likely to adhere to prescribed behaviors if they feel confident in their ability to do so (self-efficacy) and if they experience valued, tangible benefits for their efforts (outcome expectancies). Relevant to the primary study outcome in the LIFE Study are recent data of ours showing that the enhancement of self-efficacy beliefs specific to physical functioning is important to subsequent improvements observed in 400 m walk time 11. A feature of the center-based portion of the intervention is that it facilitates the development of favorable social cognitions related to PA. We have found that group-mediated interventions are particularly effective for promoting behavior change among older adults for several reasons 12,13.…”