Systematic development of a self-regulation weight-management intervention for overweight adults

Abstract

BackgroundThis paper describes the systematic development of an intervention for the prevention of obesity among overweight adults. Its development was guided by the six steps of Intervention Mapping (IM), in which the establishment of program needs, objectives and methods is followed by development of the intervention and an implementation and evaluation plan.MethodsWeight gain prevention can be achieved by making small changes in dietary intake (DI) or physical activity (PA). The intervention objectives, derived from self-regulation theory, were to establish goal-oriented behaviour. They were translated into a computer-tailored Internet-delivered intervention consisting of four modules. The intervention includes strategies to target the main determinants of self-regulation, such as feedback and action planning.The first module is intended to ensure adults' commitment to preventing weight gain, choosing behaviour change and action initiation. The second and third modules are intended to evaluate behaviour change, and to adapt action and coping plans. The fourth module is intended to maintain self-regulation of body weight without use of the program.The intervention is being evaluated for its efficacy in an RCT, whose protocol is described in this paper. Primary outcomes are weight, waist circumference and skin-fold thickness. Other outcomes are DI, PA, cognitive mediators and self-regulation skills.DiscussionThe IM protocol helped us integrating insights from various theories. The performance objectives and methods were guided by self-regulation theory but empirical evidence with regard to the effectiveness of theoretical methods was limited. Sometimes, feasibility issues made it necessary to deviate from the original, theory-based plans. With this paper, we provide transparency with regard to intervention development and evaluation.Trial registrationNTR1862

Physicians’ Discussions About Body Weight, Healthy Diet, and Physical Activity With Overweight or Obese Elderly Patients

“…On the other hand, we also think better access to health care can give both health care providers and patients more opportunities to discuss needed lifestyle changes. Either interpretation is consistent with prior studies that reported higher access to care and higher frequency of visits can give providers with opportunities to discuss behavioral change (Berkel, Carlos Poston, Reeves, & Foreyt, 2005;Lerman, 2005;Levy, Finch, Crowell, Talley, & Jeffery, 2007 To improve patients' health conditions, health care providers should acknowledge their patient's excess body weight as a first step in counseling patients on the importance of normalizing energy balance for weight management (van Genugten et al, 2010). Older patients are especially likely to accept risk communication messages and follow recommendations from authorities whom they perceive as credible and trustworthy (Lemyre, Gibson, Zlepnig, Meyer-Macleod, & Boutette, 2009).…”

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