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http://dx.doi.org/10.4162/nrp.2019.13.5.415

Identifying psychological predictors of adherence to a community-based lifestyle modification program for weight loss among Chinese overweight and obese adults  

Leung, Alice Wai Yi (Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong)
Chan, Ruth Suk Mei (Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong)
Sea, Mandy Man Mei (Centre for Nutritional Studies, Faculty of Medicine, The Chinese University of Hong Kong)
Woo, Jean (Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong)
Publication Information
Nutrition Research and Practice / v.13, no.5, 2019 , pp. 415-424 More about this Journal
Abstract
BACKGROUND/OBJECTIVES: Existing evidence on lifestyle modification programs for weight loss is limited by the high attrition rate of such programs. Identifying predictors of adherence to a lifestyle modification program could result in program improvement. However, little is known about behavior-specific adherence and its psychological predictors. This study aimed to examine the psychological predictors of adherence after one-month participation in a community-based lifestyle modification program among Chinese overweight and obese adults in Hong Kong. SUBJECTS/METHODS: A total of 205 Chinese overweight and obese adults aged $38.9{\pm}10.5years$ completed the study. Data were collected at baseline and after one month using self-reported questionnaires, which assessed knowledge (self-developed scale), motivation (Treatment Self-Regulation Questionnaire), stage of change (Stage of Exercise Scale) and self-efficacy (Self-Rated Abilities for Health Practices Scale). At one month, a 4-day dietary recall and the International Physical Activity Questionnaire-Short Form were used to assess dietary and physical activity (PA) adherence. Food and PA diaries were examined to indicate self-monitoring. Program attendance was tracked between baseline and one-month follow-up. RESULTS: After one month, participants reported high dietary adherence, attendance, and adherence to self-monitoring but low PA adherence. Multiple regression analyses suggested that diet self-efficacy (baseline) and nutrition knowledge (one-month change) were independent predictors of dietary adherence score at one month, whereas autonomous PA motivation (baseline) and PA self-efficacy (both baseline and one-month change) were independent predictors of PA adherence score at one month. No significant psychological predictor was identified for attendance or self-monitoring. CONCLUSIONS: The results suggest that the effect of psychological factors on adherence differs between diet and PA adherence outcomes. To promote adherence, practitioners should assess self-efficacy, knowledge, and motivation at the beginning of a weight-loss program and explore behavior-specific strategies to improve knowledge and self-efficacy. The results of this study have direct implications for program improvements.
Keywords
Obesity; nutrition; physical activity; psychological factors; adherence;
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