University of Alabama at Birmingham, Birmingham, AL, USA.
Emory University School of Medicine, Atlanta, GA, USA.
Scand J Psychol. 2021 Aug;62(4):574-585. doi: 10.1111/sjop.12741. Epub 2021 May 31.
A new causal chain model positing theory- and research-based interrelationships among psychosocial and behavioral variables leading to weight loss and its maintenance was assessed. Two samples of women participating in community-based cognitive-behavioral obesity treatments were assessed over either 6 months (weight loss phase; N = 103), or additionally including Months 6-12 (weight-loss maintenance phase; N = 101). Analyses first evaluated whether baseline physical, demographic, behavioral (physical activity, fruit/vegetable intake), and/or psychosocial (self-regulation, self-efficacy, negative mood) variables significantly predicted weight change. Further analyses assessed whether changes in model-based behavioral and psychosocial variables significantly differed by groupings of participants based on their short-term weight loss and weight-loss maintenance/further loss. The predictive value of changes in the psychosocial variables on behavioral changes was next assessed, also accounting for group. Finally, mediation, moderation, and moderated mediation analyses tested proposed causal chain-based interrelationships among variables. Of the 12 variables assessed at baseline, only weight was inversely associated with lost weight, and only fruit/vegetable intake was positively associated with effects during the weight-loss maintenance phase. Overall improvements in behavioral and psychosocial variables were significantly greater in participant groupings with better weight loss and weight-loss maintenance results. Changes in self-regulation, self-efficacy, and mood significantly predicted the weight-loss behavior changes, unaffected by group. Results from the five mediation, moderation, and moderated mediation analyses supported hypotheses based on the new causal chain model. The field testing indicated adequacy of the new causal chain model and informed architectures of behavioral obesity treatments concerned with long-term reductions in excess weight.
评估了一种新的因果链模型，该模型假设心理社会和行为变量之间存在理论和研究为基础的相互关系，这些变量会导致体重减轻及其维持。对参与基于社区的认知行为肥胖治疗的两个女性样本进行了评估，要么是在 6 个月（体重减轻阶段；N=103），要么是另外包括 6-12 个月（体重减轻维持阶段；N=101）。分析首先评估了基线的身体、人口统计学、行为（体力活动、水果/蔬菜摄入量）和/或心理社会（自我调节、自我效能、负面情绪）变量是否显著预测体重变化。进一步的分析评估了基于参与者短期体重减轻和体重减轻维持/进一步减轻的分组，模型为基础的行为和心理社会变量的变化是否显著不同。接下来还评估了心理社会变量变化对行为变化的预测价值，同时考虑到分组。最后，中介、调节和调节中介分析测试了基于因果链的变量间的假设关系。在基线评估的 12 个变量中，只有体重与减轻的体重呈负相关，只有水果/蔬菜摄入量与体重减轻维持阶段的效果呈正相关。在体重减轻和体重减轻维持结果较好的参与者分组中，行为和心理社会变量的总体改善明显更大。自我调节、自我效能和情绪的变化显著预测了体重减轻行为的变化，不受分组的影响。五项中介、调节和调节中介分析的结果支持了基于新因果链模型的假设。现场测试表明，新因果链模型是充分的，并为关注长期减少超重的行为肥胖治疗提供了架构。
