Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.
Care for Nutrition and Health Group, School of Nursing, Christian University of Applied Sciences, 6717 JS Ede, The Netherlands.
Ann Behav Med. 2023 Jul 19;57(8):620-629. doi: 10.1093/abm/kaac077.
When losing weight, most individuals find it difficult to maintain a healthy diet. Social environmental conditions are of pivotal importance in determining dietary behavior. To prevent individuals from lapsing, insight in social environmental predictors of lapse in dietary behavior is needed.
Identify social environmental predictors of lapse in dietary behavior, using ecological momentary assessment (EMA) amongst Dutch adults trying to lose weight.
Adults (N = 81) participated in two 7-day EMA weeks. Six times a day semi-random prompts were sent. At each prompt, participants indicated whether a lapse had occurred and responded to questions assessing social support, descriptive norm, injunctive norm, social pressure, presence of others, and current location. Generalized estimating equations were used to examine associations with lapse.
Injunctive norm (OR = 1.07, 95% CI = 1.03-1.11), descriptive norm (OR = 1.04, 95% CI = 1.02-1.07), and social pressure (OR = 1.09, 95% CI = 1.05-1.14), all toward diverting from diet plans, predicted lapses. Social support toward sticking to diet plans and presence of others did not predict lapses. When controlling for a prior lapse, all other associations became nonsignificant. Lapses occurred most often at home and gradually occurred more often during the day.
Traditional public health perspectives have mainly focused on individual choice and responsibility for overweight related unhealthy lifestyles. This study shows that there may be opportunities to enhance intervention programs by also focusing on social norms and social pressure. The involvement of partners or housemates may create more awareness of the impact of (unintentional) social pressure on risk of lapsing, and reduce the level of exerted social pressure.
在减肥过程中，大多数人发现很难保持健康的饮食。社会环境条件对决定饮食行为至关重要。为了防止个体行为倒退，需要了解社会环境对饮食行为倒退的预测因素。
使用荷兰减肥成年人的生态瞬时评估（EMA），确定饮食行为倒退的社会环境预测因素。
81 名成年人参加了两个为期 7 天的 EMA 周。每天六次随机发送半随机提示。每次提示时，参与者都会表明是否发生了倒退，并回答关于社会支持、描述性规范、规范性规范、社会压力、他人在场和当前位置的问题。使用广义估计方程来检验与倒退相关的关联。
背离饮食计划的规范性规范（OR = 1.07，95%CI = 1.03-1.11）、描述性规范（OR = 1.04，95%CI = 1.02-1.07）和社会压力（OR = 1.09，95%CI = 1.05-1.14）都预测了倒退。支持坚持饮食计划和他人在场的社会支持并没有预测倒退。在控制先前的倒退后，所有其他关联变得无意义。倒退最常发生在家里，并且逐渐在白天发生得更频繁。
传统的公共卫生观点主要侧重于与超重相关的不健康生活方式的个体选择和责任。本研究表明，通过关注社会规范和社会压力，可能有机会增强干预计划。伴侣或室友的参与可能会提高对（无意）社会压力对倒退风险的影响的认识，并降低施加的社会压力水平。
