CIDEFES, Universidade Lusófona, Campo Grande, 376, 1749-024, Lisbon, Portugal.
Comprehensive Health Research Centre (CHRC), NOVA Medical School | Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal.
Int J Behav Nutr Phys Act. 2023 Oct 27;20(1):128. doi: 10.1186/s12966-023-01529-8.
Preventing weight regain can only be achieved by sustained changes in energy balance-related behaviors that are associated with weight, such as diet and physical activity. Changes in motivation and self-regulatory skills can support long-term behavioral changes in the context of weight loss maintenance. We propose that experiencing a supportive climate care is associated with enhanced satisfaction of basic psychological needs, intrinsic goals, and autonomous motivation. These factors are expected to be associate with the utilization of self-regulation skills, leading to more sustained behavior changes and ultimately preventing weight regain. This hypothesis was tested in this ancillary analysis of the NoHoW trial, where the study arms were pooled and followed for 12 months.
The NoHoW was a three-center, large-scale weight regain prevention full factorial trial. In this longitudinal study, data were collected in adults who lost > 5% weight in the past year (N = 870, complete data only, 68.7% female, 44.10 ± 11.86 years, 84.47 ± 17.03 kg) during their participation in a 12-month digital behavior change intervention. Weight and validated measures of motivational- and self-regulatory skills-related variables were collected at baseline, six- and 12 months. Change variables were used in Mplus' path analytical models informed by NoHoW's logic model.
The bivariate correlations confirmed key mediators' potential effect on weight outcomes in the expected causal direction. The primary analysis showed that a quarter of the variance (r2 = 23.5%) of weight regain prevention was achieved via the mechanisms of action predicted in the logic model. Specifically, our results show that supportive climate care is associated with needs satisfaction and intrinsic goal content leading to better weight regain prevention via improvements in self-regulatory skills and exercise-controlled motivation. The secondary analysis showed that more mechanisms of action are significant in participants who regained or maintained their weight.
These results contribute to a better understanding of the mechanisms of action leading to behavior change in weight regain prevention. The most successful participants used only a few intrinsic motivation-related mechanisms of action, suggesting that habits may have been learned. While developing a digital behavior change intervention, researchers and practitioners should consider creating supportive climate care to improve needs satisfaction and intrinsic goal contents.
ISRCTN, ISRCTN88405328 , registered 12/22/2016.
只有通过与体重相关的能量平衡行为的持续改变，才能防止体重反弹，这些行为包括饮食和体育活动。动机和自我调节技能的改变可以支持减肥维持过程中的长期行为改变。我们提出，体验支持性的护理环境与基本心理需求、内在目标和自主动机的满足感增强有关。这些因素预计与自我调节技能的利用有关，从而导致更持续的行为改变，并最终防止体重反弹。这一假设在 NoHoW 试验的辅助分析中得到了检验，其中研究组被合并并随访了 12 个月。
NoHoW 是一项三中心、大规模的体重反弹预防全因子试验。在这项纵向研究中，数据收集于过去一年体重减轻超过 5%的成年人（N=870，仅完整数据，68.7%为女性，44.10±11.86 岁，84.47±17.03kg），他们参与了为期 12 个月的数字行为改变干预。在基线、6 个月和 12 个月时收集体重和经过验证的与动机和自我调节技能相关的变量。变化变量用于 Mplus 的路径分析模型，这些模型由 NoHoW 的逻辑模型提供信息。
二元相关证实了关键中介变量在预期因果方向上对体重结果的潜在影响。主要分析表明，通过逻辑模型预测的作用机制，体重反弹预防的四分之一方差（r2=23.5%）得到了实现。具体来说，我们的结果表明，支持性的护理环境与需求满足和内在目标内容有关，通过改善自我调节技能和锻炼控制的动机，从而更好地预防体重反弹。二次分析表明，更多的作用机制在体重增加或保持的参与者中更为显著。
这些结果有助于更好地理解导致体重反弹预防行为改变的作用机制。最成功的参与者只使用了一些与内在动机相关的作用机制，这表明可能已经养成了习惯。在开发数字行为改变干预措施时，研究人员和实践者应该考虑创造支持性的护理环境，以提高需求满足和内在目标内容。
ISRCTN，ISRCTN88405328，注册于 2016 年 12 月 22 日。
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