Submitted to: International Journal of Behavioral Nutrition and Physical Activity
Publication Type: Peer reviewed journal
Publication Acceptance Date: 1/21/2009
Publication Date: 1/21/2009
Citation: Baranowski, T., Cerin, E., Baranowski, J. 2009. Steps in the design, development and formative evaluation of obesity prevention-related behavior change trials. International Journal of Behavioral Nutrition and Physical Activity. 6(1):6. Interpretive Summary: Most obesity prevention interventions have had weak or no effects on obesity, or on the related diet or physical activity behaviors. To minimize these problems, future research based obesity prevention programs should build a stronger foundation for the intervention design in order to maximize their likelihood of beneficial effects. Our research suggests that three studies should be implemented in sequence: 1) identify the behaviors related to obesity in a target population; 2) identify the variables most predictive and causal of the behaviors in the population; and 3) test the intervention procedures to change the variables at high enough levels to change behaviors and adiposity outcomes. Although this approach may take longer to do, it will increase the likelihood of success in preventing obesity, which will have a positive impact on the health of Americans.
Technical Abstract: Obesity prevention interventions through dietary and physical activity change have generally not been effective. This paper uses the Mediating Variable Model (MVM) as a conceptual framework for examining why obesity prevention interventions have not worked. Problems were identified in measurement of all constructs, not knowing what behaviors lead to obesity, not knowing what factors influence these behaviors, and not knowing how to effectively change these influencing factors enough to change the behaviors. To minimize these problems, and thereby enhance likely intervention effectiveness, four sequential types of formative studies were proposed: first, understanding what behaviors lead to obesity in a targeted (high risk) population; second, understanding what influences these behaviors in the targeted population; third, validating what intervention procedures change the influencing (mediating variables) enough to expect to change the behavior; and fourth, conducting a pilot study that combines the targeted behaviors, influences and change procedures into one intervention. Implementing these studies would establish the relationships at each step in the mediating variable model, thereby maximizing the likelihood that an intervention would work and its effects would be detected.