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Title: Psychosocial constructs and postintervention changes in physical activity and dietary outcomes in a lifestyle intervention, HUB City Steps, 2010

Author
item Landry, Alice, S - University Of Southern Mississippi
item Thomson, Jessica
item Madson, Michael - University Of Southern Mississippi
item Zoellner, Jamie - Virginia Tech
item Mohn, Richard - University Of Southern Mississippi
item Noble, Jeremy - University Of Southern Mississippi
item Connell, Carol - University Of Southern Mississippi
item Yadrick, Kathy - University Of Southern Mississippi

Submitted to: Preventing Chronic Disease
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/16/2015
Publication Date: 5/21/2015
Publication URL: http://handle.nal.usda.gov/10113/61981
Citation: Landry, A., Thomson, J.L., Madson, M., Zoellner, J.M., Mohn, R., Noble, J., Connell, C., Yadrick, K. 2015. Changes in psychosocial constructs predict post-intervention changes in physical activity and dietary outcomes in a lifestyle intervention: HUB City Steps. Preventing Chronic Disease. 12:140525.

Interpretive Summary: Increasing exercise activities and improving diet are effective methods for decreasing hypertension (high blood pressure). The design of successful interventions that lead to behavioral changes, such as exercise and diet, is dependent upon the “why” and “how” individuals change their health-related behavior. This is particularly important for southern, African American populations because they suffer from some of the highest rates of hypertension and death related to hypertension. Hence the purpose of the present study was to determine if measures from several behavioral change theories were useful in predicting changes in health behaviors related to exercise and diet. We used data from HUB City Steps, a walking intervention with dietary advice designed to reduce blood pressure. It was conducted in a southern, African American population. Results indicated that several behavioral measures (e.g., lacking intention to perform a behavior and social support) as well as the behaviors themselves (i.e. steps/day and sugar intake) improved during the intervention. However, while some of these measures predicted changes in exercise and diet, they were not always in the expected direction (e.g. decreasing social support predicted increased exercise). Hence, further research is needed to determine if these contradictory results are due to lack of sensitivity in the measurement instruments or if some behavioral measures are not relevant to health behavior changes in specific populations.

Technical Abstract: Purpose: To examine relationships among psychosocial constructs (PSC) of behavior change and post-intervention changes in physical activity (PA) and dietary outcomes. Design: Non-controlled, pre- post-experimental intervention. Setting: Midsized, southern United States city. Subjects: 269 primarily African American adults participating in the HUB City Steps. Intervention: 6-month, community-based, lifestyle intervention consisting of motivational enhancement, social support, pedometer diary self-monitoring, and 5 education sessions emphasizing the Dietary Approaches to Stop Hypertension diet. Measures: Pedometer-determined steps/day, fitness, dietary intake, and PSC measures, including processes of change, treatment self-regulation, and social support. Analysis: Generalized linear mixed models to test for post-intervention changes in behavioral outcomes, identify predictors of PSC changes, and determine if PSC changes predicted changes in PA and diet. Results: Post-intervention changes were apparent for 11 of 24 PSC (p<.05). Gender, marital status, smoking status, education, age, income, and baseline body mass index (model coefficients ranging from -0.1 to 0.2) were significant predictors of change for these PSC. Change in amotivation, helping relationships, reinforcement management, consciousness raising, and group guidance were significant predictors of PA changes, while change in external and introjected regulation were significant predictors of diet change. Conclusion: Constructs related to treatment self-regulation, behavioral and cognitive processes of change, and group social support may be appropriate to target in intervention activities for similar minority populations.