Psychometric Evaluation of the Barriers to Healthy Eating Scale: Results from Four Independent Weight Loss Studies

Towards a Healthy Diet in an Adolescent Population: The Mediating Role of Motivation and Perceived Barriers between Self-Efficacy and Weight Regulation

(1) Background: Adolescence is a critical period when dietary choices are a major concern. It is therefore important to understand the psychological factors that explain these choices. The objective of this study was to assess the predictive role of perceived self-efficacy for healthy eating and weight regulation on healthy and unhealthy eating behavior through the mediation of autonomous motivation, controlled motivation, amotivation, and perceived barriers to daily mechanisms affecting healthy consumption. (2) Methods: A total of 994 adolescents between 15 and 19 years old from Mexico and Spain participated in the study. The Spanish versions of the healthy eating and weight self-efficacy questionnaire, the behavioral regulation in exercise questionnaire, the barriers to healthy eating scale, and the weight-related behaviors scale questionnaire were used to measure the variables of interest. (3) Results: Mediated serial regression analysis showed that barriers to healthy eating (the daily mechanism of food consumption) reduced healthy eating choices. Healthy eating and weight self-efficacy also showed a positive significant relationship with autonomous motivation and a negative relationship with controlled motivation and amotivation. All the types of motivation showed a positive relationship with barriers to healthy eating. (4) Conclusions: The results point out the need to enhance self-efficacy, promote autonomous motivation, and reduce perceived barriers in young people with respect to healthy eating.

Adaptation and validation of the Weight Efficacy Lifestyle Questionnaire (WEL) in a Chilean sample

Self-efficacy is a cognitive-emotional factor that is consistently associated with behavioral change and, in particular, with changes in health behavior. Eating self-efficacy, understood as adopting and maintaining behaviors such as controlling one's weight and trusting in one's ability to control one's eating behavior, has been proposed for managing obesity. This study aimed to validate the Chilean version of the Weight Efficacy Lifestyle Questionnaire (WEL) in a sample of adults from the general population. Four hundred sixty-nine individuals (69.08% women, mean age = 38.02; SD = 10.31) participated in the study. An instrumental design was used geared toward developing tests and psychometric instruments, including adapting existing ones. Exploratory and confirmatory factor analyses were performed. The instrument version validated in Spain was applied in the study. The analysis obtained an instrument of 11 items with adequate psychometric properties allowing its use in clinical and research settings. It can help assess eating self-efficacy in the general population.

Nightly Variation in Sleep Influences Self-efficacy for Adhering to a Healthy Lifestyle: A Prospective Study

BACKGROUND

Self-efficacy, or the perceived capability to engage in a behavior, has been shown to play an important role in adhering to weight loss treatment. Given that adherence is extremely important for successful weight loss outcomes and that sleep and self-efficacy are modifiable factors in this relationship, we examined the association between sleep and self-efficacy for adhering to the daily plan. Investigators examined whether various dimensions of sleep were associated with self-efficacy for adhering to the daily recommended lifestyle plan among participants (N = 150) in a 12-month weight loss study.

METHOD

This study was a secondary analysis of data from a 12-month prospective observational study that included a standard behavioral weight loss intervention. Daily assessments at the beginning of day (BOD) of self-efficacy and the previous night's sleep were collected in real-time using ecological momentary assessment.

RESULTS

The analysis included 44,613 BOD assessments. On average, participants reported sleeping for 6.93 ± 1.28 h, reported 1.56 ± 3.54 awakenings, and gave low ratings for trouble sleeping (3.11 ± 2.58; 0: no trouble; 10: a lot of trouble) and mid-high ratings for sleep quality (6.45 ± 2.09; 0: poor; 10: excellent). Participants woke up feeling tired 41.7% of the time. Using linear mixed effects modeling, a better rating in each sleep dimension was associated with higher self-efficacy the following day (all p values < .001).

CONCLUSION

Our findings supported the hypothesis that better sleep would be associated with higher levels of reported self-efficacy for adhering to the healthy lifestyle plan.

Identification of instruments for evaluation of behavioural and psychological parameters associated with obesity management: A systematic review with narrative synthesis of the findings

BACKGROUND AND AIMS

To identify instruments used to evaluate the predictors of successful weight loss across weight loss trials.

METHODS

We searched PubMed, PsychInfo, Cochrane Reviews and Scopus for weight loss trials reporting instruments published in the last 16 years.

RESULTS

A total of 46 significant behavioral and psychological predictors were identified, of which 32 instruments were finally selected. SF-36 questionnaire and Obesity Related Problem Scale for psychosocial health, TREMORE scale for motivation, Social Support Scale for support, Weight Efficacy Lifestyle Scale for self-efficacy and Body Shape Questionnaire for body image had moderate quality. Barriers to healthy eating questionnaire scale and Dutch Eating Behavior also had moderate quality.

CONCLUSION

Use of uniform instruments with optimum quality can benefit clinical and community-based researchers to generate reliable datasets.

Public Sector Workers' Mental Health in Argentina: Comparative Psychometrics of the Perceived Stress Scale

OBJECTIVES

Given that Argentinian public-sector workers are highly exposed to stressful conditions, and that the psychometric properties of the widely used Perceived Stress Scale (PSS) should be evaluated in different settings, this work aimed to compare the psychometric properties of the Latin American Spanish PSS-10 and PSS-4 and to identify the optimal scale for stress assessment.

METHODS

A sample of 535 participants was randomly divided into 2 groups to evaluate dimensionality by exploratory and confirmatory factor analyses. The reliability of both scales was also evaluated. Convergent validity was estimated using the Executive Complaints Questionnaire, the average variance extracted, and the composite reliability. Discriminant validity was based on the correlation with the Utrecht Work Engagement Scale and the phi-square correlation between the components.

RESULTS

The factor analyses supported bidimensionality of the PSS-10 (stress and coping), which showed a better fit than the PSS-4. Moreover, the reliability of the PSS-10 was higher, whereas the PSS-4 did not achieve adequate values of internal consistency. The PSS-10 was also correlated significantly with all validation scales, and presented proper internal convergent and divergent validity.

CONCLUSIONS

The PSS-10 is a reliable and structurally valid instrument to measure perceived stress and coping in a Latin American Spanish-speaking population with high work demands, and the findings of this study expand our knowledge on the geographical and sociocultural applicability of the PSS.

The SMARTER Trial: Design of a trial testing tailored mHealth feedback to impact self-monitoring of diet, physical activity, and weight

BACKGROUND

Self-monitoring food intake and physical activity (PA) is positively related to weight loss and the addition of feedback (FB) messages has been shown to reinforce behavior change. Moreover, the more immediate the delivery of reinforcing FB messages, the more likely they will promote the desired behaviors.

PURPOSE

Describe design and rationale of SMARTER, a National Institute of Heart, Lung, and Blood (NHLBI)-sponsored randomized, controlled trial, which compares the differential efficacy of two weight loss treatments among 530 adults, ages 18 and older.

METHODS

Single-site, 2-group design trial with subjects randomized 1:1 to either: 1) self-monitoring (SM), where participants self-monitor diet, PA, and weight using a commercial smartphone application (app); or 2) SM + FB, where participants self-monitor and receive real-time, tailored feedback (FB) as pop-up messages up to 3 times/day for 12 months. Daily FB messages address diet and PA behaviors and a weekly FB message addresses self-weighing. We hypothesize that subjects assigned to SM + FB will show greater weight loss at 6 and 12 months and greater sustained engagement in the program than the SM group, measured by adherence to the study's lifestyle and SM protocol. We will explore temporal relationships of the frequency, timing, and type of FB delivered and subsequent lifestyle behaviors through examination of serially collected real-time SM (diet, PA, weight) data over 12 months.

CONCLUSIONS

If efficacious, this fully scalable intervention could be efficiently translated and disseminated to reach large numbers of individuals through commercial apps at lower cost than existing in-person weight loss programs.