Healthy eating and exercise in the rural midwest

Age group differences in diet and physical activity-related behaviors among rural men and women

OBJECTIVES

Age group variations in dietary intake and physical activity have been noted in large epidemiologic studies. In this study, specific measures of behavioral strategies add depth to our understanding of these variations and can contribute to the design of effective behavioral interventions.

DESIGN

Cross-sectional, behavioral epidemiologic study.

SETTING

Rural Midwestern US.

PARTICIPANTS

407 adults.

MEASUREMENTS

Measures included dietary intake, physical activity, body mass index (BMI), and specific behavioral strategies related to diet and physical activity.

RESULTS

Use of most strategies related to diet increased across age groups, which was consistent with declining caloric intake and a decline in the proportion of total caloric intake from fat. The same patterns were not found with regard to physical activity. Greater use of diet-related strategies was noted in the oldest age groups compared to the others even though BMI was lower.

CONCLUSIONS

In the oldest age group at least, strategy use may be more related to attempts to control health conditions than body weight. The findings provide a unique perspective on age group differences in diet and physical activity behavior. Longitudinal tracking of these specific behaviors and their measurement in other populations is warranted.

Self-efficacy and its association with use of diet-related behavioral strategies and reported dietary intake

The construct of self-efficacy has been widely used in studies of dietary behavior change and is accepted as a helpful process indicator. This study examined associations between self-efficacy and use of specific diet-related behavioral strategies and reported dietary intake over time. Data are from two community surveys of rural adults conducted 1 year apart (n=354). Results indicate that changes in self-efficacy are positively associated with changes in strategy use but not dietary intake. Strategies may be thought of as leading to a particular level of dietary intake but are not the only influence on intake. Findings therefore confirm hypothesized associations between these components of the behavior change process. By attending to and measuring these specific links in the process, researchers and practitioners can better determine where behavioral interventions are succeeding and where they are breaking down.

Weight management strategies reported by rural men and women in Iowa

OBJECTIVE

This study compares the specific behavioral strategies that rural men and women use when trying to lose weight.

DESIGN

A cross-sectional, in-person survey.

SETTING

Participants were part of a larger study in rural Iowa (n = 407) intended to identify community health promotion issues.

PARTICIPANTS

184 adults (56 men, 128 women) who reported currently trying to lose weight

VARIABLES MEASURED

Measures capture strategies for dealing with the social environment, food choice and preparation, physical activity planning, social support, self-efficacy, outcome expectations, dietary intake and physical activity level.

ANALYSIS

T-tests, chi-square, Cronbach alpha, descriptive statistics.

RESULTS

Women reported greater use of nearly all strategies measured. Men reported more social support for diet, whereas women reported more social support for physical activity. Results for self-efficacy and outcome expectations were mixed. No gender differences were found for fat intake, fruit and vegetable servings, or physical activity level.

CONCLUSIONS AND IMPLICATIONS

Men and women differ in the specific strategies they use to lose weight, including those related to the social environment. Practitioners planning weight management programs should be aware that men and women may have different levels of experience in using specific behavioral strategies.

Stage of Change for Healthful Eating and Use of Behavioral Strategies

OBJECTIVE

To examine the distribution of behavioral strategy use across stage of change for healthful eating, and to determine if baseline stage predicts change in use of strategies over 1 year in the absence of intervention.

DESIGN

Cross-sectional assessment and 1-year follow-up with no intervention.

SUBJECTS/SETTING

Adult men and women in two rural Midwest communities.

STATISTICAL ANALYSES PERFORMED

Multiple regression, with tests for group difference and trend, controlling for age and sex.

RESULTS

Use of behavioral strategies as measured by six scales (self-monitoring, planning, preparation and buying, portion control, social interactions, and cognitive strategies) followed a clear linear trend across stages of change for healthful eating. Strategy use was more strongly related to stage than energy intake, fat intake, and fruit and vegetable servings as measured via food frequency questionnaire. Baseline stage of change showed some relationship to change in strategy use over time, although most group differences were not statistically significant.

CONCLUSIONS

Use of a range of behavioral strategies is strongly related to stage of change for healthful eating, and more closely associated with stage than dietary intake. In the absence of intervention, baseline stage only weakly predicted changes in strategy use. Programs with the goal of encouraging a range of healthful eating behaviors may find these measures of strategy use to be helpful in defining stage of change, and possibly in tracking behavior change over time.

Measurement of behavioral objectives for weight management

Measurement of specific behaviors involved in weight management is essential to understanding the behavior change process. This study presents measures of common behavioral objectives for weight management interventions. The relationships between these measures and conventional outcomes of weight management are described. Data are from a survey of 407 adults in the rural Midwest ages 23 to 88. Analyses involved bivariate and multivariate statistical tests. Relationships were stronger when limited to diet or physical activity outcomes as opposed to body mass index or waist circumference. Diet-related strategies were more strongly correlated with diet-related outcomes than physical activity-related outcomes and vice versa. Measures of social interactions and self-monitoring for both diet and physical activity were consistently related to outcomes. The measures show promise as reliable and valid indicators of behavior that could be useful in the evaluation of interventions. Intervention studies are needed to further characterize their value and sensitivity to change over time.

Healthy eating and exercise: strategies for weight management in the rural midwest

Obesity prevalence has increased dramatically in the United States. Rural areas have been especially affected, yet few weight management studies have been conducted in these populations. This study was designed to assess weight management attitudes and strategies used when rural adults in particular attempt to lose weight, employing measures that are more specific than those reported in similar studies. The survey was completed by 123 adults aged 19 to 71, with a 29% response rate. Scales demonstrated good to excellent internal consistency, and test-retest reliability. Persons currently trying to lose weight were more likely to report self-monitoring behaviors and goal setting but no more likely to report use of specific behavioral strategies compared to persons not trying to lose weight. The results suggest considerable interest in weight management among rural adults and provide a starting point for planning future weight management interventions in this and similar populations.