Transtheoretical model-based multiple behavior intervention for weight management: effectiveness on a population basis.
BACKGROUND
The increasing prevalence of overweight and obesity underscores the need for evidence-based, easily disseminable interventions for weight management that can be delivered on a population basis. The Transtheoretical Model (TTM) offers a promising theoretical framework for multiple behavior weight management interventions.


METHODS
Overweight or obese adults (BMI 25-39.9; n=1277) were randomized to no-treatment control or home-based, stage-matched multiple behavior interventions for up to three behaviors related to weight management at 0, 3, 6, and 9 months. All participants were re-assessed at 6, 12, and 24 months.


RESULTS
Significant treatment effects were found for healthy eating (47.5% versus 34.3%), exercise (44.90% versus 38.10%), managing emotional distress (49.7% versus 30.30%), and untreated fruit and vegetable intake (48.5% versus 39.0%) progressing to Action/Maintenance at 24 months. The groups differed on weight lost at 24 months. Co-variation of behavior change occurred and was much more pronounced in the treatment group, where individuals progressing to Action/Maintenance for a single behavior were 2.5-5 times more likely to make progress on another behavior. The impact of the multiple behavior intervention was more than three times that of single behavior interventions.


CONCLUSIONS
This study demonstrates the ability of TTM-based tailored feedback to improve healthy eating, exercise, managing emotional distress, and weight on a population basis. The treatment produced a high level of population impact that future multiple behavior interventions can seek to surpass.
Pro-Change Behavior Systems, Inc., USA. sjohnson@prochange.com
Sara S
SS
Johnson
Andrea L
AL
Paiva
Carol O
CO
Cummins
Janet L
JL
Johnson
Sharon J
SJ
Dyment
Julie A
JA
Wright
James O
JO
Prochaska
Janice M
JM
Prochaska
Karen
K
Sherman
D000293:Adolescent; D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D020407:Internet; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D013312:Stress, Physiological / Q000517:prevention & control; D016896:Treatment Outcome; D015431:Weight Loss