title: Social support for healthy behaviors: scale psychometrics and prediction of weight loss among women in a behavioral program.
abstract: Social support could be a powerful weight-loss treatment moderator or mediator but is rarely assessed. We assessed the psychometric properties, initial levels, and predictive validity of a measure of perceived social support and sabotage from friends and family for healthy eating and physical activity (eight subscales). Overweight/obese women randomized to one of two 6-month, group-based behavioral weight-loss programs (N = 267; mean BMI 32.1 ± 3.5; 66.3% White) completed subscales at baseline, and weight loss was assessed at 6 months. Internal consistency, discriminant validity, and content validity were excellent for support subscales and adequate for sabotage subscales; qualitative responses revealed novel deliberate instances not reflected in current sabotage items. Most women (>75%) "never" or "rarely" experienced support from friends or family. Using nonparametric classification methods, we identified two subscales-support from friends for healthy eating and support from family for physical activity-that predicted three clinically meaningful subgroups who ranged in likelihood of losing ≥5% of initial weight at 6 months. Women who "never" experienced family support were least likely to lose weight (45.7% lost weight) whereas women who experienced both frequent friend and family support were more likely to lose weight (71.6% lost weight). Paradoxically, women who "never" experienced friend support were most likely to lose weight (80.0% lost weight), perhaps because the group-based programs provided support lacking from friendships. Psychometrics for support subscales were excellent; initial support was rare; and the differential roles of friend vs. family support could inform future targeted weight-loss interventions to subgroups at risk.
authors: Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA. mkiernan@stanford.edu
authors: Michaela
authors: M
authors: Kiernan
authors: Susan D
authors: SD
authors: Moore
authors: Danielle E
authors: DE
authors: Schoffman
authors: Katherine
authors: K
authors: Lee
authors: Abby C
authors: AC
authors: King
authors: C Barr
authors: CB
authors: Taylor
authors: Nancy E
authors: NE
authors: Kiernan
authors: Michael G
authors: MG
authors: Perri
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D033062:Friends / Q000523:psychology; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D009042:Motivation; D009765:Obesity / Q000523:psychology* / Q000628:therapy; D011594:Psychometrics; D012944:Social Support; D011795:Surveys and Questionnaires; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*; D055815:Young Adult