title: Self-efficacy as a predictor of weight change and behavior change in the PREMIER trial.
abstract: OBJECTIVE
  Determine whether self-efficacy independently predicted weight loss in a behavioral intervention and explore factors that influence the path between self-efficacy and weight change.
  
  
  METHODS
  Secondary analysis of the PREMIER trial, a randomized controlled trial testing effects of lifestyle interventions on blood pressure.
  
  
  METHODS
  Four academic medical centers.
  
  
  METHODS
  PREMIER recruited adults (n = 810) with pre-hypertension/stage 1 hypertension, not currently receiving medication. This analysis excluded participants in the control arm, resulting in n = 537.
  
  
  METHODS
  Participants were randomly assigned to 1 of 3 groups: advice only, established lifestyle recommendations, or established lifestyle recommendations plus Dietary Approaches to Stop Hypertension dietary pattern.
  
  
  METHODS
  Self-efficacy (dietary self-efficacy [DSE], exercise self-efficacy [ESE]), dietary intake, fitness.
  
  
  METHODS
  Pearson correlations, 1-way analysis of variance, mediation analyses.
  
  
  RESULTS
  Despite an overall decrease in DSE/ESE, change in DSE/ESE significantly predicted weight change at 6 (β = -.21, P < .01; β = -.19, P < .01, respectively) and 18 months (β = -.19, P < .01; β = -.35, P < .01). Change in percent calories from fat partially mediated the DSE/weight change relationship at 6 months. Change in fitness partially mediated the ESE/weight change relationship at 18 months.
  
  
  CONCLUSIONS
  Changes in DSE/ESE were not associated with behavior change as hypothesized. Additional research is needed to identify mediators between self-efficacy and adoption of behaviors that influence weight loss.
authors: Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA. bcwingo@uab.edu
authors: Brooks C
authors: BC
authors: Wingo
authors: Renee A
authors: RA
authors: Desmond
authors: Phillip
authors: P
authors: Brantley
authors: Lawrence
authors: L
authors: Appel
authors: Laura
authors: L
authors: Svetkey
authors: Victor J
authors: VJ
authors: Stevens
authors: Jamy D
authors: JD
authors: Ard
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015331:Cohort Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology*; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D015431:Weight Loss