An Overview of Factors Associated with Adherence to Lifestyle Modification Programs for Weight Management in Adults
Abstract
:1. Introduction
2. Method
- Lifestyle modification program should not be pharmacological nor surgical and was clearly defined with components of diet, PA and behavioural strategies or theories. The diet component should be based on healthy diet principles and not involve meal replacement, low calorie diet or very-low-calorie diet.
- Weight management including weight loss and weight maintenance was one of the aim of the studies.
- Adherence indicators were clearly defined.
- Studies explored the association between any type of factors and adherence outcomes.
- Participants were generally healthy without existing chronic diseases, significant psychological comorbidities or any medical condition that limited the ability to perform PA.
- The main study should be prospective in nature (i.e., cohort studies, controlled trials or quasi-experimental studies).
3. Results
3.1. Study and Subject Description
3.1.1. Design
3.1.2. Primary Aims of the Studies
3.1.3. Format and Delivery
3.1.4. Lifestyle Modification Components
3.1.5. Subjects
3.2. Adherence Outcomes
3.2.1. Attrition
3.2.2. Attendance
3.2.3. Self-Monitoring
3.2.4. Dietary Adherence
3.3. Factors Associated with Adherence
3.3.1. Psychosocial Factors
Self-Efficacy
Depression
Motivation
Stress
Body Shape Concern
Stage of Change
Quality of Life
3.3.2. Socio-Demographic Factors
Age
Gender
Employment Status
Education
3.3.3. Behavioural Factors
Eating or PA Behavioural Factors
Previous Weight Loss Attempt
3.3.4. Physical Factors
4. Discussion
5. Limitations
6. Future Research
7. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
Appendix A. Example of search strategy used
- Ovid—Ovid MEDLINE(R), PsycAETICLES, PsycINFO
- (diet or “physical activity” or exercise* or lifestyle).mp.
- (“weight management” or “weight control” or “weight reduction” or “weight loss” or “weight maintenance”). mp.
- (factor * or determinant * or correlate * or predictor * or mediator *). mp.
- (attrition or dropout or adherence or compliance or goal or attendance or self-monitoring).ti
- 1 and 2 and 3 and 4
- Pubmed
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Study | Design | Primary Aim | Subjects | Country of Origin | Ethnicity | Setting | Interventionist | Format and Delivery | Dietary Component | PA Component | Behavioural Component | Duration | Assessment of Factors |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Attrition | |||||||||||||
Teixeira et al., 2004 [38] | I | Weight loss | - 158 free-living participants - All F - Age 48 ± 4.5 - BMI 31 ± 3.8 | USA | Non-Hispanic or Hispanic white | Community | Intervention team with physical activity, nutrition, psychology, and behaviour modification experts | Group based plus online follow up - 16 weekly group sessions, 150 min each - 25 participants per group | Reducing energy intake to achieve daily energy deficit (less 300–500 kcal/day) | Increase PA to achieve daily energy deficit (less 300–500 kcal/day). | CBT: Goal setting, self-monitoring, self-efficacy enhancement, relapse prevention, contingency management Social support | 16 weeks + online contact or no contact for 1 year | Baseline |
Kong et al., 2010 [39] | I | Weight loss | - 51 patients with MetS or pre-diabetes - 65% F - Age 50.8 ± 12.0 - BMI 40.5 ± 9.3 | Canada | NA | Clinical: Outpatient clinic in an academic hospital | Nurse, endocrinologist and dietitian | Individual based - 1 session every 6 weeks for 1 year - 90 min for first session - 45 min during each follow up session Group based - weekly seminar - walk-in basis | Nutrition goals e.g., (portion sizes, vegetable and whole grain intake, fat content, snacks, caloric beverages) Food labeling Eating out | Long-term objective: 60 min of moderate PA daily | Goal setting Barriers to change Reinforce behaviour Motivation Emotion management Self-esteem | 1 year | Baseline + Weight loss data for 6 weeks |
Neve et al., 2010 [46] | L | Weight loss | - 9599 participants of a web-based weight loss program 12-week: 6943 52-week: 2656 - 86%F - Age 35.7 ± 9.5 - BMI 32.9 ± 6.7 | Australia | NA | Online, Community | Online support from experts | Individual based - 12 or 52-week subscription participants included - Daily calorie goal - Weekly exercise goal - Weekly weigh-ins - Weekly email with educational information Group based - Online discussion forum - Monthly online meeting with other participants | Calorie-controlled and portion controlled diets developed by dietitians. | Step-by-step workout programs Workout videos featuring the Biggest Loser trainers | SCT Goal setting Self-monitoring | 12 or 52 weeks | Baseline |
Bradshaw et al., 2010 [37] | RCT | Weight loss | - 119 free living individuals with at least 1 CVD factor - All F - Age 25–65 (mean: 46.3) - BMI Completers: 34.9 ± 5.4 Dropouts: 36.0 ± 6.0 | New Zealand | Around 90% New Zealand European | Community | Group 1: Nutritionist and psychotherapist Group 2: Dietitian, psychotherapist and lifestyle activity consultant | Group based - Relaxation response training - Without relaxation response training • 2 h per sessions • 10 initial weekly sessions, then fortnightly and monthly for 8 months | Non-dieting approach (eating regulated by hunger and satiety) Group 1: mindful eating Group 2: low fat diet, food shopping, healthy diet, food variety | Regular PA | Relaxation technique and mindful eating (Group 1 only) Goal setting, self-monitoring, stimulus control (Group 2 only) Body image Enjoyment SCT Cognitive restructuring Coping skills | 10 weeks + 8 months (Analysis for first 10 week only) | Baseline |
Roumen et al., 2011 [31] | RCT | Prevention of DM | - 147 patients with IGT - 49% F - Age I: 55.0 ± 6.5 C: 58.8 ± 8.4 - BMI I: 29.9 ± 4.2 C:29.7 ± 3.4 | Netherlands | Caucasian | Community | Dietitian and exercise trainer | Individual based - First session 4–6 weeks after randomization - 1 session every 3 months for 3 years - 1 h per session | Dutch guidelines for a healthy diet | Increase PA at least 30 min a day, 5 days a week Voluntary exercise program Aerobic exercise training Resistance training | Goal setting | 3–6 years | Baseline |
Ahnis et al., 2012 [40] | I | Weight loss and maintenance | - 164 patients - 84.1% F - Age Completers: 47.4 ± 11.0 Dropouts: 42.9 ± 11.6 - BMI Completers: 39.6 ± 6.5 Dropouts: 39.5 ± 6.7 | Germany | NA | Clinical-Outpatient clinic | Dietitian, psychologist and physiotherapist | Group based - 2 per week in first 6 months - 1 per week in 6–12 months - 2.5 h each | Balanced diet with reduced fat Reduce intake of food with high glycemic index Reduce 500–800 kcal per day Lectures, controlled dialogue, discussion, group work, theoretical and practical exercises (e.g., cooking) | Movement therapy: equipment-based remedial gymnastics, aqua fitness and medical workout, goal to increase 2–3 h of exercise per week. Muscle relaxation: Jacobson’s progressive muscle relaxation | Psycho-educational and behavioural therapy Self-monitoring Relapse prevention Stimulus Control Behavioural substitution Goal setting | 12 months | Baseline |
Toth-Capelli et al., 2013 [41] | I | Weight loss | - 461 patients - 84% F - Age 18–55 (38% 40–50) - BMI ≥ 30 | USA | 60% African American | Clinical-Primary Care | Lifestyle counselor and health educator | Individual based - Periodic sessions, 1 per every 3 months - Occasional phone calls in the first month Group based - Biweekly education group | Food guide pyramid Food labeling Healthy meal planning Supermarket tours Healthy cooking Healthy snacking Dining out Healthier shopping | Incorporate PA into daily life | Goal setting Motivational Interviewing Stage of Change | Periodic, time not specified | Baseline |
Cresci et al., 2013 [42] | I | Weight loss | - 266 patients - 73% F - Age 43.2 ± 11.9 - BMI 38.8 ± 6.8 | USA | NA | Clinical- Outpatient academic clinic | Endocrinologist (first visit) and dietitian | Individual based - Monthly visit | 500 kcal/day reduction diet Individualized diet plan | Endocrinologist provide instruction for PA, details not mentioned | Goal Setting Self-monitoring | 6 months, follow up at 1, 2, 4, 6 months | Baseline |
Michelini et al., 2014 [32] | RCT | Weight loss and maintenance | 146 patients I: 73 C: 73 74.7% F Age 45 ± 11 BMI 32.3 ± 3.7 | Italy | NA | Clinical- Outpatient clinic | Dietitian, physician and psychologist | Group based +Individual based I group (+CBT): 0–6 months: 7 monthly group sessions 90 min each 6–12 months 1 per every 3 months 30 min each Individual visit 12–24 months: 1 per every 6 months 30 min each Individual visit C group: 0–12 months 1 per every 3 months 30 min each Individual visit 12–24 months: 1 per every 6 months 30 min each Individual visit | Both group assigned hypo-caloric diet: • 15% protein; • 55–60% carbohydrate; • 30% lipid; Booklet explaining food groups and portion size | PA for weight maintenance training | CBT: Goal setting, self-monitoring, relapse prevention | 24 months (Analysis for 6 months only) | Baseline |
Yackobovitch-Gavan et al., 2015 [43] | I | Weight loss | - 587 members of a health care service 90% F Age 46 ± 11 BMI 31.9 ± 5.5 | Israel | NA | Community | Dietitian | Group based - 10 weekly sessions - 90 min each - 12 participants each group | Healthy eating habits | Regular PA | Goal setting Coping | 10 weeks | Baseline + weight loss data for 10 weeks |
Sawamoto et al., 2016 [44] | I | Weight loss and maintenance | - 119 free living individuals - All F Age Completers: 47.7 ± 1.2 Dropouts: 43.9 ± 2.1 BMI Completers: 31.3 ± 0.5 Dropouts: 32.0 ± 0.9 | Japan | NA | Community | Physician and nutritionist | Group based - 34 weekly sessions + 6 biweekly sessions - 90 min per session - 10 participants per session Individual based - 5 sessions over 44 weeks | Reduction of 500 kcal /day More vegetables Reduction of fatty foods Reduction of sweets | Moderate PA e.g., walk 8000–10,000 steps/day Pedometers provided | CBT: Self-monitoring, stress management | 7 months (weight loss) plus 3 months (weight maintenance) | Baseline |
Susin et al., 2016 [29] | RCT | Management of MetS | - 127 patients with MetS Group 1: 43 Group 2: 43 Group 3: 41 - 59.1% F - Age 49.6 ± 7.8 - BMI 34.9 ± 3.5 | Brazil | 87% White | Clinical- Rehabilitation Center in an academic hospital | Physical therapist, psychologist, nutritionist and nurse | Individual based - Group 1: Standard MetS clinical management by nurse - Group 2: • Motivational intervention by psychologist • Weekly nutrition appointments with nutritionist • Performance of exercise monitored by physical therapist Group based - Group 3: • Motivational intervention by psychologist • Weekly group meetings with nurse, physical therapist, and nutritionist | Clinical guideline (Not specified) | Clinical guideline (Not specified) | Motivation Stage of Change | 3 months | Baseline |
Attendance | |||||||||||||
Helitzer et al., 2007 [33] | RCT | Prevention of DM | 75 free living individuals (I group) All F Age 18–40 BMI > 80% BMI ≥ 25 | USA | Indian | Community | Female American Indian health educator | Group-based - 5 monthly class-room sessions - 2–2.5 h each | Increase vegetable intake Reduce dietary fat intake Less sugar and healthy fast food strategies | Regular PA | Social support Relapse prevention -sustain healthy lifestyle behaviours SCT concepts e.g., self-efficacy, expectations, emotional coping | 5 months | Baseline |
Toft et al., 2007 [30] | RCT | Prevention of CVD | 897 free living individuals (I group) 61% F Age 30–60 (58% 40–50) Mean BMI Low adherence group: 31.6 ± 0.5 High adherence group: 30.8 ± 0.5 | Denmark | NA | Community | Nurse and dietitian | Group-based - 6 meetings in 6 months - 15–20 participants per group - 2 h each. - At 1 and 3 years follow up: participants who were still being assessed as high risk underwent the group sessions again | Decreasing saturated fat, substituting saturated fat for unsaturated fat Increasing intake of fruits and vegetables, and fish | Active at least 4 h/week, no intensity requirements (first 6 months) MVPA at least 30 min/day (at 1, 3, 5 years). | Self-perceived health risk Benefit and barriers Self-efficacy Goal setting Motivational Interviewing | 6 months | Baseline |
Mata et al., 2010 [47] | L | Weight loss | 390 participants of two online weight loss programs B: 139 WW: 251 Al F Age B: 39.2 ± 11.6; WW: 33.7 ± 10.34 BMI B: 27.9 ± 5.26; WW: 29.0 ± 6.00 | Germany | NA | Online, Community | NA | Individual based - No common starting point of program - Program length varies and depends on participants’ willingness to pay | B: Recipe-based Low calorie diet plan Shopping lists for every meal. WW: Point-based system | General recommendations on websites. Weight watchers: Point-based system Brigitte: Individualized exercise plan. | Goal setting: B: weight goal; WW: time goal; Self-monitoring of diet and PA Problem solving | 8 weeks | Baseline |
Self-monitoring | |||||||||||||
Webber et al., 2010 [45] | I | Weight loss | 66 free living individuals All F Age 50.1 ± 9.9 BMI 31.1 ± 3.7 | USA | 86% Caucasian | Online, Community | Nutrition doctoral student | Individual based - 1 Initial face-to-face session by nutrition doctoral student - 16 weekly internet based sessions - 1 group with additional weekly on-line 1-h chat led by nutrition doctoral student - Message board feature - Self-help resources available on the Web | Dietary goals: - low-fat diet (<25% of calories from fat) - low calorie diet of 1200 or 1500 Kcal Overview of energy balance Safe dietary practices Calorie Book | Exercise goal: 30–60 min of MVPA per day Safety recommendations | Goal setting Motivational Interviewing Self-monitoring | 16 weeks | Baseline, 4, 8, 12 and 16 weeks |
Krukowski et al., 2013 [34] | RCT | Weight loss | 161 free living individuals (I group) 93% F Age 46.2 ± 9.8 BMI 35.7 ± 5.7 | USA | 69% Caucasian | Online, community | Public health practitioner, clinical psychologist and dietitian | Group based - 24 Weekly online group sessions - 12–18 participants per group - 1 h per session Individual based - Weekly feedback on self-monitoring | Calorie-restricted diet ≤25% fat goal | Graded exercise progressed to 200 min/week of MVPA Pedometers provided | Self-monitoring Stimulus control Problem solving Goal setting Relapse prevention Assertiveness training | 6 months | Baseline |
Steinberg et al., 2014 [35] | RCT | Weight loss | 91 free living individuals (I group) - All F Age 35.4 ± 5.5 BMI 30.2 ± 2.5 | USA | African American | Online, community (Interactive obesity treatment approach) | Dietitian | Individual based - Weekly interactive voice response (IVR) calls for self-monitoring of goals - Monthly call with dietitian | ≥5 fruit and vegetables/day No fast food No sugar sweetened drinks | Walking 7000 steps/day | Self-monitoring Motivational readiness | 12 months | Baseline |
Dietary adherence | |||||||||||||
Aggarwal et al., 2010 [36] | RCT | Prevention of CVD | 458 family members of cardiac patients (50% in I group) 66% F Age 49 ± 14 BMI 28 ± 6 (64% with BMI ≥ 25) | USA | 65% non-Hispanic White | Clinical-Hospital | Prevention counselor and dietitian (both for I group only) | Individual based - I group: • Stage-matched lifestyle counselling, personalized CVD risk factor assessment • 6 sessions (baseline, 2 weeks,6 weeks, 3, 6 and 9 months) • 30–60 min each - C group: brief, general health message about lifestyle and CVD prevention | Therapeutic Lifestyle Changes (TLC) Diet - Avoid saturated fat, cholesterol, trans fat partially hydrogenated fats - Avoid refined sugars - ≥2 servings fruit/day - ≥3 servings vegetables/day - ≥20 g fiber/day | Moderate PA for at least 30 min per day and 60 min if weight loss was desired | Stage of Change Goal setting Self-efficacy Problem-solving Reinforcing coping skills Reward | 9 months | Baseline and 1 year |
Study | Adherence Outcome | Analysis | Significant Factors (p < 0.05) | |
---|---|---|---|---|
Attrition | ||||
Teixeira et al., 2004 [38] | Dropout at 16 months: 47 (29.7%) | Univariate | + Psychosocial: (i) Stringent weight outcome evaluation, (ii) Depression, (iii) Body shape concerns + Behavioural: (i) Previous weight loss attempts, (ii) Binge eating + Physical: (i) Initial weight, (iii) Initial BMI, (iii) Initial fat - Psychosocial: (i) Quality of Life (physical, mental and obesity specific) (ii) Self-esteem - Behavioural: (i) Carbohydrate intake, (ii) Fiber intake (iii) Exercise | |
Multivariate | + Psychosocial: Stringent weight outcome evaluation + Behavioural: Previous weight loss attempts - Psychosocial: Quality of Life (physical, mental and obesity specific) - Behavioural: Carbohydrate intake | |||
Kong et al., 2010 [39] | Loss to follow up or non-responders (failure to achieve >5% weight loss) at 1 year: 33 (64.7%) ^ Other indicators: Dropout (loss to follow up):15 (30%) | Univariate | + Physical: Initial weight - Psychosocial: (i) Self-efficacy, (ii) Conviction for diet modification - Physical: % of weight loss at 6 weeks | |
Multivariate | - Psychosocial: Self-efficacy - Physical: % of weight loss at 6 weeks | |||
Neve et al., 2010 [46] | Non-usage attrition (stopped using the website but active subscription) - 12-week: 4388 (65%) - 52-week: 1429 (70%) ^Other indicators: Dropout for 12-week (<78 days): 238 (3%) Dropout for 52-week (<359 days): 605 (23%) | Univariate | 12-week + Socio-demographics: Being male + Behavioural: (i) Eat to ease emotional upset, (ii) Eat to reduce stress, (iii) Drink full sugar soft drinks, (iv) Skipping meals + Physical: Being obese - Socio-demographics: Age - Behavioural: (i) Eat breakfast, (ii) Drink ≥ 6 glasses of water/day, (iii) Use low fat products, (iv) Exercise ≥ 2 days/week 52-week + Behavioural: (i) Fry foods, (ii) Use butter for cooking, (iii) Skipping meals, (iv) Drink full sugar soft drinks, (v) Drink tea or coffee with sugar - Psychosocial: Motivation (≥1 health-related reason for weight loss) - Socio-demographics: Age - Behavioural: (i) Eat breakfast, (ii) Use low fat products, (iii) Exercise ≥ 2 days/week | |
Multivariate | 12-week + Behavioural: (i) Eat to ease emotional upset, (ii) Skipping meals - Socio-demographics: Age - Behavioural: (i) Eat breakfast (iii) Exercise ≥ 2 days/week 52-week + Behavioural: Drink tea or coffee with sugar - Behavioural: Eat breakfast | |||
Bradshaw et al., 2010 [37] | Dropout (<8/10 sessions): 50 (42%) | Univariate | - Socio-demographics: Education - Behavioural: Healthier nutrition behaviours | |
Multivariate | - Behavioural: Healthier nutrition behaviours | |||
Roumen et al., 2011 [31] | Dropout before 3 years: 32 (21.7%) * [50% from I group] # Result were similar when tested for intervention or control group separately | Univariate | + Physical: (i) Baseline BMI, (ii) Glucose intolerance - Socio-demographics: Socioeconomic status - Physical: Aerobic fitness | |
Ahnis et al., 2012 [40] | Dropout at 12 months: 71 (43.3%) [Breakdown of dropout by 3-month period: 0–3 months: 23 (32.4%) 3–6 months: 17 (23.9%) 6–9 months: 19 (26.8%) 9–12 months: 12 (16.9%)] ^ Other indicators: Attendance (Average duration of treatment): 23.15 ± 4.31 weeks | Univariate | + Psychosocial: (i) Perceived stress, (ii) Depression, (iii) Anxiety, (iv) Subjective complaints, (v) Pessimism,(vi) Avoidant coping + Socio-demographics: (i) No partners, (ii) Unemployed - Psychosocial: (i) Mood, (ii) Sense of coherence, (iii) Mental quality of life - Socio-demographics: Age | |
Multivariate | + Psychosocial: (i) Tiredness, (ii) Self-efficacy, (iii) Pessimism, (iv) Positive reframing + Socio-demographics: Unemployed - Psychosocial: Support coping - Socio-demographics: Age | |||
Toth-Capelli et al., 2013 [41] | Individual counselling sessions Dropout (<1 follow up): 327 (70.9%) ^ Other indicators ≥1 follow up visit (1–6 visits): 134 (29.1%) | Univariate | + Socio-demographics: (i) Being African American, (ii) Being male, (iii) Presence of children at home | |
Multivariate | + Socio-demographics: (i) Being male, (ii) Presence of children at home | |||
Group class Drop-out (<1 class): 376 (81.5%) ^ Other indicators ≥1 class: 85 (18.5%) | Univariate | + Socio-demographics: (i) Being African American or Hispanic, (ii) Part-time employment, (iii) Presence of children at home | ||
Multivariate | + Socio-demographics: Part-time employment | |||
Cresci et al., 2013 [42] | Drop-out (did not attend all 4 follow ups): 149 (56%) | Univariate | - Socio-demographics: Age - Behavioural: TRE-MORE sub score (current lifestyle habits) | |
Michelini et al., 2014 [32] | Overall Dropout: 44 (30%) [Breakdown: - Intervention group (<4 group meetings): 26 (39.7%) - Control group (<2 consecutive visits): 18 (24.7%)] | Univariate | + Psychosocial: Stress + Behavioural: Previous weight loss attempt | |
Multivariate | + Psychosocial: Stress | |||
Yackobovitch-Gavan et al., 2015 [43] | Dropout before week 9: 179 (30.5%) | Multivariate | - Physical: Reduction of BMI in initial stage of the program | |
Sawamoto et al., 2016 [44] | Drop-out (Did not complete 7-month weight loss phase): 29 (24.4%) | Univariate | + Psychosocial: (i) History of mental disorders, (ii) Alexythimic (iii) Strong body shape concern, (iv) Perceived mothers overprotecting + Socio-demographics: Unemployed - Psychosocial: Maternal care | |
Multivariate | + Psychosocial: (i) Strong body shape concern + Socio-demographics: Unemployed - Psychosocial: (i) Parental bonding-Maternal care, (ii) Perfectionism- Organization score | |||
Susin et al., 2016 [29] | Drop-out (Did not complete 3-month program): 81 (63.8%) | Univariate | + Psychosocial: Stress + Socio-demographics: (i) Unemployed, (ii) No religion + Behavioural: Binge eating - Psychosocial: (i) Self-efficacy (diet); (ii) Motivation (readiness to change) - Socio-demographics: Age | |
Multivariate | + Psychosocial: Isolation and Depression + Socio-demographics: No religion + Behavioural: (i) Binge eating, (ii) No PA habit - Psychosocial: Self-efficacy (diet) - Socio-demographics: Age | |||
Attendance | ||||
Helitzer et al., 2007 [33] | - High attenders (>3 sessions): 36 (48%) - Low attenders (<2 sessions): 39 (52%) | Univariate | + Psychosocial: Action stage of change (mean of 7 health behaviours) | |
Toft et al., 2007 [30] | - High attendance (4–6 sessions): 410 (57.4%) - Low attendance (1–3 sessions): 304 (42.6%) ^ Other indicators Dropout (did not attend any): 183 (20.4%) | Multivariate | + Psychosocial: (i) High perceived susceptibility of CVD, (ii) Self-rated care of own health + Physical: Screen-detected diabetes or glucose intolerance - Psychosocial: (i) Self-efficacy (diet), (ii) Motivation to increase PA - Physical: Baseline BMI | |
Mata et al., 2010 [47] | No. of weeks on current program Brigitte: 44.1 ± 172 weeks Weight watchers: 38.5 ± 45.3 weeks ^ Other indicators Dropout from study Brigitte: 63 (45.3%); Weight watchers: 80 (31.8%) | Multivariate | Brigitte: + Psychosocial: Self-efficacy - Behavioural: Previous weight loss attempts Weight watchers: - Psychosocial: Perceived rule complexity | |
Self-monitoring | ||||
Webber et al., 2010 [45] | No. of weeks of completion of food and exercise dairies over 16 weeks (≥5 per week) [# mean not reported] | Multivariate | + Psychosocial: Autonomous motivation at week 4 | |
Krukowski et al., 2013 [34] | % of weekly journals over 24 weeks (≥1 per week): 73% | Univariate | + Socio-demographics: (i) Being male, (ii) Age | |
Steinberg et al., 2014 [35] | High completion (≥80%) of self-monitoring calls at 12-month: 52% ^ Other indicators Average proportion of participants who completed weekly calls over the no. of expected calls over 12-months: 71.6% | Univariate | + Socio-demographics: (i) Education, (ii) Age | |
Dietary adherence | ||||
Aggarwal et al., 2010 [36] | Non-adherent to Therapeutic Lifestyle Changes (TLC) diet (≥40 MEDFITS): 164 (36%) Non-adherent to TLC or Heart Healthy diet (≥70 MEDFITS): 42 (9%) # MEDFICTS: 0–216 points based on 8 food categories | Univariate | Non-adherent to TLC diet + Socio-demographics: Being male + Behavioural: Smoking *# + Physical: (i) BMI *#, (ii) WC *# - Psychosocial: Stage of change *# - Socio-demographics: Age - Behavioural: PA *# | Non-adherent to TLC or Heart Healthy diet + Psychosocial: Depression # + Socio-demographics: Being male + Physical: (i) BMI *#, (ii) WC *# - Psychosocial: (i) Stage of change *#, (ii) Social support * - Behavioural: PA # |
Multivariate | - Psychosocial: Stage of change *# |
Factors | Relationship | |||
---|---|---|---|---|
Negative | Not Significant | Positive | ||
Psychosocial | Self-efficacy General Diet PA | [40] [30] | [42] [37,38,43] [29,30,35,38] | [39] [29,47] |
Depression | [29,36,38,40] | [35,37,44] | ||
Motivation | [30,46] (PA) | [30,32,38,42] (Diet) | [29,45] | |
Stress | [29,32,40] | [35] | ||
Stage of Change | [39,41] | [33,36] | ||
Anxiety | [40] | [29,37,44] | ||
Social support | [35] [38] (Diet and PA) | [36] | ||
Body shape concerns | [38,44] | |||
Quality of Life | [38,40] | |||
Self-esteem | [38] | [44] | ||
Perceived hunger | [38,40] | |||
Others * | ||||
Socio-demographic | Age | [30,31,32,37,38,41,43,44] | [29,34,35,36,40,42,46] | |
Gender (Male) | [36,41,46] | [29,30,32,42,43] | [34] | |
Employment status Unemployment | [41] (Part-time job) [29,40,44] | [30,32,35,37] | ||
Education | [30,32,34,36,41,43,44] | [35,37] | ||
Socioeconomic status | [34,46] | [31]; | ||
Marital status | [40] (No partners) | [32,35,36,37,44] | ||
Race | [41] (Being African American) | [34,36]. | ||
Others * | Income [35]; | |||
Behavioural | Eating Behaviour - Healthy
| [31,41,44] [31] [31] [31] | [38] [46] (use low fat products) [38] | |
- Unhealthy | ||||
Binge eating | [29,38] | [32,40,44] | ||
Others * | ||||
Self-rated dietary habit | [30] | |||
PA Behaviour | [30,37,41,44] | |||
With PA habit | [36,38,46] | |||
No PA habit | [29] | |||
Previous weight loss attempts | [32,38,47] | [42,43] | ||
Smoking habit | [36,37] | [30,41] | ||
Drinking habit | [31,41] | |||
Stress management | [37] | |||
Physical | Initial weight /BMI /Fat | [30,31,36,38,39] | [29,32,37,42,43,44] | |
Initial weight loss | [39,43] | |||
Fitness | [30] (Physical) | [31] (Aerobic) | ||
Glucose intolerance | [30,31] | |||
Blood pressure | [31,37] | |||
Cholesterol | [31] |
© 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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Leung, A.W.Y.; Chan, R.S.M.; Sea, M.M.M.; Woo, J. An Overview of Factors Associated with Adherence to Lifestyle Modification Programs for Weight Management in Adults. Int. J. Environ. Res. Public Health 2017, 14, 922. https://doi.org/10.3390/ijerph14080922
Leung AWY, Chan RSM, Sea MMM, Woo J. An Overview of Factors Associated with Adherence to Lifestyle Modification Programs for Weight Management in Adults. International Journal of Environmental Research and Public Health. 2017; 14(8):922. https://doi.org/10.3390/ijerph14080922
Chicago/Turabian StyleLeung, Alice W. Y., Ruth S. M. Chan, Mandy M. M. Sea, and Jean Woo. 2017. "An Overview of Factors Associated with Adherence to Lifestyle Modification Programs for Weight Management in Adults" International Journal of Environmental Research and Public Health 14, no. 8: 922. https://doi.org/10.3390/ijerph14080922
APA StyleLeung, A. W. Y., Chan, R. S. M., Sea, M. M. M., & Woo, J. (2017). An Overview of Factors Associated with Adherence to Lifestyle Modification Programs for Weight Management in Adults. International Journal of Environmental Research and Public Health, 14(8), 922. https://doi.org/10.3390/ijerph14080922