|Title||PREVIEW study—Influence of a behavior modification intervention (PREMIT) in over 2300 people with pre-diabetes : Intention, self-efficacy and outcome expectancies during the early phase of a lifestyle intervention|
|Author(s)||Huttunen-Lenz, Maija; Hansen, Sylvia; Christensen, Pia; Larsen, Thomas Meinert; Sandø-Pedersen, Finn; Drummen, Mathijs; Adam, Tanja C.; Macdonald, Ian A.; Taylor, Moira A.; Martinez, J.A.; Navas-Carretero, Santiago; Handjiev, Svetoslav; Poppitt, Sally D.; Silvestre, Marta P.; Fogelholm, Mikael; Pietiläinen, Kirsi H.; Brand-Miller, Jennie; Berendsen, Agnes A.M.; Raben, Anne; Schlicht, Wolfgang|
|Source||Psychology Research and Behavior Management 11 (2018). - ISSN 1179-1578 - p. 383 - 394.|
|Department(s)||Chair Nutrition and Health over the Lifecourse|
|Publication type||Refereed Article in a scientific journal|
|Keyword(s)||Cognition - Diabetes mellitus - Goals - Habits - Weight loss|
Purpose: Onset of type 2 diabetes (T2D) is often gradual and preceded by impaired glucose homeostasis. Lifestyle interventions including weight loss and physical activity may reduce the risk of developing T2D, but adherence to a lifestyle change is challenging. As part of an international T2D prevention trial (PREVIEW), a behavior change intervention supported participants in achieving a healthier diet and physically active lifestyle. Here, our aim was to explore the influence of this behavioral program (PREMIT) on social-cognitive variables during an 8-week weight loss phase. Methods: PREVIEW consisted of an initial weight loss, Phase I, followed by a weight-maintenance, Phase II, for those achieving the 8-week weight loss target of ≥ 8% from initial bodyweight. Overweight and obese (BMI ≥25 kg/m2) individuals aged 25 to 70 years with confirmed pre-diabetes were enrolled. Uni-and multivariate statistical methods were deployed to explore differences in intentions, self-efficacy, and outcome expectancies between those who achieved the target weight loss (“achievers”) and those who did not (“non-achievers”). Results: At the beginning of Phase I, no significant differences in intentions, self-efficacy and outcome expectancies between “achievers” (1,857) and “non-achievers” (163) were found. “Non-achievers” tended to be younger, live with child/ren, and attended the PREMIT sessions less frequently. At the end of Phase I, “achievers” reported higher intentions (healthy eating χ2 (1)=2.57; P <0.008, exercising χ2 (1)=0.66; P <0.008), self-efficacy (F(2; 1970)=10.27, P <0.005), and were more positive about the expected outcomes (F(4; 1968)=11.22, P <0.005). Conclusion: Although statistically significant, effect sizes observed between the two groups were small. Behavior change, however, is multi-determined. Over a period of time, even small differences may make a cumulative effect. Being successful in behavior change requires that the “new” behavior is implemented time after time until it becomes a habit. Therefore, having even slightly higher self-efficacy, positive outcome expectancies and intentions may over time result in considerably improved chances to achieve long-term lifestyle changes.