What's Theory Got to Do with It: Measuring Effects of Theory on Lifestyle Behaviors and Weight in the Better Me Within Randomized Trial

BackgroundKnowing which theoretical constructs work best to design effective interventions is essential for populations with increased disease burden. African American women (AAW) experience a greater prevalence of chronic diseases and fewer benefits from weight loss interventions compared to White women.PurposeTo examine how theoretical constructs were associated with lifestyle behaviors and weight outcomes in the Better Me Within (BMW) Randomized Trial.MethodsBMW used a tailored diabetes prevention program implemented in churches among AAW with BMI >= 25. Regression models assessed relationships between constructs (self-efficacy, social support, and motivation), and outcomes (physical activity (PA), calories, and weight).ResultsAmong 221 AAW, mean (SD) age 48.8 years (11.2); mean weight 215.1 pounds (50.5), several significant relationships were found including an association between change in motivation for activity and change in PA (p = <0.01), and weight loss self-efficacy and weight at follow-up (p = <0.01).DiscussionThe clearest relationships emerged for PA with motivation for activity and weight management social support demonstrating significance in all models.Translation to Health Education PracticeSelf-efficacy, motivation, and social support show promise to promote changes in PA and weight among church-going AAW. Opportunities to keep engaging AAW in research are essential for eliminating health inequities in this population.