Formative evaluation of intervention methods designed to improve behavior change strategies

Obesity is a complex condition, often resulting from an imbalance between energy expenditure and energy intake. Preventing and treating this condition is challenging and sustainable weight loss is often unsuccessful. Behavior change models are becoming more popular in combating obesity. Motivational interviewing (MI) is a method used to promote behavior change in individuals by activating internal motivation for change. The use of technology including self-monitoring, text messaging and online health coaching is also emerging as a useful method for improving health behaviors. The purpose of this study was to determine the effectiveness of these approaches in improving behavior change strategies based on individual health goals. Forty-one subjects (10 males and 46 females) completed the 8-week intervention. Following the MI model, each participant chose a goal to work toward for the duration of the intervention (diet, physical activity or weight management). Each individual then chose their method of intervention; a self-monitoring tool called the SenseWear Armband (SWA) could be used alone, in combination with text messaging prompts, or in combination with online health coaching using MI. Group 1 (n = 14) chose a diet goal, Group 2 (n = 12) chose a physical activity goal, and Group 3 (n = 15) chose a weight management goal. The focus of the evaluation was to identify strategies used by the participants as a result of the behavior change process, as well as to determine if those with a specific goal had greater change in behavior strategies related to that goal (diet, physical activity, weight management). This was assessed using Nothwehr\u27s Behavioral Objectives Instrument both at baseline and at the completion of the intervention. Changes in reported use of the behavior change strategies were examined using One-way ANOVAs. Analyses were run both on the combined sample and each of the three goal groups to determine if change in strategies used varied by goal. The magnitude of effects was reported using effect size. The results supported the use of the Nothwehr behavior survey as an effective tool for detecting the strategies used for changing behavior related to specific health goals. The results revealed significant changes in behavior strategies for all scales on the Nothwehr instrument for the combined population. No significant changes were detected between goal groups. Data revealed those with a diet goal showed greater change in diet related behavior strategies than other goal groups, but not significantly. Findings from this study suggest that the Nothwehr survey is an effective tool for use in behavior change interventions to examine the strategies used in the process of changing health behaviors. The results warrant further studies with a larger population to gain a better understanding of the difference in strategies applied when working toward a specific health goal. In addition, with a larger population it would be beneficial to determine the effect that specific intervention methods have on the use of behavior strategies