Group Involvement 1 Abstract The purpose of this study was to investigate the effect of involvement in weight loss and fitness groups on performance of weight loss and fitness behaviors in adults trying to lose weight or maintain weight loss. The predictive, secondary analysis was guided by Social Cognitive Theory, which proposes that group involvement affects behavior performance. Weight loss and fitness involvement was measured with four dimensions: extensive (size of group social network), affective (importance that significant others give to involvement), duration, and frequency. Performance of weight loss and fitness behaviors was measured with three factors: diet and exercise balancing behaviors, food avoidance behaviors, and dietary tracking behaviors. Gender, age, and body mass index were controlled throughout all multiple regressions. Results indicated that extensive involvement significantly predicted diet tracking behaviors and affective and frequency of involvement significantly predicted diet and behavior balancing behaviors. Therefore, as social networks within the group increase, the performance of diet tracking behaviors increases. As the importance significant others place on weight loss and fitness involvement increases and as frequency of involvement increases, so do diet and exercise balancing behaviors. Since the sample was 91% Caucasian, future studies should examine other ethnic groups to see if these results apply. Group Involvement 2 Running Head: GROUP INVOLVEMENT AND BEHAVIORS Predictors of the Performance of Weight Loss and Fitness Behaviors Emily Kreuz The University of Akron March, 2011 8200 Group Involvement 3 Acknowledgements First, I would like to thank my sponsor, Dr. Graor, for supporting me and assisting me throughout the entire process of this paper. No matter how frustrated I felt on my way to our meetings, every time I left your office I felt encouraged and motivated to keep going and knew that I could do it! Thank you to Dr. Mugler and The University of Akron Honors College, as well as the College of Nursing for assisting me financially to attend the 2011 MNRS research conference. I truly appreciate the support to make the most of this opportunity. Again, thank you College of Nursing for assisting with production of my poster to present at CUGSR at the University of Akron and the MNRS conference. Thanks to my readers, Mrs. Horning and Dr. Murrock, for taking time to read my paper and give me feedback; I truly appreciate it. I thank my family and friends for supporting me throughout these past two years. Thanks for the listening ear when I was frustrated. Thanks for sharing in my excitement. And thanks for pushing me to be all that I can be. I could not have made it without you all. Group Involvement 4 The growing prevalence of those overweight and obese is a significant concern in the United States and many developed countries (BBC, 2008). In the U.S., 66% of noninstitutionalized adults are overweight or obese (CDC, 2009). The concerns related to this growing prevalence are numerous. For example, obesity is associated with many health complications, such as Type II diabetes, cardiovascular problems, and certain cancers (CDC, 2010). Therefore, it may be important for overweight or obese adults to lose weight and maintain a healthy weight in order to achieve optimal health. Despite the health issues associated with the increasing overweight problem in the U.S., researchers have found that losing weight and maintaining weight loss can be difficult (Elfhag & Rossner, 2005). Although some weight loss groups are free or supported based on member donations, such as Overeaters Anonymous (Overeaters Anonymous, 2010), it is often costly to invest in a weight loss program or to join a health and fitness center. The cost to lose 30 pounds can easily exceed $300, not including the cost of healthy foods that are also necessary (Bankrate.com, 2011). Researchers, however, have found that encouraging involvement in weight loss and fitness groups may be a cost-effective means for health care providers to support weight loss in their clients (Turner, Thomas, Wagner, & Moseley, 2008). In general, support groups contribute to relevant health related outcomes. Researchers have studied the effect of group support on alcoholics and drug addicts (Gossup, Stewart, & Marsden, 2007), imprisoned pregnant women (Ferszt & Erikson-Owens, 2008), patients with cardiovascular problems (Paul & Sneed, 2004; Sher, Bellg, Braun, Domas, Rosenson, & Canar, 2002), diabetics (Beverly & Wray, 2008), and smokers who are trying to quit (Froelicher & Li, 2008). None, however, examined the effect of weight loss and fitness involvement dimensions on the performance of weight loss and fitness behaviors. The purpose of this study was to examine if dimensions of Group Involvement 5 involvement in weight loss and fitness groups predict the performance of weight loss and fitness behaviors. The following research questions were addressed: Does frequency of involvement in weight loss and fitness groups predict performance of behaviors? Does duration of involvement in weight loss and fitness groups predict performance of behaviors? Does extensiveness of involvement in weight loss and fitness groups predict the performance of behaviors? Does affective involvement in weight loss and fitness group predict the performance of behaviors? Literature Review Researchers who have examined the relationship between involvement in support groups and weight related changes have consistently found that involvement is related to behavior changes (Beverly & Wray, 2008; Bowden, Shaul, & Bennett, 2004; Dawson, Tracey, & Berry, 2008; Felton, Saunders, Ward, Dishman, Dowda, & Pate, 2005; Turner et al., 2008). Dawson, Tracey, and Berry (2008) compared the effects of an internet-based intervention and a face-toface intervention on confidence levels to overcome barriers and on exercising in adults trying to lose weight in the work place. They found higher confidence levels and more frequent exercise in those in the face-to-face groups compared to those in the internet intervention group. Turner, Thomas, Wagner, and Moseley (2008) examined the effect of a no-cost wellness program on advancing readiness to make behavior changes, lose weight, and improve overall health in a diverse adult population. They found that the support received within these programs promoted readiness to change and positive health outcomes. Extensive involvement refers to the scope of social connection within a group. No studies found investigated the effects of extensive involvement on behavior change. Although not examining the effects of extensive involvement, Bowden and colleagues (2004) evaluated the effects of counseling sessions based on health risk behaviors on rural adults in their attempts to Group Involvement 6 make health related changes. Overall, there was a lack of behavior change for those participating in the counseling sessions. The qualitative aspect of this study found that “[t]here was a general consensus among participants that lack of regularly scheduled support groups was a barrier to individual behavior change” (page 415). In this instance, the lack of support groups was identified as a hindrance in achieving behavior changes and suggests that an increase in extensive involvement would promote behavior change. Affective involvement is the importance that significant others place on group involvement. Although no studies were found that investigated the relationship between the importance significant others placed on weight loss and fitness involvement and behavior performance, researchers have investigated the effect of spousal support on involvement in an exercise program by adults with chronic diseases, such as Type 2 diabetes (Beverly and Wray, 2008) and coronary artery disease (Sher et al., 2002). The results of both studies suggest a positive relationship between the support received within the everyday environment from the spouse and involvement in an exercise program. This may be due in part to the meaning and benefit the health-related change makes for both of the partners, i.e., the people that matter the most to each other (Sher el al., 2002). Researchers have studied the effect of group involvement frequency on behavioral outcomes, but no studies were found that examined the effect of group involvement duration on behavioral outcomes. Turner and colleagues (2008) compared how diet and frequency of involvement in a group affected weight loss in adult patients who were attempting to make changes in diet and physical activity. They found that increased frequency of attendance at the exercise classes was a greater predictor of weight loss than diet. In addition, Gossup et al. (2007) examined the effect of frequency of involvement in Alcoholics Anonymous on abstinence of Group Involvement 7 drinking in alcoholics and found that frequency of attendance at Alcoholics Anonymous had a positive effect on abstinence in alcoholics. The findings of the above studies are limited. Many focused on the effects of group involvement in those beginning to make a behavior change (Bowden et al., 2004; Felton et al., 2005; Gance-Cleveland & Mays, 2008; and Paul & Sneed, 2004). There are also a disproportionate amount of studies that either looked specifically at women (Felton et al., 2005; Ferszt & Erikson-Owens, 2008; Li & Froelicher, 2008) or that had a significantly greater number of female participants (Bowden et al., 2008; Dawson et al., 2008; Gance-Cleveland & Mays, 2008; and Turner et al., 2008). Theoretical Framework The Social-Learning Theory guides this project. The theory was developed by Albert Bandura who proposed that there is an interaction between environment, cognition, and behavior (Santrock, 2008). This theory proposes that the environment affects learning, which affects behavior. Through group involvement, the environment changes in a positive, supportive way, leading to changes in the cognition of the members. Being surrounded by people going through the same or similar situations makes a person feel less alone. Group members give each other advice and support that may lead others to feel that they can make changes. Seeing the success of others may also make members feel that if someone else can be successful and make a change, then they can too. As people’s thinking changes and they believe that they can make a change, they then begin to change their behavior in a positive, lasting way. Based on this theory, the researcher predicts that increased involvement in weight loss and fitness groups (the environment) will result in cognitive changes, which will result in increased weight loss and fitness behavior performance. Therefore, involvement will predict Group Involvement 8 weight loss and fitness behavior performance. Four dimensions of involvement will be measured: frequency of involvement, duration of involvement, affective involvement, and extensive involvement. Affective involvement is the importance that significant others place on involvement in weight loss and fitness activities. Extensive involvement is the size of the social network within the weight loss and fitness group. Methods The design of this quantitative study is predictive. This project is a secondary data analysis of data originally collected in 2006 to examine if weight loss maintenance and subculture involvement predict weight related meanings (i.e. behavior meanings, self-meanings, and identity meanings) (Graor, 2008). The cross sectional data were collected with a selfadministered survey, which was available both online and in paper form. Data from a sub-sample examined in this analysis are described based on gender, age, race and ethnicity, marital status, and highest education degree obtained. All participants were adults trying to lose weight nonsurgically or maintain non-surgical weight loss. Sample Data were collected from a convenience sample. Inclusion criteria included adults (18 years or older) trying to lose weight non-surgically or to maintain non-surgical weight loss. Data collection occurred from June 2006 to January 2007 after the study was approved by university and hospital IRB review boards. Sampling and Data Collection Procedures Participants were recruited locally with announcements posted at weight loss and fitness centers located in the North central section of a Midwestern state. Participants came from six large health and fitness centers and 32 private weight loss and fitness centers. Online, Group Involvement 9 participants were recruited with announcements posted on 43 fitness and weight loss internet websites and chat rooms and on 112 internet weight loss and fitness blogging web sites. Surveys were completed either online or in paper form, and the survey was piloted with a focus group. Measures Duration and frequency of involvement in weight loss and fitness experiences were measured with six items. Participants self-reported duration by writing the number of days, weeks, months or years they have been involved with group experiences; duration was coded into number of months. Participants self-reported frequency of involvement by writing how often they were involved per day, week, month, or year; frequency of involvement is coded into frequency per month. Weight loss and fitness experiences included: (1) Memberships and participation in a weight control program, health and/or fitness center, “work-out” individual or group sessions (2) The attendance at weight and fitness-related meetings, workshops, or conferences (3) Weight/fitness internet web site involvement (on-line groups, chat-rooms, message boards, reading of blog entries, etc.); or reading or listening to weight/fitness media, such as newsletters, books, audiotapes, CDs, DVDs, videotapes, or magazines. Affective involvement was measured as the importance that participants felt significant others placed on involvement in weight loss and fitness activities. Participants responded to the three affective involvement items on 1 to 9 point Likert scales, with 1 = very unimportant, 5 = neutral, and 9 = very important. The affective involvement survey items were: (1) How important is it to your intimate (girlfriend, boyfriend, partner or spouse) that you participate in weight management kinds of efforts or activities, such as but not limited to using weight and fitness related programs, centers, meetings, workshops, conferences, group or individual “workouts,” on-line websites, magazines, newsletters, books, audiotapes, CDs, DVDs, or videotapes? (2) How important is it to your family members, excluding your spouse or partner, that you participate in weight management kinds of efforts or activities, such as but not limited to using weight and fitness related programs, centers, meetings, workshops, conferences, group or individual “workouts,” on-line websites, magazines, newsletters, books, audiotapes, CDs, DVDs, or videotapes? Group Involvement 10 (3) How important is it to friends that you participate in weight management kinds of efforts or activities, such as but not limited to using weight and fitness related programs, centers, meetings, workshops, conferences, group or individual “workouts,” on-line websites, magazines, newsletters, books, audiotapes, CDs, DVDs, or videotapes? Extensive involvement was measured as the size of participants’ social network within the weight loss and fitness group. Participants responded to the following four survey items on 1 to 9 point Likert scales with 1 = none, 2 = 1 – 2, 3 = 3 – 5, 4 = 6 – 10, 5 = 11 – 15, 6 = 16 – 20, 7 = 21 – 25, 8 = 26 – 39, and 9 = more than 40. (1) What is the number of friends that you have made as a result of your involvement in weight and fitness related efforts or activities? (2) What is the number of meaningful relationships you would lose if you were no longer involved in weight and fitness related efforts or activities? (3) What is the number of people you would miss, including friends, exercising partners, team mates, dieting partners, internet chat connections, weight loss program staff, etc., if you no longer participated in weight and fitness related efforts or activities? (4) What is the number of people you would no longer see if you no longer participated in weight and fitness related efforts or activities? Thirteen items were used to measure the performance of weight loss and fitness behaviors. Performance was self reported as the frequency of maintaining a general daily caloric intake, maintaining a general daily fat intake, keeping track of food intake, eating at least five servings of fruits and vegetables a day, eating smaller portions sizes of food, avoiding certain kinds of foods, avoiding specific foods, keeping track of weight, making dietary and exercise adjustments based on weight changes, keeping track of daily exercise and physical activity, engaging in moderately intense physical activity at least thirty minutes a day, adjusting dietary intake or exercise to maintain a particular balance, and taking “breaks” from eating or exercise routines for special occasions. Subjects rated frequency of performing each behavior by marking their responses on a 1 to 9 point Likert scale (1 = never and 9 = always). These thirteen items were reduced to three factors: diet tracking behaviors, diet and exercise balance behaviors, and Group Involvement 11 food avoidance behaviors. In addition to the above, the following demographics were measured: gender, age, race, marital status, highest educational degree obtained, employment, personal income, and family income. Data Analysis Descriptive statistics were used to determine percentages, means, and standard deviations, based on the level of the variable measure. Multiple regression was used to determine the predictability of involvement dimensions on behavior performance factors. Gender, age, and body mass index were controlled throughout all analyses. Factor analysis (principal-component factor analysis and orthogonal varimax rotation methods) was used to reduce the performance of behaviors items and to identify underlying structure of the 13 items. Based on Kaiser’s rule and scree plot, three factors, which accounted for 57% of the variance, were retained. Appendix A shows rotated factor loadings for the pattern matrix with all behavior performance items. Factor loadings range from .91 to .49. Factor scores were used to determine behavior performance values. As a result, all involvement and performance values were centered. Level of significance was set at p values less than 0.05. Results Sample Characteristics The 305 participants in this study ranged from 18 to 80 years with an average of 42.16 (SD=12.15). The majority of the participants were female (83%), married (61.5%), white (91%), and had a bachelor’s degree (28.7%), some college or vocational training (24.4%), or a Master’s degree (21%). Over half of the participants (51%) made from $20,000- $59,999 annually and 47.45% of participants had annual family incomes of $30,000 to $79,999. Detailed demographics are shown in Appendix B. Field Code Changed Group Involvement 12 Group Involvement and Performance of Behaviors Multiple regressions were used to determine if involvement predicted performance of behaviors, and gender, age, and BMI were consistently controlled. Analysis showed that age, gender, and BMI did not predict diet tracking behaviors. When extensive group involvement was stepped into the regression, it was found to predict diet tracking behaviors (β = .13, SE = .06, p = 0.02). No other dimensions of group involvement were related to diet tracking behaviors. When all dimensions of involvement were included in the regression, extensive involvement predicted diet tracking behaviors (β = .13, SE = .06, p = 0.03), although only 2% of the variance in diet tracking behaviors was explained. Therefore as social networks within the group increase, the performance of diet tracking behaviors increases. Multiple regressions were used to determine if group involvement predicted performance of food avoidance behaviors. When age, gender, and BMI were controlled, BMI predicted food avoidance behaviors (β = -.02, SE = .01, p = 0.02). Therefore, as BMI decreased, food avoidance behaviors increased. When dimensions of involvement were stepped into the regressions, none were found to predict performance of food avoiding behaviors although BMI remained a predictor of food avoidance behaviors throughout (β = -.02, SE = .01, p = 0.01, adjusted R-squared = .02). Therefore, no dimensions of involvement predicted the performance of food avoidance behaviors. Multiple regressions were then used to determine if group involvement predicted diet and exercise balancing behaviors. When age, gender, and BMI were controlled, gender and BMI predicted the balancing behaviors (gender: β = .33, SE = .16, p = 0.04; BMI: β = -.02, SE = .01, p = .006; adjusted R-squared = 0.03). The results suggested that female participants were more likely to use diet and exercise balancing behaviors than male participants, and that as BMI decreased, tracking behaviors increased. When dimensions of involvement were separately stepped into the regression, affective involvement and frequency of involvement were found to predict diet and behavior balancing behaviors (affective: β = .12, SE = .05, p = .03; frequency: β = .45, SE = .11, p < .000). Affective and frequency involvement remained predictors of diet and behavior balancing behaviors when all dimensions were controlled (affective: β = .12, SE = .05, p = 03; frequency: β = .43, SE = .11, p < .000), explaining 9% of Group Involvement 13 the variance in diet and exercise balancing behaviors. BMI remained a predictor of the performance of balancing behaviors throughout (β = -.02, SE = .01, p = 0.02). Therefore, as affective and frequency of involvement increased, so did diet and exercise balancing behaviors. Discussion Obesity continues to be a major health concern in the United States and the health risks associated with this issue are undeniable. However, making the necessary behavior changes to decrease this problem is often difficult. This study aimed to examine if group involvement in weight loss and fitness groups predicted weight loss and fitness behaviors by analyzing survey data about four dimensions of involvement: frequency, duration, affective, and extensive. When age, gender, and BMI were controlled, the dimension of extensive involvement predicted diet tracking behaviors. As the size of social networks within the group increased, so did the use of diet tracking behaviors, e.g., the frequency of maintaining a general daily caloric intake, maintaining a general daily fat intake, keeping track of food intake, eating at least five servings of fruits and vegetables a day, eating smaller portions sizes of food. Affective involvement and frequency of involvement were found to predict diet and exercise balancing behaviors, e.g., keeping track of weight, making dietary and exercise adjustments based on weight changes, keeping track of daily exercise and physical activity, engaging in moderately intense physical activity at least thirty minutes a day, adjusting dietary intake or exercise to maintain a particular balance, and taking “breaks” from eating or exercise routines for special occasions. The greater the importance significant others placed on group involvement and the more frequent the group involvement, the more often diet and exercise balancing behaviors were used. Duration of involvement was the only dimension not found to predict any of the weight loss and fitness behaviors. In addition, BMI predicted food avoidance behaviors, e.g., avoiding certain kinds of foods, avoiding specific foods: as BMI decreased, the use of food avoidance behaviors increased. Group Involvement 14 In line with Turner and colleagues (2008) who found that increased attendance to an exercise group was related with increased weight loss, the findings show that increased frequency of involvement predicted increased frequency of diet and behavior balancing activities, which in turn may have a role in weight loss. Along with frequency, affective involvement was predicted diet and behavior balancing activities. Previous studies have shown the positive effect spouses have on support group involvement when persons suffer from a chronic disease (Beverly and Wray, 2008; Sher et al., 2002). Although affective involvement does not have to be a spouse, the majority of the participants in this study were married. This, along with the previous studies, suggests that the majority of affective involvement may come from spouses, and plays a significant role in behaviors. Extensive involvement predicted diet tracking behaviors, e.g., maintaining a general daily caloric intake, maintaining a general daily fat intake, keeping track of food intake, eating at least five servings of fruit and vegetables a day, and eating smaller portion sizes of food. None of the research found directly measured this dimension of involvement. However, Felton and colleagues (2005) studied teen girls in a physical education class and found that social network within the school and class had a positive impact on behavior. However, the study was done among teen age girls required to participate in a physical education class rather than in adults actually attempting to lose or maintain weight loss. The findings were in line with the predictions based on the Social-Learning theory. Social-Learning theory proposes that the environment affects learning and cognition, which in turn affect behavior (Santrock, 2008). The findings showed that as extensive involvement in a weight loss and fitness group increased, performance of diet tracking behaviors increased. In addition, as affective involvement and frequency of involvement increased, diet and behavior Group Involvement 15 balancing behaviors increased. Duration of involvement was the only involvement dimension that failed to significantly affect any behavior items. This could be due to the fact that the social support received due to affective involvement, extensive involvement, and the frequency of involvement had lasting positive effects on behavior apart from duration of time spent in the group. Thus, actually being involved has a greater effect than simply belonging to a group. The sample was predominately female, white, married, affluent and educated. This could represent the social pressures in the U.S. for women to be thin and present an image of unattainable “perfection” (Biordi, 2009). Access to resources, e.g., income, may affect involvement in weight loss and fitness activity, and thus those with money and the means to utilize resources may be the ones to participate in efforts to lose weight (Biordi, 2009). It is no secret that being a part of many support groups costs money that people with less income and from lower socioeconomic classes do not have. Limitations This study was limited in terms of the sample. A convenience sample was used, and while having the benefit of being relatively inexpensive and “convenient,” this method constructs a sample of participants who are readily available and does not control who participates. For this reason, participants may have similar factors that made them readily available to participate in the study, and thus bias the results. In this study, the majority of the participants were female, as were most of the participants in other related studies. Studies that evaluate a greater variety of social and cultural groups would be beneficial in attaining a greater understanding of the dynamics surrounding the benefits of involvement in weight loss and fitness groups on weight loss and fitness behaviors. Although three of the involvement dimensions Group Involvement 16 predicted weight loss and fitness behaviors, only two of the three behavior dimensions were predicted. Implications for Practice Knowing that there may be benefits to affective involvement, extensive involvement, and frequency of involvement may inform nurses of the importance of group involvement for those trying to lose weight. Practitioners often are responsible for disseminating information about health promotion and behaviors as well as educating clients on ways to achieve health related goals, specifically related to weight loss. It would therefore be beneficial for practitioners to provide information about the importance of support in maintaining efforts to achieve or maintain desired weight loss. In addition, it may be particularly important to stress the importance of affective involvement, extensive involvement, and frequency of involvement. This study found that it was the frequency of involvement rather than duration of involvement that predicted weight loss and fitness behavior performance. The friends made by attending group activities also predicted weight loss and fitness behavior performance. For these reasons, it is important for practitioners to encourage patients to get involved in a group rather than simply belonging to a group. Having the support of family, friends, and particularly significant others may be important, as shown by the predictability of affective involvement on behavior performance. It is not enough, however, to simply give information without being supporters themselves. Practitioners can take an active role in giving support to clients, as well as connecting them with local weight loss support groups that fit the individual’s needs. Implications for Future Studies Future studies should further investigate how group involvement dimensions predict behaviors cross culturally and in men. More focused studies should focus on specific groups to Group Involvement 17 see if these results still apply. Future studies could explore additional weight loss and fitness behaviors associated with group involvement, and investigate factors contributing to the performance of weight loss and fitness behaviors either within or outside of the group. Conclusion This study examined if dimensions of involvement in weight loss and fitness groups predicted the performance of weight loss and fitness behaviors. Previous research supported the effect of group involvement on positive behavior outcomes; however, the research did not examine dimensions of involvement in adults who were trying to lose weight or to maintain weight loss. This study found frequency of involvement, affective involvement, and extensive involvement predict behavior performance, while duration of involvement did not. The findings suggest that behavioral performance may be related to social processes, as suggested by the Social Learning theory. These findings were from a sample of predominately white, married, affluent women, which may suggest limitations. However, the sample also may accurately portray the targeted group of weight loss groups and products, as well as support previous studies’ findings of increased social pressures on this group of women to be thin. Future studies should more closely examine other ethnic groups to determine if these results apply across culture. Group Involvement 18 References Bankrate.com (2008). What does it cost to drop 30 pounds? Accessed February 2, 2011 from http://articles.moneycentral.msn.com/SavingandDebt/ConsumerActionGuide/WhatDoesIt CostToDrop30Pounds.aspx. BBC News (2008). Obesity: In statistics. Retrieved April 27, 2009, from http://news.bbc.co.uk /2/hi/health/7151813.stm. Beverly, E. & Wray, L. (2008). The role of collective efficacy in exercise adherence: A qualitative study of spousal support and Type 2 diabetes management. Health Education Research 25(2), 211-223. Retrieved October 2010, from EBSCOhost database. Biordi, D. (2009). Body Image. In P. D. Larsen & I. M. Lubkin (Eds.), Chronic Illness, 7th ed., (pp. 117-138). Boston: Jones and Bartlett. Bowden, J. M., Bennett, J. A., & Shaul, M. P. (2004). The process of changing health risk behaviors: An Oregon rural clinic experience. Journal of the American Academy of Nurse Practitioners, 16(9), 411-417. Retrieved March 4, 2009, from EBCOhost database. Center for Disease Control and Prevention (CDC) (2009). Overweight prevalence. Retrieved April 20, 2009, from http://www.cdc.gov/nchs/fastats/overwt.htm. Center for Disease Control and Prevention (CDC) (2010). Overweight and Obesity. Retrieved October 12, 2010, from http://www.cdc.gov/obesity/data/trends.html. Dawson, K., Tracey, J., & Berry, T. (2008). Evaluation of workplace group and internet based physical activity interventions on psychological barriers associated with exercise behavior change. Journal of Sports Science and Medicine 7, 537-543. Retrieved September 13, 2010, from EBSCOhost database. Group Involvement 19 Elfhag, K. & Rossner, S. (2005). Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obesity Reviews: an official journal of the International Association for the Study of Obesity 6(1), 67-85. Retrieved April 27, 2009, from http://www.ncbi.nlm.nih.gov/pubmed/15655039. 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Group Involvement 21 Appendix A Field Code Changed Behavior Performance Factor Loadings Behavior Performance Variables Diet and exercise balancing behaviors Factor Loadings Specific food avoidance behaviors Dietary tracking behaviors Maintaining a general daily caloric intake .79 Maintaining a general daily fat intake .76 Keeping track of food intake .62 Eating at least five servings of fruits and vegetables a day .50 Eating smaller portions sizes of food .49 Avoiding certain kinds of foods .91 Avoiding specific foods .90 Keeping track of weight .57 Making dietary and exercise adjustments based on weight changes .63 Keeping track of daily exercise and physical activity .71 Engaging in moderately intense physical activity at least thirty minutes a day .62 Adjusting dietary intake or exercise to maintain a particular balance .67 Taking “breaks” from eating or exercise routines for .51 special occasions Note: Extraction Method: Principal-Component Factor Analysis. Rotation Method: Orthogonal Varimax. Group Involvement 22 Appendix B Demographics Sample: n=305 Gender Female Male 85.9% 14.1% Mean-42.16 SD-12.15 Age Ethnicity White Black Asian Hispanic Other 91.15% 4.92% 1.31%1.64% 1.64% 0.98% Marital Status Single Married Separated Divorced Widowed Other 18.09% 61.51% 1.32% 8.55% 2.62% 7.89% Education Less than high school degree High School Degree Some college/vocational training Vocational or Associates Degree Bachelor’s Degree Master’s Degree Professional Degree(dentistry, medicine, law, etc) Doctoral Degree Other 0.33% 8.25% 24.42% 8.58% 28.71% 21.12% $0-$19,999 $20,000-$39,999 $40,000-$59,999 $60,000-$79,999 $80,000-$99,999 $100,000-$119,999 $120,000 and up 25.17% 24.49% 26.53% 13.26% 3.40% 3.06% 4.08% Personal Income 3.63% 3.96% 0.99% Group Involvement 23 Family Income $0-$19,999 $20,000-$39,999 $40,000-$59,999 $60,000-$79,999 $80,000-$99,999 $100,000-$119,999 $120,000 and up 8.47% 13.22% 17.62% 21.69% 9.83% 11.18% 17.79%
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