Abstract
Introduction: Neighborhood factors may play an important role in the treatment of obesity. However, it is unclear if exposures to certain neighborhood factors influence self-efficacy among individuals attempting to lose weight. Hypothesis: We hypothesized that individuals living in obesogenic neighborhood environments at baseline would have low self-efficacy for resisting urges to eat beyond their recommended eating plan in a 12-mo weight loss study. Methods: We used ecological momentary assessment (EMA) to collect daily data on self-efficacy with an EMA question: How CONFIDENT are you that, if you have an urge to go off your healthy lifestyle plan, you can resist the urge? (value 1 to 10) This EMA question was delivered randomly an average of 5 times/day on a smartphone. Residential address at baseline was geocoded using ArcGIS software and key neighborhood measures (e.g., grocery store and restaurant density, proportion of Black and low income residents, index of neighborhood socioeconomic disadvantage (NSED)) were linked at the census tract level. Data were analyzed using descriptive statistics and linear mixed modeling. Results: The sample (N=136) was predominately female (90%), White (80%), mean (SD) age 51.3 (10.3) years, and mean BMI 34.1 (4.6) kg/m 2 . The residential neighborhoods of participants were predominantly White, middle to high education level, and low poverty. The mean confidence score decreased from 7.3 at month 1 to 6.8 at month 12 (p <.001). A higher level of baseline neighborhood grocery store density was associated with a higher confidence score ( p = .037) (see table). No other neighborhood factor was associated with confidence score. Conclusion: Neighborhood factors, specifically access to grocery stores, may affect an individuals’ ability to lose or maintain weight loss by supporting one’s confidence to maintain a healthy lifestyle. This study needs to be replicated in a larger cohort with a more diverse neighborhood representation.
Published Version
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