Abstract
There is a paucity of research on factors influencing long-term adherence to lifestyle modification. We conducted a mixed-method study to explore the psychological factors of dietary and physical activity (PA) adherence among Chinese adults with overweight and obesity at 10 months after enrollment of a community-based lifestyle modification program in Hong Kong. We recruited Chinese adults newly enrolled in a culturally adapted lifestyle modification program and followed them for 10 months. For the quantitative study, primary outcomes were dietary and PA adherence scores while secondary outcomes included knowledge, self-efficacy, motivation and stage of change. For the qualitative study, data were collected using semi-structured interviews and observation. A total of 140 participants completed the 10-month follow-up. They reported moderate level of dietary adherence but low level of PA adherence at 10 months. Multivariable regression analyses revealed that greater improvement in nutrition knowledge and diet stage of change predicted higher dietary adherence while greater improvement in PA self-efficacy and PA stage of change predicted higher PA adherence. Qualitative data on 26 participants suggest that participants’ knowledge and self-efficacy but not motivation were enhanced during the program. The findings of this study enhanced our understanding on factors influencing long-term adherence to lifestyle changes.
Highlights
Regardless of the significant efforts made to address the obesity epidemic, obesity remains a major public health concern [1]
Identifying factors of long-term dietary and physical activity (PA) adherence can enhance our understanding on the facilitators for sustaining long term diet and PA behavioral changes, which have the potential to inform the development of evidence-based, sustainable obesity management strategies
The findings suggested that self-efficacy, social identification and motivation were predictors of dietary adherence [11]
Summary
There has been substantial evidence for successful weight loss based on various intervention methods including diet, physical activity (PA) and medications. Many regained the lost weight within one year regardless of the methods used [2,3,4]. A comprehensive lifestyle modification program (LMP) typically comprises a combination of diet, PA and behavioral approach, is recognized as the most cost-effective and sustainable option for Nutrients 2020, 12, 1379; doi:10.3390/nu12051379 www.mdpi.com/journal/nutrients. The long-term efficacy of LMPs is not well defined, due to high dropout rates and limited long-term studies [7,8]. Identifying factors of long-term dietary and PA adherence can enhance our understanding on the facilitators for sustaining long term diet and PA behavioral changes, which have the potential to inform the development of evidence-based, sustainable obesity management strategies
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