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

Background: Knowing 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. Purpose: To examine how theoretical constructs were associated with lifestyle behaviors and weight outcomes in the Better Me Within (BMW) Randomized Trial. Methods: BMW 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). Results: Among 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). Discussion: The clearest relationships emerged for PA with motivation for activity and weight management social support demonstrating significance in all models. Translation to Health Education Practice: Self-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.