Adherence is a multi-dimensional construct in the POUNDS LOST trial
Open accessAbstract
Research on the conceptualization of adherence to treatment has not addressed a key question: Is adherence best defined as being a uni-dimensional or multi-dimensional behavioral construct? The primary aim of this study was to test which of these conceptual models best described adherence to a weight management program. This ancillary study was conducted as a part of the POUNDS LOST trial that tested the efficacy of four dietary macronutrient compositions for promoting weight loss. A sample of 811 overweight/obese adults was recruited across two clinical sites, and each participant was randomly assigned to one of four macronutrient prescriptions: (1) Low fat (20% of energy), average protein (15% of energy); (2) High fat (40%), average protein (15%); (3) Low fat (20%), high protein (25%); (4) High fat (40%), high protein (25%). Throughout the first 6 months of the study, a computer tracking system collected data on eight indicators of adherence. Computer tracking data from the initial 6 months of the intervention were analyzed using exploratory and confirmatory analyses. Two factors (accounting for 66% of the variance) were identified and confirmed: (1) behavioral adherence and (2) dietary adherence. Behavioral adherence did not differ across the four interventions, but prescription of a high fat diet (vs. a low fat diet) was found to be associated with higher levels of dietary adherence. The findings of this study indicated that adherence to a weight management program was best conceptualized as being multi-dimensional, with two dimensions: behavioral and dietary adherence.
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Adherence in the first 6 months of the POUNDS LOST trial predicted weight reduction throughout the trial.
“Adherence in the first 6 months of the POUNDS LOST trial predicted weight reduction throughout the trial.33”
From Using mHealth Technology to Enhance Self-Monitoring for Weight Loss (2012) · cites this paper as [33]
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- Authors
- Williamson, D. A., Anton, S. D., Han, H., Champagne, C. M., Allen, R., LeBlanc, E., Ryan, D. H., McManus, K., Laranjo, N., Carey, V. J., Loria, C. M., Bray, G. A., & Sacks, F. M.
- Affiliations
- Pennington Biomedical Research Center (US)
- Harvard University (US)
- National Heart, Lung, and Blood Institute (US)
- Corresponding author
- Williamson, Donald A.
- ORCID
- Venue
- Journal of Behavioral Medicine
- Published
- 2009-10-25
- Volume
- 33
- Issue
- 1
- Pages
- 35-46
- ISSN
- 0160-7715 (ISSN-L)
- 1573-3521
- PMC
- PMC3153914
- OpenAlex
- W2076143725
- Cited by
- 58
- References
- 25
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 6 · 2019: 6 · 2017: 4 · 2016: 3 · 2015: 6 · 2014: 4 · 2013: 4 · 2012: 6
- FWCI
- 3.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Institute on Aging (P30AG028740)
- National Heart, Lung, and Blood Institute (HL073286, U01HL073286)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK040561)
- National Center for Research Resources (RR02635, M01RR002635)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- medication adherence, behavioral adherence, dietary adherence, weight management, macronutrient composition, high-fat diet, low-fat diet, high-protein diet, overweight and obesity, POUNDS Lost trial
- MeSH terms
- Behavior, Computers, Diet, Diet, Reducing, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Models, Psychological, Obesity, Patient Compliance, Time Factors, Cohort Studies, Overweight
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