Self-Monitoring as a Mediator of Weight Loss in the SMART Randomized Clinical Trial
Open accessAbstract
Background Integral components of behavioral weight-loss treatment include self-monitoring of diet and physical activity along with feedback to participants regarding their behaviors. While providing feedback has been associated with weight loss, no studies have examined the impact of feedback frequency on weight loss or the mediating role of self-monitoring adherence in this relationship. Purpose This study examined the effect of participant feedback frequency on weight loss and determined if this effect was mediated by adherence to self-monitoring in a behavioral weight-loss trial conducted in the USA. Method Participants (N = 210) were randomly assigned to one of three self-monitoring methods with either no-daily feedback messages or daily feedback messages: (1) paper diary (PD), no-daily feedback; (2) personal digital assistant (PDA), no-daily feedback; and (3) PDA, daily tailored feedback messages (PDA + FB). The Sobel test via bootstrapping examined the direct effect of feedback frequency on weight loss and the indirect effect through self-monitoring adherence. Results Receiving daily feedback messages significantly increased participants' self-monitoring adherence. A significant effect of feedback frequency on weight loss was noted; however, after adjusting for self-monitoring adherence, the effect of feedback frequency on weight loss was no longer significant. Feedback frequency had a significant indirect effect on weight loss through self-monitoring adherence. Conclusion Self-monitoring adherence mediated the effect of feedback frequency on weight loss. Increasing the frequency with which participants receive feedback could enhance self-monitoring adherence, a critical component of behavioral weight-loss treatment.
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Background
- Authors
- Turk, M. W., Elci, O. U., Wang, J., Sereika, S. M., Ewing, L. J., Acharya, S. D., Glanz, K., & Burke, L. E.
- Affiliations
- University of Mississippi Medical Center (US)
- The University of Texas Health Science Center at Houston (US)
- University of Pittsburgh (US)
- Centers for Disease Control and Prevention (US)
- University of Pennsylvania (US)
- Venue
- International Journal of Behavioral Medicine
- Published
- 2012-09-01
- Volume
- 20
- Issue
- 4
- Pages
- 556-561
- ISSN
- 1070-5503 (ISSN-L)
- 1532-7558
- PMC
- PMC3529986
- OpenAlex
- W2077063656
- Cited by
- 66
- References
- 9
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 7 · 2021: 4 · 2020: 10 · 2019: 6 · 2018: 5 · 2017: 8 · 2016: 4 · 2015: 4 · 2014: 8 · 2013: 2
- FWCI
- 7.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- International Journal of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000005)
- National Institute of Nursing Research (F31NR009750, P30NR003924, P30-NR-03924, K24NR010742)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK71817, R01DK071817)
- National Center for Research Resources (M01RR000056, UL1RR024153, 5 MO1 RR 00056)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- self-monitoring, weight loss, feedback frequency, behavioral weight loss, personal digital assistants, mediation, SMART trial
- MeSH terms
- Adult, Diet, Feedback, Feeding Behavior, Female, Humans, Male, Middle Aged, Patient Compliance, Self Care, Weight Loss, Health Behavior, Body Mass Index, Computers, Handheld, Young Adult
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