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Efficacy of a self-directed behavioral health change program: Weight, body composition, cardiovascular fitness, blood pressure, health risk, and psychosocial mediating variables

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Abstract

This study assessed the efficacy of a comprehensive behavioral health program designed to promote self-initiated change in overweight healthy middle-aged adults (M=49 years). Three treatment groupss (total n=25) differing in type of social support provided (i.e., group plus professional versus group plus peer versus group only) received 13 treatment sessions and 6 maintenance sessions scheduled over a full year. A self-directed change intervention taught several cognitive-behavioral techniques as they applied to exercise adherence, weight reduction/maintenance, and stress management. Combined treatment groups (n=25) improved significantly more than an assessment only control group (n=9) in weight, percentage body fat, cardiovascular fitness, exercise adherence, health-risk appraisal, chronic tension (MBHI, scale A), and systolic and diastolic blood pressure at both post-treatment and 6-month follow-up assessments. Self-motivation, group treatment attendance, and health-risk appraisal significantly related (r's=.30–.56) to several posttreatment and follow-up measures of behavioral health change. No significant differences were found among the three treatment groups on any of the outcome measures.

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References

  • Bjurstrom, L. A., and Alexiou, N. G. (1978). A program of heart disease intervention for public employees: A five-year report.J. Occup. Med. 20: 521–531.

    Google Scholar 

  • Blackburn, G. L., and Kanders, B. S. (1987). Medical evaluation and treatment of obese patients with cardiovascular disease.Am. J. Cardiol. 60: 556–586.

    Google Scholar 

  • Borkovec, T. D., and Nau, S. D. (1972). Credibility of analogue therapy rationale.J. Behav. Ther. Exp. Psychiat. 3: 257–260.

    Google Scholar 

  • Brooks, G. A., and Fahey, T. D. (1984).Exercise Physiology: Human Bioenergetics and Its Applications, John Wiley & Sons, New York.

    Google Scholar 

  • Brownell, K. D., Marlatt, G. A., Lichtenstein, E., and Wilson, G. T. (1986). Understanding and preventing relapse.Am. Psych. 41: 765–782.

    Google Scholar 

  • Cardinal Health Systems (1985).Y's Way to Physical Fitness: Software (computer program), Cardinal Health Systems, Eden Prairie, MN.

    Google Scholar 

  • Centers of Disease Control (1984).Health Risk Appraisal (computer program), Centers for Disease Control, Atlanta, GA.

    Google Scholar 

  • Cotterman, S. N. (1985a).Y's Way to Weight Management, Human Kinetics, Champaign, IL.

    Google Scholar 

  • Cotterman, S. N. (1985b).Y's Way to Weight Management: Instructor's Manual, Human Kinetics, Champaign, IL.

    Google Scholar 

  • Dishman, R. K. (1981). Biological influences on exercise adherence.Res. Q. Exercise Sport 52: 143–159.

    Google Scholar 

  • Dishman, R. K. (1982). Compliance/adherence in health-related exercise.Health Psychol. 1: 237–267.

    Google Scholar 

  • Dishman, R. K., and Ickes, W. (1981). Self-motivation and adherence to therapeutic exercise.J. Behav. Med. 4: 421–438.

    Google Scholar 

  • Dishman, R. K., Ickes, W., and Morgan, W. P. (1980). Self-motivation and adherence to habitual physical activity.J. Appl. Soc. Psychol. 2: 115–132.

    Google Scholar 

  • Dubbert, P. M., and Wilson, G. T. (1984). Goal setting and spouse involvement in the treatment of obesity.Behav. Res. Ther. 22: 227–242.

    Google Scholar 

  • D'Zurilla, T. J., and Goldfried, M. R. (1971). Problem solving and behavior modification.J. Abnorm. Psychol. 78: 107–126.

    Google Scholar 

  • Eaker, E. D., Benfari, R. C., and Reed, R. B. (1982). Coronary risk factor intervention: Characteristics associated with change.J. Clin. Psychol. 28: 703–717.

    Google Scholar 

  • Farquhar, J. W. (1979).The American Way of Life Need Not Be Hazardous to Your Health, W. W. Norton, New York.

    Google Scholar 

  • Foreyt, J. P., Mitchell, R. E., Garner, D. T., Gee, M., Scott, L. W., and Gotto, A. M. (1982). Behavioral treatment of obesity: Results and limitations.Behav. Ther. 12: 153–161.

    Google Scholar 

  • Gentry, W. D., and Kobasa, S. C. (1984). Social and psychological resources mediating stress-illness relationships in humans. In Gentry, W. D. (ed.),Handbook of Behavioral Medicine, Guilford Press, New York, pp. 87–116.

    Google Scholar 

  • Godin, G., Valois, P., Shepard, R. J., and Desharnais, R. (1987). Prediction of leisure-time exercise behavior: A path analysis (LISREL V) model.J. Behav. Med. 10: 145–158.

    Google Scholar 

  • Golding, L. A., Myers, C. R., and Sinning, W. E. (eds.) (1982).The Y's Way to Physical Fitness: A Guide Book for Instructors, YMCA of the USA, Chicago.

    Google Scholar 

  • House, J. S. (1984). Barriers to work stress: I. Social support. In Gentry, W. D., Benson, H., and de Wolff, C. (eds.),Behavioral Medicine: Work, Stress, Health, Martinus Nijhoff, The Hague, pp. 44–72.

    Google Scholar 

  • Kendall, P. C., and Shapiro, E. (1984). Cognitive-behavioral strategies and health enhancement. In Matarazzo, J. D., Weiss, S. M., Herd, J. A., Miller, N. E., and Weiss, S. M. (eds.),Behavioral Health: A Handbook of Health Enhancement and Disease Prevention, John Wiley & Sons, New York, pp. 393–405.

    Google Scholar 

  • Krantz, D. S., Contrada, R. J., Hill, D. R., and Friedler, E. (1988). Environmental stress and biobehavioral antecedents of coronary heart disease.J. Consult. Clin. Psychol. 56: 333–341.

    Google Scholar 

  • Long, B. C. (1984). Aerobic conditioning and stress inoculation: A comparison of stress-management interventions.Cognitive Ther. Res. 8: 517–542.

    Google Scholar 

  • Matarazzo, J. D. (1980). Behavioral health and behavioral medicine.Am. Psych. 35: 807–817.

    Google Scholar 

  • Matarazzo, J. D. (1982). Behavioral health's challenge to academic, scientific and professional psychology.Am. Psych. 37: 1–14.

    Google Scholar 

  • Matarazzo, J. D. (1984). Behavioral health. A 1990 challenge for the health services professions. In Matarazzo, J. D., Weiss, S. M., Herd, J. A., Miller, N. E., and Weiss, S. M. (eds.),Behavioral Health: A Handbook of Health Enhancement and Disease Prevention, John Wiley & Sons, New York, pp. 3–40.

    Google Scholar 

  • Meichenbaum, D. (1985).Stress Inoculation Training, Pergamon Press, New York.

    Google Scholar 

  • Millon, T., Green, C., and Meagher, R. (1982).Millon Behavioral Health Inventory: Manual, National Computer Systems, Minneapolis, MN.

    Google Scholar 

  • Oldridge, N. B. (1984). Adherence to adult exercise fitness programs. In Matarazzo, J. D., Weiss, S. M., Herd, J. A., Miller, N. E., and Weiss, S. M. (eds.),Behavioral Health: A Handbook of Health Enhancement and Disease Prevention, John Wiley & Sons, New York, pp. 467–487.

    Google Scholar 

  • Perri, M. G., McAdoo, W. G., McAllister, D. A., Lauer, J. B., and Yancey, D. Z. (1986). Enhancing the efficacy of behavior therapy of obesity: Effects of a multicomponent maintenance program.J. Consult. Clin. Psychol. 54: 670–675.

    Google Scholar 

  • Perri, M. G., McAddo, W. G., McAllister, D. A., Lauer, J. B., Jordan, R. C., Yancey, D. Z., and Nezu, A. M. (1987). Effects of peer support and therapist contact on long-term weight loss.J. Consult. Clin. Psychol. 55: 615–617.

    Google Scholar 

  • Perri, M. G., McAllister, D. A., Gange, J. J., Jordan, R. C., McAdoo, W. G., and Nazu, A. M. (1988). Effects of four maintenance programs on the long-term management of obesity.J. Consult. Clin. Psychol. 56: 529–534.

    Google Scholar 

  • Romano, J. L. (1984). Stress management and wellness: Reaching beyond the counselor's office.Personnel Guid. J. 62: 533–537.

    Google Scholar 

  • Rosenbaum, M. (1980). A schedule for assessing self-control behaviors: Preliminary findings.Behav. Ther. 11: 109–121.

    Google Scholar 

  • Sensenig, P. E., and Cialdini, R. B. (1984). Social-psychological influences on the compliance process: Implications of behavioral health. In Matarazzo, J. D., Weiss, S. M., Herd, J. A., Miller, N. E., and Weiss, S. M. (eds.),Behavioral Health: A Handbook of Health Enhancement and Disease Prevention, John Wiley, New York, pp. 384–392.

    Google Scholar 

  • Shapiro, D., and Goldstein, I. B. (1982). Biobehavioral perspectives on hypertension.J. Consult. Clin. Psychol. 50: 841–858.

    Google Scholar 

  • Spielberger, C. D., Gorsuch, R. L., and Lushene, R. E. (1970).STAI Manual for the State Trait Anxiety Inventory, Consulting Psychologists Press, Palo Alto, CA.

    Google Scholar 

  • Strecher, V. J., McEvoy-DeVellis, B., Becker, M. H., and Rosenstock, I. M. (1986). The role of self efficacy in achieving health behavior change.Health Ed. Q. 13: 73–91.

    Google Scholar 

  • Thoresen, C. E., and Eagleston, J. R. (1985). Counseling for health.Counsel. Psychol. 13: 15–87.

    Google Scholar 

  • Tubesing, D. A. (1981).Kicking Your Stress Habits, Whole Person Associates, Duluth, MN.

    Google Scholar 

  • Tubesing, N. L., and Tubesing, D. A. (1983–1986).Structured Exercises for Wellness Promotion, Vols. 1–3, Whole Person Associates, Duluth, MN.

    Google Scholar 

  • Tubesing, N. L., and Tubesing, D. A. (1985).Y's Way to Stress Management: Instructor's Manual, Human Kinetics, Champaign, IL.

    Google Scholar 

  • Wadden, T. A., Stunkard, A. J., and Brownell, K. D. (1983). Very low calorie diets: Their efficacy, safety, and future.Ann. Intern. Med 99: 675–684.

    Google Scholar 

  • Watson, D. L., and Tharp, R. G. (1981).Self-Directed Behavior: Self Modification for Personal Adjustment, 3rd ed., Brooks/Cole, Monterey, CA.

    Google Scholar 

  • Wilson, G. T. (1984). Weight control treatments. In Matarazzo, J. D., Weiss, S. M., Herd, J. A., Miller, N. E., and Weiss, S. M. (eds.),Behavioral Health: A Handbook of Health Enhancement and Disease Prevention, John Wiley, New York, pp. 657–670.

    Google Scholar 

  • Yalom, I. D. (1975).The Theory and Practice of Group Psychotherapy, 2nd ed., Basic Books, New York.

    Google Scholar 

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Authors and Affiliations

  1. Graduate School of Psychology, Fuller Theological Seminary, 180 North Oakland Avenue, 91101, Pasadena, California

    P. Andrew Clifford, Siang -Yang Tan & Richard L. Gorsuch

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  1. P. Andrew Clifford
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  2. Siang -Yang Tan
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  3. Richard L. Gorsuch
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This study was partially funded by the Crescenta-Canada YMCA.

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Clifford, P.A., Tan, S.Y. & Gorsuch, R.L. Efficacy of a self-directed behavioral health change program: Weight, body composition, cardiovascular fitness, blood pressure, health risk, and psychosocial mediating variables. J Behav Med 14, 303–323 (1991). https://doi.org/10.1007/BF00845457

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