Longitudinal Relations Between Health Behaviors, Psychosocial Factors and Obesity-related Outcomes in a Community-based Intervention

Abstract

Background: Pasos Adelante is a theory-based chronic disease preventive intervention integrating walking groups (to promote social support and activity) as well as nutrition and physical activity education delivered by community health workers. While prior work has shown significant improvements in health outcomes (e.g., BMI, blood pressure, lipids; Staten et al., 2012; depression, quality of life; Cutshaw et al, 2012) and health behaviors (Carvajal et al., 2013), it is not known which psychosocial and behavioral factors are most responsible for participants’ improved outcomes. METHODS: Questionnaires (e.g., psychosocial factors, diet, IPAQ-physical activity), anthropometric measures and laboratory tests were collected three times over 6 months on 221 adults. FINDINGS: Cross-lagged SEM models showed earlier levels of activity and social support (p < .05) preceded improved BMI. DISCUSSION: Improved activity more so than nutrition appears to be the most critical behavioral factor linked to improved outcomes in this evidence-based intervention. Further, increased social support is an important mechanism contributing to participants’ well-being at 6 months and perhaps longer.