Motivation for weight loss among completers of a free community-based weight loss program in a US-Mexico border region: A self-determination theory perspective.

This study explores the perceptions and motivation for weight loss among participants who completed a free community-based weight loss program in a predominantly Hispanic and low-income region along the US-Mexico border using a Self-Determination Theory (SDT) perspective. This manuscript is timely as qualitative research on the effect of motivation as a factor in behavioral interventions to reduce overweight or obesity is currently lacking. Individual semi-structured interviews were conducted with 20 participants (80%, n = 16 female) who completed a community weight-loss intervention to assess motivation for weight loss and participating, and the role of social support and self-efficacy in weight loss. Directed content analysis was used with SDT guiding the questions and subsequent theme analysis. The findings communicate perspectives of participants relevant to 8 prominent themes. The regulation types and constructs related to SDT included: non-regulation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic regulation as well as competence and relatedness. Participants mentioned external sources of motivation, such as wanting to improve their physical appearance, and motivation due to financial incentives. Fewer participants reported intrinsic motivators, which the literature suggests are more likely to create lasting change and improved health behaviors. Understanding the motivation for behavior change and completion of weight loss programs is essential to help participants reach their goals effectively and sustain weight loss. A greater emphasis during weight loss programs on the motives for individuals to lose weight may help improve outcomes in weight-loss interventions. Additionally, increasing strategies targeted at enhancing intrinsic motivation for weight loss may be beneficial.

Exploration of Fatalism and Religiosity by Gender and Varying Levels of Engagement Among Mexican-American Adults of a Type 2 Diabetes Management Program.

Objectives: Purpose of study is to explore the roles religiosity and fatalistic beliefs play in diabetes management among newly, currently, and long-term enrolled Mexican-American participants in a Type 2 diabetes mellitus (T2DM) chronic care management program. Methods: In 2017, study participants (n = 15) completed a semi-structured interview in their preferred language (English or Spanish). Sample was stratified by amount of time individual had been enrolled as a participant of the Salud y Vida program: newly, currently, or long-term. Interviews assessed religious beliefs, beliefs concerning the cause(s) of diabetes, perceived relationship between religiosity and fatalistic beliefs with T2DM management, and the appropriateness of discussing such topics with a health professional. Interview responses were analyzed using ATLAS.ti 8. Results: Themes identified included: perceived autonomy over diabetes prognosis, motivators for self-care, discussions of personal beliefs in the healthcare setting, and the church's role in diabetes management. Conclusions: Among this sample, religiosity and religious fatalism played a complex role in coping with and managing diabetes. Long-term enrolled and male participants expressed beliefs of divine control over health, and a connection between religiosity and health behavior. Long-term enrolled participants felt religious and fatalistic beliefs may be suitable and beneficial to discuss in the healthcare setting.

Comparison of obstetrician-gynecologists and family physicians regarding weight-related attitudes, communication, and bias.

OBJECTIVES: To assess physician perceptions regarding weight-related communication, quality of care, and bias in obstetrics-gynecology (OBGYN) and family physician (FP) practices. METHODS: A cross-sectional survey study based on a convenient sampling of OBGYN and FP was conducted. Physicians completed a 40-question survey assessing perceived obesity management and weight bias in caring for female patients with body mass index ≥25kg/m2. RESULTS: Reponses from 51 physicians (25 OBGYN and 26 FP) were received. There was no difference between specialties in satisfaction with care or level of confidence in treating patients with obesity. However, OBGYNs reported more negative perceptions of patients with obesity (mean score 19.2±3.3 vs. 15.0±4.0, p<0.001) and greater weight bias (11.8±2.0 vs. 9.7±2.5, p<0.01) compared to FPs. OBGYNs were also more likely to expect less favorable treatment outcomes (13.3±2.5 vs. 15.5±2.8. p<0.01). Physicians between 31-50 years old displayed a significantly higher perception of weight bias in their profession when compared to the reference 21-30year olds, and for each unit increase in self-reported BMI there was a 0.18 average increase in the composite score for perceived weight bias. CONCLUSIONS: OBGYN physicians reported significantly higher levels of weight bias than FP physicians, indicating a need for improved education in OBGYN training. CLINICAL TRIAL REGISTRATION: N/A.

Evaluation of Event Physical Activity Engagement at an Open Streets Initiative Within a Texas-Mexico Border Town.

BACKGROUND: Open streets initiatives provide an opportunity to engage in physical activity (PA) freely by temporarily closing streets to motorized traffic. METHODS: Route counting estimation and event intercept surveys (n = 682) were conducted across 4 CycloBia events in Brownsville, TX, in 2015 to determine sociodemographics, PA engagement at the event, event awareness, and past CycloBia attendance. RESULTS: Cycling was the most commonly observed activity along the route (73.6%) followed by walking (22.9%). Attendees self-reported a median of 120 minutes in PA with 17.3% of attendees meeting recommended weekly PA guidelines at the event. Significant predictors of meeting PA guidelines via event PA engagement were past event attendance, sex, age, and Hispanic ethnicity. CONCLUSIONS: Findings suggest that CycloBia reached a large, low-income, predominantly Hispanic population and may be effective in promoting PA. Results help understand the effect of an open streets initiative on attendees living in a midsize, border city.