Using PRECEDE to develop a weight management program for disadvantaged young adults.

OBJECTIVE: To conduct a needs assessment using the PRECEDE model for the development of a weight management program for low-income young adults. DESIGN: Four phases were implemented using qualitative (focus groups and interviews) and quantitative (survey) methodologies, with steering committee guidance. SETTING: Northeastern residential vocational center. PARTICIPANTS: Convenience sample of low-income young adults, 18-24 years old (total n = 203), who were attending a job training vocational center. PHENOMENON OF INTEREST: General themes of life satisfaction determinants and issues related to weight, self-reported weight and related behavior, existing environmental supports, and desired changes of behavioral and environmental influences of weight. ANALYSIS: Content analysis of qualitative data; descriptive analysis and Student t test. RESULTS: Self-image and discrimination were themes for weight issues. More than half of participants were overweight or obese (57%) and had low levels of physical activity (58%). Self-reported fruit and vegetable intake was inadequate (<2.5 cups/d). Identified environmental factors most needing improvement were accessibility for walking and biking and availability of healthful food. Participants reported exercising, getting adequate sleep, eating healthful snacks, and effectively managing stress as behavior they were willing to change. CONCLUSIONS AND IMPLICATIONS: The PRECEDE model was useful to identify concerns, priorities, and modifiable factors among a young adult community that can increase the relevancy of a weight management program.

The development and preliminary validation of the behavior, environment, and changeability survey (BECS).

OBJECTIVE: To develop and test the validity of the Behavior, Environment, and Changeability Survey (BECS) for identifying the importance and changeability of nutrition, exercise, and stress management behavior and related aspects of the environment. DESIGN: A cross-sectional, online survey of the BECS and selected validated instruments. SETTING: Ten state universities. PARTICIPANTS: A convenience sample of college students (n = 1,283), ages 18-24 years. ANALYSIS: Principal component analysis was used to confirm a 6-component structure of the BECS in 2 independent samples for the purpose of cross-validation. Internal consistency was measured and construct and criterion-related analyses were conducted to test the reliability and validity of the BECS subscales. RESULTS: Six components representing 34 BECS items were revealed from the original 69 items and explained 64% of the total variance. Six scales were retained, and internal consistency of each ranged from α = .82 to .93. BECS Nutrition Behavior and Nutrition Changeability scale scores were highest for participants in action/maintenance Stages of Change for fruit and vegetable intake. CONCLUSIONS AND IMPLICATIONS: There is strong support for the use of the BECS when planning health programs to gain insight into behavior that young adults are willing to improve, specifically related to nutrition, exercise, and sleep.

Using focus groups to identify factors affecting healthy weight maintenance in college men.

Healthful eating and physical activity are important for healthy weight maintenance. The hypothesis for this study was that college-aged men would perceive factors affecting eating and physical activity as both contributing to and inhibiting healthy weight maintenance. The overall objective was to explore how men view weight maintenance in the context of these aspects. Subjects (n = 47, mean age = 20.3 +/- 1.7 years) completed an online survey, including the 51-item Three-Factor Eating Questionnaire, and participated in 1 of 6 focus groups. Three face-to-face and 3 online synchronous groups were conducted using a 15-question discussion guide to identify weight maintenance issues around eating, physical activity, and body perceptions. Weight satisfaction decreased with increase in both dietary restraint and disinhibition. Number of attempts to lose weight was positively associated with BMI (r [44] = .465, P = .01) and dietary restraint (r [44] = .515, P = .01). Findings from both focus group formats were similar. Motivators (sports performance/fitness, self-esteem, attractiveness, long-term health) were similar for eating healthfully and being physically active; however, more motivators to be physically active than to eat healthfully emerged. Enablers for eating healthfully included liking the taste, availability of healthful foods, using food rules to guide intake, having a habit of healthful eating, and internal drive/will. Barriers to healthful eating included fat in dairy foods, fruit and vegetable taste, and quick spoilage. Barriers to being physically active included lack of time/time management, obligations, being lazy, and girlfriends. Results may be used to inform future obesity prevention interventions.

College students' barriers and enablers for healthful weight management: a qualitative study.

OBJECTIVE: To identify barriers and enablers for healthful weight management among college students. DESIGN: Sixteen on-line focus groups, homogeneous by sex and university. SETTING: Eight universities in 8 states. PARTICIPANTS: College students (N = 115; 55% female; mean age 19.7 +/- 1.6). ANALYSIS: Qualitative software, Nvivo version 2 (QSR International, Victoria, Australia, 2002), was used; similar codes were grouped together and categorized using an ecological model. RESULTS: Males and females cited the same barriers to weight management: intrapersonal (eg, temptation and lack of discipline); interpersonal (social situations); and environmental (eg, time constraints, ready access to unhealthful food). Similar enablers were identified by sex: intrapersonal (eg, regulating food intake, being physically active); interpersonal (social support); and environmental (eg, university's environment supports physical activity). More barriers than enablers were given, indicating that these college students were more sensitive to barriers than the enablers for weight management. Factors viewed by some students as barriers to weight management were viewed as enablers by others. CONCLUSIONS AND IMPLICATIONS: When designing weight management interventions for college students, sex specificity may not be as important as considering that a barrier for one student may be an enabler for another. From an ecological perspective, individually focused interventions must be implemented in conjunction with environmental-level interventions to facilitate behavior change.