Stages of change of behavior in women on a multi-professional program for treatment of obesity

Bevilaqua, Cheila Aparecida; Pelloso, Sandra Marisa; Marcon, Sonia Silva

doi:10.1590/1518-8345.0549.2809

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Revista Latino-Americana de Enfermagem

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Original Articles • Rev. Latino-Am. Enfermagem 24 • 2016 • https://doi.org/10.1590/1518-8345.0549.2809 copy

Stages of change of behavior in women on a multi-professional program for treatment of obesity^¹ 1 Paper extracted from Master's Thesis "Multiprofessional treatment for obese woman", presented to Health Sciences Graduate Program, Universidade Estadual de Maringá, Maringá, PR, Brazil. This research was supported by Fundação de Amparo à Pesquisa do Estado do Paraná, Edital Pesquisa para o SUS/2010, Protocol 19510.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to ascertain the effectiveness of an intervention program in relation to anthropometric measurements and stage of readiness for behavioral change in women with excess weight.

Methods:

the intervention group (IG) was made up of 13 women, and the control group (CG), by 20. The intervention lasted 16 weeks, and included the practice of guided physical activity three times a week, and health education once a week. The application of the questionnaire on stage of readiness for behavioral change, and the anthropometric evaluations, were undertaken at two points - before and after the period of intervention. The statistical analysis involved tests of comparison and association.

Results:

in general, at the first point, the participants in the two groups were predisposed to make changes in what they ate and in their physical activity. However, significant difference was only observed in relation to weight, body mass index (BMI), waist circumference and waist-hip ratio and readiness for change among the members of the intervention group.

Conclusion:

the intervention programmed was effective in weight loss, reduction of waist circumference and waist-hip ratio, and in changing behaviors related to the practicing of physical exercise and eating habits.

Descriptors:
Obesity; Women; Feeding Behavior; Motor Activity

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[1] Corresponding Author: Sonia Silva Marcon Universidade Estadual de Maringá. Departamento de Enfermagem Av. Colombo, 5790 Jardim Universitário CEP: 87020-900, Maringá, PR, Brasil E-mail: soniasilva.marcon@gmail.com

Variables	Intervention Group (n=13)			Control Group (n=20)
Variables	Pre-	Post-	p	Pre-	Post-	p
Weight*	79.59(±11.86)	77.22(±11.35)	0.004	75.00(±11.25)	76.01(±10.96)	0.235
BMI^†‡	31.95(±4.03)	28.95(±9.47)	0.003	31.42(±3.76)	32.14(±4.12)	0.111
WC*^§	93.54(±8.20)	89.23(±8.25)	<0.001	96.95(±8.24)	97.75(±8.21)	0.145
WHR^\|\|‡	0.980(±0.043)	0.970(±0.049)	0.002	1.000(±0.043)	1.000(±0.047)	0.104

n	Age (years)	Global SRBC*		Weight	BMI^†	WC^‡	WHR^§
n	Age (years)	Pre-	Post-	Percentage Difference
1	51	4	3	-6.42	-7.0	-2.27	-4.16
2	25	3	4	0.60	0.7	-9.30	0
3	43	4	3	-4.50	-4.9	-5.88	-1.03
4	36	2	3	-5.32	-5.8	-5.10	-1.98
5	51	2	4	-1.75	-1.8	2.38	-1.01
6	28	2	4	-0.73	-0.8	-3.84	-0.97
7	55	4	4	-1.15	-1.2	-1.86	-0.98
8	59	4	3	-5.08	-5.0	-3.40	-0.97
9	46	4	3	-0.41	-0.7	-8.51	-1
10	57	4	3	-3.04	-3.0	-3.33	-0.97
11	31	3	4	-3.91	-4.0	-10.46	-2.24
12	30	3	4	-4.96	-5.3	-6.79	-2.04
13	48	4	4	0.40	0.3	-1.16	-1.01

Domains		Pre-Contemplation		Contemplation		Preparation		Action		Maintenance
Domains		Pre-	Post-	Pre-	Post-	Pre-	Post-	Pre-	Post-	Pre-	Post-
Intervention Group (n=13)
	1 - Size and quantity of the portions*	-	-	3	-	4	2	6	11	-	-
	2 - Quantity of fat in the diet^††	-	-	1	-	5	1	6	12	1	-
	3 - Consumption of fruits and greens*	-	-	1	1	8	6	4	6	-	-
	4 - Physical activity Control Group*	-	-	3	-	2	2	4	4	4	7
Control (n=20)
	1 - Size and quantity of the portions*	2	1	9	12	6	5	2	2	1	-
	2 - Quantity of fat in the diet^†	1	-	5	3	11	15	2	2	1	-
	3 - Consumption of fruits and greens*	-	6	11	5	6	6	3	3	-	-
	4 - Physical activity*	1	-	-	5	6	8	10	7	3	-

Domains		Group
		Intervention	Control
		p	p
Domain 1 - Size and quantity of the portions
	I limit the quantity that I eat and do not eat more than I need.	0.023*	0.160
	I measure and weigh the portions of the foods that I eat.	0.002*	0.450
	I eat less in later meals if I exaggerated in previous meals.	0.410	1.000
	I stop eating before I feel "full - stuffed".	0.050	0.788
	I avoid eating when I'm nervous, sad or depressed.	0.152	0.269
	I drink a glass of water before meals.	0.014*	0.880
	I resist eating everything on the plate if I'm no longer hungry.	0.526	0.344
	I "keep track" of how much I am eating when I am snacking.	0.023*	0.732
	I say no to second portions.	0.234*	0.190
Domain 2 - Quantity of fat in the diet
	I eat a diet low in fats.	0.020*	0.225
	I eat chicken without the skin.	0.837	0.577
	I drink skimmed milk and eat low-fat dairy products (yogurt, cheese).	0.568	0.497
	I remove all the fat from poultry.	0.193	0.577
	I limit the size of the portions of meat in meals.	0.053	0.236
	I avoid fried foods such as French fries, chicken or polenta.	0.291	0.313
	I avoid fast food (hamburgers, French fries etc.).	0.433	0.101
	I avoid snacks such as chips, peanuts or popcorn.	0.570	0.415
	I have stopped putting butter and/or margarine on bread, crackers and cakes.	0.082	0.091
	I use low-fat dressing for salad	0.213	0.022*
	I avoid cake, cookies and pies.	0.075	0.081
Domain 3 - consumption of fruits and greens
	I eat at least 5 portions of fruits and vegetables a day.	0.084	0.074
	I eat at least 3 portions of green vegetables (broccoli, spinach) a day.	0.904	0.888
	When I order food, I request vegetables instead of French fries.	0.063	0.004*
	I eat at least two portions of fruit every day.	0.218	0.811
	I eat green salads and vegetables such as carrots and tomatoes.	0.589	0.042
	I include fruits with my meals, such as bananas with cereals or papaya.	0.839	0.577
	I eat fruits as puddings.	0.135	0.396
	I include vegetables with my meals, such as lettuce or tomato in sandwiches.	0.347	0.915
	When I snack, I snack on fruits.	0.250	0.715

Domains		Group
		Intervention	Control
		p	p
Domain 4 - in relation to physical activity
	I include a variety of physical activities in my daily routine.	0.018*	0.191
	I spend a good part of my time away from my table, doing more active tasks.	0.112	0.323
	I do heavy cleaning, such as cleaning windows and scrubbing the floor and walls.	0.066	1.000
	I do heavy work at work, I lift objects or use heavy machinery.	0.011*	0.157
	I do gardening, clean the backyard and paved areas.	0.194	0.100
	I seek ways to be active in my daily routine, I don't use the TV remote control, don't use the cordless telephone, and wash up by hand.	0.666	0.077
	I do active things at the end of the day, such as walks to visit friends or to stroll.	0.062	0.534
	I use the stairs instead of the lift or the escalator.	0.172	0.023*
	I park the car some distance from where I have to go, and walk to the place.	0.027*	0.025*