Self-efficacy as a predictor of weight change and behavior change in the PREMIER trial

Brooks C. Wingo, Renee A. Desmond, Phillip Brantley, Lawrence Appel, Laura Svetkey, Victor J. Stevens, Jamy D. Ard

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Objectives: Determine whether self-efficacy independently predicted weight loss in a behavioral intervention and explore factors that influence the path between self-efficacy and weight change. Design: Secondary analysis of the PREMIER trial, a randomized controlled trial testing effects of lifestyle interventions on blood pressure. Setting: Four academic medical centers. Participants: PREMIER recruited adults (n = 810) with pre-hypertension/stage 1 hypertension, not currently receiving medication. This analysis excluded participants in the control arm, resulting in n =537. Interventions: Participants were randomly assigned to 1 of 3 groups: advice only, established lifestylerecommendations, or established lifestyle recommendations plus Dietary Approaches to Stop Hypertension dietary pattern. Main Outcome Measures: Self-efficacy (dietary self-efficacy [DSE], exercise self-efficacy [ESE]), dietary intake, fitness. Analysis: Pearson correlations, 1-way analysis of variance, mediation analyses. Results: Despite an overall decrease in DSE/ESE, change in DSE/ESE significantly predicted weight change at 6 (β = -21, P < .01; β = -19, P < .01, respectively) and 18 months (β = -19, P < .01; β=-35, P < .01). Change in percent calories from fat partially mediated the DSE/weight change relationship at 6 months. Change in fitness partially mediated the ESE/weight change relationship at 18 months. Conclusions and Implications: Changes in DSE/ESE were not associated with behavior change as hypothesized. Additional research is needed to identify mediators between self-efficacy and adoption of behaviors that influence weight loss.

Original languageEnglish (US)
Pages (from-to)314-321
Number of pages8
JournalJournal of Nutrition Education and Behavior
Issue number4
StatePublished - Jul 2013


  • Behavior change
  • Dietary intake
  • Obesity
  • Physical activity
  • Self-efficacy

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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