%0 Journal Article %J J Nutr Educ Behav %D 2012 %T Measuring perceived barriers to healthful eating in obese, treatment-seeking adults. %A Welsh, Ericka M %A Jeffery, Robert W %A Levy, Rona L %A Langer, Shelby L %A Flood, Andrew P %A Jaeb, Melanie A %A Laqua, Patricia S %K Body Mass Index %K Diet, Reducing %K Energy Intake %K Factor Analysis, Statistical %K Female %K Health Behavior %K Health Knowledge, Attitudes, Practice %K Humans %K Linear Models %K Male %K Middle Aged %K Obesity %K Perception %K Self Concept %K Self Efficacy %K Surveys and Questionnaires %K Time Factors %K Weight Loss %X

OBJECTIVE: To characterize perceived barriers to healthful eating in a sample of obese, treatment-seeking adults and to examine whether changes in barriers are associated with energy intake and body weight.

DESIGN: Observational study based on findings from a randomized, controlled behavioral weight-loss trial.

PARTICIPANTS: Participants were 113 women and 100 men, mean age 48.8 years, 67% white, and mean body mass index at baseline 34.9 kg/m(2).

VARIABLES MEASURED: Perceived diet barriers were assessed using a 39-item questionnaire. Energy intake was assessed with the Block Food Frequency Questionnaire. Body weight (kg) and height (cm) were measured.

ANALYSIS: Factor-based scales constructed from exploratory factor analysis. Linear regression models regressed 12-month energy intake and body weight on baseline to 12-month factor-based score changes (α = .05).

RESULTS: Exploratory factor analysis yielded 3 factors: lack of knowledge, lack of control, and lack of time. Reported declines in lack of knowledge and lack of control from baseline to 12 months were associated with significantly greater energy restriction over 12 months, whereas reported declines in lack of control and lack of time were associated with significantly greater weight loss.

CONCLUSIONS AND IMPLICATIONS: Results suggest that declines in perceived barriers to healthful eating during treatment are associated with greater energy restriction and weight loss.

%B J Nutr Educ Behav %V 44 %P 507-12 %8 2012 Nov-Dec %G eng %N 6 %R 10.1016/j.jneb.2010.06.005 %0 Journal Article %J Am J Gastroenterol %D 2010 %T Cognitive-behavioral therapy for children with functional abdominal pain and their parents decreases pain and other symptoms. %A Levy, Rona L %A Langer, Shelby L %A Walker, Lynn S %A Romano, Joan M %A Christie, Dennis L %A Youssef, Nader %A DuPen, Melissa M %A Feld, Andrew D %A Ballard, Sheri A %A Welsh, Ericka M %A Jeffery, Robert W %A Young, Melissa %A Coffey, Melissa J %A Whitehead, William E %K Abdominal Pain %K Adaptation, Psychological %K Adolescent %K Child %K Cognitive Therapy %K Disability Evaluation %K Female %K Humans %K Linear Models %K Male %K Pain Measurement %K Parent-Child Relations %K Parents %K Prospective Studies %K Treatment Outcome %X

OBJECTIVES: Unexplained abdominal pain in children has been shown to be related to parental responses to symptoms. This randomized controlled trial tested the efficacy of an intervention designed to improve outcomes in idiopathic childhood abdominal pain by altering parental responses to pain and children's ways of coping and thinking about their symptoms.

METHODS: Two hundred children with persistent functional abdominal pain and their parents were randomly assigned to one of two conditions-a three-session intervention of cognitive-behavioral treatment targeting parents' responses to their children's pain complaints and children's coping responses, or a three-session educational intervention that controlled for time and attention. Parents and children were assessed at pretreatment, and 1 week, 3 months, and 6 months post-treatment. Outcome measures were child and parent reports of child pain levels, function, and adjustment. Process measures included parental protective responses to children's symptom reports and child coping methods.

RESULTS: Children in the cognitive-behavioral condition showed greater baseline to follow-up decreases in pain and gastrointestinal symptom severity (as reported by parents) than children in the comparison condition (time x treatment interaction, P<0.01). Also, parents in the cognitive-behavioral condition reported greater decreases in solicitous responses to their child's symptoms compared with parents in the comparison condition (time x treatment interaction, P<0.0001).

CONCLUSIONS: An intervention aimed at reducing protective parental responses and increasing child coping skills is effective in reducing children's pain and symptom levels compared with an educational control condition.

%B Am J Gastroenterol %V 105 %P 946-56 %8 2010 Apr %G eng %N 4 %R 10.1038/ajg.2010.106