Multi-Year Study

Based on the results from the Pilot Study, the cognitive component of the Outcomes Survey instrument underwent revision.  In the revised survey, participants were asked to rate their efficacy/confidence level for managing their behavior in specific situations.  They were also asked to rate the strength of their belief that specific actions in regard to eating and physical activity would lead to specific health benefits.  Participants also identified, from a list of 15, the 3 program strategies that were most helpful to them in their weight management endeavor.  There were no changes to the portion of the instrument asking about current eating and physical activity behaviors.  The data collection using the new instrument started in January 2003 and continued through the spring of 2009.  During this 6 year data collection period:

• 18 leaders provided pre- and post-treatment physical data on program participants including age, height, weight and waist circumference.
• Some form of physical or behavioral data was obtained from 1592 program participants.
• 754 participants provided complete physical and behavioral data.

Nutrition faculty and an undergraduate student at Arizona State University, in cooperation with the LIFESTEPS Management Team, analyzed the data in late 2009 an early 2010.  This resulted in an abstract presented at the SCAN Conference in March 2010.  Another abstract has been presented at a poster session at FNCE in Boston on November 7, 2010.  A paper has also been submitted for publication.

Key outcomes are:

• Significant (p<0.001) decrease in body weight, BMI, waist circumference and waist-to-height ratio.
• 1131 of the 1592 participants (71%) completed the program indicating a low level of attrition.
• “Keep food records” was reported by 63.7% of those completing the outcome instrument as the most helpful program activity. 

Statistical analysis couldn’t be done on the food intake, physical activity, efficacy and belief data from the outcome instrument, but it was possible to look at trends.  Respondents’ responses to the section of the survey instrument addressing current behaviors indicate improvements in food choices as demonstrated by improved numbers of servings from the nutrient-rich food groups.  They also showed increased levels of physical activity at post-treatment with greater gains in aerobic than in resistance activity.

The section on confidence addresses specific eating and physical activity situations.  The percentage of respondents with low confidence decreased from pre- to post-treatment for all situations.  Ratings of moderately or highly confident increased for all eating situations; high confidence ratings increased for all physical activity situations.  The percentage of respondents feeling moderately confident when family and friends are not physically active and when family and friends are not encouraging physical activity decreased from pre- to post-treatment.  However, the percentage of respondents feeling highly confident in these two situations showed a considerable increase from pre- to post-treatment.

Respondents were also asked to rate the strength of their belief that changes in eating and/or physical activity would have a positive outcome in terms of reduced disease risk, weight maintenance and maintenance of new eating and/or physical activity behaviors.  Ratings in this section did not show major change from pre- to post-treatment.  This is not surprising since belief in these outcomes probably prompted respondents to seek out a behavior change program such as LIFESTEPS.  This is evidenced in relatively high ratings at pre-treatment with little change at post-treatment. More detailed information on these trends is available for trained LIFESTEPS Leaders on the Leaders Only page.

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Updated December, 2010

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