Behavior-Specific Cognitions Moderate Rural Women's Responsiveness to Web-Based Interventions for Weight Loss

Objective: To examine whether baseline behavior-specific cognitions moderated the effects of 2 Webbased interventions with enhanced features on weight loss success in rural women. Design: Secondary analysis of behavior-specific cognition data from a community-based, randomized controlled trial, as potential moderators of weight loss over 30 months. Participants: Women, overweight or obese, from rural communities, aged 40- 69 years (n = 200). Interventions: Theory-based Web interventions, with enhanced features of either peer-led Web discussion or professional e-mail counseling. Main Outcome Measures: Benefits and barriers to healthy eating and activity; self-efficacy and interpersonal support for healthy eating and activity using validated surveys; and weight. Analysis: Longitudinal multilevel models. Results: Women in the professional e-mail counseling group were more likely to lose weight if they perceived fewer barriers to and higher self-efficacy for healthy eating and activity. Greater weight loss in the peer-led discussion group was observed for women with lower self-efficacy and higher perceptions of barriers. Interpersonal support did not moderate the effects of the interventions. Conclusions and Implications: Although women in 2 different Web-enhanced interventions achieved similar weight loss, their baseline perceptions of behavior-specific cognitions moderated their relationship with the type of intervention and weight loss success. These findings, although exploratory, may assist in matching women to Web interventions that would best maximize weight loss success. Further research is needed.