No abstract

Self-efficacy is an important mediating mechanism in advancing understanding of the treatment of obesity. This study developed and validated the Weight Efficacy Life-Style Questionnaire (WEL), improving on previous studies by the use of clinical populations, cross-validation of the initial factor analysis, exploration of the best fitting theoretical model of self-efficacy, and examination of change in treatment. The resulting 20-item WEL consists of five situational factors: Negative Emotions, Availability, Social Pressure, Physical Discomfort, and Positive Activities. A hierarchical model was found to provide the best fit to the data. Results from two separate clinical treatment studies (total N = 382) show that the WEL is sensitive to changes in global scores as well as to a subset of the five situational factor scores. Treatment programs may be incomplete if they change only a subset of the situational dimensions of self-efficacy. Theoretical and clinical implications are discussed.

Exercise has important health benefits but a large proportion of the population is physically inactive. We examined the stages of readiness to exercise and their relationship to self‐efficacy, the costs and benefits of exercising, and self‐report of physical activity in a sample of Rhode Island worksites. Using a three‐step model‐building approach, exploratory principal components analyses were followed by an examination of the stages of change model with confirmatory structural equation modeling procedures. The model was then examined with longitudinal data. Confirmatory and longitudinal analyses showed an excellent tit between the model and the data. Results indicated that the costs and benefits of exercise and self‐efficacy for exercise were related to physical activity only indirectly, through the mediation of stage of readiness to exercise. Structural modeling fit indices revealed that much of the variation and covariation in physical activity was explained by the model. There is the potential to enhance the impact of exercise interventions, by targeting them so as to address factors related to these different stages of readiness.

Research with the Important People instrument has demonstrated that social support for abstinence is related to alcohol treatment outcomes but less work has been done on the role of network support in drug treatment outcomes. A drug and alcohol version of the Important People instrument (IPDA) was developed and administered to 141 patients in residential treatment for cocaine dependence. Three components were found, all with acceptable internal consistency: (1) substance involvement of the network, (2) general/treatment support, and (3) support for abstinence. These components and three fundamental network characteristics (size of daily network, size of network, and importance of the most important people) were investigated as correlates of pretreatment and posttreatment alcohol and drug use. The general/treatment support component and network size were inversely related to pretreatment days using drugs while network substance involvement positively correlated with pretreatment drinking frequency. Size of the daily network predicted less drinking, less drug use, and less problem severity during the 6 months after treatment whereas general/treatment support and support for abstinence did not predict outcome. Network substance involvement decreased for patients who stayed abstinent but not for those who later relapsed. Results suggest that increasing the number of people the patient sees daily while replacing substance-involved with abstinentsupportive people may improve treatment outcomes. Treatment programs may use the IPDA to identify clients most likely to benefit from changes in their social networks.