Development and Validation of a Lifestyle Behavior Tool in Overweight and Obese Women through Qualitative and Quantitative Approaches

Abstract

There is a paucity of effective intervention tools for overweight/obese women to assess, guide and monitor their eating behavior. This study aimed to develop a lifestyle intervention tool, assess its acceptability and usefulness, and verify its construct validity in overweight/obese women. The 6P tool (Portion, Proportion, Pleasure, Phase, Physicality, Psychology) was developed and 15 women with a body mass index (BMI) ≥ 25 kg/m2 were interviewed to assess its perceived acceptability and usefulness. Subsequently, the revised 6P tool was tested in 46 women with a BMI ≥ 25 kg/m2. The Three-Factor Eating Questionnaire (TFEQ), International Physical Activity Questionnaire-Short (IPAQ), and weight were measured at baseline and one-month. Most participants were satisfied with the presentation of the 6P tool (86.8%), and agreed it was useful in guiding healthy eating (81.6%) and raising awareness of eating behavior (97.4%). There were significant improvements in cognitive restraint (p = 0.010) and disinhibition (p = 0.030) (TFEQ), portion size (P1), pleasure behaviors (P3), and total composite 6P score (p < 0.001). However, there was no significant reduction in weight or increase in physical activity. The 6P tool is acceptable and presents with good validity for assessing lifestyle behaviors.

A Golden Thread approach to transforming Maternal and Child Health in Singapore

“…mHealth education in English, which is the main language in Singapore, will be developed to focus guidance on healthy eating, exercise, sleep and mental well-being, in addition to increasing knowledge regarding preconception, antenatal and postpartum dyad care. A digitized tool that aims to address metabolic heath issue based on the principle of energy input and expenditure, and motivation as the foundation to make dietary change is designed [55]. It comprises dietary, activity and psychological components, which serves as a check list to facilitate an individual to be aware of own unhealthy lifestyle problems and tackle it via SMART (Specific, Measurable, Achievable, Realistic and Timely) strategy.…”

Effects of an integrated mobile health lifestyle intervention among overweight and obese women planning for pregnancy in Singapore: protocol for the single-arm healthy early life moments in Singapore (HELMS) study

“…The diet module is developed based on the 6P tool, which is designed as a platform to address metabolic health based on the principles of energy input and expenditure, as well as motivation as the basis for dietary change. 30 It is a simple, self-administered instrument based on the concept of a mental model, which can lead to self-awareness, self-evaluation and self-education, over time resulting in a positive change in eating habits and health. The 6P comprises six components as presented in table 1 .…”

“…36 ► Pregnancy outcomes include pain, obstetric and delivery complications. ► Health behaviours assessed by dietary practice (6P tool, 30 4-day food diary, Food Frequency Questionnaire, 37 Three Factor Eating Questionnaire, 38 alcohol and supplement intake), smoking exposure, physical activity and sedentary behaviours (International Physical Activity Questionnaire, 39 40 Sedentary Behaviour Questionnaire, 41 accelerometer), and sleep (Pittsburgh Sleep Quality Index, 42 digital tracker). ► Metabolic profile, including weight status, body fat distribution, blood pressure, lipid and glycaemic measures.…”