SEM constructs | Intrapersonal level | Interpersonal level | Group/Community level | Macro level |
---|---|---|---|---|
SCT constructs | Personal factors | Environmental influences | ||
Behavior (Change) | ||||
Observational learning | Intro to safe exercising; learning to read food labels; new nutrition intake | Share relatable stories & information about lifestyle change and challenges; transformation weight loss stories | Community-based lifestyle programs; local events to prevent post-MBS weight regain; cooking classes: easy, affordable recipes | PCPs referrals to DPP; PCP involvement in pre-post MBS support |
Reinforcement | Goal setting for sustained weight loss; healthy eating; exercise; create a healthy relationship with food | Supervised physical activity sessions; rewards for successful completion, and for adding more fruits and vegetables; incentives group session participation | Community-based DPPs; physical activity incentives (reduced gym fees); grocery discounts | Calorie and macro/micronutrient content skills; app to support exercise skills |
Self-control | Self-monitoring of micro/macro nutrient content to prevent weight regain; regulating exercise habits | Active listening; life coach discussions; MBS team nutritionist; social support network; supporting exercise | Social/group DPP/GLB MBS support groups in community; weight wellness programs (WWP) and other networks | Food label mastery; restaurant menu calorie mastery; exercise mastery |
Self-efficacy | Weekly goals | Family meal planning | Fitness classes | Restaurant menus |
Knowledge | Evaluation of self-esteem/body image; motivation; weight & health goals; Health-related quality of life (HRQOL); Exercise goals | Communication; best practices; in diet, activity, sleep & tech (MyFitnessPal); benefits of support | Assessment of school, home, cyber, neighborhood resources for prolonged support | Crime/safety; food swamps; public transportation knowledge mastery |
Skill building | Body acceptance; self-confidence, mindfulness; goal setting (to support weight loss retention); Managing setbacks | Sleep hygiene tracking; food records; setting reminders; exercise tracking; social support strategies (group meetings) | Wellness resources at school & in the community; social support groups to overcome weight loss hurdles; use of social media support groups | Health/fitness trackers; walking maps; journaling; safety/healthy information use (e.g., Shopwell app) |