摘要：Background: Examination of mediating behavioral factors could explain how an intervention works and thus provide guidance to optimize behavioral weight-loss programs. This study examined the mediating role of adherence to self-monitoring of diet and physical activity on weight loss in a behavioral weight-loss trial testing the use of personal digital assistants (PDA) for self-monitoring. Methods: Mediation analysis was conducted to examine the possible mediating role of adherence to self-monitoring of diet and physical activity between treatments using varying self-monitoring methods (paper record, PDA, and PDA with daily tailored feedback messages) and weight loss. Findings: The sample (N = 210) was predominantly white (78%) and female (85%). Compared to a paper record, using a PDA for self-monitoring diet ( P = 0.027) and physical activity ( P = 0.014) had significant direct effects on weight loss at 12 months, as well as a significant indirect effect on outcomes through improved adherence to self-monitoring ( P S < 0.001). Receiving an automated daily feedback message via PDA only had a significant indirect effect on weight through self-monitoring adherence to diet ( P = 0.004) and physical activity ( P = 0.002). Conclusions: Adherence to self-monitoring of diet and physical activity is important as the underlying mechanism in this technology-supported behavioral weight-loss intervention.
关键词：behavioral intervention; self-monitoring; mobile technology; mediation analysis; weight loss; adherence
