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Sugar-sweetened beverage (SSB) consumption is strongly associated with obesity. Autonomous motivation and self-efficacy, key concepts of self-determination theory, may influence SSB consumption. Low-income mothers of young children experience disproportionate rates of obesity. Whether autonomous motivation and self-efficacy are associated with SSB consumption in low-income mothers of young children is unknown. This exploratory secondary data analysis explored whether autonomous motivation or self-efficacy were associated with SBB consumption using data from a lifestyle intervention for low-income, overweight or obese mothers with young children. Participants (N = 311) completed surveys assessing autonomous motivation, self-efficacy, and SSB consumption at baseline, after the 16-week intervention, and at 3-month follow-up. Using baseline data, we performed linear regression models to explore associations of self-efficacy and autonomous motivation with SSB consumption. We also performed mixed effects models to explore whether autonomous motivation or self-efficacy were associated with SSB consumption over time. At baseline, a one-point increase in autonomous motivation and self-efficacy were associated with 4.36 (p < 0.001) and 6.43 (p = 0.025) fewer ounces of SSB consumption per day, respectively. In longitudinal models, SSB consumption decreased over time. Change in SSB consumption was associated with self-efficacy (B = -4.88; p = 0.015) and autonomous motivation (B = -2.29; p = 0.008). Our findings suggest self-efficacy and autonomous motivation may influence SSB consumption among mothers of young children with overweight and obesity. Further investigation should explore if self-efficacy and autonomous motivation have long-term effects on SSB consumption., (© 2024 The Author(s). Research in Nursing & Health published by Wiley Periodicals LLC.)

Background: Episodic future thinking (EFT) has shown efficacy in laboratory settings. We conducted a pilot goal-oriented EFT (GoEFT) intervention in a real-world setting to help low-income overweight or obese mothers lose weight. This paper presents intervention acceptability and efficacy., Methods: The study used a single-group, before-after design. During the 3-week intervention, participants (N = 15) completed weekly web-based lessons and online health coaching sessions to manage stress and emotion, eat healthier, and be more physically active. Participants completed online surveys at baseline and immediately after the intervention. They also completed an interview to evaluate intervention acceptability. We applied paired t-tests to evaluate efficacy and used content analysis to discover interview themes., Results: Participants consistently identified the intervention as acceptable, noting the usefulness of pre-written goals, GoEFT strategies, and goal progress evaluations. The intervention effectively promoted weight loss ( d = -0.69), fruit and vegetable intake ( d = 0.45-0.49), and emotion control ( d = 0.71). It also reduced fat ( d = -0.51) and added sugar intake ( d = -0.48) and alleviated stress ( d = -0.52). Moreover, the intervention increased autonomous motivation ( d = 0.75-0.88) and self-efficacy ( d = 0.46-0.61)., Conclusion: The GoEFT intervention was acceptable to participants, showing strong preliminary efficacy.

Purpose: Investigate the associations between psychosocial factors and physical activity., Design: Secondary data analysis utilizing baseline data of a large-scale community-based randomized controlled lifestyle behavior intervention., Setting: The Special Supplemental Program for Women, Infants, and Children in Michigan, USA., Subjects: Low-income overweight or obese mothers with young children (N = 740, 65% response rate)., Measures: Survey data were collected via phone interview. Predictors included self-efficacy, autonomous motivation, emotional coping, and social support. Self-reported leisure physical activity was the outcome variable. Covariates were age, race, smoking, employment, education, body mass index, and postpartum status., Analysis: A multiple linear regression model was applied., Results: Self-efficacy ( β = .32, 95% CI = .11, .52, P = .003) and autonomous motivation ( β = .10, 95% CI = .03, .17, P = .005) were positively associated with physical activity. However, emotional coping and social support were not associated with physical activity., Conclusion: Future research should examine the longitudinal association of key psychosocial factors with physical activity.

Background: Implementing lifestyle behavior programs in real-world settings challenges researchers. The Special Supplemental Nutrition Program for Women, Infants, and Children ( WIC) has implemented and sustained Mothers In Motion ( MIM )'s client videos for clients to promote healthy lifestyle behaviors, and train-the-trainer videos, for personnel to enhance motivational interviewing techniques since 2015 and 2016, respectively. This paper describes the implementation processes and the results of client video implementation acceptability by WIC personnel., Methods: To document the implementation process, we applied the Framework for Adaptation and Modifications to Evidence-Based Implementation Strategies (FRAME-IS). To evaluate implementation acceptability, we conducted semi-structured interviews with 15 WIC personnel. A qualitative analysis was conducted to identify the common themes., Results: The facilitators for client video implementation were the inclusion of the target audience and family members addressing daily challenges, easy implementation, and compatibility with daily practice. While videos online facilitated implementation, videos in DVD format could challenge implementation., Conclusions: Future lifestyle intervention programs aimed for future implementation in community settings may consider the inclusion of the target audience and their family members and take into consideration easy implementation and compatibility.

Using data from a community-based lifestyle behavioral intervention study, this secondary data analysis investigated whether emotional coping, coping self-efficacy, and autonomous motivation mediated the association between the intervention and perceived stress in low-income overweight or obese mothers of young children. Results showed that coping self-efficacy significantly mediated the association between the intervention and perceived stress. However, emotional coping and autonomous motivation did not significantly mediate the association between intervention and perceived stress. Interventions may be more effective in helping the target audience reduce stress if they incorporate practical skills that can increase a sense of coping self-efficacy.

Background: Little is known about associations between perceived stress, psychosocial factors (social support, emotional coping, coping self-efficacy, and autonomous motivation), and depressive symptoms in low-income overweight or obese mothers of young children. Using baseline data of a lifestyle intervention study, this secondary analysis investigates whether perceived stress might mediate the associations between the psychosocial factors and depressive symptoms., Methods: Convenience sampling was applied. Low-income overweight or obese mothers of young children were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in Michigan, US. Survey data were collected through phone interviews. Participants (N = 740) responded to valid surveys measuring perceived stress, social support, emotional coping, coping self-efficacy, autonomous motivation, and depressive symptoms. Composite indicator structural equation modeling was performed to test for potential mediation., Results: When investigating the potential role of perceived stress as a mediator, the indirect effects of social support (b = - 2.10, p < 0.01), emotion coping (b = - 3.81, p < 0.05), and coping self-efficacy (b = - 7.53, p < 0.01) on depressive symptoms through perceived stress were significant, but the indirect effect of autonomous motivation was not., Conclusion: Future intervention studies aiming to alleviate depressive symptoms in low-income overweight or obese mothers of young children might consider including practical strategies to promote social support, emotional coping, and coping self-efficacy to reduce perceived stress, which might potentially decrease depressive symptoms., Trial Registration: Clinical Trials NCT01839708 ; registered February 28, 2013.

Background: Mothers In Motion (MIM), a community-based lifestyle behavioral intervention, was designed and conducted to help low-income overweight and obese young mothers prevent further weight gain via promotion of stress management, healthy eating, and physical activity. This paper presents intervention effect on body weight (primary outcome) and summarizes lessons learned., Methods: Participants (N = 612) were recruited from 7 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) offices in Michigan and were individually randomized to an intervention n= 410) or a comparison (n =202) group (2: 1 ratio). During the 16-week intervention, intervention participants watched theory-based culturally sensitive videos (in DVD format) featuring peers from the target audience to learn skills for managing stress, eating healthier, and being more physically active. They also dialed into peer support group teleconferences to enhance skills learned in the videos and increase motivation for lifestyle behavioral changes. Body weight, the primary outcome, was measured at baseline, immediately after the 16-week intervention, and 3 months after the 16-week intervention. Intervention effect was tested via general linear mixed model for repeated measures, using baseline measures as adjusting covariates., Results: At baseline, the mean age of the participants was 28.5 ± 5.0 years (intervention: 28.4 ± 5.0, comparison: 28.9 ± 5.0); the mean body weight was 190.2 ± 1.4 lbs (intervention: 191.8 ± 30.0, comparison: 188.5 ± 29.1); and the mean body mass index (BMI) was 32.2 ± 4.4 (intervention: 32.2 ± 4.4, comparison: 31.7 ± 4.2). Of sample, 64.7% were obese. At 3 months after the 16-week intervention, no significant weight differences were found between the intervention (188.3 ± 10.6 lbs, BMI: 31.6 ± 1.8) and comparison groups (187.7 ± 10.6 lbs, BMI: 31.53 ± 1.8) when controlling for baseline body weight., Conclusions: This lifestyle behavioral intervention that focused on stress management, healthy eating and physical activity was not effective in helping low-income overweight and obese young mothers prevent further weight gain., Trial Registration: Clinical Trials NCT01839708 . This trial was registered retrospectively on February 28, 2013.

Background: Existing physical activity surveys have not been validated for use with low-income overweight and obese young mothers. This study aimed to validate the Pregnancy Infection and Nutrition 3 (PIN3) physical activity survey and to explore whether its validity varied by race/ethnicity and body mass index (BMI) category when including or excluding child and adult care activities in the target population., Methods: Participants were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and were asked to fill out the PIN3 survey and wear an Actigraph accelerometer. Validity was assessed (N = 42) using Spearman correlation coefficient., Results: Regardless of inclusion or exclusion of child and adult care activity, the PIN3 survey showed evidence of validity for moderate (correlation coefficients 0.33 [p = 0.03]; 0.40 [p = 0.08]) but not vigorous (-0.01 [p = 0.91]; -0.06 [p = 0.69]) physical activity. The mean minutes per week spent in moderate, vigorous and moderate-vigorous physical activity measured by the PIN3 were substantially higher than when measured by accelerometer, for example, 588 (PIN3) versus 148 (accelerometer) minutes per week. Also, correlations between self-reported and objective monitored activity varied substantially by race/ethnicity and BMI category, for example, 0.29 (p = 0.18) for overweight women versus 0.57 (p = 0.007) for obese women; 0.27 (p = 0.20) for African American versus 0.66 (p = 0.001) for white., Conclusions: The PIN3 survey may be adequate for many applications where quick and practical assessments are needed for moderate physical activity data in low-income overweight and obese young mothers. The substantial differences in mean minutes per week between the PIN3 and accelerometer may be due to over-reported physical activity by the study participants., Trial Registration: Clinical Trials Number: NCT01839708.

Objective: This paper describes the design and findings of a pilot Mothers In Motion (P-MIM) program., Design: A randomized controlled trial that collected data via telephone interviews and finger stick at 3 time points: baseline and 2 and 8 months post-intervention., Setting: Three Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) sites in southern Michigan., Participants: One hundred and twenty nine overweight and obese African-American and white mothers, 18-34 years old., Intervention: The 10-week, theory-based, culturally sensitive intervention messages were delivered via a series of 5 chapters on a DVD and complemented by 5 peer support group teleconferences., Main Outcome Measures: Dietary fat, fruit, and vegetable intake; physical activity; stress; feelings; body weight; and blood glucose., Analysis: General linear mixed model was applied to assess treatment effects across 2 and 8 months post-intervention., Results: No significant effect sizes were found in primary and secondary outcome variables at 2 and 8 months post-intervention. However, changes in body weight and blood glucose showed apparent trends consistent with the study's hypotheses., Conclusions and Implications: The P-MIM showed promise for preventing weight gain in low-income overweight and obese women. However, a larger experimental trial is warranted to determine the effectiveness of this intervention., (Copyright 2010 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.)

Background: Recruitment and retention are key functions for programs promoting nutrition and other lifestyle behavioral changes in low-income populations. This paper describes strategies for recruitment and retention and presents predictors of early (two-month post intervention) and late (eight-month post intervention) dropout (non retention) and overall retention among young, low-income overweight and obese mothers participating in a community-based randomized pilot trial called Mothers In Motion., Methods: Low-income overweight and obese African American and white mothers ages 18 to 34 were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in southern Michigan. Participants (n = 129) were randomly assigned to an intervention (n = 64) or control (n = 65) group according to a stratification procedure to equalize representation in two racial groups (African American and white) and three body mass index categories (25.0-29.9 kg/m(2), 30.0-34.9 kg/m(2), and 35.0-39.9 kg/m(2)). The 10-week theory-based culturally sensitive intervention focused on healthy eating, physical activity, and stress management messages that were delivered via an interactive DVD and reinforced by five peer-support group teleconferences. Forward stepwise multiple logistic regression was performed to examine whether dietary fat, fruit and vegetable intake behaviors, physical activity, perceived stress, positive and negative affect, depression, and race predicted dropout as data were collected two-month and eight-month after the active intervention phase., Results: Trained personnel were successful in recruiting subjects. Increased level of depression was a predictor of early dropout (odds ratio = 1.04; 95% CI = 1.00, 1.08; p = 0.03). Greater stress predicted late dropout (odds ratio = 0.20; 95% CI = 0.00, 0.37; p = 0.01). Dietary fat, fruit, and vegetable intake behaviors, physical activity, positive and negative affect, and race were not associated with either early or late dropout. Less negative affect was a marginal predictor of participant retention (odds ratio = 0.57; 95% CI = 0.31, 1.03; p = 0.06)., Conclusion: Dropout rates in this study were higher for participants who reported higher levels of depression and stress., Trial Registration: Current Controlled Trials NCT00944060.

Low-income women who are overweight and obese are at high risk for long-term retention of weight gain during pregnancy, in part because they may have poor diets and inadequate physical activity, both of which may be exacerbated by stressful situations. This study identified motivators and barriers to healthful eating and physical activity among low-income overweight and obese non-Hispanic black and non-Hispanic white mothers. Qualitative data were collected via eight focus group interviews. Eighty low-income overweight and obese non-Hispanic black (n=41) and non-Hispanic white (n=39) mothers, age 18 to 35 years, were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children sites in six counties in Michigan. Personal appearance, fit in clothes, inability to play with their children, and social support were motivating factors for healthful eating and physical activity. Stressful experiences triggered emotional eating and reduced participants' ability to practice these behaviors. Other factors-for example, wanting quick weight-loss results-made it difficult for these mothers to follow recommended healthful lifestyle practices. Nutrition educators can address these concerns by including information about ways to deal with stress and emotional eating and emphasizing the benefits of healthful eating and physical activity in their program plans.

Objective: To establish reliability and construct and discriminant validity of selected factors adapted from the Health and Taste Attitudes Questionnaire developed in Finland and the Food Choice Questionnaire developed in England for use with low-income mothers in the United States., Design: Cross-sectional., Setting: Head Start and the Special Supplemental Nutrition Program for Women, Infants and Children sites in south-central Wisconsin., Participants: A convenience sample of 211 nonpregnant non-Hispanic black and white women., Variables Measured: Predisposing, enabling, and reinforcing constructs of the PRECEDE-PROCEED model., Analysis: Factor analyses., Results: After modification, the resulting measurement models of predisposing, enabling, and reinforcing constructs demonstrated good reliability and construct and discriminant validity. These models showed excellent model fit (chi-square/df range 1.5-2.0, root mean square error of approximate range.05-.07, non-normed fit index range.97-1.0, comparative fit index range.98-1.0, incremental fit index range.98-1.0), with all factor loadings significant (P <.001). Items previously developed with European adults demonstrated different pattern structures in predisposing and enabling constructs but the same structures for reinforcing construct when applied to low-income mothers in the United States., Conclusion and Implication: This modified instrument provides a tool for researchers and educators to further explore factors affecting fat intake behaviors in low-income mothers.

Objective: To examine the influence of personal and environmental factors on healthful weight management behaviors mediated through self-efficacy among low-income obese mothers. Design: Cross-sectional design. Setting: Special Supplemental Nutrition Program for Women, Infants, and Children in Wisconsin. Participants: Two hundred eighty-four obese mothers aged 18-34 years. Main Outcome Measures: Personal factors (e.g., eating low-fat/low-calorie food for weight management), environmental factors, self-efficacy, and weight management behaviors. Data were collected via self-administered written questionnaires. Analysis: Latent class cluster analysis and structural logistic regression. Results: Women who perceived more importance of eating low-fat/low-calorie food for weight management were more likely to practice multiple behavioral strategies to manage their weight (odds ratio = 0.37) than women who perceived less importance of eating low-fat/low-calorie food for weight management. Women who reported higher positive mood self-efficacy were more likely (odds ratio = 1.63) to practice multiple strategies to manage their weight than women who reported lower positive mood self-efficacy. Environmental factors did not predict use of multiple healthful weight management behaviors. No mediation effect was found. Conclusions and Implications: Stressing the importance of food choices and reinforcing learners' self-confidence to make healthful choices at parties and celebrations may be helpful ways to address common barriers to healthful weight management.

Objective: This paper describes the design and findings of a pilot "Mothers In Motion" (P-"MIM") program. Design: A randomized controlled trial that collected data via telephone interviews and finger stick at 3 time points: baseline and 2 and 8 months post-intervention. Setting: Three Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) sites in southern Michigan. Participants: One hundred and twenty nine overweight and obese African-American and white mothers, 18-34 years old. Intervention: The 10-week, theory-based, culturally sensitive intervention messages were delivered via a series of 5 chapters on a DVD and complemented by 5 peer support group teleconferences. Main Outcome Measures: Dietary fat, fruit, and vegetable intake; physical activity; stress; feelings; body weight; and blood glucose. Analysis: General linear mixed model was applied to assess treatment effects across 2 and 8 months post-intervention. Results: No significant effect sizes were found in primary and secondary outcome variables at 2 and 8 months post-intervention. However, changes in body weight and blood glucose showed apparent trends consistent with the study's hypotheses. Conclusions and Implications: The P-"MIM" showed promise for preventing weight gain in low-income overweight and obese women. However, a larger experimental trial is warranted to determine the effectiveness of this intervention. (Contains 4 tables.)