Determinants of lifestyle behavior change to prevent type 2 diabetes in high-risk individuals

den Braver, N.R.; de Vet, E.; Duijzer, G.; ter Beek, J.; Jansen, S.C.; Hiddink, G.J.; Feskens, E.J.M.; Haveman-Nies, A.

doi:10.1186/s12966-017-0532-9

International Journal of Behavioral Nutrition and Physical Activity

Table 3 Mediation of change in behavioral determinants between intervention and dietary behavior change (18 months, n = 240)

From: Determinants of lifestyle behavior change to prevent type 2 diabetes in high-risk individuals

T0–T2 Fruit intake (g/day)	X -- > Y (c path) ^a,h
	B(SE)		95%-CI
Crude analysis	32.3 (13.2)		6.3; 58.4
	X -- > Y (c’ path) direct ^b,h		X -- > M (a path) ^c,h		M -- > Y (b path) ^d,h		*Indirect effect (ab)** ^e,g		Proportion mediated ^f
	B (SE)	95%-CI	B (SE)	95%-CI	B (SE)	95%-CI	B (SE)	95%-CI	B (SE)
Intention	20.3 (12.6)	−4.5; 45.2	0.4 (0.2)	0.1; 0.7	26.7 (5.0)	16.8; 36.5	10.9 (5.1)	2.9; 23.6	0.35
Attitude	16.0 (12.7)	−9.1; 41.1	0.6 (0.1)	0.1; 0.6	33.6 (6.7)	20.4; 46.7	11.9 (4.5)	4.7; 22.8	0.43
Social influence	29.4 (13.3)	3.2; 55.6	0.2 (0.1)	−0.1; 0.5	10.8 (6.0)	−1.0; 22.7	2.2 (2.1)	−0.4; 9.0	-
Self-efficacy	21.0 (12.4)	−3.5; 45.5	0.3 (0.1)	0.1; 0.6	34.7 (5.8)	23.3; 46.2	11.0 (5.3)	1.3; 22.7	0.35
Motivation	15.0 (11.7)	−8.0; 38.0	0.5 (0.2)	0.1; 0.9	31.3 (3.6)	24.1; 38.5	15.9 (6.6)	3.4; 29.1	0.51
Action control	11.4 (11.8)	−11.8; 34.6	0.4 (0.2)	0.2; 0.7	43.0 (5.2)	32.7; 53.3	19.0 (6.9)	6.3; 33.8	0.63
Dietary skills	28.2 (13.5)	1.6; 54.8	0.3 (0.1)	0.1; 0.5	15.3 (8.4)	−1.3; 31.9	3.9 (2.7)	0.3; 11.5	0.12
Psychological profile	11.1 (12.2)	−13.0; 35.2	2.5 (0.8)	1.0; 4.1	7.0 (1.0)	5.0; 9.0	17.7 (5.8)	6.7; 29.7	0.62
T0–T2 Fiber intake from bread (%)	X -- > Y (c path) ^{a, h}
	B(SE)		95%-CI
Crude analysis	0.3 (0.2)		0.0; 0.6
	X -- > Y (c’ path) direct ^b,h		X -- > M (a path) ^c,h		M -- > Y (b path) ^d,h		*Indirect effect (ab)** ^e,g		Proportion mediated ^f
	B (SE)	95%-CI	B (SE)	95%-CI	B (SE)		B (SE)	95%-CI	B (SE)
Intention	0.3 (0.2)	0.0; 0.6	0.4 (0.2)	−0.1; 0.8	0.0 (0.0)	−0.1; 0.1	0.0 (0.0)	−0.1; 0.0	-
Attitude	0.3 (0.2)	0.0; 0.6	0.0 (0.2)	−0.3; 0.3	0.1 (0.1)	−0.1; 0.2	0.0 (0.0)	0.0; 0.0	-
Social influence	0.3 (0.2)	0.0; 0.6	0.1 (0.2)	−0.2; 0.4	−0.1 (0.1)	−0.2; 0.1	0.0 (0.0)	−0.1; 0.0	-
Self-efficacy	0.3 (0.2)	0.0; 0.6	0.1 (0.2)	−0.2; 0.4	0.0 (0.1)	−0.1; 0.2	0.0 (0.0)	0.0; 0.0	-
Motivation	0.3 (0.2)	0.0; 0.6	0.0 (0.2)	−0.3; 0.4	−0.1 (0.1)	−0.2; 0.0	0.0 (0.0)	−0.1; 0.0	-
Action control	0.3 (0.2)	0.0; 0.6	0.2 (0.1)	−0.1; 0.4	0.1 (0.1)	0.0; 0.3	0.0 (0.0)	0.0; 0.1	-
Dietary skills	0.3 (0.2)	0.0; 0.6	0.3 (0.1)	0.1; 0.5	0.1 (0.1)	−0.1; 0.3	0.0 (0.0)	0.0; 0.1	-
Psychological profile	0.3 (0.2)	0.0; 0.6	0.9 (0.8)	−0.6; 2.4	0.0 (0.0)	0.0; 0.0	0.0 (0.03)	0.0; 0.1	-
T0–T2 Fat intake from bread spread (%)	X -- > Y (c path) ^a,h
	B(SE)		95%-CI
Crude analysis	−2.6 (0.8)		−4.2; −1.1
	X -- > Y (c’ path) direct ^b,h		X -- > M (a path) ^c,h		M -- > Y (b path) ^d,h		*Indirect effect (ab)** ^e,g		Proportion mediated ^f
	B (SE)	95%-CI	B (SE)	95%-CI	B (SE)	95%-CI	B (SE)	95%-CI ^g	(ab)/c*
Intention	−2.4 (0.8)	−4.0; −0.9	0.3 (0.2)	0.0; 0.7	−0.6 (0.3)	−1.2; 0.0	−0.2 (0.1)	−0.6; 0.0	-
Attitude	−2.6 (0.8)	−4.1; −1.1	0.1 (0.1)	−0.1; 0.4	−0.8 (0.4)	−1.6; 0.0	−0.1 (0.1)	−0.5; 0.1	-
Social influence	−2.6 (0.8)	−4.1; −1.0	0.4 (0.2)	0.1; 0.7	−0.5 (0.3)	−1.2; 0.2	−0.2 (0.1)	−0.6; 0.0	-
Self-efficacy	−2.5 (0.8)	−4.0; −1.0	0.1 (0.1)	−0.2; 0.4	−1.0 (0.4)	−1.7; −0.2	−0.1 (0.2)	−0.5; 0.2	-
Motivation	−2.5 (0.8)	−4.0; −1.0	0.2 (0.2)	−0.2; 0.5	−0.9 (0.3)	−1.5; −0.3	−0.2 (0.2)	−0.7; 0.1	-
Action control	−2.2 (0.8)	−3.7; −0.7	0.3 (0.1)	0.1; 0.6	−1.2 (0.4)	−1.9; −0.5	−0.4 (0.2)	−1.0; −0.1	0.15
Dietary skills	−2.5 (0.8)	−4.0; −1.0	0.3 (0.1)	0.1; 0.5	−0.2 (0.5)	−1.2; 0.8	−0.1 (0.2)	−0.5; 0.2	-
Psychological profile	−2.2 (0.8)	−3.7; −0.7	1.7 (0.7)	0.3; 3.1	−0.2 (0.1)	−0.4; −0.1	−0.4 (0.2)	−1.0; −0.1	0.15

^aC path (total effect): the association between intervention and dietary behaviors (fruit intake, fiber intake from bread, fat intake from bread spread). All analyses are adjusted for baseline value, sex, and recruitment phase
^bC’ path (direct effect): the association between intervention and dietary behaviors, additionally adjusted for mediator (behavioral determinants)
^cA path: association between intervention and behavioral determinant
^dB path: association between behavioral determinant and dietary behavior
^eIndirect effect (a*b): the indirect effect of the intervention on dietary behavior through behavioral determinant
^fProportion effect mediated ((a*b)/c): the proportion of the total effect that was mediated through behavioral determinant
^gStandard error and confidence interval for indirect effects were calculated with bootstrapping (5000 samples)
^hAll analyses used linear regression models

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