Abstract
This study examined whether self-efficacy was associated with lipid lowering and dietary change among men undergoing dietary counseling to lower cholesterol levels. Twenty-five hyperlipidemic men (total cholesterol ≧220 mg/dL) participated in four weeks of dietary instruction. Plasma lipids were measured prior to treatment, at posttreatment, and at three- and twelvemonth follow-up. Dietary intake and self-efficacy as measured by the revised Eating Self-Efficacy Scale (ESES-R) were assessed at pretreatment, posttreatment, and three-month follow-up. Pre-treatment to posttreatment increases in self-efficacy in situations characterized by negative affect were related to extent of lipid lowering and dietary change. Although subjects showed significant reductions in cholesterol levels following treatment, by one year, lipid levels had returned to pretreatment values. Factors related to long-term maintenance of dietary change and lipid lowering among hyperlipidemics merit further research.
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Thorn TJ, Kannel WB, Feinleib M: Factors in the decline of coronary heart disease mortality. In Connor WE, Bristow JD (eds),Coronary Heart Disease: Prevention, Complications, and Treatment. Philadelphia, PA: J. B. Lippincott Company, 1985, 5–20.
Goldman L, Cook EF: The decline in ischemic heart disease mortality rates: An analysis of the comparative effects of medical interventions and changes in lifestyle.Annals of Internal Medicine. 1984,707:825–836.
Sprafka JM, Burke GL, Folsom AR, Luepker RV, Blackburn H: Continued decline in cardiovascular disease risk factors: Results of the Minnesota Heart Survey, 1980–1982 and 1985–1987.American ournal of Epidemiology. 1990,132:489–500.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II).Journal of the American Medical Association. 1993,269:3015–3023.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. The Expert Panel.Archives of Internal Medicine. 1988,745:36–69.
Grundy SM: Dietary therapy for different forms of hyperlipoproteinemia.Circulation. 1987,76:523–528.
Kris-Etherton PM, Krummel D, Russell ME, et al: The effect of diet on plasma lipids, lipoproteins, and coronary heart disease.Journalof the American Dietetic Association. 1988,88:1373–1400.
Carmody TP, Matarazzo JD, Istvan JA: Promoting adherence to heart-healthy diets: A review of the literature.Journal of Compliance in Health Care. 1987,2:105–124.
Glanz K: Compliance with dietary regimens: Its magnitude, measurement, and determinants.Preventive Medicine. 1980,9:787–804.
Henkin Y, Garber DW, Osterlund LC, Darnell BE: Saturated fats, cholesterol, and dietary compliance.Archives of Internal Medicine. 1992,152:1167–1174.
McCann BS, RetzlafT BM, Dowdy AA, Walden CE, Knopp RH: Promoting adherence to low-fat, low-cholesterol diets: Review and recommendations.Journal of the American Dietetic Association. 1990,90:1408–1417.
Rand CS: Measuring adherence with therapy for chronic diseases: Implications for the treatment of heterozygous familial hypercholesterolemia.American Journal of Cardiology. 1993,72:68D-74D.
Bandura A: Self-efficacy mechanisms in physiological activation and health-promoting behavior. In Madden J, Matthysse S, Barchas J (eds),Adaptation, Learning, and Affect. New York: Raven Press, 1994.
Bandura A: Self-efficacy: Toward a unifying theory of behavioral change.Psychological Review. 1977,84:191–215.
O’Leary A: Self-efficacy and health.Behaviour Research and Therapy. 1985,23:437–451.
Strecher VJ, DeVellis BM, Becker MH, Rosenstock IM: The role of self-efficacy in achieving health behavior change.Health Education Quarterly. 1986,75:73–91.
Bernier M, Avard J: Self-efficacy, outcome, and attrition in a weight-reduction program.Cognitive Therapy and Research. 1986,70: 319–338.
Edell BH, Edington S, Herd B, O’Brien RM, Witkin G: Self-efficacy and self-motivation as predictors of weight loss.Addictive Behaviors. 1987,72:63–66.
Forster JL, Jeffery RW: Gender differences related to weight history, eating patterns, efficacy expectations, self-esteem, and weight loss among participants in a weight reduction program.Addictive Behaviors. 1986,77:141–147.
Glynn SM, Ruderman AJ: The development and validation of an eating self-efficacy scale.Cognitive Therapy and Research. 1986,70:403–420.
Jeffery RW, Bjomson-Benson WM, Rosenthal BS, et al: Correlates of weight loss and its maintenance over two years of follow-up among middle-aged men.Preventive Medicine. 1984,13:155–168.
Weinberg RS, Hughes HH, Critelli JW, England R, Jackson A: Effects of preexisting and manipulated self-efficacy on weight loss in a self-control program.Journal of Research in Personality. 1984,75:352–358.
Mitchell C, Stuart RB: Effect of self-efficacy on dropout from obesity treatment.Journal of Consulting and Clinical Psychology. 1984,52:1100–1101.
Friedewald WT, Levy RI, Fredrickson DS: Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.Clinical Chemistry. 1972,75:499–502.
Walden CE, McCann BS, Retzlaf TB, et al: Alternative fat-restricted diets for hypercholesterolemia and combined hyperlipidemia: Feasibility, design, subject recruitment, and baseline characteristics of the dietary alternatives study.Journal of the American College of Nutrition. 1991,70:429–442.
Keys A, Anderson JT, Grande F: Serum cholesterol response to changes in the diet. I. Iodine value of dietary fat versus 2S-P.Metabolism. 1965,14:747–758.
Keys A, Anderson JT, Grande F: Serum cholesterol response to changes in the diet. II. The effect of cholesterol in the diet.Metabolism. 1965,74:759–765.
Baer JS, Lichtenstein E: Classification and prediction of smoking relapse episodes: An exploration of individual differences.Journal of Consulting and Clinical Psychology. 1988,56:104–110.
Shiftman S: A cluster-analytic classification of smoking relapse episodes.Addictive Behaviors. 1986,11:295–307.
Rist F, Watzl H: Self-assessment of relapse risk and assertiveness in relation to treatment outcome of female alcoholics.Addictive Behaviors. 1983,5:121–127.
Sallis JF, Pinski RB, Grossman RM, Patterson TL, Nader PR: The development of self-efficacy scales for health-related diet and exercise behaviors.Health Education Research. 1988,3:283–292.
Sempos C, Fulwood R, Haines C, et al: The prevalence of high blood cholesterol levels among adults in the United States.Journal of the American Medical Association. 1989,262:45–52.
Schectman G, McKinney WP, Pleuss J, Hoffman RG: Dietary intake of Americans reporting adherence to a low-cholesterol diet (NHANES II).American Journal of Public Health. 1990,50:698–703.
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Merck, Sharp, and Dohme
Preparation of this manuscript was supported in part by a National Institutes of Health Biomedical Research Support Grant (RR 05432), and by National Institutes of Health Grants HL 28891 and DK 35816 (Clinical Nutrition Research Unit).
The authors are grateful to Dr. Susan Curry for her comments on an earlier draft of this paper, and wish to thank Ms. Cheryl Kaplan for her assistance.
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McCann, B.S., Bovbjerg, V.E., Brief, D.J. et al. Relationship of self-effecacy to cholesterol lowering and dietary change in hyperlipidemia. Ann Behav Med 17, 221–226 (1995). https://doi.org/10.1007/BF02903916
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DOI: https://doi.org/10.1007/BF02903916