Factors Associated with Motivational Stages of Change for Weight Management among Older Informal Workers in Southern Thailand
Keywords:
Stage of change, Overweight, Obesity, Older workers, Informal workersAbstract
Stages of change represent individual motivation to implement lifestyle changes and contribute to the development of more effective intervention strategies. This cross-sectional study aimed to assess the stages and processes of change for weight management and to determine factors associated with being in active stages of change for the management of weight by dieting and/or exercising among older informal workers. The study collected information regarding sociodemographic factors, lifestyle, anthropometrics, health characteristics, and the stages and processes of change for weight management from 233 informal workers aged 45-70 years. Binary logistic regression analysis was used to identify the factors associated with being in active stages of change. Of the total sample, 67.0% were overweight/obese (body mass index [BMI] ≥23 kg/m2), and 84.1% had central obesity (waist-to-height ratio [WHtR] ≥0.5). The proportions of the participants assessed as being in inactive and active stages of change were 49.8% and 50.2%, respectively. Processes of change scores were significantly higher among individuals in active stages of change, indicating that participants in active stages of change were using more processes to manage their weight than participants in inactive stages. After adjusting for age and sex, the odds of having central obesity (AOR=3.29; 95% CI: 1.42-7.63) and the presence of diabetes (AOR=2.54; 95% CI: 1.15-5.62) were positively associated with being in active stages of change, while an inverse association was observed for smoking (AOR=0.24; 95% CI: 0.09-0.67). These findings can assist in tailoring weight management interventions and targeting subjects for participation in such interventions.
References
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31. Daniel WW, Cross CL. Biostatistics: a foundation for analysis in the health sciences. 10th ed. Hoboken: Wiley; 2013. pp. 191-3.
32. Jitapunkul S, Benchajareonwong S. Long-bone measurement for height estimation in Thai adult subjects. J Med Assoc Thai 1998;81:442-8.
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35. R Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2018.
36. Ferrer R, Klein WM. Risk perceptions and health behavior. Curr Opin Psychol 2015;5:85-9. DOI: 10.1016/j.copsyc.2015.03.012
37. Rios MA, Nery AA. Working and health conditions reported by informal commerce workers. Texto Contexto Enferm 2015;24:390-8. DOI: 10.1590/0104-07072015000052014
38. Slovic P. Perception of risk. Science 1987;236(4799):280-5. DOI: 10.1126/science.3563507
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41. Kaczynski AT, Manske SR, Mannell RC, Grewal K. Smoking and physical activity: a systematic review. Am J Health Behav 2008;32(1):93-110. DOI: 10.5555/ajhb.2008.32.1.93
42. Chiolero A, Wietlisbach V, Ruffieux C, Paccaud F, Cornuz J. Clustering of risk behaviors with cigarette consumption: A population-based survey. Prev Med 2006;42:348-53. DOI: 10.1016/j.ypmed.2006.01.011
43. Sutan R. Assessing Stages of Readiness to Lose Weight among Overweight and Obese Adolescents using Trans-Theoretical Model. Obes Control Ther 2017;4:1-6. DOI: 10.15226/2374-8354/4/1/00130
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45. Buakhao J. Chronic Care Model: CCM. Nonthaburi: Department of Medical Services, Ministry of Public Health; 2016.
2. Hanklang S, Ratanasiripong P, Naksranoi S, Sathira-Anant S, Patanasri K. Quality of life and mental health among Thai older workers in community enterprises. J Health Res 2018;32:237-50. DOI: 10.1108/JHR-05-2018-025
3. National Statistical Office of Thailand. The informal employment survey. Bangkok: Statistical Forecasting Division, National Statistical Office; 2012. p. 28.
4. National Statistical Office of Thailand. The informal employment survey. Bangkok: Statistical Forecasting Division, National Statistical Office; 2018. p. 42.
5. Handayani SW. Social protection for informal workers in Asia. Mandaluyong City, Philippines: Asian Development Bank; 2016.
6. Kongtip P, Nankongnab N, Chaikittiporn C, Laohaudomchok W, Woskie S, Slatin C. Informal Workers in Thailand: Occupational Health and Social Security Disparities. New Solut 2015;25:189-211. DOI: 10.1177/1048291115586036
7. Nobrega S, Champagne N, Abreu M, Goldstein-Gelb M, Montano M, Lopez I, et al. Obesity/Overweight and the Role of Working Conditions: A Qualitative, Participatory Investigation. Health Promot Pract 2016;17:127-36. DOI: 10.1177/1524839915602439
8. Aekplakorn W. The Report of the 4th Thai National Health Examination Survey in 2008-2009. Nonthaburi, Thailand: National Health Examination Survey Office, Health System Research Institute; 2009. pp. 125-34.
9. Aekplakorn W. The Report of the 5th Thai National Health Examination Survey in 2014. Nonthaburi, Thailand: National Health Examination Survey Office, Health System Research Institute; 2014. pp. 127-34.
10. Thaikruea L, Thammasarot J. Prevalence of normal weight central obesity among Thai healthcare providers and their association with CVD risk: a cross-sectional study. Sci Rep. 2016;6:37100. DOI: 10.1038/srep37100
11. Leggio M, Lombardi M, Caldarone E, Severi P, D'Emidio S, Armeni M, et al. The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins. Hypertens Res 2017;40:947-63. DOI: 10.1038/hr.2017.75
12. Al-Goblan AS, Al-Alfi MA, Khan MZ. Mechanism linking diabetes mellitus and obesity. Diabetes Metab Syndr Obes 2014;7:587-91. DOI: 10.2147/DMSO.S67400
13. Stone TW, McPherson M, Gail Darlington L. Obesity and Cancer: Existing and New Hypotheses for a Causal Connection. EBioMedicine 2018;30:14-28. DOI: 10.1016/j.ebiom.2018.02.022
14. Jordan G, Nowrouzi-Kia B, Gohar B, Nowrouzi B. Obesity as a Possible Risk Factor for Lost-time Injury in Registered Nurses: A Literature Review. Safety and Health at Work 2015;6:1-8. DOI: 10.1016/j.shaw.2014.12.006
15. Gill LE, Bartels SJ, Batsis JA. Weight Management in Older Adults. Curr Obes Rep 2015;4:379-88. DOI: 10.1007/s13679-015-0161-z
16. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 1983;51:390-5. DOI: 10.1037//0022-006x.51.3.390
17. DiClemente CC, Prochaska JO. Self-change and therapy change of smoking behavior: a comparison of processes of change in cessation and maintenance. Addict Behav 1982;7:133-42. DOI: 10.1016/0306-4603(82)90038-7
18. Lecube A, Sanchez E, Andres A, Saldana C, Morales MJ, Calanas A, et al. Assessing Motivational Stages and Processes of Change for Weight Management Around Bariatric Surgery: a Multicenter Study. Obes Surg 2019;29:3348-56. DOI: 10.1007/s11695-019-04001-4
19. Feldman SS, Cochran RA, Mehta T. Predictors of Weight Change: Findings From an Employee Wellness Program. Front Endocrinol 2019;10:77. DOI: 10.3389/fendo.2019.00077
20. Street TD, Thomas DL. Beating Obesity: Factors Associated with Interest in Workplace Weight Management Assistance in the Mining Industry. Safety and Health at Work 2017;8(1):89-93. DOI: 10.1016/j.shaw.2016.05.005
21. Andrés A, Saldaña C, Beeken RJ. Assessment of Processes of Change for Weight Management in a UK Sample. Obes Facts 2015;8:43-53. DOI: 10.1159/000373900
22. Jacobs EJ, Newton CC, Wang Y, Patel AV, McCullough ML, Campbell PT, et al. Waist circumference and all-cause mortality in a large US cohort. Arch Intern Med 2010;170:1293-301. DOI: 10.1001/archinternmed.2010.201
23. Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Applications to addictive behaviors. Am Psychol 1992;47:1102-14. DOI: 10.1037//0003-066x.47.9.1102
24. Karintrakul S, Angkatavanich J. A randomized controlled trial of an individualized nutrition counseling program matched with a transtheoretical model for overweight and obese females in Thailand. Nutr Res Pract 2017;11:319-26. DOI: 10.4162/nrp.2017.11.4.319
25. Barbieri P, Palma RFM, Nishimura RY, Damião R, Bevilacqua M, Massimino F, et al. Factors associated with stages of change for red meat and vegetable intake by Japanese-Brazilians. Cad Saude Publica 2009;25:1466-74. DOI: 10.1590/s0102-311x2009000700004
26. Wee CC, Davis RB, Phillips RS. Stage of readiness to control weight and adopt weight control behaviors in primary care. J Gen Intern Med 2005;20:410-5. DOI: 10.1111/j.1525-1497.2005.0074.x
27. Ghannadiasl F, Mahdavi R, AsghariJafarabadi M. Assessing Readiness to Lose Weight among Obese Women Attending the Nutrition Clinic. Health Promot Perspect 2014;4:27-34. DOI: 10.5681/hpp.2014.004
28. Helitzer DL, Peterson AB, Sanders M, Thompson J. Relationship of stages of change to attendance in a diabetes prevention program. Am J Health Promot 2007;21:517-20. DOI: 10.4278/0890-1171-21.6.517
29. Provincial Statistics Office of Nakhon Si Thammarat province. The Labour Force Survey: 2017-2019 Provincial level. Nakhon Si Thammarat province: National Statistical Office; 2019 [cited 24 Jan 2020]; Available from: https://nksitham.nso.go.th.
30. Official Statistics Registration Systems. Population and Housing Statistics 2017: Population in domestic households by gender, age, district. Nonthaburi: National Statistical Office; 2017 [cited May 2017]; Available from: https://stat.dopa.go.th/stat/statnew/upstat_age.php.
31. Daniel WW, Cross CL. Biostatistics: a foundation for analysis in the health sciences. 10th ed. Hoboken: Wiley; 2013. pp. 191-3.
32. Jitapunkul S, Benchajareonwong S. Long-bone measurement for height estimation in Thai adult subjects. J Med Assoc Thai 1998;81:442-8.
33. World Health Organization, Regional Office for the Western Pacific (WPRO), International Association for the Study of Obesity, International Obesity Task Force. The Asia-Pacific perspective: Redefining obesity and its treatment. Sydney: Health Communications Australia; 2000.
34. Bosomworth NJ. Normal-weight central obesity: Unique hazard of the toxic waist. Can Fam Physician. 2019;65(6):399-408.
35. R Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2018.
36. Ferrer R, Klein WM. Risk perceptions and health behavior. Curr Opin Psychol 2015;5:85-9. DOI: 10.1016/j.copsyc.2015.03.012
37. Rios MA, Nery AA. Working and health conditions reported by informal commerce workers. Texto Contexto Enferm 2015;24:390-8. DOI: 10.1590/0104-07072015000052014
38. Slovic P. Perception of risk. Science 1987;236(4799):280-5. DOI: 10.1126/science.3563507
39. Batsis JA, Zagaria AB. Addressing Obesity in Aging Patients. Med Clin North Am 2018;102:65-85. DOI: 10.1016/j.mcna.2017.08.007
40. Ashwell M, Hsieh SD. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr 2005;56:303-7. DOI: 10.1080/09637480500195066
41. Kaczynski AT, Manske SR, Mannell RC, Grewal K. Smoking and physical activity: a systematic review. Am J Health Behav 2008;32(1):93-110. DOI: 10.5555/ajhb.2008.32.1.93
42. Chiolero A, Wietlisbach V, Ruffieux C, Paccaud F, Cornuz J. Clustering of risk behaviors with cigarette consumption: A population-based survey. Prev Med 2006;42:348-53. DOI: 10.1016/j.ypmed.2006.01.011
43. Sutan R. Assessing Stages of Readiness to Lose Weight among Overweight and Obese Adolescents using Trans-Theoretical Model. Obes Control Ther 2017;4:1-6. DOI: 10.15226/2374-8354/4/1/00130
44. Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. Improving chronic illness care: translating evidence into action. Health Aff (Millwood). 2001;20:64-78. DOI: 10.1377/hlthaff.20.6.64
45. Buakhao J. Chronic Care Model: CCM. Nonthaburi: Department of Medical Services, Ministry of Public Health; 2016.
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