Trial reportJournal of nutrition education and behavior2026
Mechanisms of Strong Hearts, Healthy Communities-2.0 Effects on Weight: A Mediation Analysis.
Trial report in Journal of nutrition education and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
12 authors.
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Abstract
objectiveTo evaluate potential mediators of weight loss in the Strong Hearts, Health Communities-2.0 (SHHC-2.0) trial.
designCommunity-randomized trial (intervention vs delayed intervention). Outcomes were evaluated at baseline and postintervention.
settingEleven rural, medically-underserved communities
participantsWomen (n = 182), mean age 57.2 years, 97.6% White, non-Hispanic.
interventionClasses delivered 2 times/wk for 24 weeks, targeting diet and physical activity behaviors. MAIN OUTCOMES MEASURES: Dependent variable: weight; mediators: diet and physical activity behaviors, and related psychosocial factors. ANALYSIS: Mixed linear regressions evaluated the effect of mediators on weight loss.
resultsSignificant mediators included dietary behaviors (Rapid Eating Assessment for Participants-Short; 31.8%; P = 0.03), healthy eating attitudes (23.0%; P = 0.03), and dietary cognitive restraint (29.8%; P = 0.01). Physical activity did not mediate weight loss; however, a worsening in attitudes toward exercise was a mediator of weight loss (22.6%; P = 0.01). Social support for diet and physical activity was unchanged in the intervention group and did not mediate weight loss effects. CONCLUSIONS AND IMPLICATIONS: Healthy eating attitudes and dietary cognitive restraint represent important targets for future behavioral interventions for weight loss. Hypothesized mediators found to be nonsignificant (i.e., social support) represent opportunities for future intervention optimization.
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