Psychometric Validation of Four-Item Exercise Identity and Healthy-Eater Identity Scales and Applications in Weight Loss Maintenance

Ann E Caldwell; Kimberly R. More; Tsz Kiu Chui; R. Drew Sayer

doi:10.1186/s12966-024-01573-y

Psychometric Validation of Four-Item Exercise Identity and Healthy-Eater Identity Scales and Applications in Weight Loss Maintenance

Ann E Caldwell, Kimberly R. More, Tsz Kiu Chui, R. Drew Sayer

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Abstract

Background: Identifying as someone who engages in health promoting behaviors like healthy eating and exercising may be associated with sustained engagement in those behaviors, but reliable and valid instruments are needed to improve the rigor of this research. Two studies were conducted to (1) examine the psychometric properties of a four-item exerciser identity measure (4-EI) and an adapted healthy-eater identity measure (4-HEI) and (2) examine differences in identity strengths across categories of weight loss success. Methods: Data from 1,709 community dwelling adults in the International Weight Control Registry (IWCR) were used. A random half of the sample was used to assess the proposed unidimensional factor structure of the 4-EI and 4-HEI and examine convergent and discriminant validity using Spearman rank-order correlations. One-way ANOVA was used in the other random half of the sample to compare 4-EI and 4-HEI scores (-3 to + 3) across three self-defined weight loss categories (‘Successful’, ‘Regain’, and ‘Unsuccessful’) and those maintaining ≥ 5% weight loss for > 1 year vs. not. Results: Results support the unidimensional factor structure with all four items (eigenvalue scores > 2.89) as well as convergent and discriminant validity for both measures. Exercise identity was strongly correlated with self-reported physical activity (r (735) = 0.52, p <.001) and measures of autonomous motivation. Healthy eating identity was moderately correlated with cognitive restraint in eating (r (744) = 0.42, p <.001) and other measures predictive of eating behavior. 4-EI and 4-HEI are stronger in Successful (4-EI: M = 0.90, SD = 1.77; 4-HEI: M = 1.56 SD = 1.37) vs. Regain (4-EI: M=-0.18, SD = 1.68; 4-HEI: M =.57, SD = 1.48) and Unsuccessful (4-EI:M=-0.28, SD = 1.62; 4-HEI: M = 0.51, SD = 1.33) and those maintaining ≥ 5% weight loss (4-EI:M = 0.47, SD = 1.78; 4-HEI: M = 1.13, SD = 1.49) vs. not (4-EI:M=-0.27, SD = 1.66; 4-HEI: M = 0.53, SD = 1.47), p’s < 0.001. Conclusions: The 4-EI and 4-HEI have acceptable psychometric properties and can advance understanding of the role of identity in exercise and dietary behaviors and weight loss maintenance. Trial registration: The parent observational study, International Weight Control Registry (IWCR), for these sub-studies is registered in ClinicalTrials.gov (NCT04907396).

Original language	English
Article number	21
Journal	International Journal of Behavioral Nutrition and Physical Activity
Volume	21
Issue number	1
Early online date	23 Feb 2024
DOIs	https://doi.org/10.1186/s12966-024-01573-y
Publication status	Published - 23 Feb 2024

Data Availability Statement

The datasets analyzed during the current study available from the corresponding author on reasonable request.

Funding

We would like to thank the IWCR co-founders Drs. Jim Hill and Susan Roberts, the large team of IWCR investigators and administrative staff, particularly those responsible for the database development and management, James Friedman, and Chia-Ying Chiu. The IWCR was established with grant funding from the National Institutes of Health (NIH) awarded to the Nutrition Obesity Research Center (NORC) at the University of Alabama Birmingham (P30DK056336-19, PI: James O. Hill), a grant from the United States Department of Agriculture awarded to Tufts University (USDA/ARS project number 8050-51000-105-00D), a grant from the NIH awarded to the University of Colorado NORC (2P30DK048520-26), and a small, 1-year unrestricted gift to help establish the IWR was received in 2018 from Gelesis, Inc. AC acknowledges funding from the NIH K01HL143039 for support while this study was conducted and manuscript was prepared. Funders did not play a role in the design of the study, data collection, analysis, or interpretation of the data and writing the manuscript.

Funders	Funder number
IWCR
National Institutes of Health
U.S. Department of Agriculture
Agricultural Research Service	8050-51000-105-00D
Tufts University
University of Alabama at Birmingham	P30DK056336-19
University of Colorado	K01HL143039, 2P30DK048520-26
Nutrition Obesity Research Center, University of North Carolina

Keywords

Exercise
Health promotion
Healthy eating
Identity
Weight loss maintenance

ASJC Scopus subject areas

Nutrition and Dietetics
Physical Therapy, Sports Therapy and Rehabilitation
Medicine (miscellaneous)

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Cite this

@article{a0e17430f03b45d1a86706caab7e56e5,

title = "Psychometric Validation of Four-Item Exercise Identity and Healthy-Eater Identity Scales and Applications in Weight Loss Maintenance",

abstract = "Background: Identifying as someone who engages in health promoting behaviors like healthy eating and exercising may be associated with sustained engagement in those behaviors, but reliable and valid instruments are needed to improve the rigor of this research. Two studies were conducted to (1) examine the psychometric properties of a four-item exerciser identity measure (4-EI) and an adapted healthy-eater identity measure (4-HEI) and (2) examine differences in identity strengths across categories of weight loss success. Methods: Data from 1,709 community dwelling adults in the International Weight Control Registry (IWCR) were used. A random half of the sample was used to assess the proposed unidimensional factor structure of the 4-EI and 4-HEI and examine convergent and discriminant validity using Spearman rank-order correlations. One-way ANOVA was used in the other random half of the sample to compare 4-EI and 4-HEI scores (-3 to + 3) across three self-defined weight loss categories ({\textquoteleft}Successful{\textquoteright}, {\textquoteleft}Regain{\textquoteright}, and {\textquoteleft}Unsuccessful{\textquoteright}) and those maintaining ≥ 5% weight loss for > 1 year vs. not. Results: Results support the unidimensional factor structure with all four items (eigenvalue scores > 2.89) as well as convergent and discriminant validity for both measures. Exercise identity was strongly correlated with self-reported physical activity (r (735) = 0.52, p <.001) and measures of autonomous motivation. Healthy eating identity was moderately correlated with cognitive restraint in eating (r (744) = 0.42, p <.001) and other measures predictive of eating behavior. 4-EI and 4-HEI are stronger in Successful (4-EI: M = 0.90, SD = 1.77; 4-HEI: M = 1.56 SD = 1.37) vs. Regain (4-EI: M=-0.18, SD = 1.68; 4-HEI: M =.57, SD = 1.48) and Unsuccessful (4-EI:M=-0.28, SD = 1.62; 4-HEI: M = 0.51, SD = 1.33) and those maintaining ≥ 5% weight loss (4-EI:M = 0.47, SD = 1.78; 4-HEI: M = 1.13, SD = 1.49) vs. not (4-EI:M=-0.27, SD = 1.66; 4-HEI: M = 0.53, SD = 1.47), p{\textquoteright}s < 0.001. Conclusions: The 4-EI and 4-HEI have acceptable psychometric properties and can advance understanding of the role of identity in exercise and dietary behaviors and weight loss maintenance. Trial registration: The parent observational study, International Weight Control Registry (IWCR), for these sub-studies is registered in ClinicalTrials.gov (NCT04907396).",

keywords = "Exercise, Health promotion, Healthy eating, Identity, Weight loss maintenance",

author = "Caldwell, {Ann E} and More, {Kimberly R.} and Chui, {Tsz Kiu} and Sayer, {R. Drew}",

year = "2024",

month = feb,

day = "23",

doi = "10.1186/s12966-024-01573-y",

language = "English",

volume = "21",

journal = "International Journal of Behavioral Nutrition and Physical Activity",

issn = "1479-5868",

publisher = "BioMed Central",

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}

TY - JOUR

T1 - Psychometric Validation of Four-Item Exercise Identity and Healthy-Eater Identity Scales and Applications in Weight Loss Maintenance

AU - Caldwell, Ann E

AU - More, Kimberly R.

AU - Chui, Tsz Kiu

AU - Sayer, R. Drew

PY - 2024/2/23

Y1 - 2024/2/23

N2 - Background: Identifying as someone who engages in health promoting behaviors like healthy eating and exercising may be associated with sustained engagement in those behaviors, but reliable and valid instruments are needed to improve the rigor of this research. Two studies were conducted to (1) examine the psychometric properties of a four-item exerciser identity measure (4-EI) and an adapted healthy-eater identity measure (4-HEI) and (2) examine differences in identity strengths across categories of weight loss success. Methods: Data from 1,709 community dwelling adults in the International Weight Control Registry (IWCR) were used. A random half of the sample was used to assess the proposed unidimensional factor structure of the 4-EI and 4-HEI and examine convergent and discriminant validity using Spearman rank-order correlations. One-way ANOVA was used in the other random half of the sample to compare 4-EI and 4-HEI scores (-3 to + 3) across three self-defined weight loss categories (‘Successful’, ‘Regain’, and ‘Unsuccessful’) and those maintaining ≥ 5% weight loss for > 1 year vs. not. Results: Results support the unidimensional factor structure with all four items (eigenvalue scores > 2.89) as well as convergent and discriminant validity for both measures. Exercise identity was strongly correlated with self-reported physical activity (r (735) = 0.52, p <.001) and measures of autonomous motivation. Healthy eating identity was moderately correlated with cognitive restraint in eating (r (744) = 0.42, p <.001) and other measures predictive of eating behavior. 4-EI and 4-HEI are stronger in Successful (4-EI: M = 0.90, SD = 1.77; 4-HEI: M = 1.56 SD = 1.37) vs. Regain (4-EI: M=-0.18, SD = 1.68; 4-HEI: M =.57, SD = 1.48) and Unsuccessful (4-EI:M=-0.28, SD = 1.62; 4-HEI: M = 0.51, SD = 1.33) and those maintaining ≥ 5% weight loss (4-EI:M = 0.47, SD = 1.78; 4-HEI: M = 1.13, SD = 1.49) vs. not (4-EI:M=-0.27, SD = 1.66; 4-HEI: M = 0.53, SD = 1.47), p’s < 0.001. Conclusions: The 4-EI and 4-HEI have acceptable psychometric properties and can advance understanding of the role of identity in exercise and dietary behaviors and weight loss maintenance. Trial registration: The parent observational study, International Weight Control Registry (IWCR), for these sub-studies is registered in ClinicalTrials.gov (NCT04907396).

AB - Background: Identifying as someone who engages in health promoting behaviors like healthy eating and exercising may be associated with sustained engagement in those behaviors, but reliable and valid instruments are needed to improve the rigor of this research. Two studies were conducted to (1) examine the psychometric properties of a four-item exerciser identity measure (4-EI) and an adapted healthy-eater identity measure (4-HEI) and (2) examine differences in identity strengths across categories of weight loss success. Methods: Data from 1,709 community dwelling adults in the International Weight Control Registry (IWCR) were used. A random half of the sample was used to assess the proposed unidimensional factor structure of the 4-EI and 4-HEI and examine convergent and discriminant validity using Spearman rank-order correlations. One-way ANOVA was used in the other random half of the sample to compare 4-EI and 4-HEI scores (-3 to + 3) across three self-defined weight loss categories (‘Successful’, ‘Regain’, and ‘Unsuccessful’) and those maintaining ≥ 5% weight loss for > 1 year vs. not. Results: Results support the unidimensional factor structure with all four items (eigenvalue scores > 2.89) as well as convergent and discriminant validity for both measures. Exercise identity was strongly correlated with self-reported physical activity (r (735) = 0.52, p <.001) and measures of autonomous motivation. Healthy eating identity was moderately correlated with cognitive restraint in eating (r (744) = 0.42, p <.001) and other measures predictive of eating behavior. 4-EI and 4-HEI are stronger in Successful (4-EI: M = 0.90, SD = 1.77; 4-HEI: M = 1.56 SD = 1.37) vs. Regain (4-EI: M=-0.18, SD = 1.68; 4-HEI: M =.57, SD = 1.48) and Unsuccessful (4-EI:M=-0.28, SD = 1.62; 4-HEI: M = 0.51, SD = 1.33) and those maintaining ≥ 5% weight loss (4-EI:M = 0.47, SD = 1.78; 4-HEI: M = 1.13, SD = 1.49) vs. not (4-EI:M=-0.27, SD = 1.66; 4-HEI: M = 0.53, SD = 1.47), p’s < 0.001. Conclusions: The 4-EI and 4-HEI have acceptable psychometric properties and can advance understanding of the role of identity in exercise and dietary behaviors and weight loss maintenance. Trial registration: The parent observational study, International Weight Control Registry (IWCR), for these sub-studies is registered in ClinicalTrials.gov (NCT04907396).

KW - Exercise

KW - Health promotion

KW - Healthy eating

KW - Identity

KW - Weight loss maintenance

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U2 - 10.1186/s12966-024-01573-y

DO - 10.1186/s12966-024-01573-y

M3 - Article

SN - 1479-5868

VL - 21

JO - International Journal of Behavioral Nutrition and Physical Activity

JF - International Journal of Behavioral Nutrition and Physical Activity

IS - 1

M1 - 21

ER -

Psychometric Validation of Four-Item Exercise Identity and Healthy-Eater Identity Scales and Applications in Weight Loss Maintenance

Abstract

Data Availability Statement

Funding

Keywords

ASJC Scopus subject areas

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