@Article{info:doi/10.2196/17967,
author="Chhabria, Karishma
and Ross, Kathryn M
and Sacco, Shane J
and Leahey, Tricia M",
title="The Assessment of Supportive Accountability in Adults Seeking Obesity Treatment: Psychometric Validation Study",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="28",
volume="22",
number="7",
pages="e17967",
keywords="supportive accountability; social support; SALLIS; factor analysis; obesity; weight loss; technology; mobile phone",
abstract="Background: Technology-mediated obesity treatments are commonly affected by poor long-term adherence. Supportive Accountability Theory suggests that the provision of social support and oversight toward goals may help to maintain adherence in technology-mediated treatments. However, no tool exists to measure the construct of supportive accountability. Objective: This study aimed to develop and psychometrically validate a supportive accountability measure (SAM) by examining its performance in technology-mediated obesity treatment. Methods: Secondary data analyses were conducted in 2 obesity treatment studies to validate the SAM (20 items). Study 1 examined reliability, criterion validity, and construct validity using an exploratory factor analysis in individuals seeking obesity treatment. Study 2 examined the construct validity of SAM in technology-mediated interventions involving different self-monitoring tools and varying amounts of phone-based interventionist support. Participants received traditional self-monitoring tools (standard, in-home self-monitoring scale [SC group]), newer, technology-based self-monitoring tools (TECH group), or these newer technology tools plus additional phone-based support (TECH+PHONE group). Given that the TECH+PHONE group involves more interventionist support, we hypothesized that this group would have greater supportive accountability than the other 2 arms. Results: In Study 1 (n=353), the SAM showed strong reliability (Cronbach $\alpha$=.92). A factor analysis revealed a 3-factor solution (representing Support for Healthy Eating Habits, Support for Exercise Habits, and Perceptions of Accountability) that explained 69{\%} of the variance. Convergent validity was established using items from the motivation for weight loss scale, specifically the social regulation subscale (r=0.33; P<.001) and social pressure for weight loss subscale (r=0.23; P<.001). In Study 2 (n=80), the TECH+PHONE group reported significantly higher SAM scores at 6 months compared with the SC and TECH groups (r2=0.45; P<.001). Higher SAM scores were associated with higher adherence to weight management behaviors, including higher scores on subscales representing healthy dietary choices, the use of self-monitoring strategies, and positive psychological coping with weight management challenges. The association between total SAM scores and percent weight change was in the expected direction but not statistically significant (r=−0.26; P=.06). Conclusions: The SAM has strong reliability and validity across the 2 studies. Future studies may consider using the SAM in technology-mediated weight loss treatment to better understand whether support and accountability are adequately represented and how supportive accountability impacts treatment adherence and outcomes. Trial Registration: ClinicalTrials.gov NCT01999244; https://clinicaltrials.gov/ct2/show/NCT01999244 ",
issn="1438-8871",
doi="10.2196/17967",
url="https://www.jmir.org/2020/7/e17967",
url="https://doi.org/10.2196/17967",
url="http://www.ncbi.nlm.nih.gov/pubmed/32720911"
}