Facilitators and barriers to behavior change in overweight and obesity management using the COM-B model

Vladimira Timkova; Daniela Minarikova; Lubomira Fabryova; Jana Buckova; Peter Minarik; Zuzana Katreniakova; Iveta Nagyova

doi:10.3389/fpsyg.2024.1280071

Facilitators and barriers to behavior change in overweight and obesity management using the COM-B model

Front Psychol. 2024 Feb 22:15:1280071. doi: 10.3389/fpsyg.2024.1280071. eCollection 2024.

Authors

Vladimira Timkova¹, Daniela Minarikova², Lubomira Fabryova^{3

4

5}, Jana Buckova¹, Peter Minarik^{3

4}, Zuzana Katreniakova¹, Iveta Nagyova¹

Affiliations

¹ Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef (PJ) Safarik University in Kosice, Kosice, Slovakia.
² Department of Organisation and Management of Pharmacy, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia.
³ Biomedical Research Centre of the Slovak Academy of Sciences, Bratislava, Slovakia.
⁴ Institute for Prevention and Intervention, St. Elisabeth University of Health and Social Work, Bratislava, Slovakia.
⁵ Faculty of Nursing and Medical Professional Studies, Slovak Health University, Bratislava, Slovakia.

Abstract

Introduction: Increasing overweight and obesity rates represent one of the global public health challenges. COM-B is a theoretical model used to identify areas to target to achieve behavior change. It identifies three factors that are needed for any behavior to occur: capability, opportunity, and motivation. We aimed to assess the potential facilitators and barriers to behavior change in weight management using the COM-B.

Methods: The study included 139 people with overweight and obesity (mean age 48.81 ± 14.49 years; 64.5% female; body mass index 32.64 ± 6.51 kg/m²; waist-to-height ratio 0.62 ± 0.10) from primary care settings. All participants completed the Brief Measure of Behavior Change (COM-B), the General Self-Efficacy Scale (GSE), the Rosenberg Self-esteem Scale (RSE), and the Overall Evaluation of Health (OEH). Multiple linear regression was performed to analyse the data.

Results: The associations between sociodemographic and clinical variables and COM-B domains attenuated or were no longer significant when psychological resources were added to the regression models. Self-efficacy was identified as a stronger facilitator of health behavior change (p < 0.001) when compared to self-esteem (p < 0.05). No associations between automatic motivation and psychological resources were identified, however. Automatic motivation was found to be associated with higher age, being in a relationship, and better health.

Discussion: Behavioral interventions for weight management should specifically target different components of COM-B. Self-efficacy and self-esteem may play a significant role in individual capabilities, opportunities, and reflective motivation and should be included in tailored public health interventions. Health programs targeting younger and single people, and people with chronic conditions may help to promote sustainable behavior change.

Keywords: COM-B; behavior change; obesity; overweight; weight management.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Scientific Grant Agency of the Ministry of Education, Science, Research, and Sport of the Slovak Republic under Grant no. VEGA 1/0748/22.