Mechanisms by Which the Fun for Wellness Intervention May Promote Subjective Well-Being in Adults with Obesity: a Reanalysis Using Baseline Target Moderation

Abstract

Fun For Wellness (FFW) is a self-efficacy theory-based online behavioral intervention that aims to promote growth in physical activity and well-being. The FFW conceptual model for the promotion of subjective well-being posits that FFW exerts both a positive direct effect, and a positive indirect effect through well-being self-efficacy, on subjective well-being. Subjective well-being is defined in FFW as an individual's satisfaction with their status in seven key domains of their life. Well-being self-efficacy is defined in FFW as the degree to which an individual perceives that they have the capability to attain a positive status in seven key domains of their life. The objective of this study was to use baseline target moderation to assess variation in the impact of FFW on subjective well-being dimensions in adults with obesity. Data (N = 667) from the Well-Being and Physical Activity Study (ClinicalTrials.gov, identifier: NCT03194854) were reanalyzed. There was evidence that well-being self-efficacy at baseline moderated the direct effect of FFW on well-being self-efficacy at 30 days post-baseline for the occupational and psychological dimensions. Both of these findings suggest a "compensatory" effect. Similarly, there was evidence that well-being self-efficacy at baseline moderated the indirect effect of FFW on subjective well-being at 60 days post-baseline through well-being self-efficacy at 30 days post-baseline for the occupational and psychological dimensions. Both of these findings suggest a "compensatory" effect. Finally, there was evidence that well-being self-efficacy at baseline moderated the direct effect of FFW on subjective well-being at 60 days post-baseline for the community, occupational, and physical dimensions. Each of these three findings suggests some version of a "rich-get-richer" effect. In summary, results provide both supportive and unsupportive (i.e., interpersonal, economic, and overall dimensions) evidence regarding variation in the impact of the FFW intervention and should impact the design of future FFW trials.

Keywords: Mediation; Self-efficacy theory; Well-being self-efficacy; e-Health; m-Health.

Figure 1. The Fun For Wellness Conceptual Model for the Promotion of Multidimensional Subjective Well-Being Under a Baseline Target Moderation (BTM) Approach

Note. A dashed line indicates a path not estimated in Myers, Prilleltensky, et al., 2020. The expression - Baseline Target Moderated Mediation (BTMM) - may be used when focusing on the product: a path x b path, conditioned on the targeted mediator at baseline.

Figure 2. Direct Effect of the Fun For Wellness (FFW) Intervention on Occupational and Psychological Well-Being Self-Efficacy (WBSE) at 30-Days Post-Baseline Across the Range of Observed Values of Occupational and Psychological WBSE at Baseline

Note. In each figure: (a) the band around the direct effect represents the 95% confidence interval and (b) the dashed vertical line demarcates regions of (non-)significance.

Figure 3. Indirect Effect of the Fun For Wellness (FFW) Intervention on Occupational and Psychological Subjective Well-Being (SWB) at 60 Days Post-Baseline through Occupational and Psychological Well-Being Self-Efficacy (WBSE) at 30 Days Post-Baseline Moderated by Occupational and Psychological WBSE at Baseline

Note. In each figure: (a) the band around the indirect effect represents the 95% confidence interval and (b) the thick dashed vertical line demarcates regions of (non-)significance.

Figure 4. Direct Effect of the Fun For Wellness (FFW) Intervention on Community, Occupational, and Physical Subjective Well-Being (SWB) at 60 Days Post-Baseline Across the Range of Observed Values of Community, Occupational, and Physical Well-Being Self-Efficacy (WBSE) at Baseline

Note. In each figure: (a) the band around the direct effect represents the 95% confidence interval and (b) the dashed vertical lines demarcate regions of (non-)significance.