Analysis of mediation and reciprocal effects of changes in weight, self-esteem, and exercise in a behavioral weight loss treatment

Improving the treatment of obesity remains a critical challenge. Several health behaviour change models, often based on a social-cognitive framework, have been used to design weight management interventions (Baranowski et al., 2003). However, most interventions have only produced modest weight reductions (Wadden et al., 2002) and socialcognitive variables have shown limited power to predict weight outcomes (Palmeira et al., 2007). Other predictors, and possibl alte nati e e planatory models, are needed to better understand the mechanisms by which weight loss and other obesity treatment-outcomes are brought about (Baranowski, 2006). Self-esteem is one of these possible mechanisms, because is commonly reported to change during the treatment, although these changes are not necessarily associated with weight loss (Blaine et al., 2007; Maciejewski et al., 2005). This possibility should be more evident if the program integrates regular exercise, as it promotes improvements in subjective well-being (Biddle & Mutrie, 2001), with possible influences on long-term behavioral adherence (e.g. diet, exercise). Following the reciprocal effects model tenets (Marsh & Craven, 2006), we expect that the influences between changes in weight, selfesteem and exercise to be reciprocal and might present one of the mechanisms by which obesity treatments can be improved.

Modeling the Diffusion of Energy Performance Contracting

The Portuguese Energy Policy considers the development of a commercially viable and competitive market for energy performance contracting (EPC) as a main mechanism to achieve the objectives of energy efficiency improvement. This paper proposes a study to investigate how to achieve widespread adoption of energy performance contracting by means of system dynamics modelling and simulation. To explore and gather insights on this question, a system dynamics model representing the system of the Portuguese EPC market at industry level will be created. The simulation of that model will provide a helpful basis for analysing and explaining the development of key variables, and accelerating learning on the managerial, organizational and political adaptation processes that foster the diffusion of EPC adoption. The first phase of this research project aims at identifying and analysing the key factors and critical cause-effect relations that drive the adoption of EPC. With this purpose, a qualitative content analysis on relevant documents was performed and a set of interviews was conducted. That data was analysed to capture the critical variables and its interrelation to formulate a preliminary representation of the system structure as stock and flow diagrams.