ABSTRACT
Background Our fi eld of behavioral nutrition and physical activity should be operating in crisis mode. The prevalence of obesity and overweight (an essentially nutrition and physical activity problem in its etiology and control) continues to increase at alarming rates in all age, demographic and gender groups in the US [1], Europe [2], and many other parts of the world [3,4]. There is concern that this will reverse the recent advances in chronic disease control [5]. In the face of this encroaching epidemic, obesity treatment programs have tended to have weak effects mostly for short periods of time [6]; and review after review have shown that obesity prevention programs also tend not to work [7-9]. Furthermore,
using the mediating variable model (see Fig.1) as a structured framework, it is not clear we know what changes in diet or physical activity behaviour have led to the current problems and thereby provide the best behavioral targets for change [link A in Fig.1] [10,11]; nor what mediating variables are most strongly related to these behaviors and thereby provide the best mechanisms for change [link B in Fig.1] [12]; nor how best to manipulate the mediating variables to obtain behavior change and lower obesity [link C in Fig.1] [13]. This is a frightful state of affairs. We should all be doing innovative theoretically guided, but high risk, research to quickly build a stronger knowledge base from which more effective interventions could be crafted. Yet, most of us appear to be acting in our usual way of doing things: “same old, same old,”
In this context, Resnicow & Vaughn [14] challenged our “same old” way of thinking about our fi eld. They correctly specifi ed the assumption of linearity in our predictive models, and proposed Chaos and Dynamic Systems Theories as iterative nonlinear models. They did not throw out all our theories per se, but challenged how we interrelated the variables, how we related them to behaviors, and offered some new variables predisposing to change. While Glass & McAtee [15] recently pointed out defi ciencies in the social dimensions of our research, Resnicow & Vaughn targeted our thinking about behavior change. Some of the issues they raised are non-issues, but others deserve that we morph our basic methods to test the new ideas.
