42 Therefore, although the literature suggests men seem to take longer to engage with the program, there is anecdotal evidence that once they have assessed and evaluated the evidence and made a commitment, they appear to achieve better results in a shorter time than women (Professor G. Egger, Founder of Gut Busters, personal communication). However, this could not be explored in this study because information on commitment was not collected. The difference in men's and women's engagement in the CHIP intervention program needs to be explored in further research. Having supportive relationships may be a behavioral factor that explains the greater effect on men than women observed in this study. Men who are married are less likely to engage in unhealthy, high-risk AG-221 mouse
behaviors and therefore experience better health through the influence of their wives.43 In the current study, there is anecdotal evidence also supported by?the literature44 RSL3 datasheet
that men are persuaded to attend CHIP with their wives, which according to the stages?of change theory suggests that they?enter the program as pre-contemplators, whereas women enter at the preparation stage.45 The supposition that the married men who attended the CHIP intervention with their spouse benefited from the ensuing household changes made by the women is supported by the literature.46 Indeed, an intervention delivered in a group setting offers the social support needed to foster new social norms and accountability. Group programs have Succimer
been shown to be more effective for achieving weight loss than individual programs, even for those who claim to prefer individual programs.47 Other factors relating to program content and structure may have contributed to the outcomes observed in this study. One may be the intensiveness of the CHIP intervention. Other studies have shown a dose response between intervention intensity and health outcomes.3?and?48 Further research is required to determine the?most efficacious dosages of lifestyle interventions with regard to the number of sessions, program duration, and type and magnitude of lifestyle modifications targeted for men and women. Other factors may be the strong educative component and repeated health risk assessments. These are believed to increase participants' health related self-efficacy and perceived control. Future research should explore self-efficacy/perceived behavioral control among men and women participating in CHIP resulting from the increased knowledge that comes from the educational videos. In this study, a greater proportion of men entered the program with previously diagnosed health conditions, which may have contributed to the higher baseline risk factor levels of men compared with women. However, < 5% of each gender entered the program with cardiovascular disease conditions, and so it is unlikely that baseline health history would have had a major impact on the outcomes of the intervention.