Assessment of Motivational Cognitions in Diabetes Self-Care: the Motivation Thought Frequency Scales for Glucose Testing, Physical Activity and Healthy Eating

Students' Knowledge of Healthy Food and Their Actual Eating Habits: A Case Study on the University of Granada (Spain)

This article focuses on an analysis of the discourses produced during 34 semi-structured interviews (17 men and 17 women) conducted at the University of Granada (Spain) with undergraduate, Master, and Ph.D. students. The interviewees were between 20 and 44 years old. It was observed that the fact of having a high educational level did not prevent University students from eating unhealthily. There is a gap between the fact that 97.1% of 34 students interviewed (that is, 33 of them) know what healthy food is and their self-perception about whether or not what they are eating is healthy, since in 41.2% of them said self-perception is negative. This gap narrows as the interviewees' age increases and their socio-economic and vital situation is stabilizing which favors that their eating habits become more regular and healthier. Thus, all the interviewees aged 27 or over self-perceived that they were eating healthily. But the biggest differences are those that have to do with the gender of interviewees. Thus, while 23.5% of women interviewed perceived that they were not eating healthy, 76.5% of them felt that they were eating healthy. However, among the men interviewed, these percentages were somehow reversed, in such a way that 58.8% of them believed that they were not eating healthy, compared to 41.2% of them who indicated that they were eating healthy. Therefore, the investigation revealed that women tend to have the best chances of assuming healthy eating habits. Male students living outside the family home or without female partners exhibited greater feeding problems, while females living under similar conditions tended to display healthier eating habits. This is related to the fact that women have traditionally been in charge of acquiring and preparing food. So, women's food education has not been restricted to the mere transmission to them of knowledge about what healthy food is, but from their childhood they were food trained through their active involvement in practical experiences. Obviously, the solution proposed to this male disadvantage is to not perpetuate macho gender stereotypes that assign women the role of home caregivers, but to seek that both women and men have the opportunity and the duty to experience equally those practical experiences that involve the tasks of the acquisition and preparation of food. Working to achieve a situation like this, not only promotes progress in gender equality, but also helps to overcome the lower training of men to perform the tasks inherent in their diet.

Imaginator: A Proof-of-Concept Feasibility Trial of a Brief Imagery-Based Psychological Intervention for Young People Who Self-Harm

OBJECTIVES

The Imaginator study tested the feasibility of a short mental imagery-based psychological intervention for young people who self-harm and used a stepped-wedge design to investigate effects on self-harm frequency reduction at 3 and 6 months.

METHOD

A total of 38 participants aged 16-25 were recruited via community self-referral and mental health services. Participants were randomized to immediate delivery of Functional Imagery Training (FIT) or usual care followed by delayed delivery after 3 months. FIT comprised two face-to-face sessions, five phone sessions, and use of a smartphone app. Outcomes' assessment was blind to allocation.

RESULTS

Three quarters of those who began treatment completed face-to-face sessions, and 57% completed five or more sessions in total. Self-harm frequency data were obtained on 76% of the sample at 3 months (primary outcome) and 63% at 6 months. FIT produced moderate reductions in self-harm frequency at 3 months after immediate (d = 0.65) and delayed delivery (d = 0.75). The Immediate FIT group maintained improvements from 3 to 6 months (d = 0.05). Participants receiving usual care also reduced self-harm (d = 0.47).

CONCLUSIONS

A brief mental imagery-based psychological intervention targeting self-harm in young people is feasible and may comprise a novel transdiagnostic treatment for self-harm.

The Motivational Thought Frequency Scales for increased physical activity and reduced high-energy snacking

OBJECTIVES

The Motivational Thought Frequency (MTF) Scale has previously demonstrated a coherent four-factor internal structure (Intensity, Incentives Imagery, Self-Efficacy Imagery, Availability) in control of alcohol and effective self-management of diabetes. The current research tested the factorial structure and concurrent associations of versions of the MTF for increasing physical activity (MTF-PA) and reducing high-energy snacks (MTF-S).

DESIGN

Study 1 examined the internal structure of the MTF-PA and its concurrent relationship with retrospective reports of vigorous physical activity. Study 2 attempted to replicate these results, also testing the internal structure of the MTF-S and examining whether higher MTF-S scores were found in participants scoring more highly on a screening test for eating disorder.

METHODS

In Study 1, 626 participants completed the MTF-PA online and reported minutes of activity in the previous week. In Study 2, 313 participants undertook an online survey that also included the MTF-S and the Eating Attitudes Test (EAT-26).

RESULTS

The studies replicated acceptable fit for the four-factor structure on the MTF-PA and MTF-S. Significant associations of the MTF-PA with recent vigorous activity and of the MTF-S with EAT-26 scores were seen, although associations were stronger in Study 1.

CONCLUSIONS

Strong preliminary support for both the MTF-PA and MTF-S was obtained, although more data on their predictive validity are needed. Associations of the MTF-S with potential eating disorder illustrate that high scores may not always be beneficial to health maintenance.

Social robots as treatment agents: Pilot randomized controlled trial to deliver a behavior change intervention

Social robots are increasingly demonstrating effectiveness as low-intensity behavior change agents. Key targets for these behavioral interventions include daily lifestyle behaviors with significant health consequences, such as the consumption of high-calorie foods and drinks ('snacks'). A pilot randomized controlled trial using a stepped-wedge design was conducted to determine the efficacy of a motivational intervention by an autonomous robot, to help reduce high-calorie snacks. Twenty-six adults were randomized to receive Immediate or 4-week Delayed treatment, with assessments at Baseline and Weeks 4 and 8. The treatment comprised motivation enhancement and self-management training using mental imagery (Functional Imagery Training). A significant condition by time effect for snack episode reduction was obtained, F(2, 32.06) = 4.30, p = .022. The Immediate condition significantly reduced snacking between Baseline and Week 4 (d = -1.06), while the Delayed condition did not (d = -0.08). Immediate participants maintained their improvement between Weeks 4 and 8 (d = -0.18), and Delayed participants then showed a significant fall (d = -1.42). Overall, 'Immediate' participants decreased their snack episodes by 54% and 'Delayed' decreased by 62% from Baseline to Week 8, and an average weight reduction of 4.4 kg was seen across over the first 2 weeks of treatment. Four weeks after starting the intervention, both conditions had significant increases in perceived confidence to control snack intake for time duration, specific scenarios and emotional states (d = 0.61 to 1.42). Working alliance was significantly correlated with reduced snack episodes. The pilot's results appear to suggest that the robot-delivered intervention may be as effective as a human clinician delivering a similar intervention. The robot-delivered pilot achieved similar snack episode reduction in the first four weeks (FIT-R, 55%) when compared with the human-delivered version by a trained clinician (FIT-H, 49%). Overall, the results provide preliminary evidence for an autonomous social robot to deliver a low-intensity treatment on dietary intake without the need for human intervention. Future trials should extend the deployment of the robot-delivered intervention protocol to other low-intensity behavioral outcomes.

The revised four-factor motivational thought frequency and state motivation scales for alcohol control

INTRODUCTION

Elaborated Intrusion (EI) Theory holds that both functional and dysfunctional motivational cognitions are characterized by their intensity, cognitive availability and involvement of imagery, and can be assessed in terms of their frequency and cross-sectional nature. Recently published data on the Motivational Thought Frequency (MTF-A) and State Motivation (SM-A) scales for alcohol control, which were based on EI theory, have shown acceptable fit for a three-subscale structure (Intensity, Imagery, Availability). However, subsequent analyses on the MTF's adaptation to diabetic regimen adherence suggested superior fit from a four-factor model, splitting Imagery into Incentives and Self-Efficacy Imagery. The current paper reanalyzed data on the MTF-A and SM-A, including an additional item on each and using a more robust statistical approach.

METHODS

Participants (n = 504) reporting recent high-risk drinking or were currently trying to control alcohol consumption volunteered to complete an online survey that included the MTF-A, SM-A, Alcohol Use Disorders Identification Test and Readiness to Change Questionnaire. Confirmatory factor analyses employed robust maximum likelihood (MLR) with Yuan-Bentler χ² adjustment, and presented internal consistencies using omega.

RESULTS

After omission of multivariate outliers, SM-A data were available from 399 participants, and MTF-A data from 351. Better fit was found for the four-factor model on both measures, and high internal consistencies were obtained for all subscales. Incentives Imagery and Self-Efficacy Imagery were both associated with greater alcohol problems and readiness to change.

CONCLUSIONS

The four-factor structures are statistically superior and more theoretically coherent, and allow a focused assessment of key targets of motivational interventions.