1
|
Stecher C, Pagni BA, Cloonan S, Vink S, Hill E, Ogbeama D, Delaney S, Braden BB. App-based meditation habits maintain reductions in depression symptoms among autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1487-1502. [PMID: 37837362 DOI: 10.1177/13623613231200679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
LAY ABSTRACT Existing research has identified an increased risk of depression among autistic adults, which can negatively impact their adaptive functioning abilities and socioeconomic outcomes. Mobile app-based meditation is a feasible, accessible, and effective self-care solution for depression among neurotypical adults, but there is limited evidence for the long-term benefits of app-based meditation among autistic adults. Habits are a key behavioral strategy for maintaining behavior change, and anchoring is one effective habit formation intervention that has yet to be tested among autistic adults. This study demonstrates that it is both feasible and effective to integrate the anchoring habit formation strategy into an app-based meditation intervention for establishing meditation habits among autistic adults. In addition, the study shows that app-based meditation habits were successful at maintaining reductions in depressive symptoms over 6 months. These results demonstrate the power of anchoring-based habit formation interventions for establishing healthy habits among autistic adults, which offers a promising behavioral intervention technique for establishing other healthy habits among autistic adults. The study also shows that app-based meditation habits are an effective long-term self-care solution for managing depressive symptoms among autistic adults that should be used by mental health providers and policymakers. Future research should test this combined anchoring and app-based meditation intervention technique among larger samples of autistic adults and over longer durations to better understand the mechanisms underlying the success of this intervention.
Collapse
|
2
|
Braun M, Schroé H, Van Dyck D, Crombez G, De Paepe AL. The relationship of affective and bodily states with goals and plans to increase physical activity: An 8-day study in students. Appl Psychol Health Well Being 2024; 16:273-295. [PMID: 37667612 DOI: 10.1111/aphw.12485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/12/2023] [Indexed: 09/06/2023]
Abstract
Planning is an important tool to translate intentions into physical activity (PA) behavior. Affective and bodily states are known to influence how much PA individuals perform, but their impact on to formulation of PA plans is not yet known. The aim of the current study is to explore the effect of within- and between-subject variations in affective and bodily states on the content of PA goals and plans. Over eight consecutive days, 362 students created action and coping plans to achieve their daily PA goals. They also reported their affective and bodily states. Generalized linear mixed effect models were used to analyze the associations between these states and the content of the goals and plans. The results showed that both between- and within-subject variations in affective and bodily states were associated with goals formulated in terms of minutes, the intensity and context of planned activities, and anticipated barriers, though more effects were found for within-subject differences. Affective and bodily states impact daily PA goals and plans, highlighting the dynamic nature of planning. Our findings can be a first step toward personalized suggestions for goals, action plans, and coping strategies that are based on individual affective and bodily states.
Collapse
Affiliation(s)
- Maya Braun
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Helene Schroé
- Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Ghent, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Annick L De Paepe
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
3
|
Garner NJ, Smith JR, Sampson MJ, Greaves CJ. Quantity and specificity of action-plans as predictors of weight loss: analysis of data from the Norfolk Diabetes Prevention Study (NDPS). Psychol Health 2024; 39:42-67. [PMID: 35333685 DOI: 10.1080/08870446.2022.2055026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Investigate associations between quantity, content and specificity of action-plans and weight loss in a diabetes prevention study. DESIGN Prospective cohort study nested within a randomised controlled trial. Participants completed action-planning worksheets during intervention sessions. MAIN OUTCOME MEASURES Action-plans were coded in terms of: number of plans set, their content, and specificity. Multivariate regression analyses assessed associations with weight loss at four-months. RESULTS 890 planning-worksheets from 106 participants were analysed. Participants wrote a mean of 2.12 (SD = 1.20) action-plans per worksheet, using a mean of 2.20 (SD = 0.68) specificity components per action-plan. Quantity of action-plans per worksheet decreased over time (r = -0.137, p < 0.001) and increased quantity was associated with reduced specificity [r = -.215, p < 0.001]. Walking (34.9% of action-plans) and reducing high fat/sugar snacks (26.1%) were the most commonly planned lifestyle actions. In multivariate modelling, increased quantity of action-plans was associated with greater weight loss (R2 = 0.135, Unstandardised Beta = 0.144, p = 0.002). Specificity was not significantly associated with weight-loss (p = 0.096). CONCLUSION Producing more action-plans was associated with greater weight loss. Further research should directly compare more versus less specific action-plans and explore ways to sustain engagement in action-planning. Our findings imply that participants should freely set numerous action-plans, rather than being encouraged to focus on specificity. Supplemental data for this article is available online at https://doi.org/10.1080/08870446.2022.2055026 .
Collapse
Affiliation(s)
- Nikki J Garner
- Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
- University of Exeter Medical School, College of Medicine & Health, University of Exeter, Exeter, UK
| | - Jane R Smith
- University of Exeter Medical School, College of Medicine & Health, University of Exeter, Exeter, UK
| | - Mike J Sampson
- Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Colin J Greaves
- School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
4
|
Braun M, Schroé H, De Paepe AL, Crombez G. Building on Existing Classifications of Behavior Change Techniques to Classify Planned Coping Strategies: Physical Activity Diary Study. JMIR Form Res 2023; 7:e50573. [PMID: 38109171 PMCID: PMC10758936 DOI: 10.2196/50573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/26/2023] [Accepted: 10/31/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND When trying to be more physically active, preparing for possible barriers by considering potential coping strategies increases the likelihood of plan enactment. Digital interventions can support this process by providing personalized recommendations for coping strategies, but this requires that possible coping strategies are identified and classified. Existing classification systems of behavior change, such as the compendium of self-enactable techniques, may be reused to classify coping strategies in the context of physical activity (PA) coping planning. OBJECTIVE This study investigated whether coping strategies created by a student population to overcome barriers to be physically active can be mapped onto the compendium of self-enactable techniques and which adaptations or additions to the frameworks are needed. METHODS In total, 359 Flemish university students created action and coping plans for PA for 8 consecutive days in 2020, resulting in 5252 coping plans. A codebook was developed iteratively using the compendium of self-enactable techniques as a starting point to code coping strategies. Additional codes were added to the codebook iteratively. Interrater reliability was calculated, and descriptive statistics were provided for the coping strategies. RESULTS Interrater reliability was moderate (Cohen κ=0.72) for the coded coping strategies. Existing self-enactable techniques covered 64.6% (3393/5252) of the coded coping strategies, and added coping strategies covered 28.52% (n=1498). The remaining coping strategies could not be coded as entries were too vague or contained no coping strategy. The added classes covered multiple ways of adapting the original action plan, managing one's time, ensuring the availability of required material, and doing the activity with someone else. When exploring the data further, we found that almost half (n=2371, 45.1%) of the coping strategies coded focused on contextual factors. CONCLUSIONS The study's objective was to categorize PA coping strategies. The compendium of self-enactable techniques addressed almost two-thirds (3393/5252, 64.6%) of these strategies, serving as valuable starting points for classification. In total, 9 additional strategies were integrated into the self-enactable techniques, which are largely absent in other existing classification systems. These new techniques can be seen as further refinements of "problem-solving" or "coping planning." Due to data constraints stemming from the COVID-19 pandemic and the study's focus on a healthy Flemish student population, it is anticipated that more coping strategies would apply under normal conditions, in the general population, and among clinical groups. Future research should expand to diverse populations and establish connections between coping strategies and PA barriers, with ontologies recommended for this purpose. This study is a first step in classifying the content of coping strategies for PA. We believe this is an important and necessary step toward digital health interventions that incorporate personalized suggestions for PA coping plans.
Collapse
Affiliation(s)
- Maya Braun
- Department of Experimental-Clinical and Health Psychology, Ghent University, Gent, Belgium
| | - Helene Schroé
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Annick L De Paepe
- Department of Experimental-Clinical and Health Psychology, Ghent University, Gent, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, Gent, Belgium
| |
Collapse
|
5
|
Beaton MA, Gratch I, Cha CB. Specificity, frequency, and intent: Multiple characteristics of adolescents' suicide plan correlate with their history of suicidal behavior. Suicide Life Threat Behav 2023; 53:1025-1037. [PMID: 37720928 DOI: 10.1111/sltb.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 08/12/2023] [Accepted: 08/30/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Suicide plans (SP) can be a common precipitant to suicidal behavior (SB) during adolescence, and SPs can vary in how specific they are, how frequently they are thought about, and how strongly they are intended to be enacted. To date, we have limited understanding of how discrete SP characteristics (i.e., specificity, frequency, and intent to act) present among adolescents, and whether they relate to SB. In the current study, we investigated SP characteristics and their association with SB history among adolescents who had previously considered suicide. METHODS Participants were 142 community-based adolescents (14-19 years; M = 17.6, SD = 1.4) who reported a history of suicidal ideation. Adolescents provided responses pertaining to their SP history, SP characteristics, and SB history, via the Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R). RESULTS Greater specificity, frequency, and intent were each associated with modestly increased odds of reporting an SB history. The associations between plan specificity and SB history, as well as between frequency of thinking about one's SP and SB history, were mediated by adolescents' intent to act on their SP. CONCLUSIONS It may not only be whether, but how, adolescents plan for suicide that relates to their tendency to engage in SB.
Collapse
Affiliation(s)
- Maura A Beaton
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA
| | - Ilana Gratch
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
| | - Christine B Cha
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
| |
Collapse
|
6
|
Keeler AR, Nydegger LA, Crano WD. Combatting negative bias: a mental contrasting and implementation intentions online intervention to increase help-seeking among individuals with elevated depressive symptomatology. Front Psychol 2023; 14:1145969. [PMID: 37397325 PMCID: PMC10310967 DOI: 10.3389/fpsyg.2023.1145969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/16/2023] [Indexed: 07/04/2023] Open
Abstract
Background There are many reasons why individuals with depression may not seek help. Among those with elevated depressive symptomatology, some previous interventions aimed at increasing help-seeking have unintentionally decreased help-seeking intentions. Beck's cognitive theory of depression posits that individuals with elevated depressive symptomatology process information differently from those without depression (i.e., increased cognitive errors, negative bias); potentially explaining the iatrogenic results of previous interventions. Mental contrasting and implementation intentions (MCII; a self-regulatory strategy) interventions have successfully influenced physical and mental health behaviors. However, MCII has not been used specifically for initiating help-seeking for depression. The goal of this research was to ascertain whether an online MCII intervention could increase actual help-seeking or the intention to seek help for depression. Method Two online randomized pre-post experiments were conducted to measure the primary outcome measures 2 weeks post-intervention (Study 1 collected Summer 2019: information-only control ["C"], help-seeking MCII intervention ["HS"], and comparison MCII intervention ["E"]; Study 2 collected Winter 2020: "C" and "HS"). At Time 1, adults recruited from MTurk had a minimum Beck Depression Inventory (BDI-II) score of 14 (mild depressive symptoms) and were not seeking professional help. Results Study 1 (N = 74) indicated that the intervention was feasible, provided preliminary support, and clarified intervention components for Study 2. Study 2 (N = 224) indicated that the HS group reported greater intentions to seek help and actual help-seeking than the C group. Proportionally, actual help-seeking was more likely among individuals who received the HS intervention and either did not perceive themselves as depressed at Time 2 or had BDI-II scores indicating that their depressive symptomatology decreased from Time 1. Limitations Participation was limited to US residents who self-reported data. Discussion These studies indicate that a brief online MCII intervention to encourage help-seeking is feasible and preliminarily successful. Future studies should consider using ecological momentary assessment measurements to establish the temporal precedence of intervention effects and whether MCII is effective for encouraging help-seeking among individuals prone to experiencing cognitive errors who may not be experiencing negative bias (e.g., bipolar disorder or anxiety). Clinicians may find this method successful in encouraging ongoing treatment engagement.
Collapse
Affiliation(s)
- Amanda R. Keeler
- Penn State Primary Care Research Laboratory, Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, United States
- Depression and Persuasion Research Laboratory, School of Social Science, Policy and Evaluation, Claremont Graduate University, Claremont, CA, United States
- Mood Disorder Research Lab, Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, United States
| | - Liesl A. Nydegger
- Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD, United States
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX, United States
| | - William D. Crano
- Institute of Health Psychology and Prevention Science, School of Social Science, Policy and Evaluation, Claremont Graduate University, Claremont, CA, United States
| |
Collapse
|
7
|
Jake-Schoffman DE, Waring ME, DiVito J, Goetz JM, Pan C, Pagoto SL. The Relationship Between How Participants Articulate Their Goals and Accomplishments and Weight Loss Outcomes: Secondary Analysis of a Pilot of a Web-Based Weight Loss Intervention. JMIR Mhealth Uhealth 2023; 11:e41275. [PMID: 36927569 PMCID: PMC10131988 DOI: 10.2196/41275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/15/2022] [Accepted: 01/25/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND In behavioral weight loss interventions, participants are asked to set weekly goals to support long-term habits that lead to weight loss. Although participants are asked to set and accomplish weekly goals, we do not know how often they do this and whether doing so is associated with weight loss. Web-based weight loss interventions allow for the analysis of participant engagement data, including how participants articulate their goals and accomplishments. OBJECTIVE Using engagement data from a web-based weight loss intervention, we examined whether participants articulating their goals and accomplishments in measurable and repeating terms were associated with greater weight loss. METHODS Adults with overweight or obesity received a 12-week Facebook-delivered weight loss intervention based on the Diabetes Prevention Program Lifestyle Intervention. Participants replied to conversation threads that queried about their goals and accomplishments. Two independent coders classified participants' posts that articulated goals or accomplishments as measurable or repeating. Crude and age-adjusted linear regression models were used to examine the relationship between the frequency of post type and percent weight loss. RESULTS Participants (N=53; n=48, 91% female; n=48, 91% non-Hispanic White) were on average 46.2 (SD 10.5) years old with a mean BMI of 32.4 (SD 4.8) kg/m2. Over 12 weeks, participants shared a median of 4 (IQR 1-8) posts that reported goals and 10 (IQR 4-24) posts that reported accomplishments. Most participants shared ≥1 post with a goal (n=43, 81%) and ≥1 post with an accomplishment (n=47, 89%). Each post reporting a goal was associated with 0.2% greater weight loss (95% CI -0.3% to 0.0%). Sharing ≥1 post with a repeating goal was associated with an average of 2.2% greater weight loss (95% CI -3.9% to -0.4%). Each post with a repeating goal was associated with an average of 0.5% greater weight loss (95% CI -1.0% to 0.0%). Sharing ≥1 post with measurable and repeating goals was associated with an average of 1.9% greater weight loss (95% CI -3.7% to -0.2%). Sharing each post with an accomplishment was associated with an average of 0.1% greater weight loss (95% CI -0.1% to 0.0%). Every post with an accomplishment that was repeating was associated with an average of 0.2% greater weight loss (95% CI -0.3% to 0.0%). Sharing other types of goals and accomplishments was not associated with weight loss. CONCLUSIONS In a web-based weight loss intervention, stating goals in repeating or both measurable and repeating terms was associated with greater weight loss, but simply stating them in measurable terms was not. For accomplishments, only those articulated in repeating terms were associated with greater weight loss. Posts about one-time goals and accomplishments represent an opportunity to encourage planning for future behaviors. Future research should examine if stating goals and accomplishments in repeating terms signals habit formation.
Collapse
Affiliation(s)
- Danielle E Jake-Schoffman
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, United States
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, United States
| | - Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Joseph DiVito
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Jared M Goetz
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Cindy Pan
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Sherry L Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| |
Collapse
|
8
|
Maltagliati S, Sarrazin P, Isoard-Gautheur S, Pelletier L, Rocchi M, Cheval B. Automaticity mediates the association between action planning and physical activity, especially when autonomous motivation is high. Psychol Health 2023:1-17. [PMID: 36916020 DOI: 10.1080/08870446.2023.2188886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVES Action planning promotes physical activity (PA). However, mechanisms underlying this association are poorly understood, as are the variables that moderate this link remain unexplored. To fill these gaps, we investigated whether automaticity mediated the association between action planning and PA, and whether autonomous motivation moderated this mediation. METHODS AND MEASURES PA was measured by accelerometry over seven days among a sample of 124 adults. Action planning, automaticity, and autonomous motivation were assessed by questionnaires. RESULTS Structural equation models revealed that automaticity mediated the association between action planning and PA (total effect, β = .29, p < .001) - action planning was associated with automaticity (a path, β = .47, p < .001), which in turn related to PA (b path, β = .33, p = .003). Autonomous motivation moderated the a path (β = .16, p = .035) - action planning was more strongly associated with automaticity when autonomous motivation was high (+1 standard-deviation [SD]) (unstandardized b = 0.77, p < .001) versus low (-1 SD) (b = 0.35, p = .023). CONCLUSION These findings not only support that action planning favors an automatic behavioral regulation, but also highlight that a high autonomous motivation toward PA may reinforce this mechanism.
Collapse
Affiliation(s)
| | | | | | | | | | - Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland.,Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Geneva, Switzerland
| |
Collapse
|
9
|
Cooke R, McEwan H, Norman P. The effect of forming implementation intentions on alcohol consumption: A systematic review and meta-analysis. Drug Alcohol Rev 2023; 42:68-80. [PMID: 36173203 PMCID: PMC10087331 DOI: 10.1111/dar.13553] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 01/10/2023]
Abstract
ISSUES Meta-analysis was used to estimate the effect of forming implementation intentions (i.e., if-then plans) on weekly alcohol consumption and heavy episodic drinking (HED). Sample type, mode of delivery, intervention format and timeframe were tested as moderator variables. APPROACH Cochrane, EThOS, Google Scholar, PsychArticles, PubMed and Web of Science were searched for relevant publications to 31 March 2021. Random-effects meta-analysis was used to estimate the effect size difference (d) between individuals forming versus not forming implementation intentions on weekly consumption and HED. KEY FINDINGS Sixteen studies were included in meta-analyses. The effect size difference for forming implementation intentions on weekly alcohol consumption was d+ = -0.14 confidence interval (CI) [-0.24; -0.03]. Moderator analyses highlighted stronger effects for: (i) community (d+ = -0.38, CI [-0.58; -0.18]) versus university (d+ = -0.04, CI [-0.13; 0.05]) samples; (ii) paper (d+ = -0.26, CI [-0.43; -0.09]) versus online (d+ = -0.04, CI [-0.14; 0.06]) mode of delivery; and (iii) volitional help sheet (d+ = -0.34, CI [-0.60; -0.07]) versus implementation intention format (d+ = -0.07, CI [-0.16; 0.02]). In addition, effects diminished over time (B = 0.02, SE = 0.01, CI [0.03; 0.01]). Forming implementation intentions had a null effect on HED, d+ = -0.01 CI [-0.10; 0.08]. IMPLICATIONS Forming implementation intentions reduces weekly consumption but has no effect on HED. CONCLUSION This review identifies boundary conditions on the effectiveness of implementation intentions to reduce alcohol consumption. Future research should focus on increasing the effectiveness of online-delivered interventions and integrating implementation intention and motivational interventions.
Collapse
Affiliation(s)
- Richard Cooke
- School of Health, Wellbeing and Science, Staffordshire University, Stoke on Trent, UK
| | - Helen McEwan
- School of Psychology, University of Worcester, Worcester, UK
| | - Paul Norman
- Department of Psychology, University of Sheffield, Sheffield, UK
| |
Collapse
|
10
|
Renko E, Kostamo K, Hankonen N. Uptake of planning as a self-regulation strategy: Adolescents' reasons for (not) planning physical activity in an intervention trial. Br J Health Psychol 2022; 27:1209-1225. [PMID: 35451544 PMCID: PMC9790213 DOI: 10.1111/bjhp.12595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 03/21/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Planning is an effective self-regulation strategy. However, little is known why some people take up planning and some do not. Such understanding would help interventions to promote planning. We investigated how adolescents explain their (non) use of planning for physical activity after an intervention. METHODS Qualitative content analysis was employed to investigate follow-up interviews (a purposeful sampling; n = 19 low-to-moderately active, vocational school students) of Let's Move It trial participants twice post-intervention: 6-8 weeks and 14 months post-baseline. In the intervention, planning was one of the key techniques used to promote PA. RESULTS We identified seven categories linked to reasons for (not) using planning. Most were related to feelings anticipated to result from planning. Action- and identity-related concerns were also raised. The reasons for planning were that the plan (1) helps to clarify what to do and to get things done, (2) strengthens the feeling of autonomy, (3) promotes a sense of progress, ability and control over one's PA. The reasons for not planning were that (having) a plan may (1) feel forced and like an unpleasant duty, (2) take away life's spontaneity and freedom, (3) result in anticipated annoyance and bad mood if one fails to enact the plan, or (4) be an effective strategy for others but not for the interviewee. CONCLUSIONS Planning may not only link to behavioural control but also the sense of autonomy, and thus subsequent motivation. We suggest various strategies to promote planning, including challenging non-planner identity and harnessing social dimension of planning.
Collapse
Affiliation(s)
- Elina Renko
- Faculty of Social SciencesUniversity of HelsinkiHelsinkiFinland
| | - Katri Kostamo
- Faculty of Social SciencesUniversity of HelsinkiHelsinkiFinland
| | - Nelli Hankonen
- Faculty of Social SciencesUniversity of HelsinkiHelsinkiFinland,Faculty of Social SciencesTampere UniversityTampereFinland
| |
Collapse
|
11
|
Schenkel K, Haug S, Castro RP, Lüscher J, Scholz U, Schaub MP, Radtke T. One SMS a day keeps the stress away? A just-in-time planning intervention to reduce occupational stress among apprentices. Appl Psychol Health Well Being 2022; 14:1389-1407. [PMID: 35060336 PMCID: PMC9786884 DOI: 10.1111/aphw.12340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/06/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Occupational stress is one of the main sources of stress in apprentices with physical and psychological health consequences. Just-in-time planning interventions (JITPIs) are one opportunity to deliver intervention components at the right times and locations to optimally support apprentices in stressful situations. The aim of this study was to test the proximal effect of a mobile phone-delivered JITPI to reduce occupational stress in 386 apprentices within a planning intervention. METHODS An AB/BA crossover design in which participants were randomly allocated to (A) the planning intervention or (B) the assessment only condition was implemented. RESULTS The analyses of the study "ready4life", multilevel modeling, revealed no significant effect of the planning intervention on occupational stress reduction. CONCLUSIONS Possible reasons for the missing effect might be the low stress level of participants or the type of the intervention delivery. Since apprenticeships in Switzerland differ considerably, future studies should enable more adapted interventions for the apprentices and consider individual circumstances of stress. Further, the intervention should focus on apprentices with high occupational stress levels or a high-risk of stress. Studies should investigate exactly when and why a person needs support regarding her/his occupational stress. Therefore, objective measurements of stress could be helpful.
Collapse
Affiliation(s)
- Konstantin Schenkel
- Department of Psychology, Social and Health PsychologyUniversity of ZurichZurichSwitzerland
| | - Severin Haug
- Swiss Research Institute for Public Health and AddictionUniversity of ZurichZurichSwitzerland
| | - Raquel Paz Castro
- Swiss Research Institute for Public Health and AddictionUniversity of ZurichZurichSwitzerland
| | - Janina Lüscher
- Department of Psychology, Social and Health PsychologyUniversity of ZurichZurichSwitzerland
| | - Urte Scholz
- Department of Psychology, Social and Health PsychologyUniversity of ZurichZurichSwitzerland,Department of Psychology, Social and Health Psychology, University Research Priority Area Dynamics of Healthy AgingUniversity of ZurichZurichSwitzerland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and AddictionUniversity of ZurichZurichSwitzerland
| | - Theda Radtke
- Health Psychology and Applied Diagnostic, Institute of PsychologyUniversity of WuppertalWuppertalGermany
| |
Collapse
|
12
|
Vogelsang A, Hinrichs C, Fleig L, Pfeffer I. Study protocol for the description and evaluation of the "Habit Coach" - a longitudinal multicenter mHealth intervention for healthy habit formation in health care professionals. BMC Public Health 2022; 22:1672. [PMID: 36058904 PMCID: PMC9440859 DOI: 10.1186/s12889-022-13986-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The adoption of a healthy lifestyle plays a crucial role for the health and well-being of health care professionals. Previous e- and mHealth interventions relied on deliberative psychological processes (e.g., intention, planning) to target lifestyle changes, while revealing mixed efficacy. The additional potential of non-deliberative, automatic processes (i.e., habits) for behavior change has been understudied in interventions so far. The Habit Coach mHealth intervention combines deliberative and non-deliberative processes to support health care professionals in forming healthy physical activity, nutrition and mindfulness habits in daily life. The aim of this paper is to outline the study protocol including a detailed description of the mHealth intervention, evaluation plan, and study design. The purpose of this trial is to understand healthy habit formation in health care professionals over time. METHODS A one-arm, multicenter mHealth intervention study will be conducted. Behavioral and psychosocial predictors will be collected via within-app questionnaires across a 100-day period at baseline, post, as well as at weekly assessments. To understand habit formation across time, linear mixed models will be used. DISCUSSION This trial aims to unravel the role of motivational and volitional determinants for healthy habit formation across multiple health behaviors in health care professionals embedded in a mHealth intervention. TRIAL REGISTRATION This trial is registered in the German Clinical Trials Register, DRKS-ID DRKS00027156. Date of registration 17 November 2021.
Collapse
Affiliation(s)
- Anna Vogelsang
- Faculty of Humanities, MSH Medical School Hamburg - University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457, Hamburg, Germany. .,Faculty of Sport Science - Department of eHealth and Sports Analytics, Ruhr-University Bochum, Gesundheitscampus - Nord 10, 44801, Bochum, Germany.
| | - Clara Hinrichs
- Faculty of Humanities, MSH Medical School Hamburg - University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457, Hamburg, Germany
| | - Lena Fleig
- Faculty of Natural Sciences- Department of Psychology, Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
| | - Ines Pfeffer
- Faculty of Humanities, MSH Medical School Hamburg - University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457, Hamburg, Germany
| |
Collapse
|
13
|
Bogg T, Vo PT. Realistic effort action plans (REAP) for exercise among underactive and inactive university students: A randomized trial. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-10. [PMID: 35930378 DOI: 10.1080/07448481.2022.2103382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/31/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
Objective: The efficacy of effort appraisal exercise action plans was tested among underactive and inactive university students (N = 221). Methods: Students were randomized across three conditions (information, action planning, or realistic effort action planning (REAP)) and participated in psychoeducational small-group sessions. Students returned after a three-week pedometer tracking period and at two and six months to assess self-reported exercise. Results: Greater three-week step averages were observed for the action planning and REAP conditions compared to the information condition. The information condition showed small-sized exercise increases at two and six months (d = .26, d = .35, ps < .05); the action planning condition showed a small-sized increase at six months (d = . 36, p < 05); and the REAP condition showed medium-sized increases at two and six months (d = .40, d = . 46, ps < .05). Conclusions: The findings provide initial evidence showing exercise action plans for college students might be improved with explicit appraisals of prior effort and persistence.
Collapse
Affiliation(s)
- Tim Bogg
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Phuong T Vo
- Michigan State University, East Lansing, Michigan, USA
| |
Collapse
|
14
|
Domke A, Keller J, Knoll N, Sniehotta FF, Heuse S, Wiedemann AU. Plan pursuit in the context of daily fruit and vegetable consumption: The importance of cue detection and the execution of the planned behaviour for overall behaviour change. Br J Health Psychol 2022; 27:1172-1187. [PMID: 35318775 DOI: 10.1111/bjhp.12593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES In action planning interventions, individuals specify and link cues with behavioural responses to implement behaviour change. To date, not much is known about how and how much the detection of the planned cue (entering and identifying the planned situation) and the execution of the planned behaviour (behavioural response exactly as planned) contribute to overall behavioural changes (changes in target behaviour) achieved by individuals. Using data from an intervention on daily fruit and vegetable (FV) action planning, this study aimed to test whether individuals' cue detection and execution of the planned behaviour are positively related to overall FV intake. DESIGN Secondary data analyses examined diary data of the intervention condition of a randomized controlled trial. Ninety participants (80% female, aged 19-63 years) formed one FV plan and completed a 13-days post-intervention self-report diary assessing daily FV consumption and situational characteristics of each consumed FV serving. Based on these self-reports and participants' FV plan, day-to-day cue detection and the execution of the planned behaviour were coded. METHODS With two-level models, cue detection and the execution of the planned behaviour were examined as between- and within-person predictors of daily FV intake. RESULTS Higher between-person execution of the planned behaviour (+1.68 daily servings), higher-than-usual within-person cue detection (+0.46 daily servings), and higher-than-usual within-person execution of the planned behaviour (+0.29 daily servings) were associated with more overall FV intake. CONCLUSIONS Detecting planned cues (within-person) and executing the planned behaviour (between- and within-person) are important for overall FV intake.
Collapse
Affiliation(s)
- Antonia Domke
- Department of Education and Psychology, Division Health Psychology, Freie Universität Berlin, Germany
| | - Jan Keller
- Department of Education and Psychology, Division Health Psychology, Freie Universität Berlin, Germany
| | - Nina Knoll
- Department of Education and Psychology, Division Health Psychology, Freie Universität Berlin, Germany
| | - Falko F Sniehotta
- Department of Public Health, Preventive and Social Medicine, Mannheim Medical Faculty, Heidelberg University, Germany
| | - Silke Heuse
- University of Europe for Applied Sciences, Hamburg, Germany
| | - Amelie U Wiedemann
- Department of Education and Psychology, Division Health Psychology, Freie Universität Berlin, Germany
- DearEmployee GmbH, Berlin, Germany
| |
Collapse
|
15
|
Warner LM, Fleig L, Wolff JK, Keller J, Schwarzer R, Nyman SR, Wurm S. What makes implementation intentions (in)effective for physical activity among older adults? Br J Health Psychol 2021; 27:571-587. [PMID: 34609039 DOI: 10.1111/bjhp.12563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 09/15/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES For most populations, implementation intentions (IIs) facilitate physical activity (PA). However, for older adults, previous studies found mixed evidence for the effectiveness of this behaviour change technique. To examine which characteristics of IIs predict successful enactment, the content of older participants' IIs formed within a self-regulatory intervention to prompt PA was analysed. DESIGN A sample of N = 126 German speaking adults aged 64 and older formed up to six IIs for PA and reported their enactment 5 weeks later. METHODS Controlling for age and sex, multilevel models tested associations between characteristics of IIs (e.g., chronological rank of II, hetero- and homogeneity, specificity, presence of certain cues) and enactment. RESULTS Significantly related to enactment were: the chronological rank of an II (first IIs superior to last IIs), greater heterogeneity in activities, greater specificity of when-cues, and greater use of pre-existing routines. CONCLUSIONS Participants were more likely to enact their IIs 5 weeks later if they planned different (heterogeneous) activities, created IIs with more specific when-cues (e.g., on Monday at 9 am), and in particular a routine (e.g., after breakfast). They also enacted the first three IIs (chronological rank of II) more often than the last three IIs. Future experimental studies should test whether providing instructions to create IIs based on the above significant characteristics lead to more effective health behaviour change among older adults.
Collapse
Affiliation(s)
| | - Lena Fleig
- Department of Psychology, MSB Medical School Berlin, Germany
| | - Julia Katharina Wolff
- IGES Institute Berlin, Germany.,Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Germany
| | - Jan Keller
- Health Psychology, Freie Universität Berlin, Germany
| | - Ralf Schwarzer
- SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Samuel R Nyman
- Bournemouth University Clinical Research Unit, Bournemouth University, UK
| | - Susanne Wurm
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Germany
| |
Collapse
|
16
|
Wang Y, König LM, Reiterer H. A Smartphone App to Support Sedentary Behavior Change by Visualizing Personal Mobility Patterns and Action Planning (SedVis): Development and Pilot Study. JMIR Form Res 2021; 5:e15369. [PMID: 33502322 PMCID: PMC7875690 DOI: 10.2196/15369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 04/22/2020] [Accepted: 11/18/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Prolonged sedentary behavior is related to a number of risk factors for chronic diseases. Given the high prevalence of sedentary behavior in daily life, simple yet practical solutions for behavior change are needed to avoid detrimental health effects. OBJECTIVE The mobile app SedVis was developed based on the health action process approach. The app provides personal mobility pattern visualization (for both physical activity and sedentary behavior) and action planning for sedentary behavior change. The primary aim of the study is to investigate the effect of mobility pattern visualization on users' action planning for changing their sedentary behavior. The secondary aim is to evaluate user engagement with the visualization and user experience of the app. METHODS A 3-week user study was conducted with 16 participants who had the motivation to reduce their sedentary behavior. Participants were allocated to either an active control group (n=8) or an intervention group (n=8). In the 1-week baseline period, none of the participants had access to the functions in the app. In the following 2-week intervention period, only the intervention group was given access to the visualizations, whereas both groups were asked to make action plans every day and reduce their sedentary behavior. Participants' sedentary behavior was estimated based on the sensor data of their smartphones, and their action plans and interaction with the app were also recorded by the app. Participants' intention to change their sedentary behavior and user experience of the app were assessed using questionnaires. RESULTS The data were analyzed using both traditional null hypothesis significance testing (NHST) and Bayesian statistics. The results suggested that the visualizations in SedVis had no effect on the participants' action planning according to both the NHST and Bayesian statistics. The intervention involving visualizations and action planning in SedVis had a positive effect on reducing participants' sedentary hours, with weak evidence according to Bayesian statistics (Bayes factor, BF+0=1.92; median 0.52; 95% CI 0.04-1.25), whereas no change in sedentary time was more likely in the active control condition (BF+0=0.28; median 0.18; 95% CI 0.01-0.64). Furthermore, Bayesian analysis weakly suggested that the more frequently the users checked the app, the more likely they were to reduce their sedentary behavior (BF-0=1.49; r=-0.50). CONCLUSIONS Using a smartphone app to collect data on users' mobility patterns and provide real-time feedback using visualizations may be a promising method to induce changes in sedentary behavior and may be more effective than action planning alone. Replications with larger samples are needed to confirm these findings.
Collapse
Affiliation(s)
- Yunlong Wang
- Department of Computer and Information Science, University of Konstanz, Konstanz, Germany
| | - Laura M König
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Harald Reiterer
- Department of Computer and Information Science, University of Konstanz, Konstanz, Germany
| |
Collapse
|
17
|
Keller J, Kwasnicka D, Klaiber P, Sichert L, Lally P, Fleig L. Habit formation following routine-based versus time-based cue planning: A randomized controlled trial. Br J Health Psychol 2021; 26:807-824. [PMID: 33405284 DOI: 10.1111/bjhp.12504] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/23/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Habit formation has been identified as one of the key determinants of behaviour change. To initiate habit formation, self-regulation interventions can support individuals to form a cue-behaviour plan and to repeatedly enact the plan in the same context. This randomized controlled trial aimed to model habit formation of an everyday nutrition behaviour and examined whether habit formation and plan enactment differ when individuals plan to enact their behaviour in response to a routine-based versus time-based cue. DESIGN Following a baseline assessment, N = 192 adults (aged 18-77 years) were randomly assigned to a routine-based cue or a time-based cue planning intervention, in which they selected an everyday nutrition behaviour and linked it to a daily routine or a time cue. METHODS Participants responded to daily questionnaires over 84 days assessing plan enactment and the behaviour's automaticity (as an indicator of habit formation). Multilevel models with days nested in participants were fitted. RESULTS As indicated by asymptotic curves, it took a median of 59 days for participants who successfully formed habits to reach peak automaticity. Group-level analyses revealed that both routine-based and time-based cue planning led to increases in automaticity and plan enactment, but no between-condition differences were found. Repeated plan enactment was a key predictor for automaticity. CONCLUSIONS Linking one's nutrition behaviour to a daily routine or a specific time was similarly effective for habit formation. Interventions should encourage persons to repeatedly carry out their planned behaviour in response to the planned cue to facilitate habit formation.
Collapse
Affiliation(s)
- Jan Keller
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Dominika Kwasnicka
- SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Patrick Klaiber
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Lena Sichert
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Phillippa Lally
- Department of Behavioural Science and Health, University College London, London, UK
| | - Lena Fleig
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| |
Collapse
|
18
|
Maltinsky W, Swanson V. Behavior change in diabetes practitioners: An intervention using motivation, action planning and prompts. PATIENT EDUCATION AND COUNSELING 2020; 103:2312-2319. [PMID: 32402490 DOI: 10.1016/j.pec.2020.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 04/10/2020] [Accepted: 04/12/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES It is important for health professionals to have behavior change skills to empower people to manage long-term-conditions. Theoretically derived, competency-based training can be particularly effective where it considers reflective and automatic routes to behavior change. The aim of this study was to develop, deliver and evaluate a motivational, action and prompting behavior change skills intervention for diabetes health practitioners in Scotland, UK. METHODS This was a longitudinal intervention study. A 2-day intervention was delivered to 99 health professionals. Participants set behavioral goals to change practice, completing action and coping plans post-training. Motivation and plan quality were evaluated in relation to goal achievement at 6-week follow-up. RESULTS Post-training, practitioners could develop high quality work-related action and coping plans, which they were motivated to enact. Although under half responded at follow-up, most reported successful goal achievement. There was no difference in plan quality for goal achievers, non-achievers and non-responders. Barriers and facilitators of behavior change included institutional, service-user and individual factors. CONCLUSIONS The intervention successfully used planning to implement participants' behaviour change goals. PRACTICE IMPLICATIONS Planning interventions are helpful to support clinicians to change their practice to help people self-manage diabetes care but may not fit demands of day-to-day clinical practice.
Collapse
Affiliation(s)
- Wendy Maltinsky
- Centre for Health and Behaviour Change, Psychology Division, University of Stirling, Stirling FK9 4LA, United Kingdom.
| | - Vivien Swanson
- Centre for Health and Behaviour Change, Psychology Division, University of Stirling, Stirling FK9 4LA, United Kingdom
| |
Collapse
|
19
|
Degroote L, Van Dyck D, De Bourdeaudhuij I, De Paepe A, Crombez G. Acceptability and feasibility of the mHealth intervention 'MyDayPlan' to increase physical activity in a general adult population. BMC Public Health 2020; 20:1032. [PMID: 32600352 PMCID: PMC7325032 DOI: 10.1186/s12889-020-09148-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/18/2020] [Indexed: 11/29/2022] Open
Abstract
Background Electronic health (eHealth) and mobile health (mHealth) interventions have the potential to tackle the worldwide problem of physical inactivity. However, they often suffer from large attrition rates. Consequently, feasibility and acceptability of interventions have become important matters in the creation of e- and mHealth interventions. The aim of this study was to evaluate participants’ opinions regarding acceptability and feasibility of a self-regulation, app-based intervention called ‘MyDayPlan’. ‘MyDayPlan’ provides an innovative daily cycle providing several self-regulation techniques throughout the day that guide users towards an active lifestyle via various self-regulation techniques. Methods Semi-structured interviews were conducted with 20 adults after using the app for 2 weeks. A directed content analysis was performed using NVivo Software. Results ‘MyDayPlan’ was well-received and seems to be feasible and acceptable with inactive adults. The straightforward lay out and ease of use of the app were appreciated. Furthermore, the incorporation of the techniques ‘action planning’, and ‘prompting review of behavioral goals’ was positively evaluated. However, the users gave some recommendations: implementation of activity trackers to self-monitor physical activity could be of added value. Furthermore, increasing intuitiveness by minimizing text input and providing more preprogrammed options could further increase the ease of use. Finally, users indicated that they would benefit from more guidance during the “coping planning” component (barrier identification/problem solving), for example by receiving more tailored examples. Conclusions Based on these findings, adaptations will be made to the ‘MyDayPlan’ app before evaluating its effectiveness. Furthermore, involving potential end users and evaluating acceptability and feasibility during the development of an e- and mHealth intervention is key. Also, creating interventions with a large ease of use and straightforward layout that provides tailored support during action and coping planning is key.
Collapse
Affiliation(s)
- L Degroote
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium. .,Research Foundation Flanders, Brussels, Belgium. .,Department of Clinical-Experimental and Health Psychology, Ghent University, Ghent, Belgium.
| | - D Van Dyck
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - A De Paepe
- Department of Clinical-Experimental and Health Psychology, Ghent University, Ghent, Belgium
| | - G Crombez
- Department of Clinical-Experimental and Health Psychology, Ghent University, Ghent, Belgium
| |
Collapse
|
20
|
Di Maio S, Keller J, Hohl DH, Schwarzer R, Knoll N. Habits and self‐efficacy moderate the effects of intentions and planning on physical activity. Br J Health Psychol 2020; 26:50-66. [DOI: 10.1111/bjhp.12452] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/15/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Sally Di Maio
- Department of Education and Psychology Health Psychology Freie Universität Berlin Germany
| | - Jan Keller
- Department of Education and Psychology Health Psychology Freie Universität Berlin Germany
| | - Diana H. Hohl
- Department of Education and Psychology Health Psychology Freie Universität Berlin Germany
| | - Ralf Schwarzer
- Department of Education and Psychology Health Psychology Freie Universität Berlin Germany
- SWPS University of Social Sciences and Humanities Wroclaw Poland
| | - Nina Knoll
- Department of Education and Psychology Health Psychology Freie Universität Berlin Germany
| |
Collapse
|
21
|
Domke A, Keller J, Fleig L, Knoll N, Schwarzer R. What makes a good action plan? Characteristics and enactment of fruit and vegetable plans. Appetite 2019; 142:104351. [PMID: 31279822 DOI: 10.1016/j.appet.2019.104351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND One promising intervention strategy to increase fruit and vegetable (FV) consumption is action planning. However, conditions of successful plan enactment, i.e., the translation of plans into action, have rarely been studied. Therefore, the relationship between plan characteristics and plan enactment is being examined. METHODS Secondary analyses of an existing data set were conducted, based on a larger behavioral intervention study with a baseline assessment as well as a 2-weeks and a 4-weeks follow-up. After baseline assessment, participants completed action plan calendars for the following seven days and subsequently reported on each plan's enactment. Two independent raters coded 1732 morning, noon/afternoon, and evening plans by n = 92 individuals regarding the level of specificity (unspecific vs. specific) and type of planned behavior (fruit vs. vegetable intake). To predict plan enactment, multilevel logistic regression analyses were conducted. FINDINGS Overall specificity of plans was unrelated to plan enactment, but interacted with time of day in predicting plan enactment. Only in the morning, specific plans were more likely being enacted than unspecific plans. Overall, plan enactment decreased during the day and throughout the seven days of the plan calendar. Furthermore, fruit plans were more likely being enacted than vegetable plans. DISCUSSION Specific morning plans were found most beneficial for the enactment of FV plans. Here, possible underlying mechanisms such as stable morning routines should be further investigated. Moreover, the nutritional choice appeared to make a difference for plan enactment: Increasing one's fruit consumption may be easier than integrating more vegetables into one's daily diet.
Collapse
Affiliation(s)
- Antonia Domke
- Department of Education and Psychology, Division Health Psychology, Freie Universität Berlin, Berlin, Germany.
| | - Jan Keller
- Department of Education and Psychology, Division Health Psychology, Freie Universität Berlin, Berlin, Germany
| | - Lena Fleig
- Department of Natural Sciences, Health Psychology, Medical School Berlin, Berlin, Germany
| | - Nina Knoll
- Department of Education and Psychology, Division Health Psychology, Freie Universität Berlin, Berlin, Germany
| | - Ralf Schwarzer
- Department of Education and Psychology, Division Health Psychology, Freie Universität Berlin, Berlin, Germany; SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| |
Collapse
|
22
|
Glover M, Nolte M, Wagemakers A, McRobbie H, Kruger R, Breier BH, Stephen J, Funaki-Tahifote M, Shanthakumar M. Adherence to daily dietary and activity goals set within a Māori and Pacific weight loss competition. BMC OBESITY 2019; 6:6. [PMID: 30867932 PMCID: PMC6398225 DOI: 10.1186/s40608-019-0228-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 01/03/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND New Zealand Pacific and Māori populations measure disproportionately high on the international body mass index (BMI). Information is needed on what behavioural weight loss goals to recommend and how to attract and retain them in interventions. Our team weight loss competition trial for participants with a BMI ≥30 used cash prizes to incentivise completion of nine daily behaviour goals. This paper evaluates the theoretical merit of and adherence to these goals. METHODS A qualitative component evaluation methodology was used. Trial data on team activity, demographics and anthropometric outcome data were extracted to determine frequency of daily goal completion by teams throughout the competition and to describe participant characteristics. T-tests were used to compare completion rates of the challenges, challenge completion by day of week and between weekdays and weekends. To examine adherence to the daily challenge activity over 24 weeks the total amount of completed challenges adjusted for number of active teams was plotted by week. A Body Shape Index (ABSI) was used to determine individual anthropometric change from baseline to 8, 16 and 24 weeks. Program documents were analysed to identify barriers to adherence and retention of participants. RESULTS Of 19 teams (N = 130) who began only five teams performed daily goals across the whole 24 weeks. Adherence was highest during the first 8 weeks. No difference in performance between goals was found suggesting they were equally viable, though tasks worth less points were performed more frequently. Goal completion was higher on weekdays. The behaviour goals appeared to have theoretical merit in that more members of high performing teams experienced a positive change in their ABSI. CONCLUSIONS Incentives offer a promising strategy for encouraging retention in weight loss interventions. This study suggests that participants in a competition will perform incentivised tasks. The findings however, are limited by missing data and high drop out of individuals and whole teams. Further research is needed on how to increase retention.
Collapse
Affiliation(s)
- Marewa Glover
- School of Health Sciences, College of Health, Massey University, PO Box 89186, Torbay, Auckland, 0742 New Zealand
| | - Marrit Nolte
- Health and Society, Wageningen University & Research, Wageningen, The Netherlands
| | - Annemarie Wagemakers
- Health and Society, Wageningen University & Research, Wageningen, The Netherlands
| | | | - Rozanne Kruger
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Bernhard H. Breier
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Jane Stephen
- School of Health Sciences, College of Health, Massey University, PO Box 89186, Torbay, Auckland, 0742 New Zealand
| | | | - Mathu Shanthakumar
- Environmental Health Indicators Programme, Centre for Public Health Research, Massey University, Wellington, New Zealand
| |
Collapse
|
23
|
Köykkä K, Absetz P, Araújo-Soares V, Knittle K, Sniehotta FF, Hankonen N. Combining the reasoned action approach and habit formation to reduce sitting time in classrooms: Outcome and process evaluation of the Let's Move It teacher intervention. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2019. [DOI: 10.1016/j.jesp.2018.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
24
|
Churchill S, Pavey L, Sparks P. The Impact of Autonomy-Framed and Control-Framed Implementation Intentions on Snacking Behaviour: The Moderating Effect of Eating Self-Efficacy. Appl Psychol Health Well Being 2018; 11:42-58. [PMID: 30302915 DOI: 10.1111/aphw.12142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Autonomy-supportive implementation intention exercises have been shown to facilitate goal-directed behaviour (Koestner et al., ). The current study explored whether eating self-efficacy moderated the impact of autonomy-framed versus control-framed implementation intentions to reduce high-calorie snack intake. METHODS The study employed a randomised prospective design, involving two waves of data collection conducted in 2016. At Time 1, UK participants (N = 300) completed an online questionnaire which asked them to report their snacking behaviour over the previous 7 days. Participants were subsequently asked to form either an autonomy-framed implementation intention or a control-framed implementation intention. Seven days later, participants reported their consumption of high-calorie snacks and completed a measure of eating self-efficacy. RESULTS Hierarchical multiple regression analysis revealed that eating self-efficacy moderated the effects of implementation intention framing. Autonomy-framed implementation intentions had a greater impact on the avoidance of snacking for high eating self-efficacy participants than did control-framed implementation intentions. In contrast, for low eating self-efficacy participants, control-framed implementation intentions had more impact than did autonomy-framed implementation intentions. CONCLUSIONS The results suggest that if implementation intentions to promote healthy diet are to be effective, the role of eating self-efficacy should be considered, and the design of interventions adapted accordingly.
Collapse
|
25
|
Brown KE, Beasley K, Das S. Self-Control, Plan Quality, and Digital Delivery of Action Planning for Condom and Contraceptive Pill Use of 14-24-Year-Olds: Findings from a Clinic-Based Online Pilot Randomised Controlled Trial. Appl Psychol Health Well Being 2018; 10:391-413. [PMID: 30198101 DOI: 10.1111/aphw.12138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Inconsistent use of the contraceptive pill and condoms contributes significantly to poor sexual health outcomes for young people. There is evidence that action planning interventions may improve pill and condom use, but this approach is not systematically used in sexual healthcare. This study is the first to assess acceptability and feasibility of evaluating a digital intervention to support action plan formation for three sexual health behaviours with clinic attendees. It also considered the role of trait self-control and whether the intervention supported production of quality plans. METHODS Eighty-eight integrated sexual health clinic attendees aged 14-24 years (M = 20.27 years) were recruited to a pilot randomised controlled trial (RCT). Of these, 67 also completed three-month follow-up. Measures included self-reported contraceptive or condom "mishaps", theory of planned behaviour variables, and a measure of self-control. RESULTS Descriptive analyses supported study acceptability and feasibility. The intervention supported pill and condom users to produce quality plans, though potential improvements were identified. Bivariate correlations suggested that high levels of trait self-control may negatively influence plan quality. Data suggest that the intervention may reduce pill or condom "mishaps". CONCLUSIONS A future full RCT is likely feasible and brief digital action planning interventions may usefully be incorporated within sexual healthcare.
Collapse
Affiliation(s)
| | - Kerrie Beasley
- Coventry and Warwickshire Partnership Trust, Coventry, UK
| | - Satyajit Das
- Coventry and Warwickshire Partnership Trust, Coventry, UK
| |
Collapse
|
26
|
Meng K, Reusch A, Musekamp G, Seekatz B, Zietz B, Steimann G, Altstidl R, Haug G, Worringen U, Faller H. Self-management education for rehabilitation inpatients: A cluster-randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2018; 101:1630-1638. [PMID: 29627267 DOI: 10.1016/j.pec.2018.03.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/06/2018] [Accepted: 03/29/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate generic self-management modules (SelMa) as an adjunct to disease-specific educational programs during inpatient medical rehabilitation. METHODS A bi-center cluster-randomized controlled trial with 698 patients with coronary artery disease, metabolic syndrome, or inflammatory bowel disease was conducted. We compared two versions of SelMa, a group with 3 h or a lecture with 1 h, respectively, in addition to disease-related patient education, to usual care (only disease-related education). SelMa aims at providing skills that may help implementing health behavior. The primary outcomes were goal setting and behavior planning at discharge and goal attainment and health behavior at 6- and 12-months follow-up. Secondary outcomes included motivation, knowledge and self-management competences. RESULTS At discharge, SelMa group, but not SelMa lecture, proved superior to usual care regarding goal setting (p = 0.007, d = 0.26), but not behavior planning (p = 0.37, d = 0.09). Significant effects were also observed on several secondary outcomes. At later follow-up, however, no effects on primary outcomes emerged. Participants' satisfaction was higher in the group than the lecture format. CONCLUSIONS These short modules did not succeed in improving self-management skills in the long-term. PRACTICE IMPLICATIONS A self-management group may foster self-management skills in short term. Interventions should be developed to increase sustainability of effects.
Collapse
Affiliation(s)
- Karin Meng
- Department of Medical Psychology, Medical Sociology, and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany.
| | - Andrea Reusch
- Department of Medical Psychology, Medical Sociology, and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
| | - Gunda Musekamp
- Department of Medical Psychology, Medical Sociology, and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
| | - Bettina Seekatz
- Department of Medical Psychology, Medical Sociology, and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
| | | | | | - Robert Altstidl
- Rehabilitation Center Bayerisch Gmain, Bayerisch Gmain, Germany
| | - Günter Haug
- Rehabilitation Center Bayerisch Gmain, Bayerisch Gmain, Germany
| | | | - Hermann Faller
- Department of Medical Psychology, Medical Sociology, and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
| |
Collapse
|
27
|
Abstract
The aim of this study was to examine the role of explicit and implicit attitudes in the improvement of exercise capacity during a 5-week pulmonary rehabilitation (PR). A total of 105 patients performed walking tests at baseline and at the end of PR. Change between performances was computed at the end of PR, and Minimal-Clinically-Important-Difference (MCID) were used to categorize patients as responders (i.e. change above MCID, N = 54) or non-responders (i.e. change below MCID, N = 51). At baseline, implicit attitudes were measured through a physical activity versus sedentary behavior Implicit Association Test; explicit attitudes toward physical activity and sedentary behavior were measured by questionnaires. Only implicit attitudes significantly differed between the two groups (p = .015), responders displaying implicit attitudes significantly more in favor of physical activity (M = .91, SD = .54) than non-responders (M = .60, SD = .71) at baseline. Measuring implicit attitudes in PR could help to accurately estimate patients' motivation, and design more individualized rehabilitation programs.
Collapse
|
28
|
Keller J, Fleig L, Hohl DH, Wiedemann AU, Burkert S, Luszczynska A, Knoll N. Which characteristics of planning matter? Individual and dyadic physical activity plans and their effects on plan enactment. Soc Sci Med 2017; 189:53-62. [PMID: 28783502 DOI: 10.1016/j.socscimed.2017.07.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 07/20/2017] [Accepted: 07/28/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Past research supports individual planning as an effective intervention strategy to increase physical activity in individuals. A similar strategy, dyadic planning, adds a planning partner who supports an individual's planning processes. Whether the two planning formats differ in terms of participants' entered plan content and whether and how different content characteristics are linked to plan enactment remains unknown. By investigating the content of generated plans, this study aimed at distinguishing plan characteristics of the two planning formats and examining their role as predictors of later plan enactment. METHODS Secondary analyses of a three-arm RCT with German couples (data collection between 2013 and 2015). Couples were assigned to an individual (IPC, n = 114) or dyadic planning condition (DPC, n = 111) and formulated up to 5 physical activity plans for a target person. Couples assigned to a control condition were not included as they did not generate plans. The following characteristics were distinguished and coded for each plan: number of planned opportunities, presence of a planned routine, planned cue- or activity-related specificity, activity-related intensity, and chronological plan rank. One week before (T0) and two weeks following (T2) the intervention (T1), increase vs. no increase of the planned activity was coded as a dichotomous plan enactment variable. Multilevel logistic regressions were fit. RESULTS Plan enactment was higher in dyadic than in individual planners. Findings indicated that routines (e.g., after work) were positively related to plan enactment, whereas a high specificity of when-cues (e.g., Friday at 6.30 p.m.) showed a negative relationship. None of the examined plan characteristics could explain differences in enactment between IPC and DPC. CONCLUSIONS Linking health behaviours to other behavioural routines seems beneficial for subsequent plan enactment. Dyadic planning was linked with higher enactment rates than individual planning. However, as mechanisms underlying this effect remain unclear, they should be investigated further.
Collapse
Affiliation(s)
- Jan Keller
- Department of Education and Psychology, Division Health Psychology, Freie Universität Berlin, Germany.
| | - Lena Fleig
- Department of Education and Psychology, Division Health Psychology, Freie Universität Berlin, Germany
| | - Diana Hilda Hohl
- Department of Education and Psychology, Division Health Psychology, Freie Universität Berlin, Germany
| | - Amelie U Wiedemann
- Department of Education and Psychology, Division Health Psychology, Freie Universität Berlin, Germany
| | - Silke Burkert
- Institute of Medical Psychology, Charité - Universitätsmedizin Berlin, Germany
| | - Aleksandra Luszczynska
- SWPS University of Social Sciences and Humanities, Wroclaw, Poland; Trauma, Health, & Hazards Center, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
| | - Nina Knoll
- Department of Education and Psychology, Division Health Psychology, Freie Universität Berlin, Germany
| |
Collapse
|