1
|
Visagie E, Deacon E, Kok R. Exploring the role of CBT in the self-management of type 2 diabetes: A rapid review. Health SA 2023; 28:2254. [PMID: 37292235 PMCID: PMC10244871 DOI: 10.4102/hsag.v28i0.2254] [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: 11/14/2022] [Accepted: 03/08/2023] [Indexed: 06/10/2023] Open
Abstract
Background Type 2 diabetes has been recognised as a global health concern: one that requires intervention to lessen the incumbrance caused by the chronic illness. This rapid review was conducted to determine the scientific evidence available on how Cognitive Behaviour Therapy (CBT) interventions improved the self-management of individuals with type 2 diabetes. Aim The aim of the review was to synthesise current scientific evidence regarding CBT-based interventions and self-management practices. Method The rapid review served as a framework to appraise current national and international literature. The researchers used Google Scholar, Journal Storage (JSTOR), PsycINFO, APA PsycArticles, SAGE journals and EBSCO Discovery Services to search for relevant studies. This was performed by employing keywords. Nine relevant studies were identified. The studies were heterogenous in methodology. Seven of the nine studies were conducted in developing countries. Results The study found that the context of developmental countries plays a significant role in the development of type 2 diabetes and requires tailored intervention because of socio-economic variabilities. The main themes identified in relation to improving self-management included: the characteristics of the CBT-based interventions, namely the format, duration, and outcomes, and identifying the techniques and components used in the CBT-based interventions. Conclusion The review emphasised the need to further investigate the role of CBT in improving self-management of type 2 diabetes, especially in a South African context. Contribution The review summarised the techniques that have proven to be effective for the self-management of type 2 diabetes.
Collapse
Affiliation(s)
- Elne Visagie
- Compress Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Elmari Deacon
- Optentia Research Unit, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Rümando Kok
- Centre for Health and Human Performance (CHHP), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| |
Collapse
|
2
|
Arnold T, Gaudiano BA, Barnett AP, Elwy AR, Whiteley L, Giorlando KK, Rogers BG, Ward LM, Leigland A, Brown LK. Development of An Acceptance Based PrEP Intervention ( ACTPrEP) to Engage Young Black MSM in the South Utilizing the Adaptome Model of Intervention Adaptation. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023; 28:60-70. [PMID: 37008800 PMCID: PMC10062414 DOI: 10.1016/j.jcbs.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Objectives HIV disproportionately affects young Black men who have sex with men (YBMSM) in the Southern United States. Pre-exposure prophylaxis (PrEP) is an efficacious, biomedical approach to prevent HIV. While Mississippi (MS) has among the highest rates of new HIV infections, it also ranks among the top three states for unmet PrEP need. Thus, increasing engagement in PrEP care for YBMSM in MS is imperative. A potential method to improve psychological flexibility and promote PrEP uptake, explored by this study, is the incorporation of Acceptance and Commitment Therapy (ACT) into PrEP interventions. ACT is an evidence-based intervention used to treat a wide range of mental and physical illnesses. Methods Twenty PrEP-eligible YBMSM and ten clinic staff working with YBMSM in MS were surveyed and interviewed between October 2021 and April 2022. The brief survey covered PrEP structural barriers, PrEP stigma, and psychological flexibility. Interview topics included internal experiences related to PrEP, existing health behaviors, PrEP related personal values, and relevant constructs from the Adaptome Model of Intervention Adaptation (service setting, target audience, mode of delivery, and cultural adaptations). Qualitative data were coded based on ACT and the Adaptome model, organized using NVivo, then thematically analyzed. Results Patients identified side effects, costs, and taking a daily prescription as top barriers to taking PrEP. Staff reported the top barrier to PrEP for clients was concern others would believe they were living with HIV. Levels of psychological flexibility and inflexibility varied widely among participants. The resulting thematic categories derived from the interviews included 1) thoughts, emotions, associations, memories, and sensations (TEAMS) related to PrEP and HIV, 2) general health behaviors (existing coping techniques, views on medication, HIV/PrEP approach and avoidance), 3) values related to PrEP use (relationship values, health values, intimacy values, longevity values), and 4) Adaptome Model adaptations. These results informed the development of a new intervention, ACTPrEP. Conclusions Interview data organized by the Adaptome Model of Intervention Adaptation determined appropriate ACT-informed intervention components, content, intervention adaptations, and implementation strategies. Interventions informed by ACT that help YBMSM endure short-term discomfort related to PrEP by relating it to their values and long-term health goals are promising for increasing individuals' willingness to initiate and maintain PrEP care.
Collapse
Affiliation(s)
- Trisha Arnold
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA 02903
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island USA 02906
| | - Brandon A. Gaudiano
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island USA 02906
| | - Andrew P. Barnett
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA 02903
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island USA 02906
| | - A. Rani Elwy
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island USA 02906
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, 01730, USA
| | - Laura Whiteley
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island USA 02906
| | - Kayla K. Giorlando
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA 02903
| | - Brooke G. Rogers
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island USA 02906
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island USA 02903
| | - Lori M. Ward
- Departments of Nursing, Medicine, and Population Health Sciences, University of Mississippi Medical Center, Jackson, Mississippi USA 39217
| | - Avery Leigland
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA 02903
| | - Larry K. Brown
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA 02903
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island USA 02906
| |
Collapse
|
3
|
Dauber A, Redondo R, Meschino KJ, Braden A. Dietary changes in an acceptance-based weight loss pilot intervention study. Eat Behav 2023; 48:101707. [PMID: 36791620 DOI: 10.1016/j.eatbeh.2023.101707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVE To evaluate pre-post changes in dietary intake and the possible role of emotional eating (EE) as a mediator of dietary changes in a novel behavioral weight loss intervention (Live FREE). DESIGN Secondary analysis of an open label pilot study. PARTICIPANTS Thirty-nine adults with overweight/obesity and EE. INTERVENTION Live FREE is a 16-week group-based program in which participants learn emotional regulation skills from Dialectical Behavior Therapy followed by traditional behavioral weight loss techniques. MAIN OUTCOME MEASURE Dietary intake and EE were measured at baseline and post-treatment with the Automated Self-Administered 24-Hour Dietary Assessment Tool and the depression subscale of the revised Emotional Eating Scale. ANALYSIS Paired sample t-tests and mediation for repeated measures designs. RESULTS Consumption of calories (t(33) = 5.31, p < .001), saturated fat (t(33) = 5.25, p < .001), and added sugar (t(33) = 4.44, p < .001) decreased from pre-post-treatment. EE change mediated the effect of the intervention on change in saturated fat intake pre-post-treatment, B = 6.16, BootSE = 2.47, 95 % CI (1.53 to 11.37), but did not mediate change in caloric or added sugar intake. CONCLUSIONS AND IMPLICATIONS Participants reported improvement in caloric, saturated fat, and added sugar intake. Improvement in EE may be closely related to decreasing saturated fat consumption. (200).
Collapse
Affiliation(s)
- Aubrey Dauber
- Bowling Green State University Psychology Department, 822 E. Merry Street, Bowling Green, OH 43403, United States of America.
| | - Rachel Redondo
- Bowling Green State University Psychology Department, 822 E. Merry Street, Bowling Green, OH 43403, United States of America.
| | - Katherine J Meschino
- Bowling Green State University Psychology Department, 822 E. Merry Street, Bowling Green, OH 43403, United States of America.
| | - Abby Braden
- Bowling Green State University Psychology Department, 822 E. Merry Street, Bowling Green, OH 43403, United States of America.
| |
Collapse
|
4
|
Van Wasshenova E, Boardley D, Geers A, Tull M, Steiner V. A Brief Value-based Randomized Intervention to Promote Physical Activity in Patients Attending Cardiac Rehabilitation. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2142334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
5
|
Horgan OZ, Crane NT, Forman EM, Milliron BJ, Simone NL, Zhang F, Butryn ML. Optimizing an mHealth Intervention to Change Food Purchasing Behaviors for Cancer Prevention: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e39669. [PMID: 35749216 PMCID: PMC9270710 DOI: 10.2196/39669] [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: 05/17/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dietary intake is a powerful modifiable factor that influences cancer risk; however, most US adults do not adhere to dietary guidelines for cancer prevention. One promising pathway for improving dietary adherence is targeting grocery shopping habits. Interventions might facilitate healthy grocery choices, with a combination of mHealth and traditional methods, by promoting the salience of dietary goals while shopping, enhancing motivation to make dietary changes, and increasing household support for healthy food purchasing. OBJECTIVE This pilot study will assess feasibility and acceptability of intervention components designed to improve adherence to dietary guidelines for cancer prevention (preliminary aim). The primary aim of the study is to quantify the effect of each intervention component, individually and in combination, on dietary intake (primary aim) and grocery store food purchases (exploratory aim). Mediation analyses will be conducted to understand the mechanisms of action (goal salience, motivation, and household support-secondary aims). The overarching goal is to optimize an mHealth intervention to be tested in a future fully powered clinical trial. METHODS The study enrolled adults (N=62) with low adherence to dietary recommendations for cancer prevention. In a 20-week program, all participants attend a nutrition education workshop and receive weekly educational messages through an app. A factorial design is used to test 4 intervention components: (1) location-triggered messages: educational messages are delivered when arriving at grocery stores; (2) reflections on the benefits of change: content is added to messages to encourage reflection on anticipated benefits of healthy eating, and participants attend an additional workshop session and 3 coach calls on this topic; (3) coach monitoring: food purchases are monitored digitally by a coach who sends personalized weekly app messages and conducts 3 coaching calls that focus on feedback about purchases; and (4) household support: another adult in the household receives messages designed to elicit support for healthy food purchasing, and support is addressed in 3 coach calls and an extra workshop session attended by the index participant and household member. Assessments are completed at weeks 0, 10, and 20 using self-report measures, as well as objective capture of grocery data from the point of purchase using store loyalty accounts. RESULTS The National Cancer Institute funded this study (R21CA252933) on July 7, 2020. Participant recruitment began in the spring of 2021 and concluded with the successful enrollment of 62 participants. Data collection is expected to be completed in the summer of 2022, and results are expected to be disseminated in the summer of 2023. CONCLUSIONS The results of this study will inform the development of scalable interventions to lower cancer risk via changes in dietary intake. TRIAL REGISTRATION ClinicalTrials.gov NCT04947150; https://clinicaltrials.gov/ct2/show/NCT04947150. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39669.
Collapse
Affiliation(s)
- Olivia Z Horgan
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Nicole T Crane
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Brandy-Joe Milliron
- Department of Nutrition Sciences, Drexel University, Philadelphia, PA, United States
| | - Nicole L Simone
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States
| | - Fengqing Zhang
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| |
Collapse
|
6
|
Arnold T, Haubrick KK, Klasko-Foster LB, Rogers BG, Barnett A, Ramirez-Sanchez NA, Bertone Z, Gaudiano BA. Acceptance and Commitment Therapy Informed Behavioral Health Interventions Delivered by Non-Mental Health Professionals: A Systematic Review. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022; 24:185-196. [PMID: 36578359 PMCID: PMC9793875 DOI: 10.1016/j.jcbs.2022.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objectives Acceptance and Commitment Therapy (ACT) is a third-wave behavioral and cognitive therapy that increases psychological flexibility through mindfulness, acceptance, and value-driven behavior change. ACT has been successfully used to inform a variety of health interventions. Using non-therapists to deliver ACT-based behavioral health interventions offers an opportunity to provide cost efficient and integrated care, particularly among underserved populations experiencing barriers to mental health care, such as inadequate insurance, mental health stigma, and provider shortages. This systematic review aims to: 1) identify ACT-informed behavioral health interventions delivered by laypeople and 2) review the specific characteristics of each intervention including number and duration of sessions, delivery modality, interventionist training, and intervention outcomes. Methods Two databases (PubMed and PsycINFO) were systematically searched for relevant literature. To further identify relevant studies, references of included manuscripts were checked, the Association for Contextual Behavioral Science's webpage was examined, and an email was sent to the ACBS Health Special Interest Group listserv. Study abstracts and full texts (in English) were screened, resulting in 23 eligible articles describing 19 different interventions. Results A total of 1,781 abstracts were screened, 76 were eligible for full-text review, and 23 were included in a narrative synthesis. There were 19 unique interventions identified and delivered by the following: general healthcare workers (n= 7), trained researchers (n = 5), women/mothers (n= 2), municipal workers (n= 2), and teachers (n = 3). Eleven studies were RCTs and eight utilized alternative study designs. Study quality varied, with two rated as high risk for bias and eight rated to have some concerns. Target populations included clinical and non-clinical samples. There was some consistency in the effects reported in the studies: increases in pain tolerance, acceptance, and identifying and engaging in value driven behavior, improvements in cognitive flexibility, and reductions in psychological distress. Conclusions Findings suggest that ACT interventions can be successfully delivered by a variety of laypeople and effectively address psychological distress and increase health behaviors.
Collapse
Affiliation(s)
- Trisha Arnold
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA 02903,Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA 02903
| | - Kayla K. Haubrick
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA 02903
| | - Lynne B. Klasko-Foster
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA 02903
| | - Brooke G. Rogers
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA 02903
| | - Andrew Barnett
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA 02903,Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA 02903
| | | | - Zoe Bertone
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA 02903
| | - Brandon A. Gaudiano
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA 02903
| |
Collapse
|
7
|
Moran O, Doyle J, Giggins O, McHugh L, Gould E, Smith S, Gavin S, Sojan N, Boyle G. Efficacy of a Digital Acceptance and Commitment Therapy Intervention for the Improvement of Self-management Behaviors and Psychological Flexibility in Adults With Cardiac Disease: Protocol for a Single Case Experimental Design. JMIR Res Protoc 2022; 11:e33783. [PMID: 35363156 PMCID: PMC9015764 DOI: 10.2196/33783] [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: 09/24/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Research indicates that the management of distress levels in those with cardiac disease is not only important for improving quality of life and functioning but also critical for condition management; adherence to treatment; and, ultimately, disease prognosis and progression. Acceptance and commitment therapy (ACT) has consistently demonstrated positive long-term outcomes across a wide array of conditions, including chronic illness. However, most empirical investigations conducted to date have also involved in-person therapy, which can be difficult to access, particularly for those dealing with the demands of chronic disease. OBJECTIVE The objective of our research is to evaluate a digital ACT intervention for improving self-management behaviors and distress levels in those with cardiac conditions. METHODS The digital ACT intervention will be delivered via a digital health self-management platform over 6 sessions. This will involve a randomized, multiple baseline, single case experimental design with approximately 3 to 15 adults with cardiac disease. The independent variable for each participant will be the pre-post intervention phase. The dependent variables will be a daily self-report measure of psychological flexibility as well as objective measures of condition self-management (eg, blood pressure readings) and engagement with the app (eg, completing guided mindfulness). One-to-one qualitative interviews will also be conducted to further examine participants' experiences with using the intervention and what factors contribute to or impede successful outcomes. RESULTS Participant recruitment and data collection began in October 2021, and it is projected that the study findings will be available for dissemination by spring 2022. CONCLUSIONS The findings will be discussed in terms of how a digital ACT intervention can best meet the needs of cardiac patients. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/33783.
Collapse
Affiliation(s)
- Orla Moran
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Julie Doyle
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Oonagh Giggins
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Louise McHugh
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Evelyn Gould
- Harvard Medical School, Boston, MA, United States
| | - Suzanne Smith
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Shane Gavin
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Nisanth Sojan
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Gordon Boyle
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| |
Collapse
|
8
|
Lampe EW, Crochiere RJ, Trainor C, Juarascio A. Be ACTive! mindfulness and acceptance-based interventions for physical activity engagement in adolescents. Transl Behav Med 2021; 11:2182-2186. [PMID: 34559881 DOI: 10.1093/tbm/ibab126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Elizabeth W Lampe
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, 3201 Chestnut Street Philadelphia, PA, USA
| | - Rebecca J Crochiere
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, 3201 Chestnut Street Philadelphia, PA, USA
| | - Claire Trainor
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, 3201 Chestnut Street Philadelphia, PA, USA
| | - Adrienne Juarascio
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, 3201 Chestnut Street Philadelphia, PA, USA
| |
Collapse
|
9
|
Behavioural response to illness: development and validation of a self-report measure of illness behaviour avoidance. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02219-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
10
|
The Role of Acceptance and Commitment Therapy in Cardiovascular and Diabetes Healthcare: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158126. [PMID: 34360420 PMCID: PMC8345942 DOI: 10.3390/ijerph18158126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 12/16/2022]
Abstract
Acceptance and commitment therapy (ACT) is an adapted form of cognitive behavioural therapy. ACT focuses on how thinking affects behaviour and promotes psychological flexibility. The prevalence of psychological distress among people living with cardiovascular disease (CVD) and/or type 2 diabetes mellitus (T2DM) is high, and ACT may offer an alternative treatment approach. This scoping review explored the use of ACT as an intervention to support adults living with CVD and/or T2DM. A systematic search of the literature resulted in the inclusion of 15 studies. Studies were reviewed using the Joanna Briggs Institute approach to conducting scoping reviews. Most studies (n = 13) related to people living with T2DM, and most (n = 10) used a pre-post design, four studies were randomised controlled trials, and one was a qualitative study. Eight studies reported an improvement in the outcome(s) assessed post-intervention, suggesting that ACT was an acceptable and valid intervention to support people living with CVD or T2DM. However, studies were underpowered and only limited studies involved people living with CVD. ACT was assessed as a valuable approach to improve a range of patient-reported outcomes for those living with CVD or T2DM, and further research involving robust study designs and larger cohorts are warranted.
Collapse
|
11
|
Butryn ML, Godfrey KM, Call CC, Forman EM, Zhang F, Volpe SL. Promotion of physical activity during weight loss maintenance: A randomized controlled trial. Health Psychol 2021; 40:178-187. [PMID: 33630639 PMCID: PMC8341135 DOI: 10.1037/hea0001043] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Behavioral weight loss (BWL) programs are not sufficiently effective at promoting high levels of moderate-to-vigorous physical activity (MVPA), despite the clear health benefits of exercise and the possibility that high levels of MVPA may improve long-term weight loss. This three-arm randomized controlled trial tested the hypotheses that 1) BWL interventions with an intensive focus on exercise would result in higher amounts of MVPA and greater long-term weight loss, compared to standard BWL, and 2) among interventions with an intensive focus on exercise, outcomes would be superior when skills for exercise promotion were taught from an acceptance-based theoretical framework (which fosters willingness to accept discomfort in the service of valued behaviors), versus a traditional behavioral approach. METHOD Three hundred and twenty adults with overweight/obesity received group-based BWL for induction of weight loss (Months 1-6) and were randomized to receive one of three interventions for weight loss maintenance (Months 7-18): continued standard behavioral treatment (BT), behavioral treatment with an emphasis on exercise (BT + PA), or acceptance-based treatment with an emphasis on exercise (ABT + PA). RESULTS MVPA and percent weight loss did not significantly differ by condition at 12 or 18 months. Participants engaging in relatively higher levels of MVPA had greater long-term weight losses compared to participants engaging in lower levels of MVPA. CONCLUSIONS Further clinical innovations are needed so that participants in BWL programs can more readily adopt and maintain the recommended amounts of MVPA. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Meghan L. Butryn
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University
- Department of Psychology, Drexel University
| | | | - Christine C. Call
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University
- Department of Psychology, Drexel University
| | - Evan M. Forman
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University
- Department of Psychology, Drexel University
| | | | | |
Collapse
|
12
|
Stevens CJ, Baldwin AS, Bryan AD, Conner M, Rhodes RE, Williams DM. Affective Determinants of Physical Activity: A Conceptual Framework and Narrative Review. Front Psychol 2020; 11:568331. [PMID: 33335497 PMCID: PMC7735992 DOI: 10.3389/fpsyg.2020.568331] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 11/09/2020] [Indexed: 12/23/2022] Open
Abstract
The literature on affective determinants of physical activity (PA) is growing rapidly. The present paper aims to provide greater clarity regarding the definition and distinctions among the various affect-related constructs that have been examined in relation to PA. Affective constructs are organized according to the Affect and Health Behavior Framework (AHBF), including: (1) affective response (e.g., how one feels in response to PA behavior) to PA; (2) incidental affect (e.g., how one feels throughout the day, unrelated to the target behavior); (3) affect processing (e.g., affective associations, implicit attitudes, remembered affect, anticipated affective response, and affective judgments); and (4) affectively charged motivational states (e.g., intrinsic motivation, fear, and hedonic motivation). After defining each category of affective construct, we provide examples of relevant research showing how each construct may relate to PA behavior. We conclude each section with a discussion of future directions for research.
Collapse
Affiliation(s)
- Courtney J. Stevens
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Austin S. Baldwin
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Angela D. Bryan
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Mark Conner
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Ryan E. Rhodes
- School of Exercise Science, Physical & Health Education, University of Victoria, Victoria, BC, Canada
| | - David M. Williams
- Department of Behavioral and Social Sciences, Department of Psychiatry and Human Behavior, School of Public Health, Brown University, Providence, RI, United States
| |
Collapse
|
13
|
Kibbey MM, DiBello AM, Babu AA, Farris SG. Validation of the Valuing Questionnaire (VQ) in adults with cardiovascular disease and risk. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
14
|
Yıldız E. The effects of acceptance and commitment therapy on lifestyle and behavioral changes: A systematic review of randomized controlled trials. Perspect Psychiatr Care 2020; 56:657-690. [PMID: 32043617 DOI: 10.1111/ppc.12482] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/21/2020] [Accepted: 02/02/2020] [Indexed: 01/03/2023] Open
Abstract
PURPOSE To determine, evaluate, and synthesize the best available evidence about the evidence-based pragmatic effects of acceptance and commitment therapy (ACT) on lifestyle and behavioral changes (LBCs). DESIGN AND METHODS The PICOS formulations were used to improve the search strategy of this systematic review with the aim to find the right evidence and ask the right questions. The assessed articles were subjected to quality assessment using the PRISMA checklist and the Joanna Briggs Institute's standardized critical assessment and data extraction tools. FINDINGS This study involved 30 randomized controlled trials (RCTs) which met the research criteria. Although the included RCTs have several limitations in themselves, the results of this study suggested that the ACT will help maintain long-term LBCs (eg, weight management, effective coping with substance-related and addictive problems, eating and physical activity). PRACTICE IMPLICATIONS Given that ACT is a trandiagnostic approach that promotes health-related LBCs in many diseases and populations, it seems reasonable for clinicians to use and test ACT to achieve pragmatic results.
Collapse
Affiliation(s)
- Erman Yıldız
- Department of Psychiatric Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
| |
Collapse
|
15
|
Stapleton A, O’Connor M, Feerick E, Kerr J, McHugh L. Testing the relationship between health values consistent living and health-related behavior. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
16
|
Manchón J, Quiles M, León E, López-Roig S. Acceptance and Commitment Therapy on physical activity: A systematic review. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
17
|
Psychosocial dimensions of hand transplantation: lessons learned from solid organ transplantation. Curr Opin Organ Transplant 2019; 24:705-713. [PMID: 31689261 DOI: 10.1097/mot.0000000000000712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The present review examines psychosocial factors emerging as predictive of clinical outcomes among solid organ transplant (SOT) recipients, with possible extensions to vascular composite allograft (VCA) and hand transplantation, in particular. The Chauvet Workgroup report and International Society of Heart and Lung Transplantation consensus guidelines are used to delineate areas of commonality between SOT and VCA, as well as unique features contributing to post-VCA psychosocial risk. RECENT FINDINGS Increasing evidence suggests that depression, cognitive function, and other posttransplant psychosocial factors consistently associate with clinical risk in SOT. However, the mechanisms precipitating these psychosocial risk factors are likely diverse in their cause, with large individual differences across SOT and VCA. Transdiagnostic dimensions may serve as mechanistic factors, increasing the risk of adverse clinical outcomes and suggesting potential treatment strategies for risk mitigation. Psychosocial dimensions including psychological flexibility, self-efficacy, and posttraumatic growth are discussed as potential contributory factors. SUMMARY Psychosocial factors hold importance in predicting posttransplant clinical outcomes. Emerging transdiagnostic factors may provide insight into mechanisms and potential treatments.
Collapse
|
18
|
Life Values as an Intrinsic Guide for Cardiopulmonary Rehabilitation Program Engagement: A QUALITATIVE ANALYSIS. J Cardiopulm Rehabil Prev 2019; 38:309-313. [PMID: 29120967 DOI: 10.1097/hcr.0000000000000295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Participation in cardiovascular and pulmonary rehabilitation (CVPR) programs can lead to improved functional abilities and improved quality of life, but attendance and adherence to these programs remain suboptimal. Behavioral therapies have emphasized the importance of life value identification as a guide for goal setting and behavior change for both psychological and physical health conditions. Individuals who choose to engage in behaviors that align with their life values are thought to be intrinsically reinforced. The purpose of the following qualitative study was to interview patients enrolled in CVPR about their own life values and motivating factors related to healthy behavior changes. METHODS Thirty cardiac or pulmonary patients were recruited from a CVPR program and participated in a semistructured interview about their life values and motivating factors related to program engagement. The data were transcribed and analyzed thematically. RESULTS Participants identified a wide range of values related to program engagement, and only half of the participants endorsed health as a value. The most frequently endorsed life values included being active, family, and independence. The interviews indicated that, although patients make lifestyle changes in the program to improve their physical health, there are often other values that primarily guide their choice to engage in and maintain lifestyle behaviors. CONCLUSIONS Life values can serve as a powerful guide for individual behavior change. The present study suggests that the piloting of brief values interventions early in CVPR treatment is warranted and has the potential to improve patient outcomes.
Collapse
|
19
|
Schneider J, Malinowski P, Watson PM, Lattimore P. The role of mindfulness in physical activity: a systematic review. Obes Rev 2019; 20:448-463. [PMID: 30468299 DOI: 10.1111/obr.12795] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/28/2018] [Accepted: 09/30/2018] [Indexed: 02/05/2023]
Abstract
Despite continued public health campaigns to promote physical activity, a majority of the population is inactive. In recent years, mindfulness-based approaches have been used in health and lifestyle interventions for physical activity promotion. We conducted a systematic literature review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to investigate the evidence for the potential of mindfulness-based approaches for physical activity. We searched electronic databases for papers that met eligibility criteria and identified 40 studies for inclusion. Evidence from cross-sectional studies (n = 20) indicated a positive relationship between dispositional mindfulness and physical activity, particularly with psychological factors related to physical activity. Five studies found that the mindfulness-physical activity relationship was mediated by stress, psychological flexibility, negative affect and shame, satisfaction and state mindfulness. Evidence from mindfulness-based interventions (n = 20) suggested positive between-subjects effects on physical activity, but interventions varied in duration, session length, group size, delivery, content and follow-up. Mindfulness-based interventions were more likely to be successful if they were physical activity-specific and targeted psychological factors related to physical activity. The body of research shows a need for more methodologically rigorous studies to establish the effect of mindfulness on physical activity and to identify potential mechanisms involved in the mindfulness-physical activity relationship reliably.
Collapse
Affiliation(s)
- J Schneider
- School of Natural Sciences and Psychology, Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - P Malinowski
- School of Natural Sciences and Psychology, Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - P M Watson
- Research Institute for Sport and Exercise Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - P Lattimore
- School of Natural Sciences and Psychology, Faculty of Science, Liverpool John Moores University, Liverpool, UK
| |
Collapse
|
20
|
Kubzansky LD, Huffman JC, Boehm JK, Hernandez R, Kim ES, Koga HK, Feig EH, Lloyd-Jones DM, Seligman MEP, Labarthe DR. Reprint of: Positive Psychological Well-Being and Cardiovascular Disease: JACC Health Promotion Series. J Am Coll Cardiol 2018; 72:3012-3026. [PMID: 30522634 DOI: 10.1016/j.jacc.2018.10.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/30/2018] [Accepted: 07/30/2018] [Indexed: 02/08/2023]
Abstract
Facets of positive psychological well-being, such as optimism, have been identified as positive health assets because they are prospectively associated with the 7 metrics of cardiovascular health (CVH) and improved outcomes related to cardiovascular disease. Connections between psychological well-being and cardiovascular conditions may be mediated through biological, behavioral, and psychosocial pathways. Individual-level interventions, such as mindfulness-based programs and positive psychological interventions, have shown promise for modifying psychological well-being. Further, workplaces are using well-being-focused interventions to promote employee CVH, and these interventions represent a potential model for expanding psychological well-being programs to communities and societies. Given the relevance of psychological well-being to promoting CVH, this review outlines clinical recommendations to assess and promote well-being in encounters with patients. Finally, a research agenda is proposed. Additional prospective observational studies are needed to understand mechanisms underlying the connection between psychological well-being and cardiovascular outcomes. Moreover, rigorous intervention trials are needed to assess whether psychological well-being-promoting programs can improve cardiovascular outcomes.
Collapse
Affiliation(s)
| | - Jeff C Huffman
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, California
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Eric S Kim
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Hayami K Koga
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emily H Feig
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Martin E P Seligman
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Darwin R Labarthe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| |
Collapse
|
21
|
Kubzansky LD, Huffman JC, Boehm JK, Hernandez R, Kim ES, Koga HK, Feig EH, Lloyd-Jones DM, Seligman MEP, Labarthe DR. Positive Psychological Well-Being and Cardiovascular Disease: JACC Health Promotion Series. J Am Coll Cardiol 2018; 72:1382-1396. [PMID: 30213332 PMCID: PMC6289282 DOI: 10.1016/j.jacc.2018.07.042] [Citation(s) in RCA: 221] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/30/2018] [Accepted: 07/30/2018] [Indexed: 02/07/2023]
Abstract
Facets of positive psychological well-being, such as optimism, have been identified as positive health assets because they are prospectively associated with the 7 metrics of cardiovascular health (CVH) and improved outcomes related to cardiovascular disease. Connections between psychological well-being and cardiovascular conditions may be mediated through biological, behavioral, and psychosocial pathways. Individual-level interventions, such as mindfulness-based programs and positive psychological interventions, have shown promise for modifying psychological well-being. Further, workplaces are using well-being-focused interventions to promote employee CVH, and these interventions represent a potential model for expanding psychological well-being programs to communities and societies. Given the relevance of psychological well-being to promoting CVH, this review outlines clinical recommendations to assess and promote well-being in encounters with patients. Finally, a research agenda is proposed. Additional prospective observational studies are needed to understand mechanisms underlying the connection between psychological well-being and cardiovascular outcomes. Moreover, rigorous intervention trials are needed to assess whether psychological well-being-promoting programs can improve cardiovascular outcomes.
Collapse
Affiliation(s)
| | - Jeff C Huffman
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, California
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Eric S Kim
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Hayami K Koga
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emily H Feig
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Martin E P Seligman
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Darwin R Labarthe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| |
Collapse
|
22
|
Coffino JA, Heiss S, Hormes JM. Targeting acceptance in the management of food craving: The mediating roles of eating styles and thought suppression. Eat Behav 2018; 29:132-136. [PMID: 29665461 DOI: 10.1016/j.eatbeh.2018.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 04/06/2018] [Accepted: 04/11/2018] [Indexed: 11/29/2022]
Abstract
Food craving is now widely considered to be a cognitively motivated state. Acceptance-based treatments are effective in reducing the adverse impact of food cravings on consumption, via a hypothesized decrease in experiential avoidance. The mechanisms that drive the success of acceptance-based management of craving remain to be empirically tested. This study examined the role of eating styles and thought suppression as mediators in the relationship between experiential avoidance and craving. Participants (n = 298, 51.5% female) completed the Food Craving Acceptance and Awareness Questionnaire (FAAQ), the Dutch Eating Behavior Questionnaire (DEBQ), the White Bear Suppression Inventory (WBSI; a measure of thought suppression), and the reduced version of the Food Craving Questionnaire- Trait (FCQ-T-r). Scores on the FAAQ were inversely associated with scores on the FCQ-T-r, DEBQ, and WBSI; FCQ-T-r scores were positively correlated with scores on the DEBQ and WBSI (all p < 0.001). The total indirect effect of acceptance on craving through the hypothesized mediators was significantly different from zero. Controlling for eating styles and thought suppression, acceptance remained a significant predictor of craving. Results thus provide initial evidence that eating styles and thought suppression mediate the relationship between food-specific experiential avoidance and food craving. Findings lay the foundation for future study of the proximal antecedents of food cravings and lend preliminary support for targeting thought suppression and eating styles in acceptance-based approaches to the management of craving.
Collapse
Affiliation(s)
- Jaime A Coffino
- Department of Psychology, University at Albany, State University of New York, USA.
| | - Sydney Heiss
- Department of Psychology, University at Albany, State University of New York, USA
| | - Julia M Hormes
- Department of Psychology, University at Albany, State University of New York, USA
| |
Collapse
|
23
|
Dunn C, Haubenreiser M, Johnson M, Nordby K, Aggarwal S, Myer S, Thomas C. Mindfulness Approaches and Weight Loss, Weight Maintenance, and Weight Regain. Curr Obes Rep 2018; 7:37-49. [PMID: 29446036 DOI: 10.1007/s13679-018-0299-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW There is an urgent need for effective weight management techniques, as more than one third of US adults are overweight or obese. Recommendations for weight loss include a combination of reducing caloric intake, increasing physical activity, and behavior modification. Behavior modification includes mindful eating or eating with awareness. The purpose of this review was to summarize the literature and examine the impact of mindful eating on weight management. RECENT FINDINGS The practice of mindful eating has been applied to the reduction of food cravings, portion control, body mass index, and body weight. Past reviews evaluating the relationship between mindfulness and weight management did not focus on change in mindful eating as the primary outcome or mindful eating as a measured variable. This review demonstrates strong support for inclusion of mindful eating as a component of weight management programs and may provide substantial benefit to the treatment of overweight and obesity.
Collapse
Affiliation(s)
- Carolyn Dunn
- Department of Agricultural and Human Sciences, North Carolina State University, Campus Box 7606, Raleigh, NC, 27695, USA.
| | - Megan Haubenreiser
- Community and Clinical Connections for Prevention and Health Branch, North Carolina Division of Public Health, 1915 Mail Service Center, Raleigh, NC, USA
| | - Madison Johnson
- Department of Agricultural and Human Sciences, North Carolina State University, Campus Box 7606, Raleigh, NC, 27695, USA
| | - Kelly Nordby
- Department of Agricultural and Human Sciences, North Carolina State University, Campus Box 7606, Raleigh, NC, 27695, USA
| | - Surabhi Aggarwal
- Department of Agricultural and Human Sciences, North Carolina State University, Campus Box 7606, Raleigh, NC, 27695, USA
| | - Sarah Myer
- Department of Agricultural and Human Sciences, North Carolina State University, Campus Box 7606, Raleigh, NC, 27695, USA
| | - Cathy Thomas
- Community and Clinical Connections for Prevention and Health Branch, North Carolina Division of Public Health, 1915 Mail Service Center, Raleigh, NC, USA
| |
Collapse
|
24
|
Bonacquisti A, Cohen MJ, Schiller CE. Acceptance and commitment therapy for perinatal mood and anxiety disorders: development of an inpatient group intervention. Arch Womens Ment Health 2017; 20:645-654. [PMID: 28600645 DOI: 10.1007/s00737-017-0735-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/17/2017] [Indexed: 11/26/2022]
Abstract
Perinatal mood and anxiety disorders are a leading cause of morbidity and mortality for childbearing women. Current treatments, such as cognitive behavioral therapy and interpersonal therapy, have demonstrated modest success in addressing perinatal psychiatric symptoms; however, additional treatment options are needed to address the limitations of current approaches, particularly for women experiencing moderate to severe perinatal mental illness during pregnancy or postpartum. We discuss the use of acceptance and commitment therapy (ACT) as a promising treatment approach that may be uniquely suited for perinatal women due to its emphasis of values, mindfulness, and acceptance; these psychological constructs notably address the significant psychiatric and behavioral health condition comorbidity, somatic symptoms, and stigma associated with perinatal mood and anxiety disorders. In addition, we describe the development of a four-session ACT-based group intervention at the Perinatal Psychiatry Inpatient Unit at the University of North Carolina at Chapel Hill. Sessions focus on core ACT processes of acceptance, cognitive defusion, present-moment awareness, value identification, and goal setting, and we describe how each of these processes is relevant to the perinatal population. Implications for future clinical applications and research investigations are discussed.
Collapse
Affiliation(s)
- Alexa Bonacquisti
- Department of Psychology, Drexel University, 3141 Chestnut Street, Stratton Hall, Suite 119, Philadelphia, PA, 19104, USA.
| | - Matthew J Cohen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, 235 E. Cameron Avenue, Chapel Hill, NC, 27599-3270, USA
| | - Crystal Edler Schiller
- UNC Department of Psychiatry, 101 Manning Drive, Campus Box #7160, Chapel Hill, NC, 27599-7160, USA
| |
Collapse
|
25
|
Huffman JC, Adams CN, Celano CM. Collaborative Care and Related Interventions in Patients With Heart Disease: An Update and New Directions. PSYCHOSOMATICS 2017; 59:1-18. [PMID: 29078987 DOI: 10.1016/j.psym.2017.09.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 09/13/2017] [Accepted: 09/13/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Psychiatric disorders, such as depression, are very common in cardiac patients and are independently linked to adverse cardiac outcomes, including mortality. Collaborative care and other integrated care models have been used successfully to manage psychiatric conditions in patients with heart disease, with beneficial effects on function and other outcomes. Novel programs using remote delivery of mental health interventions and promotion of psychological well-being may play an increasingly large role in supporting cardiovascular health. METHODS We review prior studies of standard and expanded integrated care programs among patients with cardiac disease, examine contemporary intervention delivery methods (e.g., Internet or mobile phone) that could be adapted for these programs, and outline mental health-related interventions to promote healthy behaviors and overall recovery across all cardiac patients. RESULTS Standard integrated care models for mental health disorders are effective at improving mood, anxiety, and function in patients with heart disease. Novel, "blended" collaborative care models may have even greater promise in improving cardiac outcomes, and interfacing with cardiac patients via mobile applications, text messages, and video visits may provide additional benefit. A variety of newer interventions using stress management, mindfulness, or positive psychology have shown promising effects on mental health, health behaviors, and overall cardiac outcomes. CONCLUSIONS Further study of novel applications of collaborative care and related interventions is warranted given the potential of these programs to increase the reach and effect of mental health interventions in patients with heart disease.
Collapse
Affiliation(s)
- Jeff C Huffman
- Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA.
| | - Caitlin N Adams
- Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | | |
Collapse
|
26
|
Exploring process variables through which acceptance-based behavioral interventions may improve weight loss maintenance. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2017; 6:398-403. [PMID: 29230381 DOI: 10.1016/j.jcbs.2017.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective A previously published randomized trial with individuals reporting high internal disinhibition showed significant differences in post-treatment weight change favoring Acceptance-Based Behavioral Intervention (ABBI) when compared to standard behavioral treatment (SBT). This paper examines process variables that might contribute to the observed differences in weight change. Methods Participants were 162 adults with overweight or obesity (mean BMI 37.6) randomly assigned to ABBI or SBT. Both interventions provided the same calorie intake target, exercise goal, and self-monitoring skills training. SBT incorporated current best practice interventions for addressing problematic thoughts and emotions. ABBI utilized acceptance-based techniques based on Acceptance and Commitment Therapy. ABBI and SBT were compared on process measures hypothesized to be related to outcome in ABBI and SBT and their association with weight loss outcomes using linear and non-linear mixed models methods and exploratory correlational analyses. Results Both the SBT and the ABBI groups showed significant changes over time on all process variables. The only significant between group difference was for values consistent behavior, with the ABBI group improving more as compared to SBT (t=2.45, p=.016); however, changes in values consistent behavior did not mediate weight change. Exploratory analyses suggest the possibility that changes in process variables were less associated with weight change in ABBI than in SBT after treatment was discontinued. Conclusions Both conditions produced significant changes in process variables, however there was little difference between groups. Thus, the results do not provide an adequate process account for the observed weight change differences between ABBI and SBT, leaving important questions that need to be addressed by future research.
Collapse
|
27
|
Kaar JL, Luberto CM, Campbell KA, Huffman JC. Sleep, health behaviors, and behavioral interventions: Reducing the risk of cardiovascular disease in adults. World J Cardiol 2017; 9:396-406. [PMID: 28603586 PMCID: PMC5442407 DOI: 10.4330/wjc.v9.i5.396] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 03/04/2017] [Accepted: 04/10/2017] [Indexed: 02/06/2023] Open
Abstract
Numerous health behaviors, including physical activity, diet, smoking, and sleep, play a major role in preventing the development and progression of cardiovascular disease (CVD). Among these behaviors, sleep may play a pivotal role, yet it has been studied somewhat less than other behaviors and there have been few well-designed sleep intervention studies targeting CVD. Furthermore, despite the fact that these behaviors are often interrelated, interventions tend to focus on changing one health behavior rather than concurrently intervening on multiple behaviors. Psychological constructs from depression to positive affect may also have a major effect on these health behaviors and ultimately on CVD. In this review, we summarize the existing literature on the impact of sleep and other cardiac health behaviors on CVD onset and prognosis. We also describe interventions that may promote these behaviors, from established interventions such as motivational interviewing and cognitive behavioral therapy, to more novel approaches focused on mindfulness and other positive psychological constructs. Finally, we outline population-health-level care management approaches for patients with psychiatric conditions (e.g., depression) that may impact cardiac health, and discuss their potential utility in improving mental health, promoting health behaviors, and reducing CVD-related risk. Much work is still needed to better understand how sleep and other health behaviors may uniquely contribute to CVD risk, and additional high-quality studies of interventions designed to modify cardiac health behaviors are required to improve cardiovascular health in individuals and the population at large.
Collapse
|
28
|
Schumacher TL, Burrows TL, Neubeck L, Redfern J, Callister R, Collins CE. How dietary evidence for the prevention and treatment of CVD is translated into practice in those with or at high risk of CVD: a systematic review. Public Health Nutr 2017; 20:30-45. [PMID: 27330027 PMCID: PMC10261389 DOI: 10.1017/s1368980016001543] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 03/23/2016] [Accepted: 05/13/2016] [Indexed: 01/08/2023]
Abstract
OBJECTIVE CVD is a leading cause of mortality and morbidity, and nutrition is an important lifestyle factor. The aim of the present systematic review was to synthesise the literature relating to knowledge translation (KT) of dietary evidence for the prevention and treatment of CVD into practice in populations with or at high risk of CVD. DESIGN A systematic search of six electronic databases (CINAHL, Cochrane, EMBASE, MEDLINE, PsycINFO and Scopus) was performed. Studies were included if a nutrition or dietary KT was demonstrated to occur with a relevant separate measureable outcome. Quality was assessed using a tool adapted from two quality checklists. SUBJECTS Population with or at high risk of CVD or clinicians likely to treat this population. RESULTS A total of 4420 titles and abstracts were screened for inclusion, with 354 full texts retrieved to assess inclusion. Forty-three articles were included in the review, relating to thirty-five separate studies. No studies specifically stated their aim to be KT. Thirty-one studies were in patient or high-risk populations and four targeted health professionals. Few studies stated a theory on which the intervention was based (n 10) and provision of instruction was the most common behaviour change strategy used (n 26). CONCLUSIONS KT in nutrition and dietary studies has been inferred, not stated, with few details provided regarding how dietary knowledge is translated to the end user. This presents challenges for implementation by clinicians and policy and decision makers. Consequently a need exists to improve the quality of publications in this area.
Collapse
Affiliation(s)
- Tracy L Schumacher
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia
| | - Tracy L Burrows
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia
| | - Lis Neubeck
- Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
| | - Julie Redfern
- George Institute for Global Health, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Robin Callister
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia
| | - Clare E Collins
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia
| |
Collapse
|
29
|
Rogers JM, Ferrari M, Mosely K, Lang CP, Brennan L. Mindfulness-based interventions for adults who are overweight or obese: a meta-analysis of physical and psychological health outcomes. Obes Rev 2017; 18:51-67. [PMID: 27862826 DOI: 10.1111/obr.12461] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/18/2016] [Accepted: 07/19/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the impact of mindfulness-based interventions on psychological and physical health outcomes in adults who are overweight or obese. METHODS We searched 14 electronic databases for randomized controlled trials and prospective cohort studies that met eligibility criteria. Comprehensive Meta-analysis software was used to compute the effect size estimate Hedge's g. RESULTS Fifteen studies measuring post-treatment outcomes of mindfulness-based interventions in 560 individuals were identified. The average weight loss was 4.2 kg. Overall effects were large for improving eating behaviours (g = 1.08), medium for depression (g = 0.64), anxiety (g = 0.62) and eating attitudes (g = 0.57) and small for body mass index (BMI; g = 0.47) and metacognition (g = 0.38) outcomes. Therapeutic effects for BMI (g = 0.43), anxiety (g = 0.53), eating attitudes (g = 0.48) and eating behaviours (g = 0.53) remained significant when examining results from higher quality randomized control trials alone. There was no efficacy advantage for studies exceeding the median dose of 12 h of face-to-face intervention. Studies utilizing an Acceptance and Commitment Therapy approach provided the only significant effect for improving BMI (g = 0.66), while mindfulness approaches produced great variation from small to large (g = 0.30-1.68) effects across a range of psychological health and eating-related constructs. Finally, the limited longitudinal data suggested maintenance of BMI (g = 0.85) and eating attitudes (g = 0.75) gains at follow-up were only detectable in lower quality prospective cohort studies. CONCLUSIONS Mindfulness-based interventions may be both physically and psychologically beneficial for adults who are overweight or obese, but further high-quality research examining the mechanisms of action are encouraged.
Collapse
Affiliation(s)
- Jeffrey M Rogers
- Centre for Disability and Development Research, Australian Catholic University, Sydney, NSW, Australia
| | - Madeleine Ferrari
- School of Psychology, Australian Catholic University, Sydney, NSW, Australia
| | - Kylie Mosely
- BodyMatters Australasia, Sydney, NSW, Australia.,Graduate School of Health, University of Technology, Sydney, NSW, Australia
| | - Cathryne P Lang
- School of Psychology, Australian Catholic University, Brisbane, QLD, Australia
| | - Leah Brennan
- School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| |
Collapse
|
30
|
Lillis J, Niemeier HM, Thomas JG, Unick J, Ross KM, Leahey TM, Kendra KE, Dorfman L, Wing RR. A randomized trial of an acceptance-based behavioral intervention for weight loss in people with high internal disinhibition. Obesity (Silver Spring) 2016; 24:2509-2514. [PMID: 27804255 PMCID: PMC5125828 DOI: 10.1002/oby.21680] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/07/2016] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To determine whether an acceptance-based behavioral intervention (ABBI) produces better weight losses than standard behavioral treatment (SBT) among individuals reporting high internal disinhibition. METHODS Participants were 162 adults with overweight or obesity (mean BMI 37.6 kg/m2 ) randomly assigned to ABBI or SBT. Both interventions provided the same calorie intake target, exercise goal, and self-monitoring skills training. SBT incorporated current best practice interventions for addressing problematic thoughts and emotions. ABBI utilized acceptance-based techniques based on Acceptance and Commitment Therapy. ABBI and SBT were compared on weight change and internal disinhibition change over 24 months. RESULTS Mixed models analysis showed mean weight loss at 24 months was -4.1% (SE = 0.88) for ABBI and -2.4% (SE = 0.87) for SBT (P = 0.204). Secondary analyses showed that the ABBI group regained less weight from the end of treatment to the final follow-up (4.6 vs. 7.1 kg; P = 0.005), and that a significantly higher proportion of ABBI participants achieved a 5% weight loss (38% vs. 25%; P = 0.038) at 24 months. CONCLUSIONS Results suggest that ABBI could be helpful for improving the maintenance of weight loss for individuals who report high internal disinhibition.
Collapse
Affiliation(s)
- Jason Lillis
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Heather M. Niemeier
- Department of Psychology, University of Wisconsin-Whitewater, Whitewater, WI, USA
| | - John G. Thomas
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Jessica Unick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Kathryn M. Ross
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Tricia M. Leahey
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Kathleen E. Kendra
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Leah Dorfman
- The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Rena R. Wing
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| |
Collapse
|
31
|
Forman EM, Butryn ML, Manasse SM, Crosby RD, Goldstein SP, Wyckoff EP, Thomas JG. Acceptance-based versus standard behavioral treatment for obesity: Results from the mind your health randomized controlled trial. Obesity (Silver Spring) 2016; 24:2050-6. [PMID: 27670400 PMCID: PMC5051349 DOI: 10.1002/oby.21601] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/31/2016] [Accepted: 06/01/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the efficacy, as well as potential moderators and mediators, of a revised acceptance-based behavioral treatment (ABT) for obesity, relative to standard behavioral treatment (SBT). METHODS Participants with overweight and obesity (n = 190) were randomized to 25 sessions of ABT or SBT over 1 year. Primary outcome (weight), mediator, and moderator measurements were taken at baseline, 6 months, and/or 12 months, and weight was also measured every session. RESULTS Participants assigned to ABT attained a significantly greater 12-month weight loss (13.3% ± 0.83%) than did those assigned to SBT (9.8% ± 0.87%; P = 0.005). A condition by quadratic time effect on session-by-session weights (P = 0.01) indicated that SBT had a shallower trajectory of weight loss followed by an upward deflection. ABT participants were also more likely to maintain a 10% weight loss at 12 months (64.0% vs. 48.9%; P = 0.04). No evidence of moderation was found. Results supported the mediating role of autonomous motivation and psychological acceptance of food-related urges. CONCLUSIONS Behavioral weight loss outcomes can be improved by integrating self-regulation skills that are reflected in acceptance-based treatment, i.e., tolerating discomfort and reduction in pleasure, enacting commitment to valued behavior, and being mindfully aware during moments of decision-making.
Collapse
Affiliation(s)
- Evan M Forman
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA.
| | - Meghan L Butryn
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Stephanie M Manasse
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Ross D Crosby
- Neuropsychiatric Research Institute, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | | | - Emily P Wyckoff
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| |
Collapse
|
32
|
Graham CD, Gouick J, Krahé C, Gillanders D. A systematic review of the use of Acceptance and Commitment Therapy (ACT) in chronic disease and long-term conditions. Clin Psychol Rev 2016; 46:46-58. [DOI: 10.1016/j.cpr.2016.04.009] [Citation(s) in RCA: 156] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 03/07/2016] [Accepted: 04/07/2016] [Indexed: 12/21/2022]
|
33
|
Martin S, Wolters PL, Toledo-Tamula MA, Schmitt SN, Baldwin A, Starosta A, Gillespie A, Widemann B. Acceptance and commitment therapy in youth with neurofibromatosis type 1 (NF1) and chronic pain and their parents: A pilot study of feasibility and preliminary efficacy. Am J Med Genet A 2016; 170:1462-70. [PMID: 27021207 PMCID: PMC6675568 DOI: 10.1002/ajmg.a.37623] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 02/26/2016] [Indexed: 11/09/2022]
Abstract
Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder affecting about 1 in 3,500 individuals. Chronic pain is commonly reported among individuals with NF1 and plexiform neurofibroma tumors (PNs). Acceptance and Commitment Therapy (ACT), an empirically supported method for addressing chronic pain, helps individuals re-focus on valued relationships and activities. This pilot study investigated the feasibility and preliminary efficacy of a brief ACT workshop in the NF1 population. Eligible participants included adolescents and young adults (AYA; 12-21 years) with NF1 and chronic pain that interfered with daily functioning and their parents. Patients and parents completed baseline measures of pain interference, pain intensity, functional disability, pain acceptance, depression, and anxiety. Then, AYA and parents participated separately in a 2-day small-group ACT workshop. A telephone booster session occurred 1 month post-intervention. Three-month post-treatment measures were completed by mail. Ten adolescents (4 males; M age = 16.9 years) and seven parents provided baseline and 3-month data. Mean satisfaction with the study was moderate to high (3.9 for patients and 4.6 for parents on a 1-5 scales). Patients and parents reported significant declines in patients' pain interference at 3 months post-treatment. Patient-reported pain intensity significantly declined from baseline to 3 months. Parents reported marginally greater acceptance of their child's pain. No changes emerged in functional ability or mood. Preliminary findings suggest that a brief ACT group intervention is feasible and may help AYA with NF1 and PNs cope with their chronic pain, although larger randomized studies are needed to confirm treatment efficacy. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Staci Martin
- Pediatric Oncology Branch, National Cancer Institute, Montgomery County, Bethesda, Maryland
| | - Pamela L. Wolters
- Pediatric Oncology Branch, National Cancer Institute, Montgomery County, Bethesda, Maryland
| | - Mary Anne Toledo-Tamula
- Clinical Research Directorate/CMRP, Leidos Biomedical Research, Inc., National Laboratory for Cancer Research, Frederick County, Frederick, Maryland
| | - Shawn Nelson Schmitt
- Pediatric Oncology Branch, National Cancer Institute, Montgomery County, Bethesda, Maryland
- Ettenhofer Laboratory for Neurocognitive Research, Uniformed Services University of the Health Sciences, Montgomery County, Bethesda, Maryland
| | - Andrea Baldwin
- Pediatric Oncology Branch, National Cancer Institute, Montgomery County, Bethesda, Maryland
| | - Amy Starosta
- Pediatric Oncology Branch, National Cancer Institute, Montgomery County, Bethesda, Maryland
- University at Albany, State University of New York, Albany County, Albany, New York
| | - Andrea Gillespie
- Pediatric Oncology Branch, National Cancer Institute, Montgomery County, Bethesda, Maryland
| | - Brigitte Widemann
- Pediatric Oncology Branch, National Cancer Institute, Montgomery County, Bethesda, Maryland
| |
Collapse
|
34
|
The BestFIT trial: A SMART approach to developing individualized weight loss treatments. Contemp Clin Trials 2016; 47:209-16. [PMID: 26825020 DOI: 10.1016/j.cct.2016.01.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/22/2016] [Accepted: 01/25/2016] [Indexed: 11/23/2022]
Abstract
Behavioral weight loss programs help people achieve clinically meaningful weight losses (8-10% of starting body weight). Despite data showing that only half of participants achieve this goal, a "one size fits all" approach is normative. This weight loss intervention science gap calls for adaptive interventions that provide the "right treatment at the right time for the right person." Sequential Multiple Assignment Randomized Trials (SMART), use experimental design principles to answer questions for building adaptive interventions including whether, how, or when to alter treatment intensity, type, or delivery. This paper describes the rationale and design of the BestFIT study, a SMART designed to evaluate the optimal timing for intervening with sub-optimal responders to weight loss treatment and relative efficacy of two treatments that address self-regulation challenges which impede weight loss: 1) augmenting treatment with portion-controlled meals (PCM) which decrease the need for self-regulation; and 2) switching to acceptance-based behavior treatment (ABT) which boosts capacity for self-regulation. The primary aim is to evaluate the benefit of changing treatment with PCM versus ABT. The secondary aim is to evaluate the best time to intervene with sub-optimal responders. BestFIT results will lead to the empirically-supported construction of an adaptive intervention that will optimize weight loss outcomes and associated health benefits.
Collapse
|
35
|
Martin E, Galloway-Williams N, Cox M, Winett R. Pilot testing of a mindfulness- and acceptance-based intervention for increasing cardiorespiratory fitness in sedentary adults: A feasibility study. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2015; 4:237-245. [PMID: 27104134 PMCID: PMC4834715 DOI: 10.1016/j.jcbs.2015.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Vigorous physical activity (PA) has been promoted for improving cardiorespiratory fitness (CRF). However, therapeutic techniques designed to engage participants in vigorous PA have fallen short; one reason for this may be the unpleasant physical sensations associated with vigorous exercise (e.g., temporary shortness of breath and mild muscle soreness). Mindfulness and acceptance-based therapies such as Acceptance and Commitment Therapy (ACT) may be helpful at improving adherence to vigorous PA levels. In this open clinical trial, we sought to demonstrate the feasibility and acceptability of a mindfulness- and acceptance-based intervention for increasing CRF in sedentary adults and to generate initial outcomes data. DESIGN Participants (N=24) engaged in a 10-week fitness walking program while attending regular group sessions based on ACT. MAIN OUTCOME MEASURES AND RESULTS The feasibility and acceptability of the intervention were demonstrated through high levels of walking adherence (89.30%) and group session attendance (85.50%). A large significant decrease in total 1-mile walk test time [t(18)=4.61, p=.0002, d=.64] and a moderate significant increase in estimated VO2max [t(18)=-4.05, p=.0007, d=-.43] were observed. Analyses indicated a large significant increase in exercise-related experiential acceptance [t(18)=-9.19, p <.0001, d=-2.09]. CONCLUSION This study demonstrates the feasibility and acceptability of an ACT-based intervention for supporting participation in vigorous PA in sedentary individuals.
Collapse
Affiliation(s)
- E.C. Martin
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Unit 1330, PO Box 301439, Houston, TX 77230-1439, USA
| | | | - M.G. Cox
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Unit 1330, PO Box 301439, Houston, TX 77230-1439, USA
| | - R.A. Winett
- Department of Psychology, Virginia Tech, USA
| |
Collapse
|
36
|
Stevens CJ, Bryan AD. A case for leveraging integrated regulation strategies to optimize health benefits from self-determined exercise behavior. Ann Behav Med 2015; 49:783-4. [PMID: 26231146 DOI: 10.1007/s12160-015-9722-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Courtney J Stevens
- Department of Psychology and Neuroscience, University of Colorado Boulder, Muenzinger 345 UCB, Boulder, CO, 80309-0345, USA,
| | | |
Collapse
|
37
|
Gregg JA, Lillis J, Schmidt EM. A functional contextual approach to obesity and related problems. Curr Opin Psychol 2015. [DOI: 10.1016/j.copsyc.2014.12.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
38
|
Kangasniemi AM, Lappalainen R, Kankaanpää A, Tolvanen A, Tammelin T. Towards a physically more active lifestyle based on one's own values: the results of a randomized controlled trial among physically inactive adults. BMC Public Health 2015; 15:260. [PMID: 25848812 PMCID: PMC4371624 DOI: 10.1186/s12889-015-1604-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 03/02/2015] [Indexed: 01/20/2023] Open
Abstract
Background The high prevalence of physical inactivity has led to a search for novel and feasible interventions that will enhance physical activity, especially among the least physically active individuals. This randomized controlled trial aimed to determine the effectiveness of a value-based intervention to promote a physically more active lifestyle among physically inactive adults. The framework of the study was based on Acceptance and Commitment Therapy (ACT). Methods Physically inactive participants aged 30 to 50 years (n = 138) were randomly allocated to a feedback (FB, n = 69) or an acceptance- and commitment-based group (ACT + FB, n = 69). Both groups received written feedback about their objectively measured physical activity and were offered a body composition analysis. In addition, the participants in the ACT + FB group attended six group sessions and were given a pedometer for self-monitoring their physical activity during the nine-week intervention. The primary outcome was physical activity. In addition, participants’ cognitions related to exercise and physical activity were evaluated at baseline and at three- and six-month follow-ups. The changes in mean physical activity level were analysed using multilevel random regression and rank order stability, using the structural equation model. Results Participants in both groups increased their objectively measured and self-reported physical activity with high individual differences. No difference was observed in the change of physical activity level between the FB and ACT + FB groups over time. However, the cognitions related to physical activity and exercise improved more in the ACT + FB group than in the FB group. In addition, after re-analyzing the data among the non-depressive participants, higher stability was observed in objectively measured physical activity at the individual level between the three- and six-month follow-ups in the ACT + FB group as compared to FB group. Conclusions Acceptance- and commitment-based group intervention, combined with the self-monitoring of physical activity, was beneficial in supporting the cognition related to exercise and physical activity, and brought more stability to the individual level physical activity behaviour change, especially among the non-depressive participants. Trial registration ClinicalTrials.gov, number NCT01796990. Registered in February 2013. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1604-x) contains supplementary material, which is available to authorized users.
Collapse
|
39
|
Spatola CAM, Cappella EAM, Goodwin CL, Baruffi M, Malfatto G, Facchini M, Castelnuovo G, Manzoni GM, Molinari E. Development and initial validation of the Cardiovascular Disease Acceptance and Action Questionnaire (CVD-AAQ) in an Italian sample of cardiac patients. Front Psychol 2014; 5:1284. [PMID: 25452737 PMCID: PMC4231832 DOI: 10.3389/fpsyg.2014.01284] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 10/23/2014] [Indexed: 11/20/2022] Open
Abstract
Psychological inflexibility refers to the attempt to decrease internal distress even when doing so is inconsistent with life values, and has been identified as a potential barrier to making and maintaining health behavior changes that are consistent with a heart-healthy lifestyle. Disease- and behavior-specific measures of psychological inflexibility have been developed and utilized in treatment research. However, no specific measure has been created for patients with heart disease. Thus, the CardioVascular Disease Acceptance and Action Questionnaire (CVD-AAQ) was developed. The present study is aimed to evaluate the psychometric properties of the CVD-AAQ and to explore its association with measures of psychological adjustment and cardiovascular risk factors in an Italian sample of 275 cardiac patients. Exploratory factor analysis showed a structural one-factor solution with satisfactory internal consistency and test-retest reliability. The relation with other measures was in the expected direction with stronger correlations for the theoretically consistent variables, supporting convergent and divergent validity. CVD-AAQ scores were associated with general psychological inflexibility, anxiety and depression and inversely correlated with psychological well-being. Moreover, the results showed that CVD-AAQ scores are associated with two relevant risk factors for cardiac patients, namely low adherence to medication and being overweight. In sum, results suggest that the CVD-AAQ is a reliable and valid measure of heart disease-specific psychological inflexibility with interesting clinical applications for secondary prevention care.
Collapse
Affiliation(s)
- Chiara A. M. Spatola
- Psychology Research Laboratory, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| | - Emanuele A. M. Cappella
- Psychology Research Laboratory, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| | | | - Matteo Baruffi
- Psychology Research Laboratory, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| | - Gabriella Malfatto
- Cardiology Division, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
| | - Mario Facchini
- Cardiology Division, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
- Faculty of Psychology, eCampus UniversityNovedrate, Como, Italy
| | - Enrico Molinari
- Psychology Research Laboratory, Istituto Auxologico Italiano – Istituto di Ricovero e Cura a Carattere ScientificoMilan, Italy
- Department of Psychology, Catholic University of MilanMilan, Italy
| |
Collapse
|
40
|
Moffitt R, Mohr P. The efficacy of a self-managed Acceptance and Commitment Therapy intervention DVD for physical activity initiation. Br J Health Psychol 2014; 20:115-29. [PMID: 24698135 DOI: 10.1111/bjhp.12098] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 02/18/2014] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Initiating and maintaining physical activity presents the individual with challenges of inconvenience, discomfort, and counteractive energy. Addressing these challenges requires an intervention that elicits motivation to engage in this activity, minimizes the direct relationship between unwanted internal experiences and inaction, and is also in itself accessible and convenient. Accordingly, this study investigated the efficacy of a self-managed Acceptance and Commitment Therapy (ACT) intervention delivered via DVD and tailored for physical activity initiation. DESIGN AND METHODS Fifty-nine minimally active community participants were randomly allocated to receive a 12-week pedometer-based walking programme, or the same walking programme with the additional provision of the ACT DVD. The primary outcome was overall physical activity level (assessed at baseline and post-intervention), and the secondary outcome was pedometer-assessed step count (measured at 4-weekly intervals throughout the intervention period). RESULTS Participants who received the ACT DVD achieved a significantly greater increase in physical activity levels post-intervention, were more likely to achieve the goals specified in the programme, and reported a higher average step count than participants who received the walking programme in isolation. CONCLUSIONS The ACT intervention, delivered via DVD for the promotion of physical activity, proved a simple, efficient, and accessible method to encourage positive short-term increases in an important health-promoting behaviour. Statement of contribution What is already known? ACT interventions can increase physical activity levels through augmenting initiatory self-regulatory control. Face-to-face delivery presents challenges of accessibility and feasibility for community implementation. There is a need for effective interventions that maximize impact while minimizing inconvenience. What does this study add? Supplementing a walking programme with a self-managed ACT DVD produced significant increases in physical activity. The ACT DVD is a convenient, accessible, and potentially cost-effective approach to physical activity initiation. ACT lends itself to implementation as a self-managed electronically delivered intervention.
Collapse
Affiliation(s)
- Robyn Moffitt
- School of Psychology, Australian Catholic University, Banyo, Queensland, Australia
| | | |
Collapse
|
41
|
Spatola CAM, Manzoni GM, Castelnuovo G, Malfatto G, Facchini M, Goodwin CL, Baruffi M, Molinari E. The ACTonHEART study: rationale and design of a randomized controlled clinical trial comparing a brief intervention based on Acceptance and Commitment Therapy to usual secondary prevention care of coronary heart disease. Health Qual Life Outcomes 2014; 12:22. [PMID: 24552555 PMCID: PMC3936953 DOI: 10.1186/1477-7525-12-22] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 01/20/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Modifiable risk factors, including life-style habits and psychological variables, have been increasingly demonstrated to have an important role in influencing morbidity and mortality in cardiovascular patients, and to account for approximately 90% of the population risk for cardiac events.Acceptance and Commitment Therapy (ACT) has shown effectiveness in promoting healthy behaviors, and improving psychological well-being in patients with chronic physical conditions. Moreover, a first application of an acceptance-based program in cardiac patients has revealed high treatment satisfaction and initial evidences of effectiveness in increasing heart-healthy behaviour. However, no clinical trial to date has evaluated the efficacy of an acceptance-based program for the modification of cardiovascular risk factors and the improvement of psychological well-being, compared to usual secondary prevention care. METHODS Approximately 168 patients will be recruited from an outpatient cardiac rehabilitation unit and randomly assigned to receive usual care or usual care + a brief ACT-based intervention. The ACT group will be administered five group therapy sessions integrating educational topics on heart-healthy behaviours with acceptance and mindfulness skills. Participants will be assessed at baseline, six weeks later (post treatment for the ACT condition), at six and twelve months follow-up.A partially-nested design will be used to balance effects due to clustering of participants into small therapy groups. Primary outcome measures will include biological indicators of cardiovascular risk and self-reported psychological well-being. Treatment effects will be tested via multilevel modeling after which the mediational role of psychological flexibility will be evaluated. DISCUSSION The ACTonHEART study is the first randomized clinical trial designed to evaluate the efficacy of a brief group-administered, ACT-based program to promote health behavior change and psychological well-being among cardiac patients. Results will address the effectiveness of a brief treatment created to simultaneously impact multiple cardiovascular risk factors. Conducted in the context of clinical practice, this trial will potentially offer empirical support to alternative interventions to improve quality of life and reduce mortality and morbidity rates among cardiac patients. TRIAL REGISTRATION clinicaltrials.gov/ (NCT01909102).
Collapse
Affiliation(s)
- Chiara AM Spatola
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gabriella Malfatto
- Cardiology Division, Ospedale San Luca, Istituto Auxologico Italiano IRCCS, Milano, Italy
| | - Mario Facchini
- Cardiology Division, Ospedale San Luca, Istituto Auxologico Italiano IRCCS, Milano, Italy
| | | | - Matteo Baruffi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| |
Collapse
|
42
|
Sublette VA, Douglas MW, McCaffery K, George J, Perry KN. Psychological, lifestyle and social predictors of hepatitis C treatment response: a systematic review. Liver Int 2013; 33:894-903. [PMID: 23581550 DOI: 10.1111/liv.12138] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 02/13/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND To increase cure rates for Hepatitis C, barriers to treatment adherence and completion must be identified and overcome. AIMS This study systematically reviewed evidence on the psychological, lifestyle and social determinants of achieving viral eradication with antiviral therapy. METHODS An electronic search strategy was used to identify relevant studies that examined psychological, lifestyle and social factors related to achieving a sustained virological response (SVR). RESULTS Thirty-four studies that matched our criteria were identified. Of the factors that predict response to treatment, Asian ethnicity was an independent predictor of SVR. We found an indirect relationship between diet and SVR, with non-responders to treatment consuming more polyunsaturated fatty acids, fats and carbohydrates than those who attained SVR. The effect of alcohol consumption relied on the amount consumed; fewer than 30 grams daily had no effect on SVR, whereas >70 grams daily had an adverse impact on a patient's ability to achieve SVR, with termination rates up to 44% in those who drank >2 drinks a day. Patients with psychiatric illnesses had comparable SVR rates to controls if they continued psychological therapy (average 42%), although discontinuation rates were high with 11 studies reporting rates from 14 to 48%. CONCLUSIONS There are major gaps in current knowledge of the impact of variables such as diet, exercise, attitudes and coping skills on cure rates in chronic Hepatitis C. Those who drink limited amounts of alcohol or have psychiatric disorders should be offered treatment for their disease, with adjunctive education and support to improve treatment completion.
Collapse
|
43
|
Hendrickson KL, Rasmussen EB. Effects of mindful eating training on delay and probability discounting for food and money in obese and healthy-weight individuals. Behav Res Ther 2013; 51:399-409. [PMID: 23685325 DOI: 10.1016/j.brat.2013.04.002] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 02/19/2013] [Accepted: 04/09/2013] [Indexed: 01/17/2023]
Abstract
Obese individuals tend to behave more impulsively than healthy weight individuals across a variety of measures, but it is unclear whether this pattern can be altered. The present study examined the effects of a mindful eating behavioral strategy on impulsive and risky choice patterns for hypothetical food and money. In Experiment 1, 304 participants completed computerized delay and probability discounting tasks for food-related and monetary outcomes. High percent body fat (PBF) predicted more impulsive choice for food, but not small-value money, replicating previous work. In Experiment 2, 102 randomly selected participants from Experiment 1 were assigned to participate in a 50-min workshop on mindful eating or to watch an educational video. They then completed the discounting tasks again. Participants who completed the mindful eating session showed more self-controlled and less risk-averse discounting patterns for food compared to baseline; those in the control condition discounted similarly to baseline rates. There were no changes in discounting for money for either group, suggesting stimulus specificity for food for the mindful eating condition.
Collapse
Affiliation(s)
- Kelsie L Hendrickson
- Department of Psychology, Idaho State University, 921 S. 8th Avenue, Stop 8112, Pocatello, ID 83209, United States.
| | | |
Collapse
|
44
|
Aguirre-Camacho A, Moreno-Jiménez B. La relevancia de la flexibilidad psicológica en el contexto del cáncer: una revisión de la literatura. PSICOONCOLOGIA 1970. [DOI: 10.5209/psic.55808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
La flexibilidad psicológica ha sido relacionada con diversos indicadores positivos en individuos con problemas de salud mental y enfermedades crónicas, y ha sido identificada como un importante mecanismo de cambio psicoterapéutico. Sin embargo, la atención prestada a la flexibilidad psicológica en la psicooncología ha sido limitada, a pesar de su potencial relación con el distrés relacionado con el cáncer. El objetivo de la presente revisión descriptiva fue reunir los estudios que han examinado la asociación entre la flexibilidad psicológica y distintos indicadores de bienestar en pacientes con cáncer, o evaluado el impacto de intervenciones destinadas a incrementar el nivel de flexibilidad psicológica en pacientes con cáncer. A pesar del bajo número de estudios, los resultados demuestran de forma consistente que la flexibilidad psicológica está asociada a altos niveles de bienestar en pacientes con cáncer, incluso en presencia de deterioro físico. Para finalizar, se presentan algunas implicaciones para la práctica clínica en psico-oncología.
Collapse
|