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Maltagliati S, Sarrazin P, Muller D, Fessler L, Ferry T, Wiers RW, Cheval B. Improving physical activity using a single personalized consequence-based approach-avoidance training: Effects on self-reported behaviors, attitudes, and choices. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 70:102565. [PMID: 37979927 DOI: 10.1016/j.psychsport.2023.102565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 09/27/2023] [Accepted: 11/13/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVE Despite their potential in improving health behaviors, such as physical activity (PA), the effectiveness of interventions targeting automatic precursors remains contrasted. We examined the effects of a single session of ABC training - a personalized consequence-based approach-avoidance training - on PA, relative to an active control condition and a control condition. METHODS Middle-aged US participants (N = 360, 53 % of women) either completed an ABC training (being instructed to approach PA to obtain self-relevant consequences), an approach-avoidance training (approaching PA in 90 % of trials), or a control training (approaching PA in 50 % of trials). Participants selected antecedents (e.g., "When I have little time") in which personalized choices between PA and sedentary alternatives were likely to occur. In the ABC training only, after approaching PA, self-relevant consequences were displayed (e.g., increase in the health status of participant's avatar). Primary outcome was self-reported PA seven days after the intervention. Secondary outcomes included choices for PA (vs sedentary) alternatives in a hypothetical free-choice task, intention, automatic and explicit attitudes toward PA. RESULTS No significant effect of the ABC intervention on PA was observed, so as on intention and explicit attitudes. However, the ABC intervention was associated with higher odds of choosing PA alternatives in the free-choice task and with more positive automatic attitudes toward PA. CONCLUSIONS While the ABC training was not effective at improving PA, its effects on choices and automatic attitudes suggest that this intervention may still have potential. Future studies with intensive trainings and device-based measures of PA remains needed.
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Affiliation(s)
| | | | - Dominique Muller
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, LIP/PC2S, 38000, Grenoble, France; Institut Universitaire de France, France
| | - Layan Fessler
- Univ. Grenoble Alpes, SENS, F-38000, Grenoble, France
| | - Thibaud Ferry
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, LIP/PC2S, 38000, Grenoble, France
| | - Reinout W Wiers
- Department of Psychology and Center for Urban Mental Health, University of Amsterdam, the Netherlands
| | - Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland; Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Geneva, Switzerland; Department of Sport Sciences and Physical Education, École normale supérieure de Rennes, Bruz, France; Laboratory VIPS , University of Rennes 2, Rennes, France.
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Manser P, Huber S, Seinsche J, de Bruin ED, Giannouli E. Development and initial validation of the German version of the Exergame Enjoyment Questionnaire (EEQ-G). PLoS One 2023; 18:e0286556. [PMID: 37289701 PMCID: PMC10249825 DOI: 10.1371/journal.pone.0286556] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/18/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Analyzing and adjusting training programs to increase exercise enjoyment is crucial to achieve long-term adherence and thus also maximize health benefits. The Exergame Enjoyment Questionnaire (EEQ) is the first questionnaire specifically developed to monitor exergame enjoyment. To be used in German speaking countries, the EEQ must be translated, cross-culturally adapted, and tested on its psychometric properties. OBJECTIVES The aim of this study was to develop (i.e., translate and cross-culturally adapt) the German Version of the EEQ (EEQ-G) and investigate its psychometric properties. METHODS Psychometric properties of the EEQ-G were tested using a cross-sectional study design. Each participant performed two consecutive exergame sessions (i.e., 'preferred' and 'unpreferred' condition) in randomized order and rated the EEQ-G as well as reference questionnaires. Internal consistency of the EEQ-G was assessed by calculating Cronbach's α. Construct validity was assessed by calculating Spearman's rank correlation coefficients (rs) between the scores of the EEQ-G and reference questionnaires. Responsiveness was analyzed by performing a Wilcoxon signed-rank test between the median EEQ-G scores of the two conditions. RESULTS Fourty-three healthy older adults (HOA; mean age = 69.4 ± 4.9 years; 53.5% females) were included. Cronbach's α of the EEQ-G was 0.80. The rs values between the EEQ-G and reference questionnaire scores for intrinsic motivation, game enjoyment, physical activity enjoyment, and external motivation were 0.198 (p = 0.101), 0.684 (p < 0.001), 0.277 (p = 0.036), and 0.186 (p = 0.233), respectively. The EEQ-G was rated higher in the 'preferred' than the 'unpreferred' condition (p < 0.001, r = 0.756). CONCLUSION The EEQ-G has high internal consistency and is responsive to changes in exergame enjoyment. The highly skewed data with ceiling effects in some of the reference questionnaires deem the construct validity of the EEQ-G to be inconclusive and thus in need of further evaluation.
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Affiliation(s)
- Patrick Manser
- Department of Health Sciences and Technology, Motor Control and Learning Group–Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Simone Huber
- Department of Health Sciences and Technology, Motor Control and Learning Group–Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Physiotherapy and Occupational Therapy Research Centre, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland
| | - Julia Seinsche
- Department of Health Sciences and Technology, Motor Control and Learning Group–Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Eling D. de Bruin
- Department of Health Sciences and Technology, Motor Control and Learning Group–Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Department of Health, OST–Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
| | - Eleftheria Giannouli
- Department of Health Sciences and Technology, Motor Control and Learning Group–Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Machulska A, Rinck M, Klucken T, Kleinke K, Wunder JC, Remeniuk O, Margraf J. "Push it!" or "Hold it!"? A comparison of nicotine-avoidance training and nicotine-inhibition training in smokers motivated to quit. Psychopharmacology (Berl) 2022; 239:105-121. [PMID: 35013762 PMCID: PMC8748000 DOI: 10.1007/s00213-021-06058-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/28/2021] [Indexed: 12/20/2022]
Abstract
RATIONALE Recently, experimental paradigms have been developed to strengthen automatic avoidance or inhibitory responses for smoking cues. However, these procedures have not yet been directly compared regarding their effectiveness and mechanisms of action. OBJECTIVE This study compared the effects of avoidance vs. inhibitory training as an add-on to a brief smoking cessation intervention. The standard Approach-Avoidance-Task (AAT) was adapted for both training types and control conditions. METHODS One hundred twenty-four smokers attended behavioral counseling for smoking cessation and were thereafter randomized to one of four training conditions: avoidance-AAT, sham-avoidance-AAT, inhibition-AAT, sham-inhibition-AAT. During a 2-week training period including five training sessions, smokers in the avoidance-AAT trained to implicitly avoid all smoking-related cues, while smokers in the inhibition-AAT trained to implicitly inhibit behavioral response to smoking cues. During sham training, no such contingencies appeared. Self-report and behavioral data were assessed before and after training. Cigarette smoking and nicotine dependence were also assessed at 4- and 12-week follow-ups. RESULTS At posttest, avoidance training was more effective in reducing daily smoking than inhibition training. However, this difference was no longer evident in follow-up assessments. All training conditions improved other smoking- and health-related outcomes. Neither training changed smoking-related approach biases or associations, but approach biases for smoking-unrelated pictures increased and Stroop interference decreased in all conditions. Smoking devaluation was also comparable in all groups. CONCLUSIONS Avoidance training might be slightly more effective in reducing smoking than inhibitory training. Overall, however, all four training types yielded equivalent therapy and training effects. Hence, a clear preference for one type of training remains premature.
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Affiliation(s)
- Alla Machulska
- Department of Clinical Psychology, Institute of Psychology, University of Siegen, Adolf-Reichwein-Str. 2a, D-57068, Siegen, Germany.
| | - Mike Rinck
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Tim Klucken
- Department of Clinical Psychology, Institute of Psychology, University of Siegen, Adolf-Reichwein-Str. 2a, D–57068 Siegen, Germany
| | - Kristian Kleinke
- Department of Clinical Psychology, Institute of Psychology, University of Siegen, Adolf-Reichwein-Str. 2a, D–57068 Siegen, Germany
| | - Jana-Carina Wunder
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Olga Remeniuk
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
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Machulska A, Eiler TJ, Kleinke K, Grünewald A, Brück R, Jahn K, Niehaves B, Klucken T. Approach bias retraining through virtual reality in smokers willing to quit smoking: A randomized-controlled study. Behav Res Ther 2021; 141:103858. [PMID: 33862407 DOI: 10.1016/j.brat.2021.103858] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 11/26/2022]
Abstract
Automatic approach biases toward smoking-related cues have been implicated in the development and maintenance of addictive behaviors. Studies aiming at modifying such biases have shown promise in changing maladaptive approach tendencies for smoking cues and reducing smoking behavior. However, training effects tend to be small and partly inconsistent. The present randomized-controlled trial incorporated virtual reality (VR) technology into Approach Bias Modification (ABM) to improve efficacy. One-hundred-eight smokers attended behavioral counseling for smoking cessation and were thereafter randomized to receive VR-ABM or VR-control training. During VR-ABM, participants trained to implicitly avoid smoking-related objects and to approach alternative objects, while no such contingency existed in the VR-control condition. Trainings were administered in six sessions within a two-week period. Assessments were conducted at baseline, post-intervention (three weeks after baseline), and at follow-up (seven weeks after baseline). VR-ABM did not change approach biases, nor other cognitive biases, but it was superior in reducing daily smoking. However, this effect was limited to the two-week training period. Both groups improved in other smoking- and health-related variables across time. Future work should continue to investigate working mechanisms of ABM, in particular crucial training ingredients. VR could prove valuable for public health as the potential of VR-based treatments is large and not fully explored.
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Affiliation(s)
- Alla Machulska
- Department of Clinical Psychology, University of Siegen, Siegen, Germany.
| | - Tanja Joan Eiler
- Medical Informatics and Micro Systems Engineering, University of Siegen, Siegen, Germany; Life Science Faculty, University of Siegen, Siegen, Germany.
| | - Kristian Kleinke
- Department of Clinical Psychology, University of Siegen, Siegen, Germany.
| | - Armin Grünewald
- Medical Informatics and Micro Systems Engineering, University of Siegen, Siegen, Germany; Life Science Faculty, University of Siegen, Siegen, Germany.
| | - Rainer Brück
- Life Science Faculty, University of Siegen, Siegen, Germany.
| | - Katharina Jahn
- Department of Business Informatics, University of Siegen, Siegen, Germany.
| | - Björn Niehaves
- Department of Business Informatics, University of Siegen, Siegen, Germany.
| | - Tim Klucken
- Department of Clinical Psychology, University of Siegen, Siegen, Germany.
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