Towards a physically more active lifestyle based on one's own values: study design of a randomized controlled trial for physically inactive adults

Anu Maarit Kangasniemi, Raimo Lappalainen, Anna Kankaanpää, Janne Kulmala, Harto Hakonen, Tuija Tammelin, Anu Maarit Kangasniemi, Raimo Lappalainen, Anna Kankaanpää, Janne Kulmala, Harto Hakonen, Tuija Tammelin

Abstract

Background: This randomised controlled trial demonstrates the effectiveness of a value-based intervention program to encourage a physically more active lifestyle among physically inactive adults aged 30 to 50 years. The conceptual framework of the program is based on an innovative behavioural therapy called Acceptance and Commitment Therapy (ACT) that aims to increase an individual's psychological flexibility and support behaviour change towards a higher quality and more meaningful life.

Methods: Participants will be randomly allocated to a feedback group (FB) or an Acceptance and Commitment based (ACT+FB) group. Both the groups will receive written feedback about their objectively measured physical activity levels and offered an opportunity to attend a body composition analysis. In addition, the Acceptance and Commitment based group will attend six group sessions and be given a pedometer for self-monitoring of their daily physical activity throughout the 9-week intervention. The group sessions aim to clarify individual values and enhance committed actions towards the goal of achieving a more meaningful life. Participants will also be taught new skills to work on subjective barriers related to physical activity. Physical activity will be measured objectively by an accelerometer over seven consecutive days and by self-reported questionnaires at the baseline, as well as at 3, 6, 9 and 15 months after the baseline measures. In addition, psychological well-being will be measured through the questionnaires, which assess mindfulness skills, psychological flexibility, psychological distress and depressive symptoms.

Discussion: This study's objective is to demonstrate a research protocol for a randomized controlled study motivating a physically more active lifestyle based on one's own values among physically inactive adults. The aim of the study is to evaluate the feasibility and intervention efficacy on physical activity and psychological well-being, and discuss challenges in motivating physically inactive adults towards physically more active lifestyles.

Trial registration: ClinicalTrials.gov, number NCT01796990.

Figures

Figure 1
Figure 1
Flow diagram of the progress of the study.

References

    1. Haskell WL, Lee I, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39(8):1423–1434. doi: 10.1249/mss.0b013e3180616b27.
    1. Lee I, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219. doi: 10.1016/S0140-6736(12)61031-9.
    1. Im E, Lee B, Chee W, Stuifbergen A. Attitudes Toward Physical Activity of White Midlife Women. J Obstet Gynecol Neonatal Nurs. 2011;40(3):312–321. doi: 10.1111/j.1552-6909.2011.01249.x.
    1. Rhodes RE, Pfaeffli LA. Review Mediators of physical activity behaviour change among adult non-clinical populations: a review update. Int J Behav Nutr Phys Act. 2010;7(37)
    1. Marcus BH, Williams DM, Dubbert PM, Sallis JF, King AC, Yancey AK, Franklin BA, Buchner D, Daniels SR, Claytor RP. Physical activity intervention studies. Circulation. 2006;114(24):2739–2752. doi: 10.1161/CIRCULATIONAHA.106.179683.
    1. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: Model, processes and outcomes. Behav Res Ther. 2006;44(1):1–25. doi: 10.1016/j.brat.2005.06.006.
    1. Hayes SC, Pistorello J, Levin ME. Acceptance and commitment therapy as a unified model of behavior change. Couns Psychol. 2012;40(7):976–1002. doi: 10.1177/0011000012460836.
    1. Powers MB, Zum Vörde Sive Vörding MB, Emmelkamp PMG. Acceptance and commitment therapy: A meta-analytic review. Psychother Psychosom. 2009;78(2):73–80. doi: 10.1159/000190790.
    1. Wicksell RK, Ahlqvist J, Bring A, Melin L, Olsson GL. Can Exposure and Acceptance Strategies Improve Functioning and Life Satisfaction in People with Chronic Pain and Whiplash‒Associated Disorders (WAD)? A Randomized Controlled Trial. Cogn Behav Ther. 2008;37(3):169–182. doi: 10.1080/16506070802078970.
    1. Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: a randomized controlled trial. J Consult Clin Psychol. 2007;75(2):336.
    1. Weineland S, Arvidsson D, Kakoulidis TP, Dahl J. Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT. Obesity Research & Clinical Practice. 2012;6(1):e21–e30. doi: 10.1016/j.orcp.2011.04.004.
    1. Weineland S, Hayes S, Dahl J. Psychological flexibility and the gains of acceptance‒based treatment for post‒bariatric surgery: six‒month follow‒up and a test of the underlying model. Clinical Obesity. 2012;2(1–2):15–24.
    1. Lappalainen R, Lehtonen T, Skarp E, Taubert E, Ojanen M, Hayes SC. The Impact of CBT and ACT Models Using Psychology Trainee Therapists A Preliminary Controlled Effectiveness Trial. Behav Modif. 2007;31(4):488–511. doi: 10.1177/0145445506298436.
    1. Hayes SC, Masuda A, Bissett R, Luoma J, Guerrero LF. DBT, FAP, and ACT: How empirically oriented are the new behavior therapy technologies? Behav Ther. 2004;35(1):35–54. doi: 10.1016/S0005-7894(04)80003-0.
    1. Butryn ML, Forman E, Hoffman K, Shaw J, Juarascio A. A pilot study of acceptance and commitment therapy for promotion of physical activity. J Phys Act Health. 2011;8(4):516–522.
    1. Tapper K, Shaw C, Ilsley J, Hill AJ, Bond FW, Moore L. Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. Appetite. 2009;52(2):396–404. doi: 10.1016/j.appet.2008.11.012.
    1. Fagt S, Andersen LF, Anderssen SA, Becker W, Borodulin K, Fogelholm M, Groth MV, Gunnarsdottir I, Helakorpi S, Kolle E. Nordic monitoring on diet, physical activity and overweight: Validation of indicators. Nordic Council of Ministers; 2011.
    1. Matthews CE, Ainsworth BE, Thompson RW, Bassett DR. Sources of variance in daily physical activity levels as measured by an accelerometer. Med Sci Sports Exerc. 2002;34(8):1376–1381. doi: 10.1097/00005768-200208000-00021.
    1. Matthews CE. Calibration of accelerometer output for adults. Med Sci Sports Exerc. 2005;37(11):512–522.
    1. Sasaki JE, John D, Freedson PS. Validation and comparison of ActiGraph activity monitors. J Sci Med Sport. 2011;14(5):411–416. doi: 10.1016/j.jsams.2011.04.003.
    1. Vanhelst J, Mikulovic J, Bui-Xuan G, Dieu O, Blondeau T, Fardy P, Béghin L. Comparison of two ActiGraph accelerometer generations in the assessment of physical activity in free living conditions. BMC research notes. 2012;5(1):187. doi: 10.1186/1756-0500-5-187.
    1. Schwarzer R, Renner RB. Social-cognitive predictors of health behavior: action self-efficacy and coping self-efficacy. Health Psychol. 2000;19(5):487.
    1. Sniehotta F, Schwarzer R, Scholz U, Schüz B. Action planning and coping planning for long‒term lifestyle change: theory and assessment. Eur J Soc Psychol. 2005;35(4):565–576. doi: 10.1002/ejsp.258.
    1. Goldberg DP, Gater R, Sartorius N, Ustun T, Piccinelli M, Gureje O, Rutter C. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997;27(1):191–197. doi: 10.1017/S0033291796004242.
    1. Holi MM, Marttunen M, Aalberg V. Comparison of the GHQ-36, the GHQ-12 and the SCL-90 as psychiatric screening instruments in the Finnish population. Nord J Psychiatry. 2003;57(3):233–238. doi: 10.1080/08039480310001418.
    1. Holi MM, Sammallahti PR, Aalberg VA. A Finnish validation study of the SCL‒90. Acta Psychiatr Scand. 1998;97(1):42–46. doi: 10.1111/j.1600-0447.1998.tb09961.x.
    1. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(6):561–571. doi: 10.1001/archpsyc.1961.01710120031004.
    1. Dozois DJA, Dobson KS, Ahnberg JL. A psychometric evaluation of the Beck Depression Inventory–II. Psychological Assessment; Psychological Assessment. 1998;10(2):83–89.
    1. Baer RA, Smith GT, Allen KB. Assessment of mindfulness by self-report. Assessment. 2004;11(3):191–206. doi: 10.1177/1073191104268029.
    1. Bond FW, Bunce D. The role of acceptance and job control in mental health, job satisfaction, and work performance. J Appl Psychol. 2003;88(6):1057–1067.
    1. Hayes SC, Bissett R, Roget N, Padilla M, Kohlenberg BS, Fisher G, Masuda A, Pistorello J, Rye AK, Berry K. The impact of acceptance and commitment training and multicultural training on the stigmatizing attitudes and professional burnout of substance abuse counselors. Behav Ther. 2004;35(4):821–835. doi: 10.1016/S0005-7894(04)80022-4.
    1. Muthén LK, Muthén BO. Mplus User’s Guide. 7. Los Angeles, CA: Muthén & Muthén; 1998-2012. Statistical analysis with latent variables.
    1. Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum; 1988.

Source: PubMed

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