Testing and Optimizing Guided Thinking Tasks to Promote Physical Activity: Protocol for a Randomized Factorial Trial

Austin S Baldwin, Colin L Lamb, Bree A Geary, Alexis D Mitchell, Chrystyna D Kouros, Sara Levens, Laura E Martin, Austin S Baldwin, Colin L Lamb, Bree A Geary, Alexis D Mitchell, Chrystyna D Kouros, Sara Levens, Laura E Martin

Abstract

Background: Insufficient physical activity is associated with various health risks; however, most current physical activity interventions have critical barriers to scalability. Delivering interventions via technology and identifying active and inert components in early-phase development are ways to build more efficient and scalable interventions. We developed a novel intervention to promote physical activity that targets 3 brief guided thinking tasks, separately and in combination, using brief audio recordings: (1) episodic future thinking (EFT), (2) positive affective imagery (PAI), and (3) planning.

Objective: The aim of this GeT (Guided Thinking) Active study is to optimize a scalable guided thinking intervention to promote physical activity using principles of the Multiphase Optimization Strategy (MOST). Mechanism-focused analyses will inform which components are optimal candidates for inclusion in an intervention package and which need refinement.

Methods: We will enroll 192 participants randomized to receive intervention components delivered via an audio recording that they will listen to prior to weekly in-lab physical activity sessions. Participants in the high dose conditions will also be instructed to listen to the audio recording 4 additional days each week. We will evaluate effects of the components on physical activity over 6 weeks in a 2 (EFT vs recent thinking) × 2 (PAI vs neutral imagery) × 2 (planning vs no planning) × 2 (dose: 5×/week vs 1×/week) full factorial randomized trial.

Results: The National Cancer Institute funded this study (R21CA260360) on May 13, 2021. Participant recruitment began in February 2022. Data analysis will begin after the completion of data collection.

Conclusions: The GeT Active study will result in a scalable, audio-recorded intervention that will accelerate progress toward the full development of guided thinking interventions to promote physical activity.

Trial registration: ClinicalTrials.gov NCT05235360; https://ichgcp.net/clinical-trials-registry/NCT05235360.

International registered report identifier (irrid): DERR1-10.2196/40908.

Keywords: brief intervention; episodic future thinking; exercise; optimization; physical activity; planning; positive affective imagery.

Conflict of interest statement

Conflicts of Interest: None declared.

©Austin S Baldwin, Colin L Lamb, Bree A Geary, Alexis D Mitchell, Chrystyna D Kouros, Sara Levens, Laura E Martin. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 08.09.2022.

Figures

Figure 1
Figure 1
Conceptual model of intervention components, putative mechanisms, and behavior change phases.
Figure 2
Figure 2
Timing of assessments, intervention delivery, and physical activity within each in-person session. PA: physical activity; PAR: Physical Activity Recall.

References

    1. 2018 physical activity guidelines advisory committee scientific report. . 2018. [2022-06-10]. .
    1. Boyle T, Keegel T, Bull F, Heyworth J, Fritschi L. Physical activity and risks of proximal and distal colon cancers: a systematic review and meta-analysis. J Natl Cancer Inst. 2012 Oct 17;104(20):1548–61. doi: 10.1093/jnci/djs354.djs354
    1. Cust A. Physical activity and gynecologic cancer prevention. Recent Results Cancer Res. 2011;186:159–85. doi: 10.1007/978-3-642-04231-7_7.
    1. Wu Y, Zhang D, Kang S. Physical activity and risk of breast cancer: a meta-analysis of prospective studies. Breast Cancer Res Treat. 2013 Feb;137(3):869–82. doi: 10.1007/s10549-012-2396-7.
    1. Gilchrist SC, Howard VJ, Akinyemiju T, Judd SE, Cushman M, Hooker SP, Diaz KM. Association of sedentary behavior with cancer mortality in middle-aged and older US adults. JAMA Oncol. 2020 Aug 01;6(8):1210–1217. doi: 10.1001/jamaoncol.2020.2045. 2767093
    1. Jakicic J. The effect of physical activity on body weight. Obesity (Silver Spring) 2009 Dec;17 Suppl 3:S34–8. doi: 10.1038/oby.2009.386. doi: 10.1038/oby.2009.386.oby2009386
    1. Donnelly JE, Hill JO, Jacobsen DJ, Potteiger J, Sullivan DK, Johnson SL, Heelan K, Hise M, Fennessey PV, Sonko B, Sharp T, Jakicic JM, Blair SN, Tran ZV, Mayo M, Gibson C, Washburn RA. Effects of a 16-month randomized controlled exercise trial on body weight and composition in young, overweight men and women: the Midwest Exercise Trial. Arch Intern Med. 2003 Jun 09;163(11):1343–50. doi: 10.1001/archinte.163.11.1343.163/11/1343
    1. Behavioral risk factor surveillance system survey data. Centers for Disease Control and Prevention. 2017. [2022-06-10]. .
    1. Tucker JM, Welk GJ, Beyler NK. Physical activity in U.S.: adults compliance with the Physical Activity Guidelines for Americans. Am J Prev Med. 2011 Apr;40(4):454–61. doi: 10.1016/j.amepre.2010.12.016.S0749-3797(11)00012-2
    1. Troiano RP, Berrigan D, Dodd KW, Mâsse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008 Jan;40(1):181–8. doi: 10.1249/mss.0b013e31815a51b3.
    1. Reis RS, Salvo D, Ogilvie D, Lambert EV, Goenka S, Brownson RC. Scaling up physical activity interventions worldwide: stepping up to larger and smarter approaches to get people moving. Lancet. 2016 Sep;388(10051):1337–1348. doi: 10.1016/S0140-6736(16)30728-0.
    1. Foster C, Richards J, Thorogood M. Remote and web 2.0 interventions for promoting physical activity. Cochrane Database Syst Rev. 2013:0395. doi: 10.1002/14651858.cd010395.
    1. Schoeppe S, Alley S, Van Lippevelde W, Bray NA, Williams SL, Duncan MJ, Vandelanotte C. Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act. 2016 Dec 07;13(1):127. doi: 10.1186/s12966-016-0454-y. 10.1186/s12966-016-0454-y
    1. King AC, Hekler EB, Grieco LA, Winter SJ, Sheats JL, Buman MP, Banerjee B, Robinson TN, Cirimele J. Harnessing different motivational frames via mobile phones to promote daily physical activity and reduce sedentary behavior in aging adults. PLoS One. 2013;8(4):e62613. doi: 10.1371/journal.pone.0062613.PONE-D-13-04762
    1. Collins L. Optimization of Behavioral, Biobehavioral, and Biomedical Interventions: The Multiphase Optimization Strategy (MOST) Cham, Switzerland: Springer; 2018.
    1. Howlett N, Trivedi D, Troop N, Chater AM. Are physical activity interventions for healthy inactive adults effective in promoting behavior change and maintenance, and which behavior change techniques are effective? A systematic review and meta-analysis. Transl Behav Med. 2019 Jan 01;9(1):147–157. doi: 10.1093/tbm/iby010. 4913688
    1. Chan CKY, Cameron LD. Promoting physical activity with goal-oriented mental imagery: a randomized controlled trial. J Behav Med. 2012 Jun 22;35(3):347–63. doi: 10.1007/s10865-011-9360-6.
    1. Fukuoka Y, Vittinghoff E, Jong SS, Haskell W. Innovation to motivation--pilot study of a mobile phone intervention to increase physical activity among sedentary women. Prev Med. 2010 Sep;51(3-4):287–9. doi: 10.1016/j.ypmed.2010.06.006. S0091-7435(10)00233-1
    1. Gal R, May AM, van Overmeeren EJ, Simons M, Monninkhof EM. The effect of physical activity interventions comprising wearables and smartphone applications on physical activity: a systematic review and meta-analysis. Sports Med Open. 2018 Sep 03;4(1):42. doi: 10.1186/s40798-018-0157-9. 10.1186/s40798-018-0157-9
    1. Czajkowski SM, Powell LH, Adler N, Naar-King S, Reynolds KD, Hunter CM, Laraia B, Olster DH, Perna FM, Peterson JC, Epel E, Boyington JE, Charlson ME. From ideas to efficacy: The ORBIT model for developing behavioral treatments for chronic diseases. Health Psychol. 2015 Oct;34(10):971–82. doi: 10.1037/hea0000161. 2015-03938-001
    1. Nielsen L, Riddle M, King JW, Aklin WM, Chen W, Clark D, Collier E, Czajkowski S, Esposito L, Ferrer R, Green P, Hunter C, Kehl K, King R, Onken L, Simmons JM, Stoeckel L, Stoney C, Tully L, Weber W. The NIH Science of Behavior Change Program: transforming the science through a focus on mechanisms of change. Behav Res Ther. 2018 Feb;101:3–11. doi: 10.1016/j.brat.2017.07.002. S0005-7967(17)30136-5
    1. O'Neill J, Daniel TO, Epstein LH. Episodic future thinking reduces eating in a food court. Eat Behav. 2016 Jan;20:9–13. doi: 10.1016/j.eatbeh.2015.10.002. S1471-0153(15)30014-3
    1. Stein JS, Sze YY, Athamneh L, Koffarnus MN, Epstein LH, Bickel WK. Think fast: rapid assessment of the effects of episodic future thinking on delay discounting in overweight/obese participants. J Behav Med. 2017 Oct 15;40(5):832–838. doi: 10.1007/s10865-017-9857-8. 10.1007/s10865-017-9857-8
    1. Schacter DL, Benoit RG, Szpunar KK. Episodic future thinking: mechanisms and functions. Curr Opin Behav Sci. 2017 Oct;17:41–50. doi: 10.1016/j.cobeha.2017.06.002.
    1. Stein JS, Craft WH, Paluch RA, Gatchalian KM, Greenawald MH, Quattrin T, Mastrandrea LD, Epstein LH, Bickel WK. Bleak present, bright future: II. Combined effects of episodic future thinking and scarcity on delay discounting in adults at risk for type 2 diabetes. J Behav Med. 2021 Apr 28;44(2):222–230. doi: 10.1007/s10865-020-00178-7. 10.1007/s10865-020-00178-7
    1. Epstein LH, Paluch RA, Biondolillo MJ, Stein JS, Quattrin T, Mastrandrea LD, Gatchalian K, Greenawald MH, Bickel WK. Effects of 6-month episodic future thinking training on delay discounting, weight loss and HbA1c changes in individuals with prediabetes. J Behav Med. 2022 Apr 10;45(2):227–239. doi: 10.1007/s10865-021-00278-y. 10.1007/s10865-021-00278-y
    1. Hollis-Hansen K, Seidman J, O'Donnell S, Epstein LH. Episodic future thinking and grocery shopping online. Appetite. 2019 Feb 01;133:1–9. doi: 10.1016/j.appet.2018.10.019. S0195-6663(18)31022-5
    1. Levens SM, Sagui-Henson SJ, Padro M, Martin LE, Trucco EM, Cooperman NA, Baldwin AS, Kassianos AP, Mdege ND. The effects of positive affect and episodic future thinking on temporal discounting and healthy food demand and choice among overweight and obese individuals: protocol for a pilot 2×2 factorial randomized controlled study. JMIR Res Protoc. 2019 Mar 20;8(3):e12265. doi: 10.2196/12265. v8i3e12265
    1. Luszczynska A, Sobczyk A, Abraham C. Planning to lose weight: randomized controlled trial of an implementation intention prompt to enhance weight reduction among overweight and obese women. Health Psychol. 2007 Jul;26(4):507–12. doi: 10.1037/0278-6133.26.4.507.2007-09406-015
    1. Sniehotta FF, Schwarzer R, Scholz U, Schüz B. Action planning and coping planning for long-term lifestyle change: theory and assessment. Eur J Soc Psychol. 2005 Jul;35(4):565–576. doi: 10.1002/ejsp.258.
    1. Hagger MS, Luszczynska A. Implementation intention and action planning interventions in health contexts: state of the research and proposals for the way forward. Appl Psychol Health Well Being. 2014 Mar;6(1):1–47. doi: 10.1111/aphw.12017.
    1. Salmon J, Owen N, Crawford D, Bauman A, Sallis JF. Physical activity and sedentary behavior: A population-based study of barriers, enjoyment, and preference. Health Psychology. 2003;22(2):178–188. doi: 10.1037/0278-6133.22.2.178.
    1. Trost SG, Owen N, Bauman AE, Sallis JF, Brown W. Correlates of adults' participation in physical activity: review and update. Med Sci Sports Exerc. 2002 Dec;34(12):1996–2001. doi: 10.1097/00005768-200212000-00020.
    1. Andersson E, Moss T. Imagery and implementation intention: a randomised controlled trial of interventions to increase exercise behaviour in the general population. Psychol Sport Exerc. 2011 Mar;12(2):63–70. doi: 10.1016/j.psychsport.2010.07.004.
    1. Giacobbi P, Long D, Nolan R, Shawley S, Johnson K, Misra R. Guided imagery targeting exercise, food cravings, and stress: a multi-modal randomized feasibility trial. J Behav Med. 2018 Feb 1;41(1):87–98. doi: 10.1007/s10865-017-9876-5. 10.1007/s10865-017-9876-5
    1. Conroy D, Hagger MS. Imagery interventions in health behavior: A meta-analysis. Health Psychol. 2018 Jul;37(7):668–679. doi: 10.1037/hea0000625.2018-25173-001
    1. Bélanger-Gravel A, Godin G, Amireault S. A meta-analytic review of the effect of implementation intentions on physical activity. Health Psychol Rev. 2013 Mar;7(1):23–54. doi: 10.1080/17437199.2011.560095.
    1. Luszczynska A. An implementation intentions intervention, the use of a planning strategy, and physical activity after myocardial infarction. Soc Sci Med. 2006 Feb;62(4):900–8. doi: 10.1016/j.socscimed.2005.06.043.S0277-9536(05)00358-8
    1. Prestwich A, Lawton R, Conner M. The use of implementation intentions and the decision balance sheet in promoting exercise behaviour. Psychol Health. 2003 Dec;18(6):707–721. doi: 10.1080/08870440310001594493.
    1. Prestwich A, Perugini M, Hurling R. Can implementation intentions and text messages promote brisk walking? A randomized trial. Health Psychol. 2010 Jan;29(1):40–9. doi: 10.1037/a0016993.2010-00152-006
    1. Prestwich A, Conner MT, Lawton RJ, Ward JK, Ayres K, McEachan RRC. Randomized controlled trial of collaborative implementation intentions targeting working adults' physical activity. Health Psychol. 2012 Jul;31(4):486–95. doi: 10.1037/a0027672.2012-08243-001
    1. Stein JS, Wilson AG, Koffarnus MN, Daniel TO, Epstein LH, Bickel WK. Unstuck in time: episodic future thinking reduces delay discounting and cigarette smoking. Psychopharmacology (Berl) 2016 Oct 23;233(21-22):3771–3778. doi: 10.1007/s00213-016-4410-y.10.1007/s00213-016-4410-y
    1. Hall PA, Fong GT. Temporal self-regulation theory: A model for individual health behavior. Health Psychol Rev. 2007 Mar;1(1):6–52. doi: 10.1080/17437190701492437.
    1. Hall PA, Fong GT. Temporal self-regulation theory: a neurobiologically informed model for physical activity behavior. Front Hum Neurosci. 2015 Mar 25;9:117. doi: 10.3389/fnhum.2015.00117. doi: 10.3389/fnhum.2015.00117.
    1. Hall P, Bickel W, Erickson K, Wagner Dylan D. Neuroimaging, neuromodulation, and population health: the neuroscience of chronic disease prevention. Ann N Y Acad Sci. 2018 Sep;1428(1):240–256. doi: 10.1111/nyas.13868.
    1. Ekkekakis P, Parfitt G, Petruzzello SJ. The pleasure and displeasure people feel when they exercise at different intensities: decennial update and progress towards a tripartite rationale for exercise intensity prescription. Sports Med. 2011 Aug 01;41(8):641–71. doi: 10.2165/11590680-000000000-00000.3
    1. Brand R, Ekkekakis P. Affective–Reflective Theory of physical inactivity and exercise. Ger J Exerc Sport Res. 2017 Nov 14;48(1):48–58. doi: 10.1007/s12662-017-0477-9.
    1. Rhodes RE, Kates A. Can the affective response to exercise predict future motives and physical activity behavior? A systematic review of published evidence. Ann Behav Med. 2015 Oct 29;49(5):715–31. doi: 10.1007/s12160-015-9704-5.
    1. Duncan LR, Hall CR, Wilson PM, Rodgers WM. The use of a mental imagery intervention to enhance integrated regulation for exercise among women commencing an exercise program. Motiv Emot. 2012 Jan 15;36(4):452–464. doi: 10.1007/s11031-011-9271-4.
    1. Fleig L, Pomp S, Parschau L, Barz M, Lange D, Schwarzer R, Lippke S. From intentions via planning and behavior to physical exercise habits. Psychol Sport Exerc. 2013 Sep;14(5):632–639. doi: 10.1016/j.psychsport.2013.03.006.
    1. Carraro N, Gaudreau P. Spontaneous and experimentally induced action planning and coping planning for physical activity: A meta-analysis. Psychol Sport Exerc. 2013 Mar;14(2):228–248. doi: 10.1016/j.psychsport.2012.10.004.
    1. de Bruijn G, Gardner B, van Osch L, Sniehotta FF. Predicting automaticity in exercise behaviour: the role of perceived behavioural control, affect, intention, action planning, and behaviour. Int J Behav Med. 2014 Sep 20;21(5):767–74. doi: 10.1007/s12529-013-9348-4.
    1. Rhodes R, de Bruijn GJ. What predicts intention-behavior discordance? A review of the action control framework. Exerc Sport Sci Rev. 2013;41:207. doi: 10.1097/jes.0b013e3182a4e6ed.
    1. Rhodes RE, Dickau L. Experimental evidence for the intention-behavior relationship in the physical activity domain: a meta-analysis. Health Psychol. 2012 Nov;31(6):724–7. doi: 10.1037/a0027290.2012-06000-001
    1. Sheeran P. Intention–behavior relations: a conceptual and empirical review. Eur Rev Soc Psychol. 2002 Jan;12(1):1–36. doi: 10.1080/14792772143000003.
    1. Schwarzer R, Lippke S, Luszczynska A. Mechanisms of health behavior change in persons with chronic illness or disability: the Health Action Process Approach (HAPA) Rehabil Psychol. 2011 Aug;56(3):161–70. doi: 10.1037/a0024509.2011-14571-001
    1. Gollwitzer P. The Handbook of Motivation and Cognition. New York, NY: Guilford; 1990. Action phases and mindsest; pp. 53–92.
    1. Sheeran P, Klein WM, Rothman AJ. Health behavior change: moving from observation to intervention. Annu Rev Psychol. 2017 Jan 03;68(1):573–600. doi: 10.1146/annurev-psych-010416-044007.
    1. Rothman A, Baldwin A. Handbook of Personality and Social Psychology. New York, NY: Oxford University Press; 2019. A person x intervention strategy approach to understanding health behavior; pp. 831–856.
    1. ACSMs guidelines for exercise testing and prescription. American College of Sports Medicine. [2022-06-10]. .
    1. Craig CL, Marshall AL, Sjöström Michael, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003 Aug;35(8):1381–95. doi: 10.1249/01.MSS.0000078924.61453.FB.
    1. Hayden-Wade HA, Coleman KJ, Sallis JF, Armstrong C. Validation of the telephone and in-person interview versions of the 7-day PAR. Med Sci Sports Exerc. 2003;35(5):801–809. doi: 10.1249/01.mss.0000064941.43869.4e.
    1. Dai S, Carroll D, Watson K. Participation in types of physical activities among US adults? National Health and Nutrition Examination Survey 1999?2006. J Phys Act Health. 2015;12:S128–S140. doi: 10.1123/jpah.2015-0038.
    1. Plasqui G, Westerterp KR. Physical activity assessment with accelerometers: an evaluation against doubly labeled water. Obesity (Silver Spring) 2007 Oct;15(10):2371–9. doi: 10.1038/oby.2007.281. doi: 10.1038/oby.2007.281.15/10/2371
    1. Sloane R, Snyder DC, Demark-Wahnefried W, Lobach D, Kraus WE. Comparing the 7-day physical activity recall with a triaxial accelerometer for measuring time in exercise. Med Sci Sports Exerc. 2009 Jun;41(6):1334–40. doi: 10.1249/MSS.0b013e3181984fa8.
    1. Hardy C, Rejeski W. Not what, but how one feels: the measurement of affect during exercise. J Sport Exerc Psychol. 1989;11:317. doi: 10.1123/jsep.11.3.304.
    1. Markland D, Tobin V. A modification to the Behavioural Regulation in Exercise Questionnaire to include an assessment of amotivation. J Sport Exerc Psychol. 2004 Jun;26(2):191–196. doi: 10.1123/jsep.26.2.191.
    1. Koffarnus MN, Bickel WK. A 5-trial adjusting delay discounting task: accurate discount rates in less than one minute. Exp Clin Psychopharmacol. 2014 Jun;22(3):222–8. doi: 10.1037/a0035973. 2014-12160-001
    1. Tabachnick B, Fidell L. Using Multivariate Statistics. Boston, MA: Allyn and Bacon; 2012.
    1. Enders C. Applied Missing Data Analysis. New York, NY: Guilford Press; 2010.
    1. Schafer JL, Graham JW. Missing data: Our view of the state of the art. Psychol Methods. 2002;7(2):147–177. doi: 10.1037/1082-989x.7.2.147.
    1. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Cambridge, MA: Academic Press; 2013.
    1. Dziak JJ, Nahum-Shani I, Collins LM. Multilevel factorial experiments for developing behavioral interventions: power, sample size, and resource considerations. Psychol Methods. 2012 Jun;17(2):153–75. doi: 10.1037/a0026972. 2012-02919-001
    1. Collins LM, Dziak JJ, Kugler KC, Trail JB. Factorial experiments: efficient tools for evaluation of intervention components. Am J Prev Med. 2014 Oct;47(4):498–504. doi: 10.1016/j.amepre.2014.06.021. S0749-3797(14)00325-0
    1. Baldwin AS, Kangas JL, Denman DC, Smits JAJ, Yamada T, Otto MW. Cardiorespiratory fitness moderates the effect of an affect-guided physical activity prescription: a pilot randomized controlled trial. Cogn Behav Ther. 2016 Nov 16;45(6):445–57. doi: 10.1080/16506073.2016.1194454.
    1. Kangas JL, Baldwin AS, Rosenfield D, Smits JAJ, Rethorst CD. Examining the moderating effect of depressive symptoms on the relation between exercise and self-efficacy during the initiation of regular exercise. Health Psychol. 2015 May;34(5):556–65. doi: 10.1037/hea0000142. 2014-32959-001
    1. Trivedi MH, Greer TL, Church TS, Carmody TJ, Grannemann BD, Galper DI, Dunn AL, Earnest CP, Sunderajan P, Henley SS, Blair SN. Exercise as an augmentation treatment for nonremitted major depressive disorder. J Clin Psychiatry. 2011 May 15;72(05):677–684. doi: 10.4088/jcp.10m06743.

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