An intervention to increase walking requires both motivational and volitional components: a replication and extension

An intervention to increase walking has previously been developed, consisting of three motivational techniques, designed to increase self-efficacy, and three volitional techniques, designed to help translate intentions into action. Previous research found large effects (d?=?0.90) on the objectively measured walking behaviour of 130 English adult volunteers, mediated by self-efficacy. The present study aimed to replicate this intervention, and decompose the intervention to assess whether both motivational and volitional intervention components are necessary. A three-group experimental design was employed, with n?=?35 adult volunteers randomly allocated to receive one of three interventions: (a) a "combined" intervention, containing motivational and volitional components in session at T1 and a filler task at T2, (b) a "motivation first" intervention, where the motivational components were received at T1 and the volitional components at T2, or (c) a "volition first" intervention, where the volitional components were received at T1 followed by motivational components at T2. At T2, there was a significant main effect of time, such that there was an increase in walking, but this did not differ between groups. At T3, the "combined" intervention group showed a large (d?=?1.06) and significant (p?=?0.036) increase in walking behaviour, in contrast to both other interventions (time?×?groups interaction, p?=?0.003). The "combined" intervention also produced a significant increase in self-efficacy, relative to the two other interventions. This study demonstrates generalisability of previous large intervention effects and suggests that use of both motivational and volitional components is optimal in producing change in walking behaviour. Future research should explore the mechanisms by which techniques to increase self-efficacy and planning interact.     

Applying test operating characteristics to measures of exercise motivation: A primer

Physical activity programmes that include a motivational counselling component can be effective at increasing exercise participation. Reliable screening procedures could provide a cost effective method of identifying and channelling those ‘at risk’ for non‐participation into a motivational counselling intervention and increase participation and long‐term adherence. Traditional statistical methods have played an important step in developing measures that are good predictors of future exercise behaviour. Test operating characteristics (TOCs), a set of clinical outcome statistics, could be used to evaluate the accuracy of these measures as screening tools in identifying those ‘at risk’ for non‐participation and those ‘not at risk’ for use in applied settings, such as physical activity programmes. This paper will provide a primer on the use of TOCs, particularly as they apply to the evaluation of measures of exercise motivation. Also provided is an example application using eight measures of exercise motivation previously used in research.     

Randomized controlled trial of brief interventions to reduce college students' drinking and risky sex

The present study tested the proposition that an intervention to reduce alcohol use among college students will also reduce their risky sexual behavior. In a randomized controlled trial, 154 heavy-drinking, predominantly White, heterosexual college students at behavioral risk for infection with HIV and other sexually transmitted diseases were assigned to receive no intervention or a two-session, in-person, motivational interviewing-based intervention focused on (a) reducing alcohol risk behavior, (b) reducing HIV risk behavior, or (c) reducing both alcohol and HIV risk behavior. Three-month retrospective assessments of alcohol use and sexual behavior were conducted at intake and at 3-, 6-, 9-, 12-, and 15-month follow-up appointments. During follow-up, participants who received the single-focus alcohol risk-reduction intervention drank less frequently and consumed fewer drinks per drinking day as compared with no-intervention control participants, but did not differ from control participants in their frequency of intercourse without a condom or number of sexual partners. Participants who received the single-focus HIV risk-reduction intervention evidenced fewer unprotected sex events during follow-up, as compared with control participants. The number of sexual partners reported during follow-up did not differ by condition. Effects of the interventions did not vary significantly over time and were not moderated by participant gender. Results suggest that intervening to reduce alcohol use may not reduce risky sexual behavior among nonminority college students, but that a brief motivational intervention targeting HIV risk behavior may have utility for reducing the frequency of unprotected sex in this population.     

A Dual-Focus Motivational Intervention to Reduce the Risk of Alcohol-Exposed Pregnancy

Project CHOICES developed an integrated behavioral intervention for prevention of prenatal alcohol exposure in women at high risk for alcohol-exposed pregnancies. Settings included primary care, university-hospital based obstetrical/gynecology practices, an urban jail, substance abuse treatment settings, and a media-recruited sample in three large cities. The intervention was based on motivational interviewing and targeted both adoption of effective contraception and reduction of alcohol use. Treatment included 4 manual-guided sessions delivered by mental health clinicians and 1 contraceptive counseling session delivered by a family planning clinician. This paper describes the rationale for treatment; the use of motivational interviewing and the transtheoretical model for a dual-focused approach to behavior change; the development of the Project CHOICES intervention; development of the study protocol and treatment manual; and selection, training, supervision, and monitoring of study counselors. Implications for future applications of the intervention are discussed.     

A Brief Alcohol Intervention During Inpatient Psychiatric Hospitalization for Suicidal Adolescents

Alcohol use and suicide-related thoughts and behaviors are common in psychiatrically hospitalized adolescents and each problem can exacerbate the other. Despite knowledge about the functional relationship between alcohol use and suicide-related thoughts and behaviors, inpatient psychiatric units only cursorily address alcohol use because suicide risk is considered primary. In this paper we provide theoretical and empirical rationale for the inclusion of brief motivational interventions for alcohol use in inpatient treatment settings for suicidal adolescents. We give a case example of the brief intervention in practice, including when and how to use specific techniques. Following the case example, we discuss the flexibility of this intervention and how it can be adapted for adolescents with varying risk profiles. We conclude with recommendations for future research, including the development and testing of technology-based boosters following hospital discharge.     

计算机心理干预在物质成瘾中的应用

针对物质成瘾者的计算机心理干预以传统心理干预理论为基础,通过计算机和网络对成瘾者进行干预。该方法通过提高成瘾者的自我效能感、应对技能、戒断动机等,达到帮助其戒断并预防复吸的目的。计算机心理干预对成瘾者虽有一定效果,但也存在一些问题,如其能否够弥补传统干预的不足,测量方法是否有效等。未来研究应进一步提高计算机干预的有效性,比较不同计算机干预方法对不同成瘾物质的适用性及有限性,并结合计算机干预与认知训练,推动计算机心理干预在物质成瘾中的应用。     

Feasibility of a Self-Determination Theory-based exercise intervention promoting Healthy at Every Size with sedentary overweight women: Project CHANGE

ObjectivesTo examine feasibility, acceptability and preliminary results of a Self-Determination Theory (SDT) -based exercise intervention with a Healthy at Every Size (HAES) orientation for sedentary overweight/obese women.DesignProject CHANGE was an 8-week randomized controlled trial with follow-up at 4-week.MethodTwenty-five sedentary, overweight women (BMI = 25–34.9) were randomized to either the SDT-based intervention with a HAES orientation (S/H) or exercise only (EX) intervention. The S/H group received exercise training and a weekly behavioral intervention while the EX group received only traditional supervised exercise training. Information about acceptability and feasibility was collected from process evaluation (i.e., participants' satisfaction and feedback) and objective data (e.g., retention, attendance, adherence to the PA goal). Assessments of PA participation and physical/psychological variables were obtained at baseline, post-intervention, and 4-week follow-up.ResultsParticipants reported high levels of satisfaction. Participation in the S/H group averaged 95%. Retention was high for both groups (S/H = 83.3% vs. EX = 84.6%), while adherence to the PA goal was better for the S/H group at follow-up (S/H = 60% vs. EX = 36.4%). The S/H intervention also resulted in larger effect sizes for changes in key motivational variables, including self-determination, autonomy, as well as goal-setting, planning and scheduling self-efficacy.ConclusionThe 8-week SDT-based intervention promoting Healthy at Every Size is feasible and acceptable and may result in better exercise adherence and improvements in motivational variables relative to traditional supervised exercise. These results support conducting additional research to determine the efficacy of this approach for promoting PA in sedentary, overweight women.     

Character Strengths Interventions: Building on What We Know for Improved Outcomes

For this review strengths intervention studies were located using online searches and collegial networks and included if they explicitly sought to teach or use a strengths classification to enhance well-being, and used pre- and post-intervention measures and a comparison group. Eight studies met the criteria and have been summarised by this review. To date, the effect sizes achieved by character strengths interventions have been small to moderate. An understanding of how these interventions work may facilitate development of more effective interventions, while expanding the field of character strengths interventions to include a broader range of activities and approaches may also offer benefits. Research examining individual factors, such as strengths use, psychological need satisfaction, goal-setting and goal-striving provides promising leads to explain how strengths interventions work. However, the effect on intervention efficacy of relational or contextual factors, such as intervention environment or facilitator attitude to strengths, has not yet been explored. Implications for interventions in school settings are considered.     

Regulate to facilitate: A scoping review of prefrontal asymmetry in sport and exercise

BackgroundPrefrontal asymmetry (PFA) describes the relative activity of the right PFC compared to the left PFC. It has been shown that PFA is associated with affective and motivational variables in several contexts, including sport and exercise. Considering the significant roles of affect and motivation in different performance settings, PFA might also be an important indicator of athletic performance. However, the relevance of PFA in the sport and exercise setting has not yet been addressed in its entirety. Instead, previous systematic reviews have solely focused on affective variables. Mapping out the complex interactions between PFA and affective, motivational as well as performance variables could help to understand what determines successful athletic performance as well as the positive psychological effects associated with exercise.ApproachScientific databases were searched for quantitative studies in English language published in international peer-reviewed journals. All 27 selected studies assessed physical activity and measured PFA in the brain locations F4-F3 and/or F8-F7 using electroencephalography.FindingsThe majority of the studies used a non-athlete sample (78%) and exercise types were diverse. While all studies focused on affective or motivational processes, 19% also reported associations with performance. Even though findings are inconsistent, they support the assumption that PFA plays a role in self-regulation.ConclusionThere is evidence for an involvement of PFA in affective, motivational and performance processes in the sport and exercise setting that can be interpreted as regulatory mechanisms. Future research on the underlying mechanisms is warranted, in particular, associations with motivational processes and performance need to be investigated more explicitly.     

Alcohol affects goal commitment by explicitly and implicitly induced myopia

Alcohol commits people to personally important goals even if expectations of reaching the goals are low. To illuminate this effect, we used alcohol myopia theory, stating that alcohol intoxicated people disproportionally attend to the most salient aspects of a situation and ignore peripheral aspects. When low expectations of reaching an important goal were activated students who consumed alcohol were less committed than students who consumed a placebo. We observed less commitment regardless of whether low expectations were explicitly activated in a questionnaire (Study 1) or implicitly activated through subliminal priming (Study 2). The results imply that, intoxicated people commit to goals according to what aspects of a goal are activated either explicitly or implicitly.     

Promoting “Healthy Futures” to Reduce Risk Behaviors in Urban Youth: A Randomized Controlled Trial

There is increasing evidence of the interconnection between educational and health outcomes. Unfortunately wide disparities exist by both socioeconomic status and race/ethnicity in educational and vocational success. This study sought to promote urban youths’ career readiness as a way to reduce involvement in risk behaviors. Two hundred primarily African‐American youth (ages 14–21) were recruited from a pediatric primary care clinic. Youth randomized to the intervention received three motivational interviewing sessions focused around expectations and planning for the future. Baseline and 6‐month follow‐up assessments included measures of career readiness and risk behavior involvement (i.e., physical fighting, alcohol and marijuana use). At 6‐months, youth randomized to the intervention condition showed increased confidence in their ability to perform the behaviors needed to reach their college/career goals. Additionally, youth randomized to the intervention arm showed decreased fighting behavior (adjusted rate ratio: .27) and marijuana use (adjusted rate ratio: .61). Assisting urban youth in thinking and planning about their future holds promise as a way to reduce their involvement in risk behaviors. This study also demonstrated that motivational interviewing could be used to promote positive behaviors (i.e., career readiness).     

Energy Management of People in Organizations: A Review and Research Agenda

Although energy is a concept that is implied in many motivational theories, is hardly ever explicitly mentioned or researched. The current article first relates theories and research findings that were thus far not explicitly related to energy. We describe theories such as flow, subjective well-being, engagement and burn-out, and make the link with energy more explicit. Also, we make a first link between personality characteristics and energy, and describe the role of leadership in unleashing followers’ energy. Following, we identify how the topic of energy management can be profitably incorporated in research from a scientific as well as a practitioner viewpoint. Finally, we describe several interventions to enhance energy in individuals and organizations.     

Perceived self-regulation of exercise goals and interfering goals among regular and irregular exercisers: a life space analysis

ObjectivesTo investigate whether adults self-classified as regular and irregular exercisers tend to differentially perceive the self-regulation of their exercise goals (a between groups comparison) and whether the groups’ differ in their self-regulatory perceptions of an exercise goal versus a goal that strongly interferes with exercise (a within groups comparison).DesignsCross-Sectional Survey.MethodsCollege students (N=399, 66% female), who were either regular or irregular exercisers, completed the Goal Systems Assessment Battery [GSAB; Karoly, P., & Ruehlman, L. S. (1995). Goal cognition and its clinical implications: Development and preliminary validation of four motivational assessment instruments. Assessment, 2, 113–129] for the goal of exercise and for a self-selected interfering goal. The GSAB gauges how individuals evaluate multiple functional components of self-regulation.ResultsA doubly multivariate MANOVA revealed a significant interaction between exercise regularity and goal type. Irregular exercisers manifested a pattern of goal regulatory thinking favoring their interfering goal relative to their exercise goal with respect to its value and the extent of their monitoring, planning, social comparison, and self-rewarding their progress toward that goal. Regular exercisers tended not to make such regulatory distinctions.ConclusionsAlthough life pursuits identified as interfering with exercise (e.g. academic goals) generally require more of a psychological investment than engaging in exercise, regular exercisers tend to construe their physical activity goals in a manner that closely matches their ratings of competing life aspirations. A dual focus on exercise goals and their aspirational rivals may inform motivational theory and intervention.     

Brief Intervention of Alcohol Problems in Sub-Saharan Africa: A Review

The purpose of this review was to identify and assess studies that have described and quantified brief interventions of alcohol problems in sub-Saharan Africa. PubMed, Google scholar, CAB Abstracts and article references were searched to identify studies published in English between 1980 and 2009. Twenty-one eligible studies were described in detail and information on study characteristics extracted. All of the identified studies were conducted either in east or southern Africa and varied substantially in terms of study design, population and alcohol use definitions. Overall, brief intervention of alcohol problems in health care settings showed positive results but were difficult to integrate into routine practice. Brief interventions (ranging from a few to 12 sessions) in school settings showed mixed results. In individual or group format in community settings, brief interventions combined with HIV risk reduction counselling showed promising short term results. The findings of this review of sub-Saharan African research strongly support the possible impact of brief interventions of alcohol problems in various settings.     

The use of implementation intentions and the decision balance sheet in promoting exercise behaviour

Although increasing exercise and fitness has often been associated with positive health outcomes, infrequent exercise participation has remained a problem. Since two distinct motivational and volitional phases to goal pursuit have been proposed, a combined motivational (decision balance sheet, DBS) and volitional (implementation intentions) intervention was predicted to be more effective in increasing exercise behaviour than a control or either strategy alone. A total of 86 students were randomly assigned to one of the four conditions, and were all asked to try to exercise two more times a week than they currently did, over a four week period. Their fitness levels were measured through fitness tests conducted pre- and post-intervention. A priori orthogonal contrasts indicated that the experimental strategies produced a greater increase in exercise frequency and total time spent exercising per week and accordingly showed greater fitness improvements than the control group. Moreover, the volitional groups taken together produced greater increase in time spent exercising and a marginally greater improvement in frequency than the DBS alone. The combined intervention led to improvements in fitness and marginal increases in frequency over the implementation intention alone group. It is proposed that for the combined group the DBS may have aided recall of the implementation intention or increased commitment to it, as remembering and then acting on the plan, in the stated place and time, mediated the implementation intention–behaviour relationship. The combined intervention produced the greatest fitness improvements, indicating that this strategy can lead to important health benefits.     

Primary Care Treatment Integrating Motivation and Exposure for PTSD Symptoms and Hazardous Alcohol Use: A Case Series

Symptoms of posttraumatic stress disorder (PTSD) and hazardous alcohol use are highly comorbid. Research on integrated interventions to address PTSD symptoms and hazardous alcohol use concurrently has demonstrated efficacy, yet integrated treatments are underutilized. Both patient (e.g., stigma, scheduling/logistics) and clinician (e.g., concern about symptom exacerbation and/or treatment dropout) barriers may impede utilization of integrated interventions among those with comorbid PTSD symptoms and hazardous alcohol use. Primary care behavioral health models (PCBH), in which embedded behavioral health providers deliver treatment to individuals with mild or moderate behavioral health symptoms in primary care, may help address treatment barriers by offering accessible behavioral health interventions in a destigmatizing setting. This paper presents two case examples from a randomized controlled trial testing the efficacy of an integrated intervention for PTSD symptoms and hazardous alcohol use developed for and delivered in primary care. Outcome data and session-by-session content for two participants are included, along with discussion of barriers encountered during the course of treatment. Clinician-suggested strategies for navigating barriers to facilitate utilization of integrated interventions for PTSD symptoms and hazardous alcohol use are also discussed.     

Enhancing dissemination in selective eating disorders prevention: An investigation of voluntary participation among female university students

Maximising dissemination of efficacious psychological interventions is an important undertaking, particularly in prevention work where the target population may not be seeking help. Consequently, the current study investigated voluntary participation in a selective eating disorder prevention programme by examining predictors of, and evaluating a motivational enhancement approach to, increased participation. Female students studying first-year psychology (N = 124, M_age = 19.30, SD = 1.55) completed baseline measures, were randomised to a motivational or control condition, then presented with a flyer for an eating disorders prevention trial and assessed regarding potential participation. Results showed that interest and likelihood of participation were low overall and lack of time the most commonly endorsed reason. Participants high on weight concerns were more likely to cite the group format of the intervention as a deterrent. A greater belief in the helpfulness of body image programmes and higher personal ineffectiveness were significant predictors of interest in participation. There was no significant difference between those who did and did not undergo the motivational enhancement with respect to interest and likelihood of participation. These findings suggest important avenues for consideration when designing eating disorder prevention efforts relying on voluntary participation, and highlight the importance of evaluating programmes cross-culturally.     

Cancer-related fatigue: a systematic and meta-analytic review of non-pharmacological therapies for cancer patients

Cancer-related fatigue (CRF) is a significant clinical problem for more than 10 million adults diagnosed with cancer each year worldwide. No "gold standard" treatment presently exists for CRF. To provide a guide for future research to improve the treatment of CRF, the authors conducted the most comprehensive combined systematic and meta-analytic review of the literature to date on non-pharmacological (psychosocial and exercise) interventions to ameliorate CRF and associated symptoms (vigor/vitality) in adults with cancer, based on 119 randomized controlled trials (RCTs) and non-RCT studies. Meta-analyses conducted on 57 RCTs indicated that exercise and psychological interventions provided reductions in CRF, with no significant differences between these 2 major types of interventions considered as a whole. Specifically, multimodal exercise and walking programs, restorative approaches, supportive-expressive, and cognitive-behavioral psychosocial interventions show promising potential for ameliorating CRF. The results also suggest that vigor and vitality are distinct phenomena from CRF with regard to responsiveness to intervention. With improved methodological approaches, further research in this area may soon provide clinicians with effective strategies for reducing CRF and enhancing the lives of millions of cancer patients and survivors.     

Enhanced Brief Motivational Intervention for College Student Drinkers With ADHD: Goal-Directed Activation as a Mechanism of Change

College students with attention-deficit/hyperactivity disorder (ADHD) are at risk for alcohol-related problems and disorders relative to their typically developing peers. Despite risk, the optimal therapeutic approach for reducing problem alcohol use in students with ADHD, and mechanisms of change underlying treatment effects in this population, are largely unknown. The current study evaluated putative mechanisms of change in a randomized controlled trial of two harm reduction interventions for college student drinkers with ADHD (N = 113; 49% male): brief motivational intervention plus supportive counseling (BMI + SC) versus brief motivational intervention plus behavioral activation (BMI + BA). Results showed that participants in the BMI + BA condition engaged in more goal-directed activation and less avoidant behavior over the course of treatment compared to those in the BMI + SC condition, in turn predicting reductions in alcohol-related negative consequences. Effects were more robust 1 month following intervention, and diminished by 3 months. Sensitivity analyses revealed a significant indirect effect of treatment condition on alcohol-related negative consequence via reductions in avoidance over treatment. Post hoc moderated mediations showed that BMI + BA engaged target mechanisms more robustly for students with more severe ADHD and depressive symptoms compared to BMI + SC. These findings support the application of BMI + BA intervention, particularly in targeting goal-directed activation and avoidance/rumination in at-risk student drinkers with ADHD.