Does proactive cyclic usage of a footrest prevent the development of standing induced low back pain?

Various interventions, such as standing intermittently with one leg on a footrest, have been suggested to prevent low back pain (LBP) development during prolonged standing. To assess this standing intervention twelve participants stood for 80 min while cycling through three minute periods of level-ground standing divided by one minute periods with either the right or left leg elevated onto a platform. All participants had previously participated in a prolonged level standing protocol and were classified as pain (PD) or non-pain developers (NPD). Out of the six known PDs, only one PD developed LBP by the end of the standing intervention. The intervals of elevated leg standing resulted in increased lumbar spine flexion in comparison to level standing. In addition, over time there was an increase in lumbar spine flexion during the level standing intervals. This change in lumbar spine posture in standing pain developers likely contributed to the reduced LBP development during this prolonged standing intervention     

Comparing different boosters of planning interventions on changes in fat consumption in overweight and obese individuals: A randomized controlled trial

Single planning interventions have been found to promote short‐term dietary change. Repeated planning interventions may foster long‐term effects on behavior change. It remains unknown whether there is a critical number of boosters to establish long‐term maintenance of behavioral changes. This study aimed at investigating what social‐cognitive variables mediate the effects of the interventions on dietary behavior change. Overall, 373 participants (n = 270 women, 72.4%; age M = 52.42, SD = 12.79) were randomly allocated to one of five groups: a control group, a single planning group, and three groups with 3, 6, or 9 weeks’ repeated planning interventions. Follow‐ups took place 4, 6, and 12 months after baseline. Change in fat consumption was not promoted by any of the interventions. In terms of social‐cognitive variables, intentions, self‐efficacy and coping planning displayed a time × group interaction, with the 9 weeks’ planning group showing the most beneficial effects. Effect sizes, however, were very small. None of the tested planning interventions successfully promoted change in fat consumption across the 12 month period. This, however, could not be explained by problems with adherence to the intervention protocol. Potential explanations for this unexpected result are discussed.     

“It’s Not Like Judgment Day”: Public Understanding of and Reactions to Personalized Genomic Risk Information

The value of genomic risk assessment depends upon patients making appropriate behavioral changes in response to increased risk leading to disease prevention and early detection. To date, few studies have investigated consumers’ response to personalized genomic disease risk information. To address this gap, we conducted semi-structured interviews with 60 adults participating in the Coriell Personalized Medicine Collaborative. The interviews took place after receiving results providing genomic and other risk information for up to eight common complex diseases. We found that participants were most likely to recall results which conferred an increased risk or those of particular personal interest. Participants understood the multi-factorial nature of common complex disease, and generally did not have negative emotional responses or overly deterministic perceptions of their results. Although most participants expressed a desire to use results to improve their health, a minority had actually taken action (behavior change or shared results with their doctor) at the time of the interview. These results suggest that participants have a reasonable understanding of genomic risk information and that provision of genomic risk information may motivate behavior change in some individuals; however additional work is needed to better understand the lack of change seen in the majority of participants.     

Self-affirmation and physical activity messages

We examined the effects of a self-affirmation intervention in conjunction with message frame on attentional bias toward physical activity messages, and explicit psychological and behavioral responses to these messages. Inactive participants (N = 153) completed either a self-affirmation or a control task, were told they were not active enough for health benefits, then read either a gain or loss-framed message, followed by an attentional bias task and questionnaires measuring message processing, psychological reactions and behavior. One week later, participants completed an on-line measure of physical activity. Message frame did not moderate the self-affirmation effect. Self-affirmed participants reported slightly higher self-efficacy for exercising in the future and slightly lower, but not significant, perceived threat than participants in the control group. Self-affirmation and messages may need to be further supplemented with more intense interventions accompanied with adequate resources to facilitate intentions for and actual behavioral change for a complex behavior like physical activity.     

Stimulus Fading and Response Elaboration in Differential Reinforcement for Alternative Behavior

A hallmark of applied behavior analysis is the development of function‐based interventions for problem behavior. A widely recommended function‐based intervention is differential reinforcement of alternative behavior (DRA), in which reinforcement is contingent upon socially acceptable alternatives to problem behavior (e.g., teaching communication skills). Typically, DRA is introduced under rich schedules of reinforcement. Although effective for initiating behavior change, rich schedules are often impractical in the natural setting. In this study, we evaluated the extent to which a stimulus fading program could be employed to elaborate alternative behavior (mands) in two individuals diagnosed with an autism spectrum disorder. For both participants, problem behavior was reduced substantially upon implementation of the DRA procedure. Further, problem behavior rates remained low and mand rates decreased to more practical levels as the DRA behavioral requirements increased during the fading program. The fading approach demonstrated in this paper may be a useful component of intervention packages for clinicians. Copyright © 2015 John Wiley & Sons, Ltd.     

Happy Family Kitchen: Behavioral Outcomes of a Brief Community-Based Family Intervention in Hong Kong

Positive psychology interventions commonly involve behavioral exercises to improve psychosocial well-being. Intervention effect on behavior is unclear. The Happy Family Kitchen project, one of the community-based brief intervention projects under The FAMILY: A Jockey Club Initiative for a Harmonious Society, was conducted in Hong Kong to develop and evaluate the effectiveness of a positive psychology family intervention. We have previously reported positive intervention effects on family communication, family well-being, and subjective happiness. This paper aims to explore the effectiveness of the intervention on behavioral outcomes and their associations with psychosocial well-being. A total of 23 social service units organized and conducted intervention programs for 1419 individuals from 612 families in Hong Kong. Each intervention was developed with emphasis on one of five positive psychology themes: gratitude, flow, happiness, health, and savoring. Intervention outcomes were assessed at pre-intervention, immediate post-intervention, and 6 weeks and 12 weeks post-intervention. Results showed that family communication time and frequency of meal preparation with family members increased with sustainable small effects up to 12 weeks. Theme-specific behavior change was observed in the gratitude, flow, and happiness interventions, respectively. Family communication time, frequency of eating with family members, and theme-specific behaviors, including gratitude, flow, happiness behavior, health attitude, and health behavior, were positively associated with psychosocial well-being. Qualitative data provided additional evidence of effectiveness with in-depth insights into behavior change. The positive associations between target behaviors and well-being suggest that improvements in well-being as a function of the intervention may be associated with behavior change.     

Testing mediator variables in a physical activity intervention for women with type 2 diabetes

ObjectivesA limited understanding of the mechanisms of behavior change has hindered the development of more effective interventions. The aim of this study was to identify potential mediators of objectively measured physical activity (PA) behavior change in women with type 2 diabetes (T2DM).DesignMediation test of a randomized controlled trial.MethodWomen with T2DM (n = 93) from the control group (standard PA materials, n = 44) and the full intervention group (control + stage-matched printed material and telephone counseling, n = 49) of a larger PA intervention trial were included. PA outcomes were minutes of MET weighted moderate and vigorous PA/week (self-report) and steps/3-days (objective) recorded at baseline and 12-months. Social-cognitive constructs were measured and tested in a mediating variable framework.ResultsPerceived behavioral control and barrier self-efficacy mediated intervention effects on objective PA (proportion of intervention effect mediated = 18% and 24% respectively). Intention was a mediator of objective PA (23%).ConclusionPerceived behavior control, barrier self-efficacy, and intention are effective mechanisms of PA behavior change in women with T2DM.     

What is the best way to promote cycling? A systematic review and meta-analysis

Cycling has the potential to address a number of personal and societal challenges, not least with respect to health and the need for more sustainable modes of transport. However, the best way(s) to promote cycling is still unclear. In an effort to answer this question, we identified 39 interventions designed to promote cycling, with a total sample of 46,102 participants. Random effects meta-analysis estimated a small but statistically significant effect of interventions on cycling behaviour (g₊ = 0.14, 95% CI [0.05, 0.23]). To identify the most effective intervention strategies, we coded the behaviour change techniques used within each of the interventions. Interventions that prompted people to self-monitor their behaviour or added objects to the environment (e.g., provided shared bikes) were more effective than those that did not use these strategies. Interventions that restructured the physical environment (e.g., built new cycle paths) were less effective than the studies that did not do this. We also identified a number of factors that moderated the effect of the interventions on outcomes; specifically, interventions that targeted a specific group, used objective measures of cycling such as accelerometers, and that were tested using independent groups designs typically yielded stronger effects. The findings should help to guide interventions to promote cycling in the future.     

SEPARATE AND COMBINED EFFECTS OF METHYLPHENIDATE AND A BEHAVIORAL INTERVENTION ON DISRUPTIVE BEHAVIOR IN CHILDREN WITH MENTAL RETARDATION

We investigated the separate and combined effects of a behavioral intervention and methylphenidate (Ritalin®) on disruptive behavior and task engagement in 3 children with severe to profound mental retardation. The behavioral intervention involved differential reinforcement of appropriate behavior and guided compliance. All 3 children demonstrated decreased disruptive behavior and improved task engagement in response to the behavioral intervention. Two of the 3 children demonstrated similar improvement in response to methylphenidate. Although both interventions were highly effective for these 2 participants, the relative efficacy of the interventions varied between the 2 children. There was no evidence of an additive or synergistic effect of the two interventions, but the high efficacy of each intervention alone limited our ability to detect such effects.     

Using self-determination theory to promote adolescent girls' physical activity: Exploring the theoretical fidelity of the Bristol Girls Dance Project

ObjectivesTo report the theory-based process evaluation of the Bristol Girls' Dance Project, a cluster-randomised controlled trial to increase adolescent girls' physical activity.DesignA mixed-method process evaluation of the intervention's self-determination theory components comprising lesson observations, post-intervention interviews and focus groups.MethodFour intervention dance lessons per dance instructor were observed, audio recorded and rated to estimate the use of need-supportive teaching strategies. Intervention participants (n = 281) reported their dance instructors' provision of autonomy-support. Semi-structured interviews with the dance instructors (n = 10) explored fidelity to the theory and focus groups were conducted with participants (n = 59) in each school to explore their receipt of the intervention and views on the dance instructors' motivating style.ResultsAlthough instructors accepted the theory-based approach, intervention fidelity was variable. Relatedness support was the most commonly observed need-supportive teaching behaviour, provision of structure was moderate and autonomy-support was comparatively low. The qualitative findings identified how instructors supported competence and developed trusting relationships with participants. Fidelity was challenged where autonomy provision was limited to option choices rather than input into the pace or direction of lessons and where controlling teaching styles were adopted, often to manage disruptive behaviour.ConclusionThe successes and challenges to achieving theoretical fidelity in the Bristol Girls' Dance Project may help explain the intervention effects and can more broadly inform the design of theory-based complex interventions aimed at increasing young people's physical activity in after-school settings.     

A Cognitive Behavioral Adherence Intervention for Adolescents with Type 1 Diabetes

This study examined the impact of a cognitive behavioral intervention for nonadherent adolescents with type 1 diabetes. Six youths having problems following the diabetes regimen received training in cognitive restructuring and problem solving during individual sessions. A multiple baseline design across participants was used. Treatment effectiveness was assessed through 24-hr recall adherence interviews with adolescents and frequency of testing data was downloaded from glucose meters. Data was also collected for diabetes-specific stress. Five youths displayed improvement on at least one self-care behavior. Furthermore, the results suggest that the cognitive behavioral intervention was effective in diminishing diabetes-related stress in two participants. Cognitive behavioral interventions show promise for increasing self-care behaviors among nonadherent youths with type 1 diabetes. However, individual youths varied in their response to treatment. Further research is needed in developing procedures to better meet the needs of youths, improve youth participation, and enhance treatment effectiveness.     

Application of the Theory of Planned Behaviour in Behaviour Change Interventions: A Systematic Review

This paper reviews studies explicitly applying the Theory of Planned Behaviour (TPB) to behaviour change interventions. A systematic and multiple search strategy identified 30 papers, describing 24 distinct interventions. Studies were rarely explicit about use of the TPB. The TPB was mainly used to measure process and outcome variables and to predict intention and behaviour, and less commonly to develop the intervention. Behaviour change methods were mostly persuasion and information, with increasing skills, goal setting, and rehearsal of skills used less often. When reported, half of the interventions were effective in changing intention, and two-thirds in changing behaviour, with generally small effect sizes, where calculable. Effectiveness was unrelated to use of the theory to develop interventions. Evidence about mediation of effects by TPB components was sparse. The TPB may have potential for developing behaviour change interventions, but more comprehensive studies are needed that compare the utility of the TPB with other social cognition models and behavioural techniques.     

Are we going to close social gaps in HIV? Likely effects of behavioral HIV-prevention interventions on health disparities

Although experimental behavioral interventions to prevent HIV are generally designed to correct undesirable epidemiological trends, it is presently unknown whether the resulting body of behavioral interventions is adequate to correct the social disparities in HIV-prevalence and incidence present in the United States. Two large, diverse-population meta-analytic databases were reanalyzed to estimate potential perpetuation and change in demographic and behavioral gaps as a result of introducing the available behavioral interventions advocating condom use. This review suggested that, if uniformly applied across populations, the analyzed set of experimental (i.e. under testing) interventions is well poised to correct the higher prevalence and incidence among males (vs. females) and African-Americans and Latinos (vs. other groups), but ill poised to correct the higher prevalence and incidence among younger (vs. older) people, as well as men who have sex with men, injection-drug users, and multiple partner heterosexuals (vs. other behavioral groups). Importantly, when the characteristics of the interventions most efficacious for each population were included in the analyses of behavior change, results replicated with three exceptions. Specifically, after accounting for interactions of intervention and facilitator features with characteristics of the recipient population (e.g. gender), there was no behavior change bias for men who have sex with men, younger individuals changed their behavior more than older individuals, and African-Americans changed their behavior less than other groups.     

Ten-year follow-up of a successful treatment of self-injurious behavior

Ten years ago, self-injurious behavior that produced blindness in a man with profound mental retardation was treated through behavioral intervention. This person's behavioral history was reviewed for 12 years prior to the intervention through examination of his clinical record and for 10 years following the intervention through examination of his clinical record, direct observation, and interviews with staff. Physical injury occurred only once in the last 46 months; physical restraint has not been used in 10 years; and for the past 9 years, no more than one medication has been prescribed for the control of behavior or seizures. Suggestions are presented for designing behavioral interventions at the beginning of treatment to maintain reductions in behavior.     

The effectiveness of function‐based interventions to treat sleep problems,including unwanted co‐sleeping,in children with autism

This study investigated the effectiveness of functional behavioral assessment (FBA)—informed interventions for sleep problems, particularly co‐sleeping, in children with autism spectrum disorder (ASD). Seven children, who exhibited multiple sleep problems including unwanted co‐sleeping, participated. FBA, based on information derived from interviews and parent‐recorded sleep diaries, was used to develop individualized case formulations upon which multicomponent, parent‐implemented interventions were based. These were evaluated using a single‐case, non‐concurrent multiple‐baseline‐across‐participants design. Improvements were observed across all sleep problems, including the elimination of co‐sleeping. Gains were maintained at follow‐up for five out of seven children, though two children did not complete intervention. Parents reported high levels of satisfaction with the program. FBA‐based interventions for sleep problems in children with ASD and their clinical implications are further discussed.     

Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth.

This study assessed the effects of 3 theoretically grounded, school-based HIV prevention interventions on inner-city minority high school students' levels of HIV prevention information, motivation, behavioral skills, and behavior. It involved a quasi-experimental controlled trial comparing classroom-based, peer-based, and combined classroom- and peer-based HIV prevention interventions with a standard-of-care control condition in 4 urban high schools (N = 1,532, primarily 9th-grade students). At 12 months postintervention, the classroom-based intervention resulted in sustained changes in HIV prevention behavior. This article discusses why both of the interventions involving peers were less effective than the classroom-based intervention at the 12-month follow-up and, more generally, suggests a set of possible limiting conditions for the efficacy of peer-based interventions.     

Non-pharmacologic Interventions for CFS: A Randomized Trial

Non-pharmacological behavioral treatments for CFS have been suggested as promising. These trials have tested protocols composed of behavioral, cognitive and cognitive–behavioral interventions but there have been few efforts to differentially evaluate their outcomes. The primary purpose of the current study was to evaluate the effectiveness of nurse delivered non-pharmacologic interventions. In the present study, 114 participants diagnosed with CFS were randomly assigned to four 6-month interventions. The interventions were: cognitive–behavior therapy, cognitive therapy, anaerobic activity, and a relaxation control group. The study found that these interventions led to increases in several areas of functioning, with more consistent changes occurring among those participants in the cognitive condition. For the 25 variables in this study, significant change occurred for 28%, 20%, 16%, and 12% of the variables for the cognitive, cognitive behavior therapy, anaerobic activity, and relaxation conditions, respectively. However, the majority of participants continued to be diagnosed with CFS following the treatment trial. Implications of these findings are discussed.     

Psychosocial mediators of a lifestyle physical activity intervention in women

ObjectivesA lifestyle physical activity intervention in women based on the transtheoretical model and social–cognitive theory effectively increased physical activity. The aim of the present study was to examine possible mediators (perceived benefits and barriers of physical activity, self-efficacy, processes of change, and social support) of these physical activity changes.MethodsMembers of four units of a women's organization followed a six-month minimal-contact physical activity program. The intervention program included one group meeting, a self-help booklet and five monthly reminder letters. Members of two other units served as control group. Physical activity (accelerometer counts), and psychosocial constructs (self-report questionnaires) were assessed at baseline (pretest) and directly after the intervention (posttest). Women who completed all measurements (n = 101) were included in the mediation analyses.ResultsParticipants in the intervention group reported significantly greater increases in the use of behavioral processes from pretest to posttest than participants in the control group. None of the proposed psychosocial constructs showed a mediating effect on changes in physical activity.ConclusionsThe mechanisms proposed by the transtheoretical model and social–cognitive theory could not explain the positive effect of the intervention on physical activity. Identifying the working components of an intervention remains a challenging and necessary step in the development of effective low-cost and high-reach physical activity interventions.