A Positive Psychology–Motivational Interviewing Intervention to Promote Positive Affect and Physical Activity in Type 2 Diabetes: The BEHOLD-8 Controlled Clinical Trial

Huffman, Jeff C.; Golden, Julia; Massey, Christina; Feig, Emily H.; Chung, Wei-Jean; Millstein, Rachel; Brown, L. David; Gianangelo, Taylor; Healy, Brian C.; Wexler, Deborah J.; Park, Elyse R.; Celano, Christopher M.

doi:10.1097/psy.0000000000000840

Cited by 29 publications

(35 citation statements)

References 49 publications

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“…We next chose to conduct a second proof-of-concept trial of this PP-MI intervention– now utilizing a shorter duration of full phone sessions and with the addition of adjunctive text messaging, in an attempt to further optimize scalability. The framework utilizing the specific PP activities, MI-based physical activity program, and text messages was adapted from our prior intervention studies using a similar framework, (Huffman et al, 2020 ; Huffman, Feig, et al, 2019 ) other PP-based studies in medical populations, (Cohn et al, 2014 ; Moskowitz et al, 2012 ; Moskowitz et al, 2017 ) and the above developmental work to allow specific adaptation to the midlife population. Within these models, the main focus of the study was to assess feasibility of recruitment, retention, study procedures, and the phone and text components of the intervention (Gomez-Bernal et al, 2019 ).…”

Section: Methodsmentioning

confidence: 99%

“…Intervention delivery and fidelity. Interventionists were four psychologists (three of whom were board-certified, while the other was a research psychologist) who received training in both the PP and MI components of the intervention from the lead study intervention supervisor (CC), based on a protocol from our prior work (Huffman et al, 2020 ; Huffman, Feig, et al, 2019 ; Zambrano et al, 2020a ). Training consisted of didactic sessions, provision of written materials (including a written annotated training manual containing guidelines and tips for each session), and role-playing sessions, which were based on similar training programs run by our behavioral intervention collaborators (Park et al, 2006 ; Park et al, 2013b ).…”

Section: Methodsmentioning

confidence: 99%

“…MVPA, measured by accelerometer, was chosen as the main secondary outcome because it is the intensity of activity most clearly and strongly associated with lower cardiovascular risk and overall improved health outcomes (Colberg et al, 2016 ; Full et al, 2021 ; Kraus et al, 2019 ; Stamatakis et al, 2019 ). We required valid accelerometer data from at least 10 h per day for at least 4 days as per prior studies using these devices and a study of the device compared to doubly labeled water (Helgadottir, Forsell, & Ekblom, 2015 ; Huffman et al, 2020 ). We did not include one weekend day of activity, given that we expected that not all participants (or midlife persons) would working, or that some would not be working traditional daytime weekday positions.…”

Section: Methodsmentioning

confidence: 99%

“…acts of kindness, using personal strengths, recalling positive life events), Seligman, Steen, Park, & Peterson, 2005 consistently improve well-being (Bolier et al, 2013 ; Carr et al, 2021 ; Sin & Lyubomirsky, 2009 ). There have been few studies of PP-based interventions designed to boost well-being and physical activity, but PP-based interventions have led to increased physical activity in medical settings in such projects, (Huffman et al, 2020 ; Peterson et al, 2012 ) potentially mediated through better mood, greater motivation and energy, increased perceived social support, and increased self-efficacy (Huffman, DuBois, Millstein, Celano, & Wexler, 2015a ; Zambrano et al, 2020a ).…”

mentioning

confidence: 99%

“…To be effective, such a physical activity program for midlife adults would need to be efficient and accessible, and it would need to address the barriers to physical activity commonly experienced by this population. Remotely delivered interventions reduce the time, financial, and transportation burdens of in-person programs, and both phone- and text message-based programs have led to improvements in physical activity, (Huffman et al, 2020 ; Huffman et al, 2021b ) with text messaging programs for physical activity having a small-to-medium effect size (Cohen’s d = .31-.38 Smith, Duque, Huffman, Healy, & Celano, 2020 ), though the evidence for their impact is mixed (Nguyen, Gill, Wolpin, Steele, & Benditt, 2009 ; Smith et al, 2020 ; Wang et al, 2015 ). Additionally, text messages for physical activity appear to work best as part of multicomponent programs, rather than alone, (Smith et al, 2020 ) and they can be used to reinforce principles that were previously introduced in more detail by phone or in writing.…”

mentioning

confidence: 99%

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A phone and text message intervention to improve physical activity in midlife: initial feasibility testing

Huffman

Harnedy

Massey

et al. 2022

Health Psychology and Behavioral Medicine

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Background Physical activity during midlife (ages 45-64) plays a major role in the prevention of chronic and serious medical conditions. Unfortunately, many midlife adults struggle to be physically active in the setting of low levels of psychological well-being and the management of multiple confluent sources of stress. Effective, scalable, midlife-specific interventions are needed to promote physical activity and prevent the development of chronic medical conditions. Objectives In an initial proof-of-concept trial, we assessed the feasibility and acceptability of a new, midlife-adapted, phone- and text message-based intervention using positive psychology (PP) skill-building and motivational interviewing (MI) techniques. We secondarily analyzed post-intervention changes in accelerometer-measured physical activity and self-reported outcomes. Methods The PP-MI intervention included six weekly phone sessions with a study trainer, with completion of PP activities and physical activity goals between calls, and in the subsequent six weeks briefer phone check-ins were conducted. Text messages over the 12-week intervention period were utilized to support participants and identify barriers to goal completion. Feasibility (session completion rates) and acceptability (participant ratings of intervention ease and utility) were assessed via descriptive statistics, and pre-post improvements in psychological, functional, and physical activity outcomes at 12 weeks were examined via mixed effects regression models. Results Twelve midlife adults with low baseline physical activity enrolled in the single-arm trial. Overall, 76.8% of all possible sessions were completed by participants, and mean ratings of weekly phone sessions were 8.9/10 (SD 1.6), exceeding our a priori thresholds for feasibility and acceptability. Participants demonstrated generally medium to large effect size magnitude improvements in accelerometer-measured physical activity, psychological outcomes, and function. Conclusions A novel, midlife-specific phone- and text-based PP-MI intervention was feasible and had promising effects on physical activity and other clinically relevant outcomes, supporting next-step testing of this program via a randomized controlled trial.

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