Preliminary Evaluation of a 1-Day Acceptance and Commitment Therapy Workshop for Increasing Moderate-to-Vigorous Physical Activity in Adults with Overweight or Obesity

Abstract

Background

Novel strategies to help adults with overweight/obesity increase motivation for becoming active are needed. This single-arm trial aimed to test the feasibility, acceptability, and preliminary efficacy of a 4-h acceptance and commitment therapy (ACT)-based workshop intervention for increasing moderate-to-vigorous physical activity (MVPA) among insufficiently active adults with overweight/obesity.

Methods

Participants (N = 41) received a 1-day 4-h ACT workshop followed by weekly e-mails and monthly phone calls for 3 months. The primary outcome was change in accelerometer-measured MVPA minutes/day at 3 and 6 months. Process variables (i.e., autonomous motivation, PA acceptance) through which the ACT intervention was hypothesized to increase MVPA were assessed via questionnaires.

Results

Participants completed 91% of phone calls and 75% of e-mail surveys. Acceptability ratings were > 4.5 out of 5 for “understandable,” “useful,” and “intent-to-use” on all intervention components. Participants on average achieved significant increases in bouted and total MVPA at 3 months that were maintained at 6 months. Participants also reported significant increases in physical activity acceptance and autonomous motivation, the latter of which related to MVPA changes.

Conclusion

Results support the feasibility and acceptability of the ACT workshop intervention for promoting MVPA changes among insufficiently active adults with overweight/obesity. Rigorous testing of this approach as a low-intensity standalone or add-on intervention to increase MVPA is warranted.

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References

  1. 1.

    Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63(25):2985–3023.

    Article  Google Scholar 

  2. 2.

    Rhodes RE, Janssen I, Bredin SS, Warburton DE, Bauman A. Physical activity: health impact, prevalence, correlates and interventions. Psychol Health. 2017;32(8):942–75.

    Article  Google Scholar 

  3. 3.

    Tudor-Locke C, Brashear MM, Johnson WD, Katzmarzyk PT. Accelerometer profiles of physical activity and inactivity in normal weight, overweight, and obese US men and women. Int J Behav Nutr Phys Act. 2010;7(1):60.

    Article  Google Scholar 

  4. 4.

    Unick JL, Gaussoin SA, Hill JO, et al. Four-year physical activity levels among intervention participants with type 2 diabetes. Med Sci Sports Exerc. 2016;48(12):2437.

    Article  Google Scholar 

  5. 5.

    Gloster AT, Walder N, Levin ME, Twohig MP, Karekla M. The empirical status of acceptance and commitment therapy: a review of meta-analyses. J Contextual Behav Sci. 2020;18:181–92.

    Article  Google Scholar 

  6. 6.

    Pears S, Sutton S. Effectiveness of acceptance and commitment therapy (ACT) interventions for promoting physical activity: a systematic review and meta-analysis. Health Psychol Rev. 2020:1–26 https://doi.org/10.1080/17437199.2020.1727759 [published Online First: Epub Date]|.

  7. 7.

    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.

    Article  Google Scholar 

  8. 8.

    McIntosh T, Hunter DJ, Royce S. Barriers to physical activity in obese adults: a rapid evidence assessment. J Res Nurs. 2016;21(4):271–87 https://doi.org/10.1177/1744987116647762 [published Online First: Epub Date]|.

  9. 9.

    Teixeira PJ, Carraça EV, Markland D, Silva MN, Ryan RM. Exercise, physical activity, and self-determination theory: a systematic review. Int J Behav Nutr Phys Act. 2012;9(1):78.

    Article  Google Scholar 

  10. 10.

    Butryn ML, Kerrigan SG, Arigo D, Raggio G, Forman EM. Pilot test of an acceptance-based behavioral intervention to promote physical activity durign weight loss maintenance. Behav Med. 2018;44(1):77–87.

    Article  Google Scholar 

  11. 11.

    Lillis J, Bond DS. Values-based and acceptance-based intervention to promote adoption and maintenance of habitual physical activity among inactive adults with overweight/obesity: a study protocol for an open trial. BMJ Open. 2019;9(1):e025115.

    Article  Google Scholar 

  12. 12.

    Brug J, Steenhuis I, van Assema P, de Vries H. The impact of a computer-tailored nutrition intervention. Prev Med. 1996;25(3):236–42 https://doi.org/10.1006/pmed.1996.0052 [published Online First: Epub Date]|.

  13. 13.

    Vandelanotte C, De Bourdeaudhuij I. Acceptability and feasibility of a computer-tailored physical activity intervention using stages of change: project FAITH. Health Educ Res. 2003;18(3):304–17 https://doi.org/10.1093/her/cyf027 [published Online First: Epub Date]|.

  14. 14.

    Choi L, Liu Z, Matthews CE, Buchowski MS. Validation of accelerometer wear and nonwear time classification algorithm. Med Sci Sports Exerc. 2011;43(2):357.

    Article  Google Scholar 

  15. 15.

    Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40(1):181–8.

    Article  Google Scholar 

  16. 16.

    Ryan RM, Connell JP. Perceived locus of causality and internalization: examining reasons for acting in two domains. J Pers Soc Psychol. 1989;57(5):749.

    CAS  Article  Google Scholar 

  17. 17.

    Butryn ML, Arigo D, Raggio GA, Kaufman AI, Kerrigan SG, Forman EM. Measuring the ability to tolerate activity-related discomfort: initial validation of the physical activity acceptance questionnaire (PAAQ). J Phys Act Health. 2015;12(5):717–26.

    Article  Google Scholar 

  18. 18.

    Physical activity guidelines for Americans, 2nd edition. In: Services USDoHaH, ed. Washington, DC: Department of Health and Human Services, 2018.

  19. 19.

    Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–91.

    Article  Google Scholar 

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Acknowledgements

The authors would like to acknowledge Ms. Krystal DeFaria (MS) and Mr. Kevin O’Leary (MS) for their assistance in study implementation and data collection. We thank the study participants for their commitment to this trial.

Funding

This study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (R03 DK114254). Dr. Schumacher is supported by a grant from the National Heart, Lung, and Blood Institute (T32 HL076134-11; PI: Wing).

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Correspondence to Jason Lillis.

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Ethical Approval

All procedures were approved by Miriam Hospital IRB and were performed in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

All participants included in the study provided informed consent.

Conflict of Interest

JL, DSB, and LMS report grant funding from NIH.

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Lillis, J., Schumacher, L.M. & Bond, D.S. Preliminary Evaluation of a 1-Day Acceptance and Commitment Therapy Workshop for Increasing Moderate-to-Vigorous Physical Activity in Adults with Overweight or Obesity. Int.J. Behav. Med. (2021). https://doi.org/10.1007/s12529-021-09965-1

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Keywords

  • Acceptance and commitment therapy
  • Motivation
  • Exercise
  • Obesity