A Remote Acceptance-Based Affect Regulation Intervention to Promote Physical Activity Among Early Career Professionals: A Mixed Methods Examination of Feasibility
Date
2023-01-17
Authors
Grant, Stina J.
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Abstract
Background: The benefits of physical activity (PA) are well-established, yet much of the population is insufficiently active to reap optimal health effects. Early career professionals (ECPs) comprise one transitional group at-risk for inactivity and therefore a critical target for PA promotion. A web-based intervention utilizing online modules and podcasts represents an innovative delivery format for this time-pressed population; however, theoretical mechanisms of action and corresponding behaviour change techniques need to be honed to effectively increase PA. Affective state (e.g., challenging emotion or mood) is one factor that contributes to an established intention-behaviour gap and is especially pertinent among ECPs who face many demands and stressors. As such, an intervention designed to foster intention translation, strengthen emotion regulation, and mitigate the effect of incidental affect (e.g., work-related stress on PA engagement) to assist with PA initiation is warranted. This study uses a parallel randomized controlled design to explore the feasibility of a web-based intervention grounded in the Multi-Process Action Control (M-PAC) Framework and with a specific focus on Acceptance and Commitment Therapy (ACT) principles to promote PA among ECPs. Objectives: 1) To examine primary outcomes related to the feasibility and acceptability of a six-week web-based intervention and 2) explore the effects of the intervention on secondary outcomes of interest including moderate-to-vigorous PA (MVPA), emotion regulation, M-PAC constructs, and ACT constructs (acceptance, valued living, and mindfulness). Methods: Adults aged 25-44 residing in Canada who were employed at least part-time in a desk-based job and identifying as not meeting PA guidelines (<150 min MVPA) were recruited. Participants were randomized into a 6-week online intervention or a wait-list control group using a mixed block design. The intervention group gained access to 6-weekly self-guided online modules incorporating select M-PAC
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iv constructs and integrating ACT principles with an emphasis on affect regulation strategies. Short
podcast episodes were offered as a complement to the lesson concepts. Primary feasibility outcomes were descriptive and included recruitment, retention, engagement and adherence. Satisfaction and acceptability were measured via self-report and through qualitative interviews. Secondary outcomes of MVPA, emotion regulation, M-PAC constructs, and ACT constructs were assessed via self-report at baseline and post-intervention at 6 weeks using questionnaires. Effect sizes were calculated using analysis of covariance to control for baseline values. Results: Twenty-six adults were recruited and randomized to the web-based intervention (n=14) and waitlist control (n=12) groups. The recruitment rate was 35%, retention was 73%, engagement was 63%, and satisfaction was high (M = 2.68/4; M = 4.07/5). Qualitative feedback was highly positive and suggestions for intervention improvement were themed around ideas for strengthening engagement, increasing podcast awareness, and addressing minor technical issues. Participants logged in 4.57 times (SD = 3.30) and spent 31.6 minutes (SD = 18.25) per week on the intervention. Participants allocated to the intervention improved MVPA (ηp2 = 0.53), emotion regulation (ηp2 = 0.42), M-PAC action control constructs of behavioural regulation (ηp2 = 0.48), affective attitude (ηp2 = 0.26), identity (ηp2 = 0.11), and ACT-related constructs of mindfulness (ηp2 = 0.47), valued living (ηp2 = 0.20), and acceptance and action (ηp2 = 0.07), Conclusion: The recruitment, retention, and engagement rates were adequate while satisfaction was favourable, suggesting a full-scale randomized controlled trial is feasible with minor modifications. Secondary outcomes showed movement in the hypothesized direction suggesting intervention fidelity. A large-scale study is warranted to establish intervention effectiveness.
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Keywords
physical activity, affect regulation, feasibility, randomized controlled trial, early career professionals