Behavioral Activation Treatment Research Articles

Modifying outcome expectancies and behavioral reinforcers to induce quit attempts among young adult smokers

Research has shown that outcome expectancies predict smoking behavior, and expectancy challenge interventions can reduce smoking. This study tested the hypothesis that supplementing expectancy challenge with a behavioral activation intervention promoting increased exposure to alternative reinforcers would help increase motivation to quit and induce actual quit attempts within the following month among young adult smokers. Smokers, aged 18–35 (N = 159, of whom 93 provided one-month follow-up data) and not required to be interested in quitting at the point of enrollment, were randomized to (a) the combined cognitive-behavioral intervention, (b) a cognitive-only expectancy challenge, or (c) a neutral reading (control) task. There were no significant between-group effects on motivation, but the conditions differed significantly in likelihood of leading to a quit attempt. Post hoc comparisons showed the combined condition participants (52 % of completers) to be significantly more likely than control group participants (25 %) to make a quit attempt, with the cognitive-only group (43 %) intermediate and not significantly different from the other conditions. These data provide preliminary evidence of utility for the brief cognitive-behavioral intervention in promoting smoking cessation attempts; more research is needed to test various possible explanations of how and for whom the intervention is effective, as well as whether it would significantly exceed expectancy challenge alone in larger samples.

Comparing the effectiveness of behavioral activation group therapy and treatment based on acceptance and commitment on depression and quality of life of people with cancer

Comparing the effectiveness of behavioral activation group therapy and treatment based on acceptance and commitment on depression and quality of life of people with cancer

Incomplete reporting of activity behaviour interventions in school-based research: a systematic review of randomised controlled trials published 2015-2020

Introduction: To date, systematic reviews including research published up until 2015, which describe staff training delivered in school-based interventions targeting changes in students’ activity behaviour, have consistently reported insufficient information about staff training. Complete descriptions of the behaviour change techniques that target teachers (and other actors) involved in implementation are crucial to interpret student outcomes and replicate effective interventions. Given relevant guidelines to promote complete reporting of interventions were published in 2014, the quality may have improved in recent years.

Reward-related predictors of symptom change in behavioral activation therapy for anhedonic adolescents: a multimodal approach.

Anhedonia is a cardinal characteristic of depression which predicts worse treatment outcome and is among the most common residual symptoms following treatment. Behavioral Activation (BA) has been shown to be an effective treatment for depressed adults, and more recently, depressed adolescents. Given its emphasis on systematically and gradually increasing exposure to and engagement with rewarding activities and experiences, BA may be a particularly effective intervention for adolescents experiencing anhedonia and associated reward system dysfunction. In the present study, anhedonic adolescents (AA; n = 39) received 12 weekly sessions of BA and completed a multimodal (i.e., neural, behavioral, and self-report [ecological momentary assessment]) assessment of reward function at pre-treatment and post-treatment (as well as weekly self-report assessments of anhedonia). Typically developing adolescents (TDA; n = 41) completed the same measures at corresponding timepoints. Multilevel models tested pre-treatment reward-related predictors of anhedonia improvement, as well as change in reward measures over the course of BA. Analyses revealed significant reductions in anhedonia following BA treatment. Enhanced pre-treatment neural (striatal) reward responsiveness predicted greater anhedonia improvement. In contrast, baseline self-report and behavioral reward measures did not predict treatment outcome. A group x time interaction revealed greater increases in both reward- and loss-related neural responsiveness among AA relative to TDA adolescents. Consistent with a capitalization (rather than compensatory) model, pre-treatment neural - but not self-report or behavioral - measures of relatively enhanced reward responsiveness predicted better BA outcome. In addition to alleviating anhedonia, successful BA may also increase neural sensitivity to affectively salient (e.g., reward- and loss-related) stimuli among anhedonic youth.

Peer recovery specialist-delivered, behavioral activation intervention to improve retention in methadone treatment: Results from an open-label, Type 1 hybrid effectiveness-implementation pilot trial.

Despite the efficacy of methadone to treat opioid use disorder (OUD), retention is an urgent priority, particularly among low-income, minoritized populations. Peer recovery specialists are well-positioned to engage vulnerable patients, particularly when trained in an evidence-based intervention to promote retention. This hybrid effectiveness-implementation pilot trial aimed to demonstrate the proof of concept of a peer recovery specialist-delivered behavioral activation and problem solving-based approach (Peer Activate) to improve methadone retention. Implementation outcomes included feasibility, acceptability, and fidelity. Feasibility and acceptability were defined by the percentage of participants who initiated the intervention (≥75%) and completed ≥75% of core sessions, respectively. Fidelity was assessed via independent rating of a randomly selected 20% of sessions. The primary effectiveness outcome was methadone retention at three-months post-intervention vs. a comparison cohort initiating methadone during the same time period. Secondary outcomes included methadone adherence, substance use frequency, and substance use-related problems. Benchmarks for feasibility and acceptability were surpassed: 86.5% (32/37) initiated the intervention, and 81.3% of participants who initiated attended ≥75% of core sessions. The mean independent rater fidelity score was 87.9%, indicating high peer fidelity. For effectiveness outcomes, 88.6% of participants in Peer Activate were retained in methadone treatment at three-months post-intervention-28.9% higher than individuals initiating methadone treatment alone in the same time period [χ2(1) = 10.10, p=0.001]. Among Peer Activate participants, urine-verified methadone adherence reached 97% at post-intervention, and there was a significant reduction in substance use frequency from 48% of past two-week days used at baseline to 31.9% at post-intervention [t(25)=1.82, p=.041]. Among participants who completed the core Peer Activate sessions (n=26), there was a significant reduction in substance use-related problems [t(21)=1.84, p=0.040]. Given the rapid scale-up of peer recovery specialist programs nationwide and the urgent need to promote methadone retention, these results, although preliminary, have important potential clinical significance. The next steps are to conduct a Type 1 hybrid effectiveness-implementation randomized trial with a larger sample size and longer-term follow-up to further establish the implementation and effectiveness of the Peer Activate approach.

Do what matters, no matter what! Factorizing positive activities during COVID-19 lockdown.

Behavioral activation (BA) interventions systematically encourage positive and value-based activities. Engaging in them is an effective way to counteract negative affect, but it is unknown whether there are subtypes of activities that may have differential effects on mood. This study investigated the factorial structure of 99 potentially rewarding activities used in an online BA intervention during the COVID-19 lockdown. About 3624 German-speaking participants evaluated a list of 99 activities that were easy to apply. We analyzed the initially 99 activities by means of confirmatory factor analysis. Since activities can either be seen as reflective or formative indicators, a reflective as well as a formative model was analyzed. Although the range of chosen activities differed clearly between respondents, a one-factor model provided the best fit. It seems that a general “activity” factor is more important for explaining whether people choose a certain activity or not, than specific characteristics of the activity itself.

The effect of the Progressive Goal Attainment Program on cognitions, perceptions, and work participation of workers with chronic health problems: study protocol for a randomized controlled trial

BackgroundCognitions and perceptions of workers with chronic health problems, such as catastrophizing thoughts and fear-avoidance beliefs, can negatively influence work participation. The Progressive Goal Attainment Program (PGAP) is an intervention developed in Canada with the aim of decreasing limiting cognitions and perceptions and increasing work participation. The objective of this protocol article is to describe the design of a randomized controlled superiority trial to study whether PGAP is effective in decreasing limiting cognitions and perceptions and increasing workability and work participation of workers with chronic health problems in the Netherlands.MethodsThis study is a randomized controlled superiority trial with two (parallel) groups, in which workers on sick leave are randomly assigned to an intervention group (PGAP intervention) or to a waiting-list control group (care as usual). The PGAP intervention consists of a maximum of 10 weekly individual sessions provided by a trained PGAP professional in which the worker learns about staying active, planning activities, and setting goals. Participants in this risk-targeted behavioral activation intervention also learn to be more aware of their cognitions and perceptions and learn about solution-focused problem-solving skills in challenging situations. The primary outcome is the degree of catastrophizing. Secondary outcomes are other personal cognitions and perceptions (e.g., expectations regarding return to work, self-efficacy), health symptoms (e.g., fatigue, depression), work participation (e.g., sick leave status, work hours), and other work-related outcomes (e.g., workability, quality of working life).DiscussionAlthough PGAP shows positive effects in Canada, we do not know whether this intervention is effective in the Netherlands. This study is the first randomized controlled trial to test the effect of PGAP on limiting cognitions and perceptions and on work participation of workers with chronic health problems in the Netherlands. If PGAP is effective it could be implemented in the Netherlands in order to stimulate workability and work participation of workers.Trial registrationThe protocol of this study is registered in the Netherlands Trial Register (NL9832) in October 2021.

An adapted behavioural activation intervention (DiaDeM) for people with diabetes and depression in South Asia: A feasibility study protocol

Background: The burden of depression is a rapidly growing problem worldwide. Its prevalence is particularly high among individuals with chronic physical conditions such as Type 2 Diabetes (T2DM), precipitating poorer health outcomes. There is a lack of evidence around treatments that can work among such groups, particularly in Low and Middle-Income Countries (LMICs). This study aims to test the feasibility and acceptability of a culturally adapted Behavioural Activation (BA) intervention (DiaDeM) for people with T2DM and depression in two LMICs in South Asia. Methods: A multicentre, randomised-controlled feasibility trial will be conducted from March 2022 to February 2023. We will recruit 128 adults from health facilities in Bangladesh and Pakistan with a diagnosis of T2DM and depression. Using a 1:1 allocation ratio, consenting individuals will be randomised to either optimised usual care or the DiaDeM intervention. The latter will involve six face-to-face or remotely delivered BA sessions conducted by non-mental health facilitators over six to twelve weeks. Participants will be followed up at three and six months post-randomisation. Feasibility outcomes include the feasibility and acceptability of recruitment and retention, the feasibility of intervention delivery and the feasibility of data collection at baseline and follow-up (including economic data). An embedded mixed-methods process evaluation will also be carried out to inform the main trial. Conclusions: BA is a low resource intervention for depression treatment that can be optimised for delivery in LMIC settings such as South Asia. The planned feasibility trial will directly inform a larger trial to assess the effectiveness and cost-effectiveness of such an intervention in people with T2DM and depression. It will also contribute to the wider evidence base around BA in patients with chronic physical illnesses, with particular relevance to South Asian, as well as wider LMIC regions and populations. Trial registration: ISRCTN 75501608

Protocol for a collaborative randomised effectiveness trial of lay-delivered versus clinician-delivered behavioural activation in senior centres

IntroductionDepression is common among community-dwelling older adults who make use of senior centre services yet remains undertreated due to a lack of acceptable and available treatments. Emerging evidence suggests that...

A brief report informing the adaptation of a behavioural activation intervention for delivery by non-mental health specialists for the treatment of perinatal depression.

Behavioural activation (BA) is recommended by the National Institute for Health and Care Excellence guidelines for the treatment of perinatal depression; however, there is limited evidence about whether it is effective when delivered by non-mental health specialists (NMHS) in a perinatal setting in the UK. This study aimed to adapt a BA intervention manual and guided self-help booklet intended for delivery by NMHSs for the treatment of perinatal depression. Interviews were conducted with 15 women and 19 healthcare professionals (HCP) within the first study element. Four experience-based co-design (EBCD) workshops were held, with the involvement of 14 women and three HCPs, to modify the BA documents for the specific needs of perinatal women. Thematic analysis was used to analyse the data. The findings from the study elements were presented with themes. The co-designers (women and HCPs) pointed out that having sleeping problems, changes in appetite, feeling exhausted and feeling emotional, may be experienced by non-depressed mothers as well during pregnancy or in the postpartum period, especially around the fourth day after giving birth. Therefore, it was important to differentiate these feelings from depression. The women also wanted to see an example for each activity before being asked to do it. Having examples would help them to see the possibilities before creating their own diary sheets or tables of activities. Aside of the tool adaptation, the findings of this study provide a foundation to assess the effectiveness of the adapted intervention in a subsequent feasibility trial.

Effectiveness of internet-based behavioral activation on quality of life among young adult survivors of childhood brain tumor: a randomized controlled trial

Purpose Diagnosis and treatment of childhood brain tumor have detrimental effects on physical, neurocognitive, psychological, and social functioning that lasts into adulthood and effects quality of life (QOL). To address diminished QOL, an Internet-based behavioral activation (BA) intervention was developed. Behavioral activation aims to increase activities and behaviors likely to improve thoughts, mood, and QOL. Methods Participants included 127 young adult survivors of childhood brain tumor (SCBT) randomized into the experimental group (n= 64) or the waitlist control group (n= 63). The dependent variables included: life satisfaction, stress, and activation and were assessed with a two-way mixed analysis of variance (ANOVA). Results Results revealed a significant interaction between the intervention and time on life satisfaction, F(1, 125)=4.793, p = 0.03. There were no significant main effects over time for perceived stress and activation. Conclusions Findings offer initial evidence that BA can be delivered over the internet and that Internet-delivered BA can have a positive effect on the QOL of young adult SCBT. Internet-based BA interventions can serve as a resource for young adult SCBT who desire to boost their mood and QOL. Implications for rehabilitation Behavioral activation (BA) is aimed at increasing positively reinforcing overt behaviors that are likely to promote improved thoughts, mood, and quality of life (QOL). Results indicated study participants in the experimental group demonstrated a significant gain in life satisfaction compared to the control group after receiving the Internet-based BA intervention; and provides support that the intervention was associated with positive changes across time. Findings offer initial evidence that BA can be delivered over the internet and that Internet-delivered BA can have a positive effect on the QOL of young adult survivors of childhood brain tumor (SCBT). Internet-based BA interventions can serve as a resource for young adult SCBT who desire to boost their mood and QOL.

Intervention effects on children’s movement behaviour accumulation as a result of the Transform-Us! school- and home-based cluster randomised controlled trial

BackgroundIt is unknown if and how children’s movement behaviour accumulation patterns change as a result of physical activity and/or sedentary behaviour interventions. It is important to establish the effectiveness of interventions targeting changes in such accumulation patterns. This study aimed to investigate the effect of the Transform-Us! school- and home-based intervention program on children’s movement behaviour accumulation patterns, focusing on sporadic accumulation versus time in bouts.MethodsBaseline and post-intervention (18 months) accelerometer data from the Transform-Us! 2 × 2 factorial design cluster randomised controlled trial was used (Melbourne, 2010–2012; analytical sample n = 267; aged 8–9 years). Linear mixed models were fitted to examine effects of three different interventions (targeting increases in physical activity [PA-I], reductions in sedentary time [SB-I], or both [PA + SB-I]) compared to a usual practice (control) group on post-intervention movement behaviour accumulation compositions with eight components, including sporadic time and bouts of sedentary time, and light-, moderate- and vigorous-intensity physical activity.ResultsIntervention effects on distribution of time in the post-intervention waking movement behaviour accumulation composition (adjusted for baseline composition) were small and not significant. However, visual inspection of the change in compositions over time revealed that only groups with a sedentary behaviour intervention component (SB-I and PA + SB-I) reduced time in sedentary bouts, compared to the overall sample compositional mean. In addition, the SB-I group was the only group with an increase in vigorous-intensity physical activity. The combined intervention group (PA + SB-I) was characterized by the largest proportional increase in MPA bouts. The usual practice group was characterized by the largest proportional increases in both sporadic and bouts of sedentary time.ConclusionsThis study showed some early evidence to suggest that the “break up your sitting” message may result in greater impact than the “move more” message. Future research, including larger sample sizes, should investigate if this type of messaging is indeed more effective in changing movement behaviours and ultimately child health.Trial registrationInternational Standard Randomized Controlled Trial Number ISRCTN83725066; Australian New Zealand Clinical Trials Registry Number ACTRN12609000715279.

Engagement with Activity Monitoring During a Behavioral Activation Intervention: A Randomized Test of Monitoring Format and Qualitative Evaluation of Participant Experiences.

Behavioural activation (BA) is an efficacious treatment approach. Activity monitoring is a key component of brief BA treatments; however, no studies have examined the most efficacious format for monitoring. The present pilot study tested brief versus intensive activity monitoring approaches during a BA intervention administered in a college orientation course. Outcomes characterised (1) engagement with the treatment protocol via activity monitoring and (2) participant qualitative experiences with monitoring and the intervention as reported during focus group interviews. Four course sections were randomly assigned to receive monitoring forms that were brief (assessed activities three times daily) or intensive (assessed activities hourly). Forms were provided electronically to students via a web-based platform which tracked completion. There were no significant differences in monitoring frequency (38.0 vs. 23.0 days; p = .154) or the duration of monitoring engagement (62.0 vs. 36.0 days; p = .054) between the brief and intensive conditions. Qualitative findings suggested that participants in both conditions found utility in activity monitoring, particularly during the first month as they transitioned to college. Overall, findings indicated that participants may find utility in monitoring during the first month of a BA intervention using either brief or intensive monitoring forms.

Smartphone assessment uncovers real-time relationships between depressed mood and daily functional behaviors after stroke

Introduction The impact of depressed mood in daily life is difficult to investigate using traditional retrospective assessments, given daily or even within-day mood fluctuations in various contexts. This study aimed to use a smartphone-based ambulatory assessment to examine real-time relationships between depressed mood and functional behaviors among individuals with stroke. Methods A total of 202 participants with mild-to-moderate stroke (90% ischemic, 45% female, 44% Black) completed an ecological momentary assessment five times per day for 2 weeks by reporting their depressed mood and functional behaviors regarding where, with whom, and what activity was spent. Results Participants spent 28% of their wake-up time participating in passive leisure activities but spent the least time in physical (4%) and vocational (9%) activities. Depressed mood was concurrently lower when participants engaged in social activities (β = −0.023 ± 0.011) and instrumental activities of daily living (β = −0.061 ± 0.013); spent time with family members (β = −0.061 ± 0.014), spouses (β = −0.043, ± 0.016), friends (β = −0.094, ± 0.021), and coworkers (β = −0.050 ± 0.021); and were located in restaurants (β = −0.068 ± 0.029), and homes of family members (β = −0.039 ± 0.020) or friends (β = −0.069 ± 0.031). Greater depressed mood was associated with worse ratings in satisfaction, performance, and engagement of activities in concurrent (βs = −0.036 ± 0.003, −0.053 ± 0.003, −0.044 ± 0.003) and time-lagged models (βs = −0.011 ± 0.004, −0.012 ± 0.004, −0.013 ± 0.004). Discussion Smartphone-based ambulatory assessment can elucidate functional behaviors and associated mood after stroke. Findings support behavioral activation treatments to schedule social and instrumental activities for stroke survivors to reduce their depressed mood.

Virtual Reality Behavioral Activation for Adults With Major Depressive Disorder: Feasibility Randomized Controlled Trial.

BackgroundMajor depressive disorder (MDD) is a global crisis with increasing incidence and prevalence. There are many established evidence-based psychotherapies (EBPs) for depression, but numerous barriers still exist; most notably, access and dissemination. Virtual reality (VR) may offer some solutions to existing constraints of EBPs for MDD.ObjectiveWe aimed to examine the feasibility, acceptability, and tolerability of using VR as a method of delivering behavioral activation (BA) for adults diagnosed with MDD during a global pandemic and to explore for signs of clinical efficacy by comparing VR-enhanced BA (VR BA) to a standard BA treatment and a treatment as usual control group for individuals diagnosed with MDD.MethodsA feasibility trial using a 3-armed, unblinded, randomized controlled pilot design was conducted. The study took place remotely via Zoom telehealth visits between April 8, 2020, and January 15, 2021. This study used a 3-week, 4-session protocol in which VR BA participants used a VR headset to complete their BA homework. Feasibility was measured using dropout rates, serious adverse events, completion of homework, an adapted telepresence scale, the Simulator Sickness Questionnaire, the Brief Agitation Measure, and an adapted Technology Acceptance Model. Efficacy was assessed using the Patient Health Questionnaire–9.ResultsOf the 35 participants assessed for eligibility, 13 (37%) were randomized into VR BA (n=5, 38%), traditional BA (n=4, 31%), or a treatment as usual control (n=4, 31%). The mean age of the 13 participants (5/13, 38% male; 7/13, 54% female; and 1/13, 8% nonbinary or third gender) was 35.4 (SD 12.3) years. This study demonstrated VR BA feasibility in participants with MDD through documented high levels of acceptability and tolerability while engaging in VR-induced pleasurable activities in conjunction with a brief BA protocol. No adverse events were reported. This study also illustrated that VR BA may have potential clinical utility for treating MDD, as the average VR BA participant’s clinical severity decreased by 5.67 points, signifying a clinically meaningful change in severity from a moderate to a mild level of depression as per the Patient Health Questionnaire–9 score.ConclusionsThe findings of this study demonstrate that VR BA is safe and feasible to explore for the treatment of MDD. This study documented evidence that VR BA may be efficacious and justifies further examination in an adequately powered randomized controlled trial. This pilot study highlights the potential utility that VR technology may offer patients with MDD, especially those who have difficulty accessing real-world pleasant activities. In addition, for those having difficulty accessing care, VR BA could be adapted as a first step to help people improve their mood and increase their motivation while waiting to connect with a health care professional for other EBPs.Trial RegistrationClinicalTrials.gov NCT04268316; https://clinicaltrials.gov/ct2/show/NCT04268316International Registered Report Identifier (IRRID)RR2-10.2196/24331

Effect of behavioral activation on time and frequency domain heart rate variability in older adults with subthreshold depression: a cluster randomized controlled trial in Thailand.

BackgroundIncreased prevalence of depression highlights the need for effective interventions. Behavioral activation (BA), which can easily be adapted for non-clinical populations, has been the recommended treatment for depression. It is based on a model of psychopathology explaining that losses or chronically low levels of positive reinforcement yield behavioral and emotional changes in depression and that encouraging individuals to increase their engagement in reinforcing activities can improve their mood and enhance their valuable life experiences. Heart rate variability (HRV) provides indices of autonomic function related to depression, but only a few studies have investigated the effect of BA on HRV, particularly among older adults with subthreshold depression. Accordingly, we aimed to investigate the effect of BA on HRV in older adults with subthreshold depression.MethodsWe conducted a 9-month cluster randomized controlled trial in two Health Promoting Hospitals (HPHs). Eighty-two participants were randomized into either intervention (BA with usual care) or control (usual care only) groups, with 41 participants per group. Daily step count was collected weekly during the 12-week BA intervention period, while HRV parameters, including the Standard Deviation of the Normal-to-Normal interval (SDNN), High Frequency (lnHF), Low Frequency (LF), and Low Frequency/High Frequency ratio (LF/HF), were examined at 0, 3, 6 and 9 months. Generalized Estimating Equations (GEEs) were used in the data analysis.ResultsOver nine months, the intervention and control groups differed significantly in the unadjusted mean change of HRV, SDNN [7.59 ms (95% CI: 1.67, 13.50)], lnHF [0.44 ms2 (95% CI: 0.04, 0.85)], and LF [0.53 ms2 (95% CI: 0.09, 0.98)], whereas the groups did not differ significantly in LF/HF ratio [0.01 ms2 (95% CI: -0.04, 0.06)].ConclusionOur results suggest that BA may have a therapeutic effect on depression symptoms of older adults with subthreshold depression via improved HRV.Trial registrationTCTR20211019003, thaiclinicaltrials.org, retrospectively registered on 19 October 2021. Supplementary InformationThe online version contains supplementary material available at 10.1186/s12888-022-03962-8.

Measuring behavior change technique delivery and receipt in physical activity behavioral interventions.

Research on physical activity behavioral support has mainly focused on measuring the absence or presence of behavior change techniques (BCTs) delivered by a counselor. We present a method to measure BCT delivery and receipt in physical activity behavioral support interventions. The method was developed and tested using transcripts from behavior change counseling sessions delivered as part of a theory- and evidence-based physical activity intervention for adults with disabilities. Using existing methods, a new method was developed to code counselor and clients' verbal statements (BCTs and other statements). Two coders independently coded 30 transcripts of audio-recorded counseling sessions. Interrater reliability was assessed using percentage agreement and Prevalence Adjusted Bias Adjusted Kappa (PABAK). Forty-eight codes were developed for counselor statements (35 BCT delivery and 13 other statements) and 46 codes for client statements (34 BCT receipt and 12 other statements). The average interrater reliability was considered nearly perfect for the counselor statements (84% agreement; PABAK = .98) and client statements (86% agreement; PABAK = .98). The BCT delivered and received were most frequently related to Goals and Planning (counselor:36%, client:35%), Support Strategies (counselor:21%, client:17%) and Self Belief (counselor:13%, client:24%). This study presents a reliable coding method to measure BCT delivery and receipt in physical activity behavioral support interventions. The method can be used to enhance intervention fidelity assessment and study interactions between counselors and clients with and without disabilities. Measuring and evaluating BCT delivery and receipt can provide new insights into what types of behavioral support work best under which circumstances. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Physical activity and sedentary behaviour interventions for people living with both frailty and multiple long-term conditions: a scoping review protocol

IntroductionThe number of people living with multiple long-term conditions (MLTCs) is predicted to rise. Within this population, those also living with frailty are particularly vulnerable to poor outcomes, including decreased...

Introduction to Topical Issue on mHealth for Brain Injury Rehabilitation.

Introduction to Topical Issue on mHealth for Brain Injury Rehabilitation.

A decision framework for an adaptive behavioral intervention for physical activity using hybrid model predictive control: illustration with Just Walk

ResumenLa inactividad física es uno de los principales factores que contribuyen a la morbilidad y la mortalidad mundial. Muchas intervenciones comportamentales de actividad física en la actualidad han mostrado un éxito limitado al abordar el problema desde una perspectiva a largo plazo que incluye el mantenimiento. Este artículo propone el diseño de un algoritmo de decisión para una intervención adaptativa de salud móvil e inalámbrica (mHealth) que se basa en conceptos de ingeniería de control. El proceso de diseño se basa en un modelo dinámico que representa el comportamiento basada en la Teoría Cognitiva Social (TCS), con una formulación de toma de decisiones basada en control predictivo por modelo híbrido (HMPC por sus siglas en inglés). Las características discretas y lógicas del HMPC coinciden con la naturaleza categórica de los componentes de la intervención y las decisiones lógicas que son propias de una intervención para la actividad física. La intervención incorpora un modo de reconfiguración del controlador en línea que aplica cambios en los pesos de penalización para lograr la transición entre las etapas de entrenamiento de iniciación comportamental y mantenimiento. Se ilustra el desempeño del controlador utilizando un modelo ARX estimado de datos de un participante representativo de Just Walk, una intervención de actividad física diseñada usando principios de sistemas de control.