Self-monitoring Behavior Research Articles

Effectiveness and Durability of a Workplace Sedentary Behavior Intervention Based on the Total Worker Health® Approach

We used the Total Worker Health® approach to develop a multi-component workplace sedentary behavior intervention and tested intervention effectiveness in a cluster randomized trial. Participants (n = 198; 75% female) were recruited from three call-centers (two intervention and one usual practice control). All worksites received pedal stand active workstations. The usual practice site received no additional support, while the intervention group completed a six-month program of activities including computer-based training, behavioral self-monitoring, health and safety discussions, and pedaling competitions. Data collection included a survey, a physical health assessment, and accelerometer measures of sedentary behavior, physical activity, and sitting/standing time. Primary analyses were generalized estimating equations comparing changes between intervention and usual practice conditions over time, along with analyses of changes in both groups combined over time. Six-month results revealed less prolonged sitting and reductions in musculoskeletal pain in both groups (all p < 0.05), while the intervention group showed additional improvements in moderate physical activity (p < 0.001) and use of pedal stands (p < 0.01). At 12-months, the additional physical activity and pedal stand use in the intervention group regressed to baseline levels, while reductions in prolonged sitting in both groups were durable (p < 0.01). This study adds to previous research showing the effectiveness of the Total Worker Health® approach for workplace health and safety. Results also show that, while providing employees with health and safety resources is beneficial, providing ongoing support for the adoption and use of resources is more effective.

Effect of participant baseline characteristics on adherence to self-monitoring of diet, physical activity and weight in a 12-month weight loss mHealth trial

Abstract Background Self-monitoring (SM) of lifestyle behaviors is the centerpiece of standard behavioral treatment (SBT) for weight loss as SM increases one’s awareness of their behaviors. Extensive evidence demonstrates a significant relationship between adherence to SM and successful weight loss outcomes. Purpose Examine baseline characteristics of participants that are associated with higher adherence to SM of diet, physical activity (PA), and weight in a 12-month mHealth weight loss trial. Methods SMARTER was a single-site, 2-arm randomized controlled trial. We randomized 502 adults with a body mass index (BMI) 27-43 kg/m2 to diet, weight, and PA SM plus tailored feedback messages (SM+FB, n=251) or SM alone (n=251). We provided the SM+FB group feedback messages via the SMARTER app on diet daily, PA every other day and weight weekly. The study provided a wearable PA tracker and smart scale for weight and utilized a smartphone app for dietary SM. Adherence of dietary SM was defined as the % of days with ≥50% of calorie goal recorded and PA SM was % of days with ≥500 steps. Weight SM was the % of days with weight based on the scale record. Linear mixed modeling was applied to assess the monthly percent adherence to SM of diet, PA, and weight over a 12-month period. Our analysis incorporated time effects in months and polynomials of time, treatment group assignment (SM+FB vs. SM), baseline variables of interest (e.g., BMI, age, sex, race, education years, income), and the interactions between treatment and time effects with other variables. For parsimony, non-significant effects were removed. Results The sample (N=502) was 82% white (n=414), 79% female (n=399), and had a mean age of 45.0±14.4 years and BMI of 33.7±4.0 kg/m2. Over 12 months, percent adherence to SM of diet, PA, and weight declined non-linearly. Treatment groups did not demonstrate significant differences. The impact of treatment on the monthly decline in adherence to diet SM was curvilinear and varied significantly over 12 months. Older age was associated with greater adherence to the SM of diet (b=0.72, 95% CI: 0.55-0.88, P < .0001), PA (b=0.50, 95% CI: 0.35-0.66, P < .0001), and weight (b=0.71, 95% CI: 0.57-0.85, P < .0001). Conversely, higher baseline BMI was associated with lower adherence to SM of diet (b=-1.14, 95% CI: -1.73 to -0.55, P < .0001) and PA (b=-0.79, 95% CI: -1.35 to -0.22, P= .006). Other baseline variables were not significantly related to adherence. Conclusion The findings suggest that individuals with a higher BMI at baseline may need additional enhancement strategies to improve their engagement with the digital tools for SM lifestyle which could lead to improved weight outcomes.

Biometrically measured sleep in medical students as a predictor of psychological health and academic experiences in the preclinical years

ABSTRACT Background Student wellness is of increasing concern in medical education. Increased rates of burnout, sleep disturbances, and psychological concerns in medical students are well documented. These concerns lead to impacts on current educational goals and may set students on a path for long-term health consequences. Methods Undergraduate medical students were recruited to participate in a novel longitudinal wellness tracking project. This project utilized validated wellness surveys to assess emotional health, sleep health, and burnout at multiple timepoints. Biometric information was collected from participant Fitbit devices that tracked longitudinal sleep patterns. Results Eighty-one students from three cohorts were assessed during the first semester of their M1 preclinical curriculum. Biometric data showed that nearly 30% of the students had frequent short sleep episodes (<6 hours of sleep for at least 30% of recorded days), and nearly 68% of students had at least one episode of three or more consecutive days of short sleep. Students that had consecutive short sleep episodes had higher rates of stress (8.3%) and depression (5.4%) symptoms and decreased academic efficiency (1.72%). Conclusions Biometric data were shown to significantly predict psychological health and academic experiences in medical students. Biometrically assessed sleep is poor in medical students, and consecutive days of short sleep duration are particularly impactful as it relates to other measures of wellness. Longitudinal, biometric data tracking is feasible and can provide students the ability to self-monitor health behaviors and allow for low-intensity health interventions.

On-Site or Remote? Impact of Remote Audits and Self-Monitoring of Expressive Behavior on External Auditors’ Job Satisfaction

SYNOPSIS This study examines how remote work affects external auditors’ job satisfaction. We survey 308 external auditors and measure their job satisfaction to understand how remote work frequency, self-monitoring of expressive behavior (SMEB), personality traits, technology adoption, job position, and remote onboarding experiences impact auditors’ job satisfaction in the post-COVID-19 era. Results reveal that frequent remote work is associated with high job satisfaction. Auditors who report high SMEB levels have high job satisfaction. However, the positive association between SMEB and job satisfaction decreases as auditors’ remote work frequency increases. Engagement team leaders may wish to encourage high self-monitoring auditors to continue to perform on-site work while encouraging low self-monitoring auditors to work remotely when on-site work is not necessary. We also suggest that audit firms build better supervisory relationships, provide sufficient resources for junior auditors, and continue to provide technology training to increase auditor job satisfaction. Data Availability: The data that support the findings of this study are available from the first author upon request.

Rate-dependent mechanical and self-monitoring behaviors of 3D printed continuous carbon fiber composites

3D printed continuous carbon fiber reinforced polymer (CFRP) composites offer great advantages in structural health monitoring (SHM) owing to their flexibility in complex structure fabrication. Considering the many prospective aerospace applications, tensile experiments were designed to study their mechanical and self-sensing behaviors under a wide range of strain rates. The turning points in the resistance vs strain curves reveal the damage evolution of the specimens and divide the deformations into linear straining and damage evolution regions. Fiber elongation and fiber contact reduction dominate the resistance increase in the linear straining region and the resistance curve behaves linearly. But fiber breakage is the predominant factor in the damage evolution region, yielding a concave resistance curve. Strength, fracture strain, and resistance variation are found to display significant strain rate dependencies that increase with increasing strain rate. Numerous microcracks are formed and evolved into secondary cracks under dynamic loading. This process absorbs more strain energy and produces more carbon fiber breaks, sustaining a higher fracture strain and resistance variations. A model is developed to describe the strain- and strain rate- dependent resistance behaviors, and the predicted results agree well with experimental data. The outcomes of this work contribute to the application of 3D printed continuous CFRP composites in SHM.

The SMILE scale: a wellness behavioral tool for patients with cancer.

As cancer survivorship increases, there is a need for simple tools to measure and promote healthy behaviors. We created a wellness behavioral tool (the SMILE Scale) to encourage self-monitoring of wellness behaviors. This study aimed to determine the feasibility of collecting daily self-reported SMILE Scale data and weekly quality of life data among patients with cancer. We also aimed to measure the association between SMILE Scale responses and validated health-related quality of life (HRQOL) tools (PROMIS-29 + 2 and SymTrak-8) as a pilot test of the hypothesis that increased wellness behaviors may impact quality of life. We surveyed 100 patients with cancer at the Indiana University Simon Comprehensive Cancer Center. Participants were asked to complete daily SMILE Scale assessments over a two-week period, as well as weekly PROMIS-29 + 2 and SymTrak-8 surveys. The primary endpoint was the SMILE Scale completion rate. Secondary endpoints in this single-arm pilot study included correlations between the SMILE Scale and other HRQOL tools. Daily completion rate of the SMILE Scale ranged from 57% to 65% of participants over a 14-day period. Among the 61% of participants who completed SMILE on day 1, 87% completed SMILE on 10 of 14 days. By end of study, participants who self-reported more wellness behaviors (i.e., higher daily SMILE scores) demonstrated significantly higher PROMIS physical health (p = 0.003), higher PROMIS mental health (p = 0.008), and lower (better) SymTrak total symptom burden (p = 0.006). Further, among those who completed at least 1 of 14 daily SMILE assessments, quality of life significantly improved over the two-week period for PROMIS mental health (p = 0.018) and SymTrak total symptom burden (p = 0.014). The SMILE Scale completion rate did not satisfy our pre-planned ≥70% threshold for feasibility; however, the rate for completing SMILE at least once during the 14 days (77%) met this threshold. Participants with higher average daily SMILE scores had significantly better scores across other validated HRQOL tools. While these results may be correlative and not causative, this suggests a potential physical and mental health benefit for delivering the SMILE Scale in clinical practice to help encourage healthy behaviors and warrants testing the SMILE Scale's impact in future studies.

Effect of the Implementation of a Multiple-Behavior Self-Monitoring Intervention on Dietary Intake in Type 2 Diabetes: Secondary Data Analysis.

An electronic diary embedded in a mobile device to monitor lifestyle can be as effective as traditional methods. However, the efficacy of self-monitoring multiple behaviors for dietary intake has not been well studied in people with diabetes. This study aimed to compare the effect of using technology-assisted self-monitoring versus paper diaries on changes in dietary intake. This is a secondary analysis of data collected from 39 people with type 2 diabetes as part of a 3-month pilot clinical trial. Changes in energy intake and the contribution of total fat intake and total carbohydrate intake to total calories (%) from baseline to after intervention (3 months) were evaluated. In total, 26 (67%) of the 39 participants preferred mobile diaries over paper diaries. Participants in the mobile diary group showed slightly higher self-monitoring adherence. Linear mixed modeling results indicated a significant overall decrease in total energy intake (P=.005), dietary fat intake (P=.01), and carbohydrate intake (P=.08) from baseline to 3 months. No significant group differences were detected (P>.05). The implementation of a 3-month, multiple-behavior, self-monitoring intervention in Diabetes Self-Management Education programs has resulted in successful reduction in dietary intake (energy, fat, and carbohydrate), whichever self-monitoring method is chosen by participants according to their preferences. Long-term studies are needed to confirm our findings on dietary intake and examine other behavioral and disease outcomes that require monitoring.

Behavior change techniques to increase physical activity among older adults living in long-term care facilities: A systematic review.

Despite the health benefits of physical activity, many older adults living in long-term care facilities lead sedentary lifestyles and do not meet minimum physical activity recommendations. Determining the behavior change techniques (BCTs) used in physical activity interventions can help us understand the underlying mechanisms by which behavioral change is achieved. The purpose of this systematic review was to identify and evaluate BCTs in physical activity interventions for the elderly residents. Six electronic databases were searched and 15 eligible studies were retained. Nine promising BCTs associated with physical activity promotion among elderly residents were identified: credible source, social support (unspecified), goal setting (outcome), goal setting (behavior), demonstration of the behavior, instruction on how to perform a behavior, self-monitoring of behavior, self-monitoring of outcome(s) of behavior, and adding objects to the environment. Future research is encouraged to select and tailor these BCTs to the specific needs and preferences of the target population.

Barriers and Facilitators to Binge-Watching Using the Theoretical Domains Framework

Using the Theoretical Domains Framework (TDF), this rapid review coded the barriers and facilitators to binge-watching and identified corresponding behaviour change techniques (BCTs) for intervention purposes. Twenty-nine studies reporting influences on binge-watching fulfilled the inclusion criteria and passed quality appraisal checks. Data were extracted and coded accordingly, as informed by the TDF. Findings indicate that most facilitators focused on the goals of binge-watching, such as escapism, and the social influences, such as companionship, while most barriers related to behavioural regulation, such as self-control and self-regulation. BCTs included ‘Goal setting (outcome)’, ‘Social comparison’, and ‘Self-monitoring of behaviour’. Results suggest intervention strategies targeting facilitators to binge-watching by incorporating the identified BCTs may succeed in inhibiting binge-watching behaviours. However, accounting for the intensity of binge-watching was not an objective of the present review; therefore, future research should take into account the varying levels of engagement in binge-watching when developing interventions.

Effect of wearable activity trackers on physical activity in children and adolescents: a systematic review and meta-analysis

Physical inactivity in children and adolescents has become a pressing public health concern. Wearable activity trackers can allow self-monitoring of physical activity behaviour and promote autonomous motivation for exercise. However, the effects of wearable trackers on physical activity in young populations remain uncertain. In this systematic review and meta-analysis, we searched PubMed, Embase, SPORTDiscus, and Web of Science for publications from database inception up to Aug 30, 2023, without restrictions on language. Studies were eligible if they were randomised controlled trials or clustered randomised controlled trials that examined the use of wearable activity trackers to promote physical activity, reduce sedentary behaviours, or promote overall health in participants with a mean age of 19 years or younger, with no restrictions on health condition or study settings. Studies were excluded if children or adolescents were not the primary intervention cohort, or wearable activity trackers were not worn on users' bodies to objectively track users' physical activity levels. Two independent reviewers (WWA and FR) assessed eligibility of studies and contacted authors of studies if more information was needed to assess eligibility. We also searched reference lists from relevant systematic reviews and meta-analyses. Systematic review software Covidence was used for study screening and data extraction. Study characteristics including study setting, participant characteristics, intervention characteristics, comparator, and outcome measurements were extracted from eligible studies. The two primary outcomes were objectively measured daily steps and moderate-to-vigorous physical activity. We used a random-effects model with Hartung-Knapp adjustments to calculate standardised mean differences. Between-study heterogeneity was examined using Higgins I2 and Cochran Q statistic. Publication bias was assessed using Egger's regression test. This systematic review was registered with PROSPERO, CRD42023397248. We identified 9619 studies from our database research and 174 studies from searching relevant systematic reviews and meta-analyses, of which 105 were subjected to full text screening. We included 21 eligible studies, involving 3676 children and adolescents (1618 [44%] were female and 2058 [56%] were male, mean age was 13·7 years [SD 2·7]) in our systematic review and meta-analysis. Ten studies were included in the estimation of the effect of wearable activity trackers on objectively measured daily steps and 11 were included for objectively measured moderate-to-vigorous physical activity. Compared with controls, we found a significant increase in objectively measured daily steps (standardised mean difference 0·37 [95% CI 0·09 to 0·65; p=0·013]; Q 47·60 [p<0·0001]; I2 72·7% [95% CI 53·4 to 84·0]), but not for moderate-to-vigorous physical activity (-0·08 [-0·18 to 0·02; p=0·11]; Q 10·26 [p=0·74]; I2 0·0% [0·0 to 53·6]). Wearable activity trackers might increase daily steps in young cohorts of various health statuses, but not moderate-to-vigorous physical activity, highlighting the potential of wearable trackers for motivating physical activity in children and adolescents. More rigorously designed trials that minimise missing data are warranted to validate our positive findings on steps and to explore possible long-term effects. The Hong Kong University Grants Committee and Seed Fund for Basic Research of the University of Hong Kong.

Effectiveness of self-management program for gastric cancer patients: A randomized controlled trial comparing gain vs. loss message framing

ObjectiveThis study aims to evaluate the effectiveness of a self-management program using gain/loss-framed messages in patients with gastric cancer. MethodsIn this randomized controlled trial, 69 patients with gastric cancer who underwent gastrectomy at a university hospital were assigned to the gain- or loss-framed message group. The self-management program consisted of: 1) face-to-face education, 2) gain/loss-framed text messages, and 3) self-monitoring of health behaviors. Health outcomes (i.e., nutritional status, physical activity, exercise intensity, and distress), and health behaviors (i.e., dietary habits, physical activity performance, and distress management) were measured, and a generalized estimating equation was used for the analysis. ResultsNutritional status and dietary habits in the loss framed message group were statistically higher after the intervention compared to the counterpart (β = −1.72, p = .049; β = 0.36, p = .033, respectively). There was no time-group interaction effect on physical activity, exercise intensity, physical activity performance, distress or distress management. ConclusionsA self-management program employing loss-framed messages was effective in promoting nutrition-related self-management among patients with gastric cancer. Practice implicationsMessage-framing is an effective communication technique that can be easily used in clinical settings, and a loss-message-framing strategy may enhance nutrition-related self-management in patients with gastric cancer.

Do engagement and behavioural mechanisms underpin the effectiveness of the Drink Less app?

This is a process evaluation of a large UK-based randomised controlled trial (RCT) (n = 5602) evaluating the effectiveness of recommending an alcohol reduction app, Drink Less, compared with usual digital care in reducing alcohol consumption in increasing and higher risk drinkers. The aim was to understand whether participants’ engagement (‘self-reported adherence’) and behavioural characteristics were mechanisms of action underpinning the effectiveness of Drink Less. Self-reported adherence with both digital tools was over 70% (Drink Less: 78.0%, 95% CI = 77.6–78.4; usual digital care: 71.5%, 95% CI = 71.0–71.9). Self-reported adherence to the intervention (average causal mediation effect [ACME] = −0.250, 95% CI = −0.42, −0.11) and self-monitoring behaviour (ACME = −0.235, 95% CI = −0.44, −0.03) both partially mediated the effect of the intervention (versus comparator) on alcohol reduction. Following the recommendation (self-reported adherence) and the tracking (self-monitoring behaviour) feature of the Drink Less app appear to be important mechanisms of action for alcohol reduction among increasing and higher risk drinkers.

CHARACTERISTICS OF THE MANIFESTATION AND EXHIBITION OF MUAY TAY ATHLETE’S STRESS RESISTANCE AND SELF-CONTROL BEHAVIOR

Abstract The article is dedicated to the modern developmental problems of sport psychology.Nowdays the life of individuals is related to stress and stress resistance, which are reflected in everyday life, including sports. Learning successful ways to deal with stress is extremely important for an athlete. Sport (sporting activity) is inherently stressful for elite and novice Thai boxers,both of them equally exposed to stress during training and competition and need appropriate psychological support[2;8]. Almost every Thai boxer is in a state of high or pronounced stress. At the same time, men and women are equally susceptible to stress during sports activities. Such athletes widely use several self-supporting behavior strategies during their activities to cope with stress moreover, most of them reach a high level of expressiveness. In the work, an attempt was made to reveal the characteristics of the manifestation of stress resistance and self-control behavior formation of Muay Thai athletes, to study the mutual relationship between stress resistance and self-control behavior and the characteristics of behavior formation and manifestation. An experimental study was organized to study the manifestation of stress resistance of athletes of the mentioned sport [1]. Observations, testing and data processing methods were used for the studies, as a result very important conclusions were made. Various manifestations of stress resistance and self-control behavior among Thai boxers were revealed in the studied groups. In athletes, a high tension was observed in the self-monitoring behavior of positive reappraisal and seeking social support. This can be said to characterize Thai boxers as individuals who are focused on the personal, philosophical, reinterpretation of the problematic situation and are included in the broader context of the individual's self-development work. Perception of social support also indicates athletes' focus on interaction with other people, their support, attention, advice, sympathy, and expectation of concrete effective help. The dominant self-control behavior stress behavioral strategies of athletes are distraction and social distraction from the problem. An indicator of the level of neuropsychological stability or stress resistance is negatively correlated with self-control behavior strategies of taking responsibility and planning for problem solving, as well as problem solving strategies.

Trouble with the curve: the 90-9-1 rule to measure volitional participation inequalities among Royal Canadian Mounted Police cadets during training.

The Royal Canadian Mounted Police (RCMP) Study includes longitudinal multimodal assessments of RCMP cadets from pre-training (i.e., starting the Cadet Training Program [CTP]) to post-deployment and for five years thereafter. The data allow for investigating the multidimensionality of volitional participation in digital health data collection frameworks within serial data collection platforms and the impact of participation inequalities by classifying cadets using the 90-9-1 rule. By classifying cadets as Lurkers, Contributors, and Superusers formally described by the 90-9-1 rule, where 90% of actors do not participate, 9% seldom contribute, and 1% contribute substantially allows for the assessing of relationships between participation inequalities in self-monitoring behaviors as well as whether mental health disorder symptoms at pre-training (i.e., starting the CTP) were associated with subsequent participation. Participants were asked to complete a Full Assessment prior to their training at CTP, as well as short daily surveys throughout their training. Participation frequency was described using a process where participants were rank ordered by the number of daily surveys completed and classified into one of three categories. Full assessment surveys completed prior to their training at CTP included screening tools for generalized anxiety disorder (GAD), major depressive disorder (MDD), posttraumatic stress disorder (PTSD), alcohol use disorder (AUD), and panic disorder (PD). The Kruskal-Wallis H test was used to assess differences in participation rates between mental health disorder symptom screening groups for each measure at pre-training, and Spearman's Rho was used to test for associations amongst self-reported Full Assessment screening tool responses and the number of daily surveys completed during CTP. There were 18557 daily survey records collected from 772 participants. The rank-ordering of cadets by the number of daily surveys completed produced three categories in line with the 90-9-1 rule: Superusers who were the top 1% of cadets (n=8) and produced 6.4% of all recordings; Contributors who were the next 9% of cadets (n=68) and produced 49.2% of the recordings; and Lurkers who were the next 90% of cadets (n=695) and produced 44.4% of daily survey recordings. Lurkers had the largest proportion of positive screens for self-reported mental health disorders at pre-training. The creation of highly individualized, population-based mental health injury programs has been limited by an incomplete understanding of the causal relationships between protective factors and mental health. Disproportionate rates of disengagement from persons who screen positive for mental health disorders further compounds the difficulty in understanding the relationships between training programs and mental health. The current results suggest persons with mental health challenges may be less likely to engage in some forms of proactive mental health training. The current results also provide useful information about participation, adherence, and engagement that can be used to inform evidence-based paradigm shifts in health-related data collection in occupational populations.

Digital Behavior Change Intervention Designs for Habit Formation: Systematic Review.

With the development of emerging technologies, digital behavior change interventions (DBCIs) help to maintain regular physical activity in daily life. To comprehensively understand the design implementations of habit formation techniques in current DBCIs, a systematic review was conducted to investigate the implementations of behavior change techniques, types of habit formation techniques, and design strategies in current DBCIs. The process of this review followed the PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. A total of 4 databases were systematically searched from 2012 to 2022, which included Web of Science, Scopus, ACM Digital Library, and PubMed. The inclusion criteria encompassed studies that used digital tools for physical activity, examined behavior change intervention techniques, and were written in English. A total of 41 identified research articles were included in this review. The results show that the most applied behavior change techniques were the self-monitoring of behavior, goal setting, and prompts and cues. Moreover, habit formation techniques were identified and developed based on intentions, cues, and positive reinforcement. Commonly used methods included automatic monitoring, descriptive feedback, general guidelines, self-set goals, time-based cues, and virtual rewards. A total of 32 commonly design strategies of habit formation techniques were summarized and mapped to the proposed conceptual framework, which was categorized into target-mediated (generalization and personalization) and technology-mediated interactions (explicitness and implicitness). Most of the existing studies use the explicit interaction, aligning with the personalized habit formation techniques in the design strategies of DBCIs. However, implicit interaction design strategies are lacking in the reviewed studies. The proposed conceptual framework and potential solutions can serve as guidelines for designing strategies aimed at habit formation within DBCIs.

An Ecological Mobile Momentary Intervention to Support Dynamic Goal Pursuit: Feasibility and Acceptability Study.

Individuals can experience difficulties pursuing their goals amid multiple competing priorities in their environment. Effective goal dynamics require flexible and generalizable pursuit skills. Supporting successful goal pursuit requires a perpetually adapting intervention responsive to internal states. The purpose of this study was to (1) develop a flexible intervention that can adapt to an individual's changing short to medium-term goals and be applied to their daily life and (2) examine the feasibility and acceptability of the just-in-time adaptive intervention for goal pursuit. This study involved 3 iterations to test and systematically enhance all aspects of the intervention. During the pilot phase, 73 participants engaged in an ecological momentary assessment (EMA) over 1 month. After week 1, they attended an intervention training session and received just-in-time intervention prompts during the following 3 weeks. The training employed the Capability, Opportunity, Motivation, and Behavior (COM-B) framework for goal setting, along with mental contrasting with implementation intentions (MCII). Subsequent prompts, triggered by variability in goal pursuit, guided the participants to engage in MCII in relation to their current goal. We evaluated feasibility and acceptability, efficacy, and individual change processes by combining intensive (single-case experimental design) and extensive methods. The results suggest that the digital intervention was feasible and acceptable to participants. Compliance with the intervention was high (n=63, 86%). The participants endorsed high acceptability ratings relating to both the study procedures and the intervention. All participants (N=73, 100%) demonstrated significant improvements in goal pursuit with an average difference of 0.495 units in the outcome (P<.001). The results of the dynamic network modeling suggest that self-monitoring behavior (EMA) and implementing the MCII strategy may aid in goal reprioritization, where goal pursuit itself is a driver of further goal pursuit. This pilot study demonstrated the feasibility and acceptability of a just-in-time adaptive intervention among a nonclinical adult sample. This intervention used self-monitoring of behavior, the COM-B framework, and MCII strategies to improve dynamic goal pursuit. It was delivered via an Ecological Momentary Intervention (EMI) procedure. Future research should consider the utility of this approach as an additional intervention element within psychological interventions to improve goal pursuit. Sustaining goal pursuit throughout interventions is central to their effectiveness and warrants further evaluation.

Self-control and self-monitoring behaviour of gifted learners in the mathematical problem-solving process: A case study

In the study reported on here we used a qualitative case study design to examine the self-control and self-monitoring behaviour of gifted learners in problem-solving processes. We selected 3 gifted secondary learners using the purposeful sampling method. For the study, each learner completed 10 individual problem-solving sessions. A think-aloud protocol as well as observations and interviews were used in each problem-solving session. The gifted learners displayed various and intertwined self-control and self-monitoring behaviour to read, understand, and solve the problems, and to find and verify the answer. They also displayed this behaviour much more frequently in problems that required using visual drawings and/or had long texts. The gifted learners left or adapted self-control behaviour when the behaviour did not work for solving mathematical problems. They made decisions regarding self-control behaviour by means of the self-monitoring process. The participants presented insistent, quick, flexible, and fluent actions for both self-control and self-monitoring processes. Based on our findings, we propose a portrait of gifted learners’ self-regulative behaviour in the mathematical problem-solving process.

Behavior Change Techniques Within Digital Interventions for the Treatment of Eating Disorders: Systematic Review and Meta-Analysis.

Previous systematic reviews of digital eating disorder interventions have demonstrated effectiveness at improving symptoms of eating disorders; however, our understanding of how these interventions work and what contributes to their effectiveness is limited. Understanding the behavior change techniques (BCTs) that are most commonly included within effective interventions may provide valuable information for researchers and developers. Establishing whether these techniques have been informed by theory will identify whether they target those mechanisms of action that have been identified as core to changing eating disorder behaviors. It will also evaluate the importance of a theoretical approach to digital intervention design. This study aims to define the BCTs within digital self-management interventions or minimally guided self-help interventions for adults with eating disorders that have been evaluated within randomized controlled trials. It also assessed which of the digital interventions were grounded in theory and the range of modes of delivery included. A literature search identified randomized controlled trials of digital intervention for the treatment of adults with eating disorders with minimal therapist support. Each digital intervention was coded for BCTs using the established BCT Taxonomy v1; for the application of theory using an adapted version of the theory coding scheme (TCS); and for modes of delivery using the Mode of Delivery Ontology. A meta-analysis evaluated the evidence that any individual BCT moderated effect size or that other potential factors such as the application of theory or number of modes of delivery had an effect on eating disorder outcomes. Digital interventions included an average of 14 (SD 2.6; range 9-18) BCTs. Self-monitoring of behavior was included in all effective interventions, with Problem-solving, Information about antecedents, Feedback on behavior, Self-monitoring of outcomes of behavior, and Action planning identified in >75% (13/17) of effective interventions. Social support and Information about health consequences were more evident in effective interventions at follow-up compared with postintervention measurement. The mean number of modes of delivery was 4 (SD 1.6; range 2-7) out of 12 possible modes, with most interventions (15/17, 88%) being web based. Digital interventions that had a higher score on the TCS had a greater effect size than those with a lower TCS score (subgroup differences: χ21=9.7; P=.002; I²=89.7%) within the meta-analysis. No other subgroup analyses had statistically significant results. There was a high level of consistency in terms of the most common BCTs within effective interventions; however, there was no evidence that any specific BCT contributed to intervention efficacy. The interventions that were more strongly informed by theory demonstrated greater improvements in eating disorder outcomes compared to waitlist or treatment-as-usual controls. These results can be used to inform the development of future digital eating disorder interventions. PROSPERO CRD42023410060; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=410060.

Effect of a Bladder Control Self-Management Program Delivered Through a Health Kiosk.

The purpose of this study was to examine the feasibility of delivering a bladder control self-management program through a multiuser health kiosk and to evaluate the program's effect on urinary incontinence (UI) and incontinence-specific quality of life (QoL). Secondary analysis of data collected during participants' interactions with the Bladder Control Module (BCM) from the parent study. One hundred eleven participants from the parent study were eligible to be included in this secondary analysis. Their mean age was 72.8years, and most were female (n=95, 85.6%); 81 (75.7%) identified themselves as Caucasian. Each participant could access the BCM at a health kiosk situated at one of several sites: senior centers, subsidized senior housing, retirement communities, and a public library. The BCM comprised 6 sessions self-administered at least 1 week apart. The content focused on lifestyle modification, pelvic floor muscle training, and bladder (habit) retraining, with encouragement of behavioral self-monitoring between sessions. The feasibility of delivering the intervention was measured by the proportion of participants completing each session. The effect of the BCM on incontinence episodes and incontinence-specific QoL was measured, respectively, by a 7-day bladder diary and the Incontinence Impact Questionnaire Short Form. Sixty-one of the 111 eligible participants accessed the BCM. Participants recording incontinence episodes in their baseline bladder diary and completing at least 3 BCM sessions experienced significant decreases in median total UI (P =.01), urge UI (P <.001), and stress UI (P =.02) episodes per day. Incontinence-related QoL significantly improved (P =.03). Our findings support the potential effectiveness of providing community-based, kiosk-enabled access to a conservative behavioral intervention designed to improve incontinence-related outcomes among older adults with UI. Additional research with a larger sample is warranted.

A114: Promoting Exercise Behavior for College Students by Compensating Intervention of Beliefs

Purpose: Compensatory Health Beliefs (CHBs) are essential to resolving the motivational conflicts between the desired and healthy goal in college students. Theory of Planned Behavior (TPB) framework is used to design a multidimensional training model, which compensates belief as a mediator, to research the influence of belief intervention compensation on promoting right exercise cognitive and behavior in college students. The purpose of this study was to discover whether this training model is able to inspire college students to attend exercise more effectively. Methods: A cohort of 218 college students from Guangzhou were involved in the research (20.04±1.5). The objects were divided into two groups. A total of 110 objects in the control group were mentored by professional physical exercise instructor, while for the rest 108 objects in the interventional group who received 45-minute lessons about compensatory beliefs 5 days per week for 12 weeks on top of professional physical exercise instructor. All objects were asked to write a tracker daily for self-monitor daily exercise behavior and mental condition. All objects were asked by the researcher to fill out the Exercise Motivational Conflict Questionnaire and the International Physical Activity Questionnaire one week before and after the intervention. The correlations of compensated beliefs and other two variables were analyzed with descriptive data analysis, independent sample T-test, and multiple regression. Results: The subjects in the intervention group had higher levels of the exercise behavior than those in the control group. Multiple regression analysis indicated that the exercise motivational conflict has significantly positive correlations to exercise behavior (β = 0.47, SE = 0. 41, P &lt; 0. 01). By adding compensated belief in the intervention group, exercise motivational conflict still has significantly positive correlations to exercise behavior（β = 0.47, SE = 0.41, P &lt; 0.01）. The compensated belief has a significant effect among exercise motivational conflict and exercise behavior (β=0.26，SE=0.16，95% CI= (0.03 ~ 0.11) indirectly. Therefore, the mediating effect of compensated belief plays a significant role in promoting the effect between exercise motivational conflict and exercise behavior. Conclusion: The study indicated that the training model can positively predict college students’ exercise motivational conflict and exercise behavior and encourage college students to do exercise effectively. Meanwhile, compensated belief is an effective mediator which can reduce the problem of lack of exercise among college students.