Self-regulation Intervention Research Articles

Moving to Action: The Effects of a Self-Regulation Intervention on the Stress, Burnout, Well-Being, and Self-Regulation Capacity Levels of University Student-Athletes

Background:The purpose of this study was to implement and assess the impact of a person-centered, feel-based self-regulation intervention on the stress, burnout, well-being, and self-regulation capacity of eight university student-athletes experiencing burnout. This was warranted given the negative outcomes associated with athlete burnout, the scarcity of burnout research focusing on student-athletes, and the lack of intervention research addressing burnout in sport.Method:A mixed methods design including questionnaires administered at four time points during the athletic season, pre- and postintervention interviews, and multiple intervention sessions was used.Results:Repeated-measures ANOVAs revealed that stress and burnout levels significantly decreased, and well-being and self-regulation capacity levels significantly increased as the intervention progressed. The qualitative data supported these findings.Conclusion:It appears that university student-athletes participating in this type of intervention can learn to effectively manage themselves and their environment to reduce adverse symptoms and improve optimal functioning.

Abstract MP15: Innovative Self-Regulation Strategies Reduce Weight Gain in Young Adults

Introduction: Young adults gain an average of 2 pounds per year, increasing their risk for obesity and co-morbidities. To date, no approaches have successfully reduced this weight gain. The Study of Novel Approaches to Prevention of Weight Gain (SNAP) is a randomized clinical trial testing two innovative self-regulation interventions. Hypothesis: We hypothesized that both interventions would reduce weight change over an average follow-up of 3 years relative to a control. Methods: Participants age 18-35 with a BMI of 21-30 were recruited in Raleigh-Durham, NC and Providence, RI. The 599 participants included 27% from minority groups and 22% males, mean age 28.4 (SD 4.4) yrs and BMI 25.4 (2.6). The interventions were based on a self-regulation model, involving frequent self-weighing and changes in eating and activity if weight gain occurred. The SMALL changes approach focused on making small (100 calorie) changes in daily eating and exercise; LARGE changes emphasized larger initial changes in eating and exercise, to create a 5 to 10-pound buffer against anticipated weight gain. Interventions were delivered via 8 face-to-face group sessions in the first 4 months, followed by ongoing weight reporting and feedback and optional Internet refreshers. CONTROL received one face-to-face session. Assessments were at baseline, 4 months, and then annually. Results: Data collection ends 12/31/14; final results will be presented. Retention at year 3 is 87%. Currently, mean (SE) weight changes across 3 years differ significantly between the groups (see Fig 1); for LARGE, mean weight loss is -2.48 (0.22) kg, which differs significantly from -0.75 (0.22) kg loss in SMALL, and both differ from the +0.10 (0.22) kg gain in Control. For secondary outcomes of weight gain from baseline to 2 years and % gaining >1 lb at 2 years, both interventions significantly differed from Control, but not from each other. Conclusion: Self-regulation approaches using LARGE or SMALL change strategies reduce weight gain in young adults.

The effects of a brief intervention to promote walking on Theory of Planned Behavior constructs: A cluster randomized controlled trial in general practice

ObjectivePerceived behavioral control (PBC) is a consistent predictor of intentions to walk more. A previously successful intervention to promote walking by altering PBC has been adapted for delivery in general practice. This study aimed to evaluate the effect of this intervention on Theory of Planned Behavior (TPB) constructs in this context. MethodsCluster randomized controlled trial, with n=315 general practice patients. Practice nurses and Healthcare Assistants delivered a self-regulation intervention or information provision (control). Questionnaires assessed TPB variables at baseline, post-intervention, 6 weeks and 6 months. Walking was measured by pedometer. ResultsThe control group reported significantly higher subjective norm at all follow-up time points. There were no significant differences between the two groups in PBC, intention, attitude or walking behavior. TPB variables significantly predicted intentions to walk more, but not objective walking behavior, after accounting for clustering. ConclusionThe lack of effect of the intervention was probably due to a failure to maintain intervention fidelity, and the unsuitability of the behavior change techniques included in the intervention for the population investigated. Practice implicationsThis previously successful intervention was not successful when delivered in this context, calling into question whether practice nurses are best placed to deliver such interventions.

Fatigue in neurological disorders: a review of self-regulation and mindfulness-based interventions

Background: Fatigue is prevalent in neurological disorders and is associated with increased disability and mortality rates. Currently, clinical assessment and management of fatigue is difficult as underlying mechanisms remain poorly understood. Purpose: This narrative review integrates models of pathological fatigue with the concepts of self-regulation and mindfulness. Findings from clinical trials testing the efficacy of mindfulness-based interventions (MBI) for fatigue in neurological disorders are also reviewed. Methods: A search of Medline and PsycINFO databases was conducted using “fatigue,” “neurological disorders,” “exercise,” “self-regulation,” and “mindfulness” search terms to identify articles published from 1980 to the present. Only articles reporting on fatigue relevant clinical outcomes were included in the review of trials testing MBI. Results: Recent definitions and models of pathological fatigue suggest that neurological disorders might instigate maladaptive changes in self-regulation leading to difficulties in sustaining movement and disproportionate levels of perceived effort. MBI might be effective in the management of fatigue since mindfulness training is thought to promote self-regulation by developing attention control and cognitive and emotional flexibility. Findings from a small number of clinical trials provide limited support for the efficacy of mindfulness-based interventions for fatigue in neurological disorders. Conclusion: Given the prevalence and debilitating effect of fatigue in neurological conditions, further research is needed to investigate the potential role of maladaptive self-regulation in the aetiology of this condition. Further research is also needed to test the efficacy of MBI including large randomised controlled trials with active control conditions and which directly assess changes in mindfulness along with fatigue.

Strengthening school readiness for Head Start children: Evaluation of a self-regulation intervention

The present study examined the efficacy of a self-regulation intervention for children experiencing demographic risk. Utilizing a randomized controlled design, analyses examined if children (N=276 children in 14 Head Start classrooms; M age=51.69, SD=6.55) who participated in an 8-week self-regulation intervention demonstrated greater gains in self-regulation and academic achievement over the preschool year compared to children in a control group. In addition, indirect intervention effects on achievement outcomes through self-regulation were explored and differential intervention effects for English language learners within a sample of children from low-income families were tested. Results indicated that children in the intervention group demonstrated stronger levels of self-regulation compared to the control group in the spring of the preschool year. Group comparisons also revealed that the intervention was related to significantly higher math skills for children who were English language learners. In other words, English language learners who participated in the intervention demonstrated stronger levels of math in the spring of preschool in comparison to children in the control group and relative to English speakers who also participated in the intervention. The present study provides support for the efficacy of a school readiness intervention in promoting self-regulation and achievement in young children, especially English language learners.

School-based interventions for elementary school students with ADHD.

Children with attention-deficit/hyperactivity disorder (ADHD) experience significant difficulties with behavior, social functioning, and academic performance in elementary school classrooms. Although psychotropic medication may enhance classroom behavior, pharmacologic treatment is rarely sufficient in addressing the many challenges encountered by individuals with ADHD in school settings. This article describes 3 evidence-based strategies including behavioral, academic, and self-regulation interventions. Future directions for research on school-based interventions are discussed.

Intervention use and action planning in a web-based computer-tailored weight management program for overweight adults: randomized controlled trial.

BackgroundThere are many online interventions aiming for health behavior change but it is unclear how such interventions and specific planning tools are being used.ObjectiveThe aim of this study is to identify which user characteristics were associated with use of an online, computer-tailored self-regulation intervention aimed at prevention of weight gain; and to examine the quality of the goals and action plans that were generated using the online planning tools.MethodsData were obtained with a randomized controlled effect evaluation trial in which the online computer-tailored intervention was compared to a website containing generic information about prevention of weight gain. The tailored intervention included self-regulation techniques such as personalized feedback, goal setting, action planning, monitoring, and other techniques aimed at weight management. Participants included 539 overweight adults (mean age 46.9 years, mean body mass index [BMI] 28.03 kg/m2, 31.2% male, 11% low education level) recruited from the general population. Use of the intervention and its planning tools were derived from server registration data. Physical activity, fat intake, motivational factors, and self-regulation skills were self-reported at baseline. Descriptive analyses and logistic regression analyses were used to analyze the results.ResultsUse of the tailored intervention decreased sharply after the first modules. Visiting the first tailored intervention module was more likely among participants with low levels of fat intake (OR 0.77, 95% CI 0.62-0.95) or planning for change in PA (OR 0.23, 95% CI 0.05-0.97). Revisiting the intervention was more likely among participants high in restrained eating (OR 2.45, 95% CI 1.12-5.43) or low in proactive coping skills for weight control (OR 0.28, 95% CI 0.10-0.76). The planning tools were used by 5%-55% of the participants, but only 20%-75% of the plans were of good quality.ConclusionsThis study showed that psychological factors such as self-regulation skills and action planning were associated with repeated use of an online, computer-tailored self-regulation intervention aimed at prevention of weight gain among adults being overweight. Use of the intervention was not optimal, with a limited number of participants who visited all the intervention modules. The use of the action and coping planning components of the intervention was mediocre and the quality of the generated plans was low, especially for the coping plans. It is important to identify how the use of action planning and coping planning components in online interventions can be promoted and how the quality of plans generated through these tools can be improved.Trial RegistrationNetherlands Trial Register: NTR1862; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1862 (Archived by WebCite at http://www.webcitation.org/6QG1ZPIzZ).

Mothers improve their daughters’ vegetable intake: A randomized controlled trial

The increasing prevalence of childhood overweight makes children an important target for health promotion programmes. An intervention was designed for mothers to provide more vegetables to their daughters’ diet. A randomized controlled trial compared a self-regulation condition with a control condition in 155 mothers aged 25–50 years. Dependent variable was children’s (aged 6–11 years) vegetable consumption which was reported by their mothers at three points in time. After baseline (Time 1), the intervention group received theory-based instructional leaflets to promote self-regulatory skills for providing a healthy nutrition for children. Changes were assessed after two weeks (Time 2) and at three-month follow-up (Time 3). The self-regulation intervention in mothers led to an increase in vegetable intake among their daughters at Time 2 but not at Time 3. However, maintenance of vegetable consumption at Time 3 was mediated by the amount of vegetable intake at Time 2. Engaging mothers in self-regulatory health promotion programmes may be a feasible strategy to facilitate more vegetable intake among their daughters.

Which Behaviour Change Techniques Are Most Effective at Increasing Older Adults’ Self-Efficacy and Physical Activity Behaviour? A Systematic Review

Increasing self-efficacy is an effective mechanism for increasing physical activity, especially for older people. The aim of this review was to identify behaviour change techniques (BCTs) that increase self-efficacy and physical activity behaviour in non-clinical community-dwelling adults 60years or over. A systematic search identified 24 eligible studies reporting change in self-efficacy for physical activity following an intervention. Moderator analyses examined whether the inclusion of specific BCTs (as defined by CALO-RE taxonomy) was associated with changes in self-efficacy and physical activity behaviour. Overall, interventions increased self-efficacy (d = 0.37) and physical activity (d = 0.14). Self-regulatory techniques such as setting behavioural goals, prompting self-monitoring of behaviour, planning for relapses, providing normative information and providing feedback on performance were associated with lower levels of both self-efficacy and physical activity. Many commonly used self-regulation intervention techniques that are effective for younger adults may not be effective for older adults.

Self-regulation strategies support children with ADHD to overcome symptom-related behavior in the classroom

Children with attention deficit hyperactivity disorder (ADHD) suffer from self-regulation deficits that cause inattention, impulsivity, and hyperactivity. Self-regulation interventions may address these deficits, but to date, only few empirical studies have examined their benefits for children with ADHD in everyday life. The present study investigated three classroom interventions to promote self-regulation and tested their benefit on self-regulatory competencies (assessed with an ADHD questionnaire) in children with ADHD. Students of a special education school for children with ADHD participated in the intervention study that included three sessions (Session 1: Goal Intention or Goal Intention + If-Then Plan; Session 2: Goal Intention + If-Then Plan; Session 3: Goal Intention + If-Then Plan + Self-Monitoring). Teacher-rated self-regulatory competencies were assessed both before and after the intervention sessions. Children with ADHD had better self-regulatory competencies after their first Goal Intention + If-Then Plan Session, but lasting intervention effects were found only when children started with a mere goal intention session.

The role of self-regulation in developing leaders: A longitudinal field experiment

A longitudinal field experiment examined a leader self-regulation intervention in teams engaged in a Business Strategy Module (BSM) of a University course. The BSM, which is an integral part of the degree programme, involved teams of four or five individuals, under the direction of a leader, working on a (simulated) car manufacturing task over a period of 24weeks. Various aspects of team performance contributed towards module assessment. All leaders received multi-source feedback of leader task-relevant capabilities (from the leader, followers and module tutor). Leaders were randomly allocated into a self-regulation intervention (15 leaders, 46 followers) or control (25 leaders, 109 followers) conditions. The intervention, which was run by an independent coach, was designed to improve leaders' use of self-regulatory processes to aid the development of task-relevant leadership competencies. Survey data was collected from the leaders and followers (on three occasions: pre- and two post-test intervention), team financial performance (three occasions: post-test) and a final team report (post-test). The leader self-regulation intervention led to increased followers' ratings of leader's effectiveness, higher team financial performance and higher final team grade compared to the control (non-intervention) condition. Furthermore, the benefits of the self-regulation intervention were mediated by leaders' attaining task-relevant competencies.

A Randomized Controlled Trial of a Self‐Regulation Intervention for Older Adults with Asthma

To evaluate a self-regulation intervention for asthma for older adults. A blinded randomized controlled trial. Single-center tertiary care academic center. Seventy older adults aged 65 and older with persistent asthma randomized to an intervention or control group. Participants participate in a six-session program conducted over the telephone and in group sessions. Participants selected an asthma-specific goal, identified problems, and addressed potential barriers. Outcomes were assessed at 1, 6, and 12 months and included the mini-Asthma Quality of Life Questionnaire (mAQLQ), Asthma Control Questionnaire (ACQ), healthcare utilization, exhaled nitric oxide (FENO), and percentage of predicted forced expiratory volume in 1 second (FEV1%). The mAQLQ score was significantly higher in the intervention group at 1, 6, and 12 months, even after controlling for confounding factors. The between-group difference decreased over time, although at 12 months, it remained greater than 0.5 points. The ACQ was better in the intervention group than in the control group at 1, 6, and 12 months. At 12 months, those in the intervention group were 4.2 times as likely as those in the control group to have an ACQ score in the controlled range. Healthcare utilization was lower in the intervention group, although no difference was observed in FENO or predicted FEV1%. A self-regulation intervention can improve asthma control, quality of life, and healthcare utilization in older adults.

Automatic risk behavior: Direct effects of binge drinker stereotypes on drinking behavior.

We investigated whether research on stereotype priming effects can increase understanding of binge drinking among young people. Four studies tested whether evaluations of the binge drinker stereotype have a direct and automatic effect on binge drinking behavior, and whether a self-regulation intervention can overcome stereotype effects on drinking behavior. Studies 1a and 1b were prospective surveys conducted over two weeks. Study 2 was a field experiment with a 1-week behavioral follow-up. Study 3 was an exploratory RCT that tested whether implementation intentions can override binge drinker stereotype effects on behavior over one month. Participants were college students (Studies 1a, 1b, and 2; Ns = 226, 72, and 255, respectively) and school-age youth (Study 3, N = 202). Correlational (Studies 1a and 1b) and experimental (Study 2) evidence indicated that favorable binge drinker stereotypes had direct effects on binge drinking among experienced drinkers. These effects were automatic in the sense that participants were neither aware of, nor intended, this influence. Study 3 showed that implementation intentions geared at increasing self-focused attention overcame stereotype effects on binge drinking behavior. These findings suggest that stereotype priming research can offer valuable insights into binge drinking behavior. Implications for health behavior theories and behavior change interventions are outlined.

Effects of a self-regulation intervention on exercise are moderated by depressive symptoms: A quasi-experimental study

This study investigated whether a computer-based self-regulation intervention increases physical exercise in individuals with or without depressive symptoms. A total of 361 individuals in orthopedic rehabilitation, 36 of them with depressive symptoms, were recruited in Germany. In a quasi-experimental study, individuals were allocated to either a computer-based self-regulation intervention or an online questionnaire. Exercise was measured at the beginning of rehabilitation and six weeks after rehabilitation. Depressive symptoms were assessed at the end of rehabilitation. An analysis of covariance was conducted, controlling for exercise baseline, sex, and phase of assessment. A main effect for depressive symptoms (p=.005) and intervention group (p=.011), as well as a marginal interaction of intervention x depressive symptoms were found (p=.076). Results indicate that the self-regulation exercise intervention in an orthopedic rehabilitation setting seem to be only effective in non-depressed individuals. Future research should examine how health behavior change programs can be designed more effectively for individuals with depressive symptoms.

Meta-Analysis of Single-Case Design Research on Self-Regulatory Interventions for Academic Performance

The current study examined the effects of self-regulatory interventions on reading, writing, and math by conducting a meta-analysis of single-case design research. Self-regulatory interventions have promise as an effective approach that is both minimally invasive and involves minimal resources. Effects of the interventions were analyzed by academic subject, grade, educational placement, and the number of sessions. Results indicated that self-regulatory strategies showed promise in addressing academic issues in the areas of reading, writing, and math regardless of age, grade, educational placement, and intervention length.

A self-regulation intervention can improve quality of life for families with food allergy

A self-regulation intervention can improve quality of life for families with food allergy

Protocol for the "four steps to control your fatigue (4-STEPS)" randomised controlled trial: a self-regulation based physical activity intervention for patients with unexplained chronic fatigue.

BackgroundUnexplained Chronic Fatigue is a medical condition characterized by the presence of persistent, severe and debilitating medically unexplained fatigue, leading to impaired functioning and lower quality of life. Research suggests that physical activity can contribute to the reduction of fatigue and other somatic symptoms and can thus significantly improve physical functioning and quality of life in these patients. Based on the self-regulation (SR) theory of behaviour change, we developed a brief physical activity program for patients suffering from unexplained chronic fatigue which focuses on the training of self-regulation skills, the "4-STEPS to control your fatigue" program.Methods/DesignThis is a multi-centre, randomised controlled trial (RCT) that will be carried out in local primary care centres and at the Portuguese Fibromyalgia and Chronic Fatigue Syndrome Patients Association. Patients aged between 18 and 65 and fulfilling operationalized criteria for Idiopathic Chronic Fatigue (ICF) and Chronic Fatigue Syndrome (CFS) will be recruited and randomly allocated to standard care (SC) or standard care plus a self-regulation based physical activity program (4-STEPS). Patients will be assessed at baseline, after the intervention (3 months) and at 12 months follow-up. The primary outcome is fatigue severity.DiscussionThe results of the RCT will provide information about the effectiveness of a brief self-regulation intervention for promoting physical activity in patients with unexplained chronic fatigue. If the program proves to be effective, it may be considered as an adjunctive treatment for these patients.Trial RegistrationISRCTN: ISRCTN70763996

Testing self-regulation interventions to increase walking using factorial randomized N-of-1 trials.

To investigate the suitability of N-of-1 randomized controlled trials (RCTs) as a means of testing the effectiveness of behavior change techniques based on self-regulation theory (goal setting and self-monitoring) for promoting walking in healthy adult volunteers. A series of N-of-1 RCTs in 10 normal and overweight adults ages 19-67 (M = 36.9 years). We randomly allocated 60 days within each individual to text message-prompted daily goal-setting and/or self-monitoring interventions in accordance with a 2 (step-count goal prompt vs. alternative goal prompt) × 2 (self-monitoring: open vs. blinded Omron-HJ-113-E pedometer) factorial design. Aggregated data were analyzed using random intercept multilevel models. Single cases were analyzed individually. The primary outcome was daily pedometer step counts over 60 days. Single-case analyses showed that 4 participants significantly increased walking: 2 on self-monitoring days and 2 on goal-setting days, compared with control days. Six participants did not benefit from the interventions. In aggregated analyses, mean step counts were higher on goal-setting days (8,499.9 vs. 7,956.3) and on self-monitoring days (8,630.3 vs. 7,825.9). Multilevel analyses showed a significant effect of the self-monitoring condition (p = .01), the goal-setting condition approached significance (p = .08), and there was a small linear increase in walking over time (p = .03). N-of-1 randomized trials are a suitable means to test behavioral interventions in individual participants.

Intervention effects of exercise self-regulation on physical exercise and eating fruits and vegetables: A longitudinal study in orthopedic and cardiac rehabilitation

Objective The primary objective of this study was to unveil the mechanisms by which an exercise self-regulation intervention affects physical exercise in a rehabilitation context. The second aim was to investigate whether the intervention led to changes in fruit and vegetable intake that was not targeted in the intervention. Finally, it was tested whether changes in exercise habit strength may explain such a transfer effect. Method A quasi-experimental design was conducted in Germany between 2009 and 2011 with 725 rehabilitation patients. Patients received either a self-regulation intervention or an online questionnaire. Six weeks after discharge, self-reported changes in exercise and dietary behaviors, exercise habit strength, and cognitions were measured. Quantitative results The exercise self-regulation intervention led to a higher increment in exercise behavior, exercise habit strength, and fruit and vegetable intake than the control condition. Changes in physical exercise were mediated by changes in action control ( slope = 0.04; 99% CI = 0.01 to 0.06) and satisfaction ( slope = 0.05; 99% CI: = 0.02 to 0.08), but not in action planning. Changes in fruit and vegetable intake were mediated by changes in exercise habit strength ( slope = 0.05; 99% CI = 0.01 to 0.08). Conclusion Interventions could be optimized if they aim at fostering exercise habits. This in turn may also facilitate transfer effects from one health behavior to the other.

A cluster randomised controlled trial of the efficacy of a brief walking intervention delivered in primary care: Study protocol

BackgroundThe aim of the present research is to conduct a fully powered explanatory trial to evaluate the efficacy of a brief self-regulation intervention to increase walking. The intervention will be delivered in primary care by practice nurses (PNs) and Healthcare Assistants (HCAs) to patients for whom increasing physical activity is a particular priority. The intervention has previously demonstrated efficacy with a volunteer population, and subsequently went through an iterative process of refinement in primary care, to maximise acceptability to both providers and recipients.Methods/ DesignThis two arm cluster randomised controlled trial set in UK general practices will compare two strategies for increasing walking, assessed by pedometer, over six months. Patients attending practices randomised to the self-regulation intervention arm will receive an intervention consisting of behaviour change techniques designed to increase walking self-efficacy (confidence in ability to perform the behaviour), and to help people translate their "good" intentions into behaviour change by making plans. Patients attending practices randomised to the information provision arm will receive written materials promoting walking, and a short unstructured discussion about increasing their walking.The trial will recruit 20 PN/HCAs (10 per arm), who will be trained by the research team to deliver the self-regulation intervention or information provision control intervention, to 400 patients registered at their practices (20 patients per PN/HCA). This will provide 85% power to detect a mean difference of five minutes/day walking between the self-regulation intervention group and the information provision control group. Secondary outcomes include health services costs, and intervention effects in sub-groups defined by age, ethnicity, gender, socio-economic status, and clinical condition. A mediation analysis will investigate the extent to which changes in constructs specified by the Theory of Planned Behaviour lead to changes in objectively assessed walking behaviour.DiscussionThis trial addresses the current lack of evidence for interventions that are effective at increasing walking and that can be offered to patients in primary care. The intervention being evaluated has demonstrated efficacy, and has been through an extensive process of adaptation to ensure acceptability to both provider and recipient, thus optimising fidelity of intervention delivery and treatment receipt. It therefore provides a strong test of the hypothesis that a self-regulation intervention can help primary care patients increase their walking.Trial registrationCurrent Controlled Trials ISRCTN95932902