Six-Month Outcomes of a Theory- and Technology-Enhanced Physical Activity Intervention for Latina Women (Pasos Hacia La Salud II): Randomized Controlled Trial.

BACKGROUND: More than half (55%) of Latina women do not meet aerobic physical activity (PA) guidelines, and frequently cite time, childcare, and transportation as barriers to PA. In addition to linguistic adaptations for this population, successful PA interventions for Latina women addressed these barriers through remote intervention delivery approaches (eg, mail, phone, or web delivery). OBJECTIVE: We aimed to evaluate 6-month outcomes of a randomized trial comparing a Spanish-language, individually tailored, web-delivered PA intervention (original) to an enhanced version with text messages and additional features (enhanced). Further, we evaluated if increases in PA at 6 months were moderated by baseline activity status. METHODS: In total, 195 Latina women aged 18-65 years participated in a trial comparing the efficacy of the enhanced versus original interventions at initiating PA behavior change. We examined minutes per week of accelerometer-measured PA in the enhanced versus original arms, and the proportion of each arm meeting aerobic PA guidelines (150 min/wk at 6 mo). For moderator analyses, participants were classified as inactive (0 min/wk) or low active (1-90 min/wk) at baseline, measured via the 7 Day Physical Activity Recall interview. RESULTS: PA increased from 19.7 (SD 47.9) minutes per week at baseline to 46.9 (SD 66.2) minutes per week at 6 months in the enhanced arm versus 20.6 (SD 42.7) minutes per week to 42.9 (SD 78.2) minutes per week in the original arm (P=.78). Overall, 30% (31/103) of the enhanced group met aerobic PA guidelines at 6 months, compared to 21% (19/92) of the original group (odds ratio [OR] 1.75, 95% CI 0.87-3.55). Baseline PA (inactive vs low active) moderated treatment effects on PA. For inactive participants, there were no group differences at 6 months (b=7.1; SE 22.8; P=.75), while low-active participants increased more in enhanced than original (b=72.5; SE 27.9; P=.01). For low-active participants, 45% (46/103) of the enhanced group met PA guidelines at 6 months, versus 20% (18/92) of the original arm (OR 3.29, 95% CI 1.05-11.31). For inactive participants, there were no group differences (25/103, 24% vs n=19/92, 21% for enhanced vs original, respectively; OR 1.28, 95% CI 0.54-3.06). CONCLUSIONS: Intervention effects were conditional on baseline PA. For low-active Latina women, the enhanced intervention was more effective at increasing PA. Additional tailored intervention enhancements may be necessary to increase PA for inactive Latina women. TRIAL REGISTRATION: ClinicalTrials.gov NCT03491592; https://www.clinicaltrials.gov/study/NCT03491592. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-022-06575-4.

Linking measures to mechanisms of action in behavior change: A qualitative analysis of expert views.

RATIONALE: Testing mechanisms of action (MoAs) hypothesized to underlie behavior change can enhance intervention effectiveness. Rigorous measurement of putative mechanisms is critical to this effort, but measures are rarely validated with respect to target MoAs. OBJECTIVE: This study aimed to elucidate challenges of linking measures to putative MoAs and to identify priorities for future research. METHOD: This study was a systematic exploration of written comments by experts in behavioral intervention research and theories of behavior change (N = 20) capturing their opinions about a task querying whether self-report measures from the Science Of Behavior Change (SOBC) Measures Repository were related to a set of MoAs identified by the Human Behaviour Change Project (HBCP). RESULTS: Six themes were identified: 1) Study Value, 2) Measure Properties, 3) Mechanism Properties, 4) Miscellaneous Measure Concerns, 5) Conceptual Challenges, and 6) Approaches to Developing Measure-Mechanism Links. Experts noted challenges such as lack of measure validation, poor measure properties (e.g., double-barreled items), overly broad MoA definitions that limited their utility, lack of clarity around the term "related," and more. Nonetheless, experts expressed the importance of the exercise. Suggestions included developing and refining measures that are validate for assessing MoAs, clarifying and elaborating MoA definitions, and conducting further, more granular research. CONCLUSION: This systematic examination of expert comments highlights issues that need further investigation to advance behavioral science, specifically pertaining to identifying valid measures of MoAs in behavioral and process research. This study highlights the challenges and opportunities for future research on linking measures and MoA in behavioral science and subsequently enhancing the efficacy of behavioral interventions.

There is no happiness in positive affect: the pervasive misunderstanding of the rotated circumplex model.

Research on positive affect (PA) and negative affect (NA) is often guided by the rotational variant of the circumplex model of affect (RCMA). According to the RCMA, PA and NA are posited to be orthogonal, with PA ranging from the union of positive valence and high activation (e.g., excited) to the union of negative valence and low activation (e.g., sluggish), and NA ranging from the union of negative valence and high activation (e.g., distressed) to the union of positive valence and low activation (e.g., relaxed). However, many authors incorrectly interpret the RCMA as positing that positively valenced affect (i.e., pleasure) and negatively valenced affect (i.e., displeasure)-rather than PA and NA, as defined in the RCMA-are orthogonal. This "received view" of the RCMA has led to significant confusion in the literature. The present paper articulates the "received view" of the RCMA and characterizes its prevalence in psychological research. A random sample of 140 empirical research articles on affect published in 14 high-impact journals covering a range of psychological subdisciplines were reviewed. Over half of the articles subscribing to the RCMA showed evidence of the "received view," demonstrating that misuse of the terms PA and NA in the context of the RCMA is rampant in the psychological literature. To reduce continued confusion in the literature, we recommend abandoning use of the terms positive affect and negative affect. We further recommend referring to the two dimensions of the RCMA as positive activation and negative activation, and the two poles of the valence dimension as positive valence and negative valence (or pleasure and displeasure).

Linking measures to mechanisms of action: An expert opinion study.

OBJECTIVE: This study sought to integrate the NIH Science of Behaviour Change (SOBC) measures repository comprising measures of putative mechanisms with mechanisms of action (MoA) identified by the Human Behaviour-Change Project (HBCP). DESIGN: Participants were 30 international experts recruited from professional networks and societies. In three anonymous virtual rounds, experts established consensus on hypothesized links between 26 MoAs and 44 self-report measures. METHODS: In Round 1, experts completed a survey rating agreement with 84 pre-identified measure-MoA links and suggested new links. In Round 2, experts discussed 10 links in an online forum, including pre-identified links with <50% agreement and new links suggested by 20-50% of experts. In Round 3, experts completed a survey rating all links eligible for discussion in Round 2. RESULTS: Twenty-seven experts completed Round 1, 23 completed Round 2 and 18 completed Round 3. In Round 1, 82 of 84 pre-identified links reached >50% agreement and 14 new links were suggested by >50% of experts. In Round 2, experts discussed measure-MoA links and measurement quality. In Round 3, 71 of 96 links reached ≥50% agreement. A total of 167 links reached >50% expert agreement, 33 of which reached ≥90% agreement. CONCLUSION: By identifying putative mechanisms (HBCP) for the 44 self-report measures (SOBC), this study advances the cumulation of scientific results and interoperability of resources to facilitate process research.

Development of an online tool for linking behavior change techniques and mechanisms of action based on triangulation of findings from literature synthesis and expert consensus.

Researchers, practitioners, and policymakers develop interventions to change behavior based on their understanding of how behavior change techniques (BCTs) impact the determinants of behavior. A transparent, systematic, and accessible method of linking BCTs with the processes through which they change behavior (i.e., their mechanisms of action [MoAs]) would advance the understanding of intervention effects and improve theory and intervention development. The purpose of this study is to triangulate evidence for hypothesized BCT-MoA links obtained in two previous studies and present the results in an interactive, online tool. Two previous studies generated evidence on links between 56 BCTs and 26 MoAs based on their frequency in literature synthesis and on expert consensus. Concordance between the findings of the two studies was examined using multilevel modeling. Uncertainties and differences between the two studies were reconciled by 16 behavior change experts using consensus development methods. The resulting evidence was used to generate an online tool. The two studies showed concordance for 25 of the 26 MoAs and agreement for 37 links and for 460 "nonlinks." A further 55 links were resolved by consensus (total of 92 [37 + 55] hypothesized BCT-MoA links). Full data on 1,456 possible links was incorporated into the online interactive Theory and Technique Tool (https://theoryandtechniquetool.humanbehaviourchange.org/). This triangulation of two distinct sources of evidence provides guidance on how BCTs may affect the mechanisms that change behavior and is available as a resource for behavior change intervention designers, researchers and theorists, supporting intervention design, research synthesis, and collaborative research.

Age Moderates the Effect of Self-Paced Exercise on Exercise Adherence among Overweight Adults.

Objective: The present study tested the hypothesis that the effect of self-paced exercise on adherence to exercise programs is more pronounced with increasing age. Method: Fifty-nine low-active overweight adults (18-65 years) were encouraged to walk 30 to 60 min/day and randomized to either self-paced (n = 30) or prescribed moderate-intensity (n = 29) conditions. Results: The effect of study condition was moderated by age (main effect: b = 6.14, SE = 2.54, p = .02; Condition × Age: b = -11.55, SE = 3.77, p < .01), such that among participants >50 years, those in the self-paced condition exercised 6 more min/day than participants in the prescribed moderate-intensity condition (p = .02), whereas among participants <50 years, those in the self-paced condition exercised 5.4 fewer min/day compared with those in the moderate-intensity condition (p = .05). Affective response to physical activity did not mediate the moderating effect of age. Discussion: As age increases, adults may be more likely to adhere to self-paced versus prescribed moderate-intensity exercise.