App-based interventions to improve cancer outcomes rely on informational support from professionals: a systematic review.

The importance of social support for cancer patients is well-established, and mobile applications hold promise for implementation. This systematic review examines app-based interventions with social support components for cancer patients, investigating the use of different support functions from different sources and the impact on cancer-related symptoms and psychological outcomes. A systematic search across five databases (EMBASE, Scopus, PsycINFO, PubMed, Web of Science) yielded 449 records, of which 17 studies (12 controlled designs) were included. Two independent reviewers extracted data and assessed study quality, revealing a high risk of bias across studies. Social support was implemented through different app functions, including contact/chat functions (n = 9), automatic alerts based on app input (n = 6) and discussion forums (n = 5). Social support predominantly focused on informational support (n = 17), mostly from healthcare professionals. Emotional support was less common (n = 7). Results indicated some promising intervention effects for pain, fatigue, nausea/vomiting, insomnia, constipation and overall symptom distress, but heterogeneous effects for health-related quality of life. Overall, results were mixed, but indicate that mobile apps incorporating social support may hold promise for cancer patients. However, future studies should focus on measuring and reporting social support as an intervention mechanism to systematically investigate its specific impact and improve effectiveness.HighlightsApps for cancer patients predominantly include informational social supportEmotional social support is substantially less frequently includedApps focus on formal support sources like healthcare professionalsFirst results are somewhat promising for improving cancer-related symptoms.

Compendium of dyadic intervention techniques (DITs) to change health behaviours: a systematic review.

BACKGROUND: Dyadic interventions for health behaviour change involving the romantic partner are promising. However, it often remains unclear how exactly the partner is involved in dyadic interventions. We propose a novel compendium of dyadic intervention techniques (DITs) that facilitates systematic description of dyadic interventions in terms of who performs what for whom during intervention delivery and subsequent implementation. OBJECTIVE: We aimed to systematically characterise dyadic interventions along their degree of partner involvement and to provide a comprehensive list of DITs used in dyadic interventions with romantic partners. METHODS: We systematically reviewed dyadic health behaviour change interventions with controlled designs. We included 165 studies describing 122 distinct dyadic interventions with romantic partners. Interventions were classified along their degree of partner involvement, 160 DITs were extracted, and their frequencies of use counted. RESULTS: The majority of interventions (n = 90, 74%) explicitly instructed partners to interact. Half of the DITs were performed jointly by the couple and also targeted the couple. Mostly, couples were instructed to jointly practice communication skills and to jointly perform problem solving for the couple. DISCUSSION: The present review contributes to the development of a shared and systematic way of describing dyadic interventions to facilitate cumulation of evidence.

Let's Enjoy an Evening on the Couch? A Daily Life Investigation of Shared Problematic Behaviors in Three Couple Studies.

Symptom-system fit theory proposes that problematic behaviors are maintained by the social system (e.g., the couple relationship) in which they occur because they help promote positive relationship functioning in the short-term. Across three daily life studies, we examined whether mixed-gender couples reported more positive relationship functioning on days in which they engaged in more shared problematic behaviors. In two studies (Study 1: 82 couples who smoke; Study 2: 117 couples who are inactive), days of more shared problematic behavior were accompanied by higher daily closeness and relationship satisfaction. A third study with 79 couples post-stroke investigating unhealthy eating failed to provide evidence for symptom-system fit. In exploratory lagged analyses, we found more support for prior-day problematic behavior being associated with next-day daily relationship functioning than vice-versa. Together, findings point to the importance of a systems perspective when studying interpersonal dynamics that might be involved in the maintenance of problematic behaviors.

Daily support seeking as coping strategy in dual-smoker couples attempting to quit.

OBJECTIVE: Smoking cessation is a stressful event and lapses are frequent. The dynamic model of relapse has been criticized for not integrating interpersonal factors as phasic influences. Seeking social support, as a coping strategy to deal with cravings, may help to refrain from smoking. DESIGN: Overall, 83 heterosexual dual-smoker couples reported on their craving, the extent of seeking social support from one's partner regarding smoking cessation, and their number of cigarettes smoked in smartphone-based end-of-day diaries, from a joint self-set quit date on across 22 consecutive days. MAIN OUTCOME MEASURE: Number of cigarettes smoked. RESULTS: Multilevel analyses indicated that on days with higher-than-average levels of craving, male and female smokers reported more cigarettes smoked. Higher-than-usual support seeking was related to fewer cigarettes smoked that same day. For women only, we found a within-person interaction between craving and support seeking on smoking. On days with higher-than-average support-seeking, the effect of craving on smoking was attenuated. CONCLUSION: Findings confirm the relevance of interpersonal processes in the relapse process, such as support seeking as coping behavior. Further, as a 'first act' in initiating supportive interactions, support seeking is an important piece in the social support process and a promising target for interventions.

Dynamic associations between stress and relationship functioning in the wake of COVID-19: Longitudinal data from the German family panel (pairfam).

Individuals all across the world experienced significant disruptions in their personal and family life with the outbreak of the new coronavirus disease 2019 (COVID-19). The current study investigated dynamic associations between stress and relationship functioning over time in the face of the COVID-19 pandemic. Perceived stress, relationship satisfaction, and relationship quality (appreciation, intimacy, conflict) were reported by 1483 young to middle-aged participants who were in a romantic relationship and lived with their partner in 2018/2019 and in May-July 2020 (a few months after the onset of COVID-19). Data were analyzed using bivariate latent change score models. Relationship functioning (satisfaction, appreciation, intimacy) showed small decreases from before to during the pandemic. Contrary to expectations, levels of perceived stress also decreased on average from before to during the pandemic. Changes in relationship functioning were correlated with changes in stress over time, so that participants with greater decreases in relationship satisfaction, appreciation, and intimacy and greater increases in conflict from before to during the pandemic showed lesser decreases/greater increases in stress. Higher pre-pandemic relationship satisfaction was associated with greater decreases/lesser increases in stress from before to during the pandemic. Pre-pandemic levels of other measures of relationship functioning or stress were not associated with changes in outcomes over time. Results add to the literature demonstrating that stress is closely intertwined with the functioning of intimate relationships. Furthermore, they suggest that greater relationship satisfaction may serve as a protective factor for stressful life events.

Long-Term and Transfer Effects of an Action Control Intervention in Overweight Couples: A Randomized Controlled Trial Using Text Messages.

Keeping a physically active lifestyle requires consistent self-regulatory effort such as action control (e.g., continuously monitoring and evaluating a behavior in terms of one's goals). Involving the romantic partner in interventions might be particularly effective in the long run. The present study examined the long-term and transfer effects of an action control intervention in couples using text messaging for promoting target persons' and partners' physical activity, anthropometric measures and physical fitness 6 months post baseline. A total of 121 overweight and obese romantic couples, randomly allocated to an intervention (n = 60; information + action control text messages) or a control group (n = 61; information only) and to participating as target person or partner, completed baseline assessments (T1). 100 couples (82.6%) completed the 6-month follow-up (T3) assessment. Primary outcomes included self-reported moderate-to-vigorous physical activity (MVPA) and objective MVPA and MVPA adherence using triaxial accelerometers across a diary period of 14 days after T3. Secondary outcomes included BMI, waist-to-hip circumference and physical fitness (target persons only) using a submaximal aerobic cycle test. At T3, there were no significant between-group differences between target persons and partners with regard to their objective MVPA, self-reported MVPA, BMI, waist-hip ratio or physical fitness. No significant changes in outcomes were observed from T1 to T3; however, changes in BMI from T1 to T3 between target persons and partners in the intervention group were associated. Overall, the brief 14-days action control intervention was not effective in improving target person's physical activity, body measures and physical fitness in the long-term. Moreover, no long-term benefits for partners emerged. While brief ecological momentary interventions might be a promising tool for short-term effects, future studies are needed to test features enhancing long-term effectiveness. Associations in romantic partners' changes suggest that dyadic interventions can be a promising approach, as changes induced in one partner may then transfer over to the other (controlled-trials.com ISRCTN15705531).

Effectiveness of a Dyadic Buddy App for Smoking Cessation: Randomized Controlled Trial.

BACKGROUND: Tobacco smoking is one of the biggest public health threats. Smartphone apps offer new promising opportunities for supporting smoking cessation in real time. This randomized controlled trial investigated the effectiveness of an app that encourages individuals to quit smoking with the help of a social network member (buddy) in daily life. OBJECTIVE: The objective of this study is to test the effectiveness of the SmokeFree buddy app compared with a control group with self-reported smoking abstinence and carbon monoxide (CO)-verified smoking abstinence as primary outcomes and self-reports of smoked cigarettes per day (CPD) as a secondary outcome. METHODS: A total of 162 adults who smoked participated in this single-blind, two-arm, parallel-group, intensive longitudinal randomized controlled trial. Around a self-set quit date (ie, 7 days before the self-set quit date and 20 days after) and 6 months later, participants of the intervention and control groups reported on daily smoking abstinence and CPD in end-of-day diaries. Daily smoking abstinence was verified via daily exhaled CO assessments. This assessment was administered via an app displaying results of exhaled CO, thus addressing self-monitoring in both groups. In addition, participants in the intervention group used the SmokeFree buddy app, a multicomponent app that facilitates social support from a buddy of choice. RESULTS: A significant reduction in CPD from baseline to the 6-month follow-up was observed among participants in both groups. Multilevel analyses revealed no significant intervention effect on self-reported and CO-verified daily smoking abstinence at the quit date and 3 weeks later. However, CPD was lower at the quit date and 3 weeks later in the intervention group than in the control group. No significant differences between groups were found for any outcome measures 6 months after the quit date. Overall, low app engagement and low perceived usefulness were observed. CONCLUSIONS: Despite some encouraging short-term findings on the amount of smoking, the SmokeFree buddy app did not have beneficial effects on smoking abstinence over and above the self-monitoring control condition. Future studies should examine whether and what support processes can be effectively stimulated and how app use can be improved to better achieve this goal. TRIAL REGISTRATION: ISRCTN Registry 11154315; https://www.isrctn.com/ISRCTN11154315. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-019-7723-z.

Cultivation or enabling? Day-to-day associations between self-efficacy and received support in couples.

OBJECTIVE: Theories and empirical findings identify social support and self-efficacy as important variables for behavior change. Two competing hypotheses describe the bidirectional relationship of these two constructs: The cultivation hypothesis assumes that self-efficacy facilitates social support, whereas the enabling hypothesis assumes that social support fosters self-efficacy. To shed more light on the interplay of interpersonal and intrapersonal factors in the behavior change context in daily life, the present study aims to investigate these hypotheses at the within-person level. METHODS: In total, 99 overweight heterosexual couples intending to increase their physical activity participated in this dyadic intensive longitudinal study. Both partners independently reported on their self-efficacy and their support receipt from their partner in smartphone-based end-of-day diaries across 14 days. To investigate the competing hypotheses prospective lagged multilevel models were applied. RESULTS: For both partners, higher-than-average levels of self-efficacy on a given day predicted higher support receipt the next day, confirming the cultivation hypothesis. We found no effect of higher-than-average levels of support receipt on a given day on self-efficacy the next day, disconfirming the enabling hypothesis. Same-day support receipt and previous day self-efficacy were positively related to daily physical activity. CONCLUSIONS: This is the first study investigating the cultivation and the enabling hypothesis on a day-to-day basis using a dyadic intensive longitudinal approach. Findings support the cultivation hypothesis at the within-person level, suggesting that self-efficacy may help to facilitate support receipt close in time. Future studies should use within-person experimental designs and ecological momentary assessments within days to increase our understanding of the temporal dynamics of the cultivation and enabling effect.

Understanding Between-Person Interventions With Time-Intensive Longitudinal Outcome Data: Longitudinal Mediation Analyses.

BACKGROUND: Mediation analysis is an important tool for understanding the processes through which interventions affect health outcomes over time. Typically the temporal intervals between X, M, and Y are fixed by design, and little focus is given to the temporal dynamics of the processes. PURPOSE: In this article, we aim to highlight the importance of considering the timing of the causal effects of a between-person intervention X, on M and Y, resulting in a deeper understanding of mediation. METHODS: We provide a framework for examining the impact of a between-person intervention X on M and Y over time when M and Y are measured repeatedly. Five conceptual and analytic steps involve visualizing the effects of the intervention on Y, M, the relationship of M and Y, and the mediating process over time and selecting an appropriate analytic model. RESULTS: We demonstrate how these steps can be applied to two empirical examples of health behavior change interventions. We show that the patterns of longitudinal mediation can be fit with versions of longitudinal multilevel structural equation models that represent how the magnitude of direct and indirect effects vary over time. CONCLUSIONS: We urge researchers and methodologists to pay more attention to temporal dynamics in the causal analysis of interventions.

Do Daily Compensatory Health Beliefs Predict Intention to Quit and Smoking Behavior? A Daily Diary Study during Smoking Cessation.

Compensatory health beliefs (CHBs) are a means to cope with motivational conflicts between intended health goals and the temptation for an unhealthy behavior. As CHBs can fluctuate on a daily basis, this study examined how daily CHBs are associated with daily intention to quit smoking and daily number of cigarettes smoked before and after a quit date at the between- and within-person level. The study comprised a prospective longitudinal design and investigated 83 women and 83 men for 32 consecutive days during an ongoing joint self-set quit attempt. Daily CHBs varied from day to day and between individuals. At the between-person level, higher women's mean CHBs were associated with lower intention (b = -0.23, p = 0.04) and at the 10% level with more cigarettes smoked after the quit date (rate ratio (RR) = 1.92, p = 0.07). At the within-person level, women's higher than usual CHBs were unrelated to intention to quit, but were related to less smoking before (RR = 0.96, p = 0.03) and at the 10% level after the quit date (RR = 0.91, p = 0.09). A marginally positive association between daily CHBs and smoking at the within-person level emerged for men. The negative effect of daily CHBs at the between-person level on smoking seems to unfold after the quit attempt and for women only.

How Do People Experience and Respond to Social Control From Their Partner? Three Daily Diary Studies.

Positive and negative forms of social control are commonly used to regulate another person's health-related behaviors, especially in couples. Social control efforts have been shown to result in desirable, but also undesirable effects on different outcomes. Little is known for which outcomes, when, and under which contextual conditions these different effects unfold in people's everyday lives. Using the dual-effects model of health-related social control, we predicted that same-day and previous-day positive social control would result in desirable effects on target behavior, and same-day positive control on affect. Same-day and previous-day negative control was assumed to result in undesirable effects on reactant responses (i.e., doing the opposite of what the partner wanted and hiding the unhealthy behavior), and same-day negative control on affect. Further, we explored whether it makes a difference if one or both partners intend to change their health behavior. Three daily diary studies addressed these questions for smoking (Studies 1 and 2), and physical activity (Study 3). Receiving more positive control related to more desirable target behavior, and feeling better; more negative control was associated with more reactant responses and feeling worse. Social control unfolded its effects within 1 day, but hardly across days, indicating that control and its reactions to it are fast-acting processes in daily life. The pattern of results were the same for couples with one and both partners intending to change their behavior. Further, results replicated when using partner-reported provided control. Based on these results, social control cannot be unanimously recommended as a behavior change strategy in couples. Future studies should follow up on dyadic and temporal dynamics of social control in couples' everyday lives in different contexts.

"We Feel Good": Daily Support Provision, Health Behavior, and Well-Being in Romantic Couples.

Intimate partners are an important source of support when pursuing health goals. A vast amount of literature documents the role of social support in alleviating recipients' distress and facilitating health behaviors. Less studied is the phenomenon that providing support may entail a benefit for the provider, particularly in the context of health behavior change. In the present study, we investigated whether providing social support in daily life would be associated with more health behavior, and emotional and relational well-being that same day, using a sample of romantic couples aiming to become more physically active. Ninety-nine inactive and overweight heterosexual romantic couples (=198 individuals) participated in this dyadic daily diary study. Both partners reported on the provision of social support, positive and negative affect, and relationship satisfaction in electronic end-of-day diaries across 14 consecutive days. Moderate-to-vigorous physical activity (MVPA) was objectively assessed via triaxial accelerometers (Actigraph GT3X+). Using the Actor-Partner Interdependence Model (APIM), dyadic data analyses indicated that providing support to the partner was associated with higher own MVPA, more own positive affect, less own negative affect, and more own relationship satisfaction (actor effects), over and above the effect of support provision on outcomes in the other partner (partner effects). The present findings suggest that the provision of daily social support in couples is strongly associated with enhanced well-being not only at a personal level but also at a relational level. Providing social support may also serve the function of relationship maintenance. Thus, shifting the focus away from the recipient to examine beneficial effects of social support in providers is highly relevant. Future research should address the question of when, why, and how giving support is beneficial.

Smoking cessation with smartphone applications (SWAPP): study protocol for a randomized controlled trial.

BACKGROUND: Tobacco smoking remains one of the biggest public health threats. Smartphone apps offer new promising opportunities for supporting smoking cessation in real-time. The social context of smokers has, however, been neglected in smartphone apps promoting smoking cessation. This randomized controlled trial investigates the effectiveness of a smartphone app in which smokers quit smoking with the help of a social network member. METHODS: This protocol describes the design of a single-blind, two-arm, parallel-group, intensive longitudinal randomized controlled trial. Participants of this study are adult smokers who smoke at least one cigarette per day and intend to quit smoking at a self-set quit date. Blocking as means of group-balanced randomization is used to allocate participants to intervention or control conditions. Both intervention and control group use a smartphone-compatible device for measuring their daily smoking behavior objectively via exhaled carbon monoxide. In addition, the intervention group is instructed to use the SmokeFree Buddy app, a multicomponent app that also facilitates smoking-cessation specific social support from a buddy over a smartphone application. All participants fill out a baseline diary for three consecutive days and are invited to the lab for a background assessment. They subsequently participate in an end-of-day diary phase from 7 days before and until 20 days after a self-set quit date. Six months after the self-set quit date a follow-up diary for three consecutive days takes place. The primary outcome measures are daily self-reported and objectively-assessed smoking abstinence and secondary outcome measures are daily self-reported number of cigarettes smoked. DISCUSSION: This is the first study examining the effectiveness of a smoking cessation mobile intervention using the SmokeFree Buddy app compared to a control group in a real-life setting around a self-set quit date using a portable objective measure to assess smoking abstinence. Opportunities and challenges with running studies with smoking participants and certain design-related decisions are discussed. TRIAL REGISTRATION: This trial was prospectively registered on 04/04/2018 at ISRCTNregistry: ISRCTN11154315 .

Couples' daily self-regulation: The Health Action Process Approach at the dyadic level.

OBJECTIVE: Regulating health behavior change often occurs in a dyadic context of romantic relationships. Dyadic approaches to standard health behavior change models are, however, barely considered. We investigated volitional processes of the Health Action Process Approach model for two health behaviors within a dyadic context of romantic couples. Specifically, we tested whether day-to-day volitional self-regulation predicted one's own and one's partner's cigarettes smoked (Study 1) and physical activity (Study 2). METHODS: In two dyadic intensive longitudinal studies (Study 1: 83 dual-smoker couples intending to jointly quit smoking; Study 2: 61 overweight couples intending to become physically active), heterosexual partners independently reported on intention, self-efficacy, action planning, and action control in end-of-day diaries. In Study 1, daily number of cigarettes smoked was assessed via self-report. In Study 2, daily moderate-to-vigorous physical activity (MVPA) was assessed objectively via accelerometers. In both studies, dyadic cross-lagged intensive longitudinal analyses based on the Actor-Partner Interdependence Model were applied. RESULTS: Across both studies, individual's own volitional self-regulation positively predicted one's own health behavior (less cigarettes smoked and more MVPA). One's partner's action control and intention also positively predicted one's own health behavior. A marginal partner effect for self-efficacy was found in the context of smoking only. CONCLUSIONS: Behavioral self-regulation is not only relevant for individuals themselves, but some volitional processes may spill over to their partners. This highlights the need to specify couple-level processes involved in health behavior change, and to consider a social context of self-regulation.

Interpersonal Processes of Couples' Daily Support for Goal Pursuit: The Example of Physical Activity.

Little is known about how couples' social support facilitates the pursuit of important goals in daily life. Using an interpersonal perspective, we examined the effects of support provision and receipt on same-day physical activity, and studied the role of partners' joint engagement in activities. One hundred nineteen heterosexual couples reported on target persons' received and partners' provided support across 28 diary days, yielding 2,854 valid days. A dyadic report on couples' joint engagement was obtained from a subset of 88 couples. Target persons' daily activity was objectively assessed via accelerometers. On days with high versus low levels of provided support, target persons' activity was 25 min higher. Support receipt mediated 20% of this effect. Joint engagement accounted for around half of the effects of provided and received support. Support provision is uniquely linked to goal implementation in everyday life. Joint engagement in activities may be one explanation for how support is facilitated.

Mediators of Physical Activity Adherence: Results from an Action Control Intervention in Couples.

Background: Behavior change interventions targeting self-regulation skills have generally shown promising effects. However, the psychological working mechanisms remain poorly understood. Purpose: We examined theory-based mediators of a randomized controlled trial in couples targeting action control (i.e., continuously monitoring and evaluating an ongoing behavior). Self-reported action control was tested as the main mediating mechanism of physical activity adherence, and in addition self-efficacy and received social support from the partner. Methods: Overweight individuals (N = 121) and their heterosexual partners were randomly allocated to an intervention (information + action control text messages) or a control group (information only). Across a period of 28 days, participants reported on action control, self-efficacy, and received support in end-of-day diaries, and wore triaxial accelerometers to assess stable between-person differences in mediators and the outcome adherence to recommended daily activity levels (≥30 min of moderate activity in bouts of at least 10 min). Results: On average, participants in the intervention group showed higher physical activity adherence levels and higher action control, self-efficacy, and received support compared to participants in the control group. Action control and received support emerged as mediating mechanisms, explaining 19.7 and 24.6% of the total intervention effect, respectively, in separate analyses, and 13.9 and 22.2% when analyzed simultaneously. No evidence emerged for self-efficacy as mediator. Conclusions: Action control and received support partly explain the effects of an action control intervention on physical activity adherence levels. Continued research is needed to better understand what drives intervention effects to guide innovative and effective health promotion. Trial Registration Number: (controlled-trials.com ISRCTN15705531).

Goal Disengagement, Well-Being, and Goal Achievement in Romantic Couples Pursuing Health Behavior Change: Evidence from Two Daily Diary Studies.

BACKGROUND: Withdrawing effort and commitment from important goals (i.e. goal disengagement) has been discussed as an effective aspect of goal adaption. However, studies have focused especially on between-person differences. The present studies aimed to investigate within-person differences in goal disengagement within a dyadic context of romantic couples. Across two different health behaviors, we specifically tested whether goal disengagement would be associated with better well-being, but lower goal achievement in everyday life. METHODS: In two dyadic daily diary studies (Study 1: 61 overweight couples aiming to become physically active; Study 2: 83 dual-smoker couples aiming to quit smoking), both partners independently reported on goal disengagement, positive and negative affect. Behavioral goal achievement was measured via accelerometer (Study 1) and self-report (Study 2). RESULTS: Analyses based on the Actor-Partner Interdependence Model revealed that across both studies, one's own goal disengagement was related to lower well-being and a lower likelihood for goal achievement on a daily level (actor effects). Only in Study 1 were partner effects on negative affect and goal achievement found. CONCLUSIONS: In daily life, goal disengagement may not be as adaptive for well-being and goal achievement in health behavior change. Dyadic associations were not consistent, and might be more context-sensitive.

Action control in dyads: A randomized controlled trial to promote physical activity in everyday life.

RATIONALE: Engaging in regular physical activity requires substantial self-regulatory effort such as action control (e.g., continuously monitoring and evaluating an ongoing behavior with regard to one's standards). OBJECTIVE: The present study examined the effectiveness of an ecological momentary action control intervention for promoting daily physical activity. Also, we tested whether a dyadic compared to an individual intervention displayed an additional benefit. METHODS: 121 overweight and obese individuals and their partners were randomly allocated to an intervention (n = 60; information + action control text messages) or a control group (n = 61; information only). The intervention was delivered in a dyadic vs. individual version of action control. Allocation ratio was 1:1:2 for the dyadic, individual, and control groups, respectively. Daily physical activity was assessed with triaxial accelerometers during a 14-day intervention phase and a 14-day follow-up phase. RESULTS: Participants in the intervention group showed a higher probability (36.5%) to achieve the recommended daily activity levels (≥30 min of moderate-to-vigorous physical activity per day performed in bouts of at least 10 min) during the intervention and follow-up phase compared to those in the control group (23.0%). The intervention and control group did not differ in terms of daily moderate-to-vigorous physical activity (40.7 vs. 38.6 min per day, p = 0.623). CONCLUSION: Interventions facilitating action control via text messages seem to be an effective tool for increasing adherence to physical activity guidelines in everyday life. The comparable effects for the dyadic and individual intervention suggest that automated text messages may be just as effective as personalized messages from the romantic partner. Further investigation is needed to examine the usefulness of a dyadic conceptualizing of action control. (controlled-trials.com ISRCTN15705531).

Volitional processes and daily smoking: examining inter- and intraindividual associations around a quit attempt.

The Health Action Process Approach (HAPA) assumes that volitional processes are important for effective behavioral change. However, intraindividual associations have not yet been tested in the context of smoking cessation. This study examined the inter- and intraindividual associations between volitional HAPA variables and daily smoking before and after a quit attempt. Overall, 100 smokers completed daily surveys on mobile phones from 10 days before until 21 days after a self-set quit date, including self-efficacy, action planning, action control, and numbers of cigarettes smoked. Negative associations between volitional variables and daily numbers of cigarettes smoked emerged at the inter- and intraindividual level. Except for interindividual action planning, associations were stronger after the quit date than before the quit date. Self-efficacy, planning and action control were identified as critical inter- and intraindividual processes in smoking cessation, particularly after a self-set quit attempt when actual behavior change is performed.

A Dyadic Action Control Trial in Overweight and Obese Couples (DYACTIC).

BACKGROUND: Enhancing physical activity in overweight and obese individuals is an important means to promote health in this target population. The Health Action Process Approach (HAPA), which was the theoretical framework of this study, focuses on individual self-regulation variables for successful health behavior change. One key self-regulation variable of this model is action control with its three subfacets awareness of intentions, self-monitoring and regulatory effort. The social context of individuals, however, is usually neglected in common health behavior change theories. In order to integrate social influences into the HAPA, this randomized controlled trial investigated the effectiveness of a dyadic conceptualization of action control for promoting physical activity. METHODS/DESIGN: This protocol describes the design of a single-blind randomized controlled trial, which comprises four experimental groups: a dyadic action control group, an individual action control group and two control groups. Participants of this study are overweight or obese, heterosexual adult couples who intend to increase their physical activity. Blocking as means of a gender-balanced randomization is used to allocate couples to conditions and partners to either being the target person of the intervention or to the partner condition. The ecological momentary intervention takes place in the first 14 days after baseline assessment and is followed by another 14 days diary phase without intervention. Follow-ups are one month and six months later. Subsequent to the six-months follow-up another 14 days diary phase takes place.The main outcome measures are self-reported and accelerometer-assessed physical activity. Secondary outcome measures are Body Mass Index (BMI), aerobic fitness and habitual physical activity. DISCUSSION: This is the first study examining a dyadic action control intervention in comparison to an individual action control condition and two control groups applying a single-blind randomized control trial. Challenges with running couples studies as well as advantages and disadvantages of certain design-related decisions are discussed. This RCT was funded by the Swiss National Science Foundation (PP00P1_133632/1) and was registered on 27/04/2012 at http://www.isrctn.com/ISRCTN15705531.