Matched or nonmatched interventions based on the transtheoretical model to promote physical activity. A meta-analysis of randomized controlled trials.

PURPOSE: The aim of this study was to examine whether the efficacy of transtheoretical model (TTM)-based interventions on physical activity (PA) varied according to the following criteria: (1) interventions targeted the actual stages of change (SOCs) or did not; (2) participants were selected according to their SOC or were not; and (3) its theoretical constructs (decisional balance, temptation, self-efficacy, processes of change). METHODS: Thirty-three randomized controlled trials assessing TTM-based interventions promoting PA in adults were systematically identified. RESULTS: The between-group heterogeneity statistic (Qb) did not reveal any differential efficacy either in interventions targeting the actual SOC compared with those that did not (Qb = 1.48, p = 0.22) or in interventions selecting participants according to their SOC compared with those that did not (Qb = 0.01, p = 0.91). TTM-based interventions enhanced PA behavior whether they targeted the actual SOC (Cohen's d = 0.36; 95% confidence interval (CI): 0.22-0.49) or not (d = 0.23; 95%CI: 0.09-0.38) and whether they selected their participants according to their SOC (d = 0.33; 95%CI: 0.13-0.53) or not (d = 0.32; 95%CI: 0.19-0.44). The moderators of the efficacy of TTM-based interventions were the number of theoretical constructs used to tailor the intervention (Qb = 8.82, p = 0.003), the use of self-efficacy (Qb = 6.09, p = 0.01), and the processes of change (Qb = 3.51, p = 0.06). CONCLUSION: TTM-based interventions significantly improved PA behavior, and their efficacy was not moderated by SOC but by the TTM theoretical constructs.

[Interventions based on mindfulness for the elderly chronic pain: review of the literature]. / Les interventions basées sur la pleine conscience pour le sujet âgé douloureux chronique : revue de la littérature.

The chronic pain-bio-psycho-social phenomenon would index a transition between a pain alarm and a pain disease, with reshaping of the inhibitive brain areas and a takeover of psychological factors on the modulatory systems. The current treatment of elders' chronic pain suffers from many limits, and this article addresses this issue by discussing a new and innovative non-pharmacological intervention (mindfulness therapy) to reduce consequences of chronic pain in daily-life. Mindfulness therapy mainly targets two transdiagnostic mental processes - avoidance and self-centered ruminations - which leads to emotional dysregulation in chronic pain patients. Although many studies documented the beneficial effect of mindfulness therapy on psychological symptoms in adults, there is still a lack of studies testing the effect of mindfulness therapy on emotional regulation and psychological symptoms in elderly population with chronic pain. It is therefore necessary to investigate therapeutic efficacy with this population. In conclusion, we formulate several lines of research to test the hypothesis that the effect of the mindfulness therapy on targeted processes would improve elders' ability to cope with chronic pain and would reduce disturbances associated with chronic pain.