Promoting participation in physical activity through Snacktivity: A qualitative mixed methods study.

BACKGROUND: Public health guidance acknowledges the benefits of physical activity of any duration. We have proposed a whole-day approach to promoting physical activity called Snacktivity™, which encourages frequent 2-5 minute 'activity snacks' of moderate-to-vigorous intensity. METHODS: Using repeated semi-structured interviews and a think aloud protocol, this study aimed to understand participants' experiences of integrating Snacktivity™ into daily life, to provide insights to refine the delivery of Snacktivity™ interventions. Physically inactive adults recruited via primary care and a community health service engaged with an intervention to encourage Snacktivity™ over three weeks, which included using a Fitbit and linked mobile phone app (SnackApp). Participants took part in semi-structured interviews on two occasions during the intervention, with a sub-group participating in a think aloud study. Three study data sets were generated and independently explored using inductive thematic analysis, with findings combined into a single set of themes. RESULTS: Eleven adults participated in the interview study who were interviewed twice (total interviews completed n = 21, 1 participant declined the second interview), of whom six completed the think aloud study (total voice recordings n = 103). Three main themes emerged from the combined data; lived experience of participating in Snacktivity™, motivation for Snacktivity™ and experiences with the Snacktivity™ technology. Participants undertook a variety of activity snacks, utilising their environment, which they believed improved their psychological wellbeing. Participants were enthusiastic about Snacktivity™, with some stating that activity snacks were more accessible than traditional exercise, but perceived they were often prevented from doing so in the presence of others. Participants were mostly enthusiastic about using the Snacktivity™ technology. CONCLUSION: Participants were able to incorporate Snacktivity™ into their lives, particularly at home, and found this approach acceptable. Participants felt they experienced health benefits from Snacktivity™ although barriers to participation were reported. This study offers insights for translating guidance into practice and supporting people to become more physically active.

Systematic review, meta-analysis with subgroup analysis of hypnotherapy for irritable bowel syndrome, effect of intervention characteristics.

BACKGROUND: Hypnotherapy has been shown to be effective at relieving global gastrointestinal symptoms (GGS) in irritable bowel syndrome (IBS). This study examines the impact of hypnotherapy delivery and participant characteristics on IBS outcomes. METHODS: This systematic review searched CINAHL, Cochrane Library, Conference Citation Index, Embase, PubMed, PsycARTICLES, PsychINFO, Science Citation index-expanded, Social Science Citation Index. Titles and abstracts, then full-text articles were screened against inclusion criteria: trials with a concurrent comparator of hypnotherapy in adults with IBS diagnosed using Manning or ROME criteria, which provided symptom data. Included studies were extracted and assessed for bias using Cochrane Collaboration 2011 guidance. Random-effects meta-analysis was conducted with sub-group analysis to assess the impact of delivery characteristics on outcomes. RESULTS: Twelve trials were included, 7 in the meta-analyses. Hypnotherapy reduced the risk of GGS, but this was not statistically significant, (standardised mean difference (SMD) 0.24, [-0.06, 0.54], I2 66 %). Higher frequency of sessions (≥1/week) reduced GGS (SMD 0.45 [0.23,0.67] I2 0 %), as did higher volumes of intervention (≥8 sessions with ≥6 h of contact) (SMD 0.51 [0.27,0.76] I2 0 %) and group interventions (SMD 0.45 [0.03, 0.88] I2 62 %). Only volume of intervention produced a significant effect between the subgroups. CONCLUSION: This review suggests that high volume hypnotherapy is more beneficial than low and should be adopted for GDH. Both high frequency and group interventions are effective in reducing GGS in IBS. However, the sample size is small and more studies are needed to confirm this.

Comparing Skype (video calling) and in-person qualitative interview modes in a study of people with irritable bowel syndrome - an exploratory comparative analysis.

BACKGROUND: Within qualitative research in-person interviews have the reputation for being the highest standard of interviewer-participant encounter. However, there are other approaches to interviewing such as telephone and e-mail, which may be appropriate for a variety of reasons such as cost, time and privacy. Although there has been much discussion of the relative values of different interview methods, little research has been conducted to assess what differentiates them using quantifiable measures. None of this research has addressed the video call, which is the interview mode most like the in-person interview. This study uses quantifiable measures generated by the interview to explore the relative value of in-person and video call interview modes. METHODS: Interview data gathered by a qualitative research study exploring the views of people with IBS about hypnotherapy for their condition were used. In-person and video call interviews using the same topic guide were compared on measures of length (time and word count), proportion of time the interviewer was dominant, the number of topics generated (codes) and the number of individual statements on which those topics were based. RESULTS: Both interview methods produced a similar number of words and a similar number of topics (codes) were discussed, however the number of statements upon which the variety of topics was based was notably larger for the in-person interviews. CONCLUSION: These findings suggest that in in-person study interviews were marginally superior to video calls in that interviewees said more, although this was on a similar range of topics. However, the difference is sufficiently modest that time and budget constraints may justify the use of some video call interviews within a qualitative research study.

How do people with refractory irritable bowel syndrome perceive hypnotherapy?: Qualitative study.

OBJECTIVES: Hypnotherapy is recognised in the UK's National Institute for Health and Care Excellence (NICE) guidelines as a potential treatment for Irritable Bowel Syndrome (IBS). However, little is known about the views of people with IBS regarding hypnotherapy. This qualitative study aimed to identify perceptions of and barriers to hypnotherapy for IBS by people with the condition. DESIGN: One-to-one semi-structured interviews using thematic analysis. SETTING: Convenience sampling in the UK. Participants were recruited by poster advertising and online IBS support groups. Interviews were conducted at the interviewees' preferred location or via video calling. PARTICIPANTS: 17 people (15 female, 2 male) who self-identified as having refractory IBS according to a provided definition. RESULTS: Four hypnotherapy related themes arose from the data: conceptualisation of hypnotherapy, hypnotherapy for IBS, barriers to hypnotherapy for IBS, ideal format of hypnotherapy for IBS. Participants saw hypnosis as an altered state in which change was possible, but many had not considered it for IBS. They were broadly open to hypnotherapy for IBS, but a variety of potential barriers were apparent, including cost and therapist validity. Group hypnotherapy was less acceptable than one-to-one treatment. Hypnotherapy via video call was seen as convenient, but there were concerns about its effectiveness. CONCLUSION: People with IBS may be put off hypnotherapy by a lack of understanding of how it works for their condition and lack of awareness of it as a therapeutic option. Uptake may be improved through effective promotion of the approach which addresses its mechanisms of effect.

What the public think about hypnosis and hypnotherapy: A narrative review of literature covering opinions and attitudes of the general public 1996-2016.

OBJECTIVES: To describe the public's understanding of hypnosis and openness to hypnotherapy. METHODS: A comprehensive search of English language peer reviewed journal articles from 1st January 1996-11th March 2016 was performed over 9 databases (Medline, PubMed, PsycARTICLES, CINAHL, Embase (excerpta medica), PsychInfo, Cochrane, Science citation index-expanded, Conference citation index) and a title-only search of Google scholar. 39 keyword combinations were employed: hypnosis, hypnotherapy, hypnotic, perception, beliefs, knowledge, view, opinion and understanding, in singular and plural where appropriate. A search of the bibliographies of eligible articles was undertaken. Inclusion criteria - Articles containing original data regarding the general public's attitudes towards hypnotherapy or hypnosis. Exclusion criteria - Non-therapy hypnosis (forensic, entertainment) materials and those concerned with groups likely to possess prior or professional knowledge of hypnosis, (hypnotists, clinicians and psychologists). Analysis was conducted in line with the questions. RESULTS: 31 articles were identified, covering diverse populations. Most people believe that: hypnosis is an altered state which requires collaboration to enter; once hypnotized perception changes; hypnotherapy is beneficial for psychological issues and is supportive of medical interventions; hypnosis can also enhance abilities especially memory. People are open to hypnotherapy subject to validation from the psychological or medical establishment. Similarity of opinion is more apparent than difference. CONCLUSION: Most people are positive towards hypnotherapy, and would consider its use under the right circumstances.