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.

COVID-19 protective behaviors: A longitudinal study applying an extended protection motivation theory.

OBJECTIVE: Behavioral measures have proven indispensable to slow down the spread of COVID-19. However, adopting new health behaviors is generally challenging. This study aimed at identifying determinants of adopting protective behaviors over the course of the COVID-19 pandemic. To explain adherence to protective behaviors over time, this study applied an extended version of the protection motivation theory combined with objective contextual pandemic-specific measures. METHOD: Six measurement points covered a period of 15 months during the COVID-19 pandemic in Switzerland. The sample of N = 4,001 (Mage = 53.1, SDage = 19.3, rangeage = 18-98, 49.2% female) participated via telephone or online. Data were analyzed on inter- and intraindividual levels using generalized estimating equations with intentions and self-reported engagement in four protective behaviors (hygiene behaviors, physical distancing, adherence to recommendations in case of symptoms, and mask wearing) as outcomes. RESULTS: Over time, response efficacy and self-efficacy were the most important predictors for all intentions and self-reported behaviors and on both levels of analysis. Moreover, intentions also emerged as important predictor of self-reported behavior. Social norms, measured as subjectively expected disapproval from others, were mostly negatively related to intentions and self-reported behaviors on the interindividual level, but less consistently on the intraindividual level. Perceived risks to oneself and others, as well as objective, contextual variables (incidences, mortality, stringency index) showed inconsistent effects. CONCLUSIONS: This study demonstrates that threat appraisals (e.g., risk perceptions) are less important than positive beliefs about the behavior (i.e., coping appraisals) for the adherence to protective behaviors during a pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The role of daily adjustment disorder, depression and anxiety symptoms for the physical activity of cardiac patients.

BACKGROUND: Physical activity (PA) is crucial in the treatment of cardiac disease. There is a high prevalence of stress-response and affective disorders among cardiac patients, which might be negatively associated with their PA. This study aimed at investigating daily differential associations of International Classification of Diseases (ICD)-11 adjustment disorder, depression and anxiety symptoms with PA and sedentary behaviour (SB) during and right after inpatient cardiac rehabilitation. METHODS: The sample included N = 129 inpatients in cardiac rehabilitation, Mage = 62.2, s.d.age = 11.3, 84.5% male, n = 2845 days. Adjustment disorder, depression and anxiety symptoms were measured daily during the last 7 days of rehabilitation and for 3 weeks after discharge. Moderate-to-vigorous PA (MVPA), light PA (LPA) and SB were measured with an accelerometer. Bayesian lagged multilevel regressions including all three symptoms to obtain their unique effects were conducted. RESULTS: On days with higher adjustment disorder symptoms than usual, patients engaged in less MVPA, and more SB. Patients with overall higher depression symptoms engaged in less MVPA, less LPA and more SB. On days with higher depression symptoms than usual, there was less MVPA and LPA, and more SB. Patients with higher anxiety symptoms engaged in more LPA and less SB. CONCLUSIONS: Results highlight the necessity to screen for and treat adjustment disorder and depression symptoms during cardiac rehabilitation.

Physical activity planning interventions, body fat and energy-dense food intake in dyads: ripple, spillover, or compensatory effects?

OBJECTIVES: It is unclear if planning to change one behavior may prompt changes in other health behaviors or health outcomes. This study tested if physical activity (PA) planning interventions may result in (i) a body fat reduction in target persons and their dyadic partners (a ripple effect), (ii) a decrease in energy-dense food intake (a spillover effect), or an increase in energy-dense food intake (a compensatory effect). METHOD: N = 320 adult-adult dyads were assigned to an individual ('I-for-me'), dyadic ('we-for-me'), or collaborative ('we-for-us') PA planning intervention or a control condition. Body fat and energy-dense food intake were measured at baseline and at the 36-week follow-up. RESULTS: No Time x Condition effects were found for target persons' body fat. There was a reduction in body fat among partners participating in any PA planning intervention, compared to the control condition. Across conditions, target persons and partners reduced energy-dense food intake over time. The reduction was smaller among target persons assigned to the individual PA planning condition compared to the control condition. CONCLUSIONS: PA planning interventions delivered to dyads may result in a ripple effect involving body fat reduction among partners. Among target persons, the individual PA planning may activate compensatory changes in energy-dense food intake.

In it Together: Relationship Transitions and Couple Concordance in Health and Well-Being.

Events that change the family system have the potential to impact couple dynamics such as concordance, that is, partner similarity in health and well-being. This project analyzes longitudinal data (≥ two decades) from both partners of up to 3,501 German and 1,842 Australian couples to investigate how couple concordance in life satisfaction, self-rated health, mental health, and physical health might change with transitioning to parenthood and an empty nest. Results revealed couple concordance in intercepts (averaged r = .52), linear trajectories (averaged r = .55), and wave-specific fluctuations around trajectories (averaged r = .21). Concordance in linear trajectories was stronger after transitions (averaged r = .81) than before transitions (averaged r = .43), whereas no systematic transition-related change in concordance of wave-specific fluctuations was found. Findings emphasize that shared transitions represent windows of change capable of sending couples onto mutual upward or downward trajectories in health and well-being.

Predicting the use of a COVID-19 contact tracing application: A study across two points of measurements.

Contact tracing mobile applications (apps) were important in combating the COVID-19 pandemic. Most previous studies predicting contact tracing app use were cross-sectional and not theory-based. This study aimed at contributing to a better understanding of app use intentions and app use by applying an extended version of the protection motivation theory across two measurement points while accounting for the development of the pandemic. A total of N = 1525 participants from Switzerland (Mage = 53.70, SD = 18.73; 47% female; n = 270 completed both assessments) reported on risk perceptions, response efficacy, self-efficacy, social norms, trust in government, trust in the healthcare system, active search of COVID-19-related information, intentions for and actual (self-reported) app use. Analyses included country-specific incidences and death toll. Increases in response-efficacy, self-efficacy, trust in government, and the active search of COVID-19-related information predicted increased app-use intentions. Increases in self-efficacy, intentions, and the active search of COVID-19-related information predicted increased self-reported app use. Risk perceptions, incidence, and death toll were unrelated to both outcomes. Across an aggravation of the pandemic situation, intentions for and app use were primarily related to response-efficacy, self-efficacy, trust in government, and the active search of COVID-19-related information.

Predicting physical activity following cardiac rehabilitation: A longitudinal observational study.

PURPOSE: The adoption of a healthy lifestyle is crucial for patients with established cardiac diseases. However, many patients do not engage in regular physical activity in their everyday life. RESEARCH METHOD: The present study applied the health action process approach (HAPA) in an intensive longitudinal research design (n = 3,354 daily surveys) investigating intention towards physical activity and objectively measured physical activity in 137 cardiac patients (Mage = 62.1 years) during and after inpatient rehabilitation across 28 days. Self-reported HAPA variables were measured daily in online questionnaires at the end of each day. Theory-driven hypotheses were tested using linear multilevel models. RESULTS: One-third of the sample did not reach the recommended physical activity levels in the first weeks after discharge from rehabilitation. Results are mostly in line with the motivational HAPA phase at both levels of analysis; outcome expectations and self-efficacy were positively associated with intentions. Results for the volitional phase were partly in line with the HAPA. Daily deviations in previous-day planning and concurrent action control were positively associated with physical activity during and after cardiac rehabilitation. CONCLUSION: The results of this study partly speak towards the HAPA in predicting physical activity in cardiac patients, thereby replicating prior research. The HAPA framework offers guidance for motivating and empowering cardiac patients to be more active in their everyday life. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

How is companionship related to romantic partners' affect, relationship satisfaction, and health behavior? Using a longitudinal dyadic score model to understand daily and couple-level effects of a dyadic predictor.

Companionship is related to better affect and relationship satisfaction, but few studies have examined both partners' perspectives over time and the link between companionship and health. In three intensive longitudinal studies (Study 1: 57 community couples; Study 2: 99 smoker-nonsmoker couples; Study 3: 83 dual-smoker couples), both partners reported daily companionship, affect, relationship satisfaction, and a health behavior (smoking in Studies 2 and 3). We proposed a dyadic score model that focuses on the couple level for companionship as a dyadic predictor with considerable shared variance. On days with higher companionship, couples reported better affect and relationship satisfaction. When partners differed in companionship, they also differed in affect and relationship satisfaction. For smoking, a different picture emerged: Whereas smokers with nonsmoking partners smoked less on average with higher companionship, smokers with smoking partners smoked more on days with higher companionship. Findings show companionship as a consequential relationship construct deserving further study. Using the dyadic score model acknowledged both partners' perspectives on companionship. It demonstrated higher precision for detecting effects of partner averages in a dyadic predictor compared with traditional approaches, tests for effects of partner differences in a dyadic predictor and in outcome while maintaining the focus on the dyad.

Social Stigma, Mental Health, Stress, and Health-Related Quality of Life in People with Long COVID.

A considerable amount of people who have been infected with SARS-CoV-2 experience ongoing symptoms, a condition termed long COVID. This study examined nuanced experiences of social stigma in people with long COVID and their associations with perceived stress, depressive symptoms, anxiety, and mental and physical health-related quality of life (hrqol). A total of N = 253 participants with long COVID symptoms (mean age = 45.49, SD = 12.03; n = 224, 88.5% women) completed a cross-sectional online survey on overall social stigma and the subfacets enacted and perceived external stigma, disclosure concerns, and internalized stigma. Data were analysed using multiple regression and controlling for overall burden of consequences of long COVID, overall burden of symptoms of long COVID, and outcome-specific confounders. In line with our preregistered hypotheses, total social stigma was related to more perceived stress, more depressive symptoms, higher anxiety, and lower mental hrqol, but-in contrast to our hypothesis-it was unrelated to physical hrqol after controlling for confounders. The three subscales of social stigma resulted in differential associations with the outcomes. Social stigma experiences go hand in hand with worse mental health in people with long COVID. Future studies should examine potential protective factors to buffer the effects of social stigma on people's well-being.

Social support, distress and well-being in individuals experiencing Long-COVID: a cross-sectional survey study.

OBJECTIVES: Increasingly attention of the COVID-19 pandemic is directed towards its long-term effects, also known as Long-COVID. So far, Long-COVID was examined mainly from a medical perspective, leaving psychosocial effects of Long-COVID understudied. The present study advances the current literature by examining social support in the context of Long-COVID. The study not only examines received support reported by individuals with Long-COVID, but also provided support reported by relatives of individuals with Long-COVID. DESIGN: Cross-sectional study. SETTING: The study was conducted from June to October 2021 in Austria, Germany and the German-speaking part of Switzerland. PARTICIPANTS: We examined 256 individuals with Long-COVID (MAge=45.05 years, 90.2% women) and 50 relatives of individuals with Long-COVID (MAge=48.34 years, 66.1% female) in two separate online surveys, assessing social support, well-being and distress. PRIMARY OUTCOME MEASURES: Primary outcomes were positive and negative affect, anxiety and depressive symptoms and perceived stress. RESULTS: For individuals with Long-COVID, receiving emotional support was related to higher well-being (positive affect: b=0.29, p<0.01; negative affect: b=-0.31, p<0.05) and less distress (anxiety: b=-1.45, p<0.01; depressive symptoms: b=-1.04, p<0.05; perceived stress: b=-0.21, p<0.05) but no effects emerged for receiving practical support. For relatives of individuals with Long-COVID, providing emotional support was only related to lower depressive symptoms (b=-2.57, p<0.05). Again, provided practical support was unrelated to the outcomes considered. CONCLUSIONS: Emotional support is likely to play an important role in well-being and distress of patients and relatives, whereas practical support does not seem to make a difference. Future research should clarify under what conditions different kinds of support unfold their positive effects on well-being and distress in the context of Long-COVID.

Handwashing adherence during the COVID-19 pandemic: A longitudinal study based on protection motivation theory.

RATIONALE: The associations between the number of COVID-19 cases/deaths and subsequent uptake of protective behaviors may reflect cognitive and behavioral responses to threat-relevant information. OBJECTIVE: Applying protection motivation theory (PMT), this study explored whether the number of total COVID-19 cases/deaths and general anxiety were associated with cross-situational handwashing adherence and whether these associations were mediated by PMT-specific self-regulatory cognitions (threat appraisal: perceived vulnerability, perceived illness severity; coping appraisal: self-efficacy, response efficacy, response costs). METHOD: The study (#NCT04367337) was conducted in March-September 2020 among 1256 adults residing in 14 countries. Self-reports on baseline general anxiety levels, handwashing adherence across 12 situations, and PMT-related constructs were collected using an online survey at two points in time, four weeks apart. Values of COVID-19 cases and deaths were retrieved twice for each country (one week prior to the individual data collection). RESULTS: Across countries and time, levels of adherence to handwashing guidelines were high. Path analysis indicated that smaller numbers of COVID-19 cases/deaths (Time 0; T0) were related to stronger self-efficacy (T1), which in turn was associated with higher handwashing adherence (T3). Lower general anxiety (T1) was related to better adherence (T3), with this effect mediated by higher response efficacy (T1, T3) and lower response cost (T3). However, higher general anxiety (T1) was related to better adherence via higher illness severity (T1, T3). General anxiety was unrelated to COVID-19 indicators. CONCLUSIONS: We found a complex pattern of associations between the numbers of COVID-19 cases/deaths, general anxiety, PMT variables, and handwashing adherence at the early stages of the pandemic. Higher general anxiety may enable threat appraisal (perceived illness severity), but it may hinder coping appraisal (response efficacy and response costs). The indicators of the trajectory of the pandemic (i.e., the smaller number of COVID-19 cases) may be indirectly associated with higher handwashing adherence via stronger self-efficacy.

Using family-centered communication to optimize patient-provider-companion encounters about changing to biosimilars: A randomized controlled trial.

OBJECTIVE: To explore whether family-centered communication impacts decisions and optimizes patient-companion-provider consultations. METHODS: A parallel, two-arm randomized controlled trial was conducted with 108 participants acting as patients with inflammatory arthritis or companions. Pairs attended a mock consultation where a physician explained the change from a bio-originator to a biosimilar using family-centered or patient-only communication. Participants reported their willingness to transition, risk perceptions, understanding and social support, and completed various scales including the Patient Perception Scale. Interviews helped understand perceptions towards the consultation. RESULTS: Family-centered communication did not impact willingness to change or cognitive risk perceptions compared to patient-only communication. However, it improved emotional risk perceptions (p = 0.047, Cohen's d=.55) and satisfaction with communication (p = 0.015, Cohen's d=.71). Feeling the explanation was reassuring was associated with less worry (p = 0.004). Receiving emotional support (p = 0.014) and companions asking fewer questions (p = 0.046) were associated with higher recall. The intervention improved companion involvement (p < 0.001, Cohen's d= 1.23) and support (p = 0.002, Cohen's d=.86). Interviews showed that encouraging questions, inclusive body language, and acknowledging companions facilitated involvement. CONCLUSION: Family-centered communication augments patient-companion-provider encounters but does not influence willingness to change treatment. PRACTICE IMPLICATIONS: Practitioners can use family-centered communication when discussing biosimilars but should provide reassurance, encourage emotional support, and summarize key points to improve understanding.

Differential associations of emotional and physical domains of the MacNew Heart with changes in 6-min walking test.

AIMS: Cardiac rehabilitation (CR), a key component of secondary prevention in cardiac patients, contributes fundamentally to improved cardiovascular health outcomes. Health-related quality of life (HRQOL) represents a widely employed outcome measure in CR, yet, its predictive properties on exercise capacity change during CR are poorly understood. Aim of this study was to examine the association between baseline HRQOL and its subdomains on improvement of exercise capacity during CR. METHODS: Study participants were 13,717 inpatients of six Swiss CR clinics from 2012 to 2018. We measured HRQOL at admission to CR with the MacNew Heart (MNH) questionnaire and exercise capacity at admission and discharge using the six minutes walking test (6MWT). Following factorial analyses, we performed univariate and multivariate analyses to test the predictive properties of baseline global HRQOL and its domains for improvement in exercise capacity, adjusting for demographic and clinical characteristics. RESULTS: Mean improvement in 6MWT was 114 m (SD = 90), achieved after 17.4 days (SD = 5.5). Lower emotional HRQOL (b = 7.85, p = < .001, 95% CI [- 5.67, 10.03]) and higher physical HRQOL (b = - 5.23, p < .001, 95% CI [- 6.56, - 3.90]) were associated with less improvement in the 6MWT. Global MNH and social HRQOL showed no association with exercise capacity improvement. CONCLUSION: Patients entering CR with low emotional and high physical HRQOL are at risk for a lower gain in exercise capacity during CR. Global MNH alone does not provide a reliable assessment of HRQOL; thus a focus on specific domains of HRQOL is needed.

Implementation of a Novel Medication Regimen Following Cardiac Rehabilitation: an Application of the Health Action Process Approach.

BACKGROUND: Medication adherence is an indispensable prerequisite for the long-term management of many chronic diseases. However, published literature suggests that non-adherence is widely prevalent. Health behavior change theories can help understand the underlying processes and allow the accumulation of knowledge in the field. The present study applied the health action process approach (HAPA) in an intensive longitudinal research design to investigate medication adherence in patients after discharge from inpatient cardiac rehabilitation. METHOD: In total, n = 139 patients (84.9% male, Mage = 62.2 years) completed n = 2,699 daily diaries in the 22 days following discharge from inpatient cardiac rehabilitation. Patients' intentions to take medication and predictors were assessed in daily end-of-day questionnaires. Adherence to medication was measured subjectively (self-report) and objectively. Multilevel modeling was applied to disentangle the between- and within-person level. RESULTS: Higher levels of risk awareness and self-efficacy were positively associated with intentions to take medication at both levels of analysis. Contrary to theoretical assumptions, positive outcome expectations were not associated with intention, neither between- nor within-person. In contrast to published literature, patients showed very high medication adherence (95.2% self-report, 92.2% objectively). CONCLUSION: In line with the theoretical assumptions, the results showed that risk awareness and self-efficacy are promising modifiable factors that could be targeted to motivate patients to take medication as prescribed. Daily measurements revealed that patients took their medication as prescribed; thus, future studies should make every effort to recruit patients vulnerable to non-adherence to avoid ceiling effects.

The mode of delivery and content of communication strategies used in mandatory and non-mandatory biosimilar transitions: a systematic review with meta-analysis.

Effective patient-provider communication is crucial to promote shared decision-making. However, it is unclear how to explain treatment changes to ensure patient acceptance, such as when transitioning from a bio-originator to a biosimilar. This review investigates communication strategies used to educate patients on transitioning to biosimilars and explores whether the willingness to transition and treatment persistence differs for the delivery (verbal or written) and the amount of information provided. MEDLINE, Embase, Scopus, and relevant conference databases were systematically searched. Communication strategies from 33 studies (88% observational cohort studies) published from 2012 to 2020 were synthesized and willingness to transition, persistence, and subjective adverse events explored. Patients only received information verbally in 11 studies. The remaining 22 studies also provided written information. Cost-saving was the main reason provided for the transition. Patients were most willing to transition when receiving written and verbal information (χ2 = 5.83, p = .02) or written information that only addressed a few (3-5) concerns (χ2 = 16.08, p < .001). There was no significant difference for persistence or subjective adverse events (p's > .05). Few randomized controlled trials have been conducted. Available data shows more willingness to transition when patients received written and verbal information. Initial documents should contain basic information and consultations or telephone calls used to address concerns.

School principals' social support and teachers' basic need satisfaction: The mediating role of job demands and job resources.

Many teachers report high levels of occupational stress. Teachers' basic need satisfaction is essential for teachers' well-being at work. Social support from school principals is assumed to play an important role for teachers' basic need satisfaction. However, the underlying mechanisms of the relationship between social support from school principals and teachers' basic need satisfaction are mostly unknown. Previous research suggests that job demands and job resources may play an important mediating role. Therefore, we examine whether teachers' perceived job demands and job resources serve as mediators between social support from the school principal and teachers' basic need satisfaction. Using longitudinal data of N = 1071 teachers over the course of one school year, we applied structural equation modelling to test the hypothesised mediation model. Results showed that the relationship between social support from the school principal and teachers' basic need satisfaction was mediated by teachers' perceived job demands and job resources. Particularly, the job demand 'unclear organisational conditions' and job resource 'social support from colleagues' indicated the strongest effects on teachers' basic need satisfaction. These findings emphasise the responsibility of school principals to provide social support to their teachers and create a well-structured and supportive workplace. In doing so, school principals contribute to a work environment in which teachers can thrive.

Insights into effects of individual, dyadic, and collaborative planning interventions on automatic, conscious, and social process variables.

OBJECTIVE: Going beyond the effects of individual planning ("I-for-me"), we investigate the associations of dyadic ("we-for-me") and collaborative ("we-for-us") planning with automatic, conscious, and social process variables that may elucidate the differences through which these three types of planning operate. We tested the effects of three planning interventions on: (1) habit strength, representing an automatic process, (2) the use of individual planning, representing a conscious process, (3) the use of collaborative planning, representing conscious and social processes, and (4) collaborative social control, representing a social process. METHODS: N = 320 adults were randomly assigned to one of four conditions: (1) the active control condition, (2) the individual planning condition, (3) the dyadic planning condition, or (4) the collaborative planning condition. Self-reported data on habit strength, the use of individual planning, the use of collaborative planning, and collaborative social control were assessed at baseline and at the 9-week follow-up. Analyses used linear mixed modelling. RESULTS: Compared to the control group, participants in the individual planning condition had stronger habits at the 9-week follow-up. Those in the dyadic planning condition reported higher levels of the use of collaborative planning and higher levels of collaborative social control at the follow-up. Finally, compared to those assigned to the control group, participants in the collaborative planning condition reported stronger habits, higher levels of the use of both individual and collaborative planning, and higher levels of collaborative social control at the follow-up. CONCLUSIONS: Individual, dyadic, and collaborative planning interventions may result in distinct patterns of changes in the variables representing automatic, conscious, and social processes. In particular, changes in automatic, conscious and social process variables, evoked by the collaborative "we-for-us" planning intervention may reflect the major regulatory effort of forming joint plans and subsequently integrating regular joint exercise into the weekly schedule.

One SMS a day keeps the stress away? A just-in-time planning intervention to reduce occupational stress among apprentices.

BACKGROUND: Occupational stress is one of the main sources of stress in apprentices with physical and psychological health consequences. Just-in-time planning interventions (JITPIs) are one opportunity to deliver intervention components at the right times and locations to optimally support apprentices in stressful situations. The aim of this study was to test the proximal effect of a mobile phone-delivered JITPI to reduce occupational stress in 386 apprentices within a planning intervention. METHODS: An AB/BA crossover design in which participants were randomly allocated to (A) the planning intervention or (B) the assessment only condition was implemented. RESULTS: The analyses of the study "ready4life", multilevel modeling, revealed no significant effect of the planning intervention on occupational stress reduction. CONCLUSIONS: Possible reasons for the missing effect might be the low stress level of participants or the type of the intervention delivery. Since apprenticeships in Switzerland differ considerably, future studies should enable more adapted interventions for the apprentices and consider individual circumstances of stress. Further, the intervention should focus on apprentices with high occupational stress levels or a high-risk of stress. Studies should investigate exactly when and why a person needs support regarding her/his occupational stress. Therefore, objective measurements of stress could be helpful.