www.likes.f i The Role of Acceptance and Commitment Therapy (ACT) in encouraging a physically active lifestyle Kangasniemi Anu 1,2 , Lappalainen Raimo 2 , Kulmala Janne 1, Hakonen Harto 1 , Kankaanpää, Anna 1 & Tammelin Tuija 1 1 LIKES Research center, Jyväskylä, Finland 2 University of Jyväskylä Nordic ACBS Forum 8.-10.11.2012
Kangasniemi, Lappalainen, Kulmala Hakonen, Kankaanpää & Tammelin "The Role of Acceptance and Commitment Therapy (ACT) in encouraging a physically active lifestyle"
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The Role of Acceptance and Commitment Therapy (ACT) in encouraging a physically active lifestyle
1 LIKES Research center, Jyväskylä, Finland 2 University of Jyväskylä
Nordic ACBS Forum 8.-10.11.2012
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Introduction
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Introduction
• Physical inactivity increases the risk of many lifestyle diseases
-> type II diabetes, cardiovascular disease, breast and colon cancers and shortens life expectancy
• Physical inactivity has been identified as the fourth leading risk factor for global mortality.
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Aim of the study
• is to investigate the efficacy of the Acceptance and Commitment Therapy method in enhacing a physically active lifestyle among 30-50 years old sedentary adults.
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Methods
• Participants• Study setting• Measurements
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Global recommendation for physical activity for adults (WHO)
• Adults should do at least 150 minutes of moderately intense physical activity throughout the week or at least 75 minutes of vigorous- activity throughout the week or an equivalent combination of moderate- and vigorous activity.
• All activity should be performed in bouts of at least 10 minutes duration.
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Eligible participants (n=70)
Randomization
ACT group (n=35):
Controlgroup(n=35)
Participated in the ACT group
(N=29)
Included in analysis (n=32)
Outlier (n=1)
Invalid data (n=1)
Drop out n=1)
Drop out (n=6) Drop out (n=3)
Included in analysis (N=26)
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Timeline of the study
Baseline
09/2011
ACT Intervention,
6 sessions
Post measurements
12/2011
Follow up 3 months, 03/2012
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Procedure
• Control and ACT group:- Written feedback about their PA level
at the baseline, after the intervention and follow up (3 months) compared to the current physical activity recommendations
- Opportunity to attend a body composition analyze
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Procedure
• ACT group participated the intervention program:
- Six group sessions, 90 minutes/session
- Group size: 5-8 members- They also used pedometer for
monitoring their PA during the 9 weeks intervention
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Measurements
• Physical activity (PA):- was measured objectively by
accelerometer (ActiGraph GT1M):MVPA, moderate to vigorous intensity PAHEPA, health enhancing PASteps in a day
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Accelerometer (ActiGraph GT1M)
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Measurements
• Psychological well-being:- GHQ-12, General health
1. Session: ”Health Behavior-analysis”2. Session: ”Values and important things in the
life”3. Session: ”Value based actions and barriers”4. Session: ”Living in the present moment and
self-regulation skills”5. Session: ”Self as a context and social support”6. Session: ”Where are you going?”
–evaluations of the learning process, set goals and values”
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The ACT program
• Every session included:- mindfulness exercise- pair/group discussions- homework between the sessions
• Varied number of defusion exercises and metaphors
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Little changes make the difference in the everyday life!
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Statistical analysis
• Analysis of independent samples t-test and Chi-square tests were used to compare the descriptive statistics and baseline measures of the control and ACT group.
• Repeated measures multivariate analysis of covariance (MANCOVA).
• The analyses of physical activity measures were conducted while controlling for baseline depressive symptoms (BDI-II score). Effect sizes were estimated using Cohen’s d.
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Results
• Physical activity: Health enhancing time, (HEPA)
• Psychological well-being:- GHQ-12, General health questionnaire- Symptom Check-List-90, SCL-90
- Beck Depression Inventory, BDI-II- Kentucky Inventory of Mindfulness Skills, KIMS- Acceptance and Action
Questionnaire,AAQ-2
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Changes in the health enhancing time (HEPA)
0
2
4
6
8
10
12
14
16
Control group
ACT group
min/day
p=.045, d=.667
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Psychological well-being: decrease in the symptoms, (GHQ-12)
Baseline After the intervention Follow up 3 months0
2
4
6
8
10
12
14
16
Control group
ACT group
P=.001, d=.601
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Conclusions
• The main results showed significant improvement in the health enhancing (HEPA) physical activity time in the ACT group compared to the control group.
• Implications of the reductions in the psychological symptoms were also observed in measures of the psychological well-being.
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Conclusions
• The ACT application offers a novel and innovative method to enhance physical activity among adults.
-> People know quite well why and how, but don´t get started or motivated enough.
-> The holistic approach is needed especially among sedentary people.
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Future directions
• The small sample size (n=70), the data collection continues
-> second wave started in the august 2012
-> follow–up measurements will give information about the maintenance of the changes.