Behavior modification exercise adherence literature review

Behavior modification exercise adherence literature review

intervention, physical activity, behavioral modification, and pleasant events. The aims of this study were: • To evaluate the impact of Caregiver factors on adherence to exercise frequency, behavioral plan implementation, and application of pleasant events with the PWD Factors in Exercise Adherence 5 Steady state: the point at which a metric, such as oxygen consumption or heart rate, levels off in an exercise test at a fixed work rate. Transtheoretical model: also known as the stages of change model, this theoretical construct attempts to classify individuals as to which stage of behavior Oct 23,  · Leith LM. Behavior modification and exercise adherence: a literature review. Journal of Sport Behavior 60–74, Google Scholar Leon AS, Connet, Jacob DR, Ravramaa R. Leisure-time physical activity levels and risk of coronary heart disease and death: the Multiple Risk Factor Intervention Trial

Adherence to Exercise Programmes | SpringerLink

Behavior change interventions typically contain multiple potentially active components: behavior change techniques BCTs. Identifying which specific BCTs or BCT combinations have the potential to be effective for a given behavior in a given context presents a major challenge. The aim of this study was to review the methods that have been used to identify effective BCTs for given behaviors in given contexts and evaluate their strengths and limitations.

A scoping review was conducted of studies that had sought to identify effective BCTs. The methods reported were coded. One hundred and thirty-five studies were identified.

The methods used in those studies were experimental manipulation of BCTs, observational studies comparing outcomes in the presence or absence of BCTs, meta-analyses of BCT comparisons, meta-regressions evaluating effect sizes with and without specific BCTs, reviews of BCTs found in effective interventions, and meta-classification and regression trees.

The limitations of each method meant that only weak conclusions could be drawn regarding the effectiveness of specific BCTs or BCT combinations. Methods for identifying effective BCTs linked to target behavior and context all have important inherent limitations. A strategy needs to be developed that can systematically combine the strengths of the different methods and that can link these constructs in an ontology behavior modification exercise adherence literature review behavior change interventions.

Practice: When deciding what combination of BCTs to use in an intervention, assessment of likely effectiveness needs to be based on integration of findings across different methods; until a formal method for doing this is developed, conclusions need to be subject to major qualifications.

Policy : When considering components to include in behavior change strategies, policymakers need to combine evidence from the full range of methods available and make conclusions subject to major caveats; given this uncertainty, monitoring outcomes and adjusting policies in the light of experience are crucial.

The primary practical purpose of research into behavior change is the development of interventions that will be effective, subject to other constraints such as affordability [ 12 ]. In doing so, one wants to be able to draw on research findings that identify behavior change techniques BCTs that, if enacted appropriately, are most likely to effect the desired change.

This will depend not only on the behavioral outcome but also on the ways the BCTs are delivered and the context. This paper reviews the methods that researchers have used to identify relevant BCTs for use in behavior change interventions and analyses their strengths and limitations specifically for this purpose. Content can be characterized in terms of BCTs [ 3—7 ], defined as the smallest identifiable components that in themselves have the potential to change behavior [ 8 ].

BCT taxonomies have been developed that provide a standardized method of classifying intervention content [ 9 behavior modification exercise adherence literature review. In Michie et al.

A key task in behavioral science can be seen as understanding the extent to which BCTs contribute to the effectiveness of interventions of which they form a part. In health care, behavior change interventions are aimed at a range of behavioral outcomes: preventing and stopping people engaging in harmful or risky behaviors e. Interventions aimed at changing health professional behaviors can involve the following: ensuring that those working in health care follow evidence-based guidelines e.

In all of these cases, the theory and practice of behavior change can be improved by conducting interventions and assessing their effects. Specifying the content of behavior change interventions in terms of BCTs enables the identification of potentially effective components within complex interventions, both in primary research e.

Factors that complicate the process of identifying effective specific BCTs or BCT combinations include the following: a behavior modification exercise adherence literature review effect of a single BCT may be very small, b many BCTs typically occur together in a given intervention, c BCTs may interact with each other to amplify or reduce effectiveness, d effectiveness of BCT depend on how they are delivered, e effectiveness may depend on specific features that are not captured by the BCT classification being used, and behavior modification exercise adherence literature review all the preceding may vary across context population and setting.

Complicating matters further, methods of identifying effective BCTs that involve synthesizing findings across studies depend critically on accurate and complete descriptions of interventions, the target populations and settings, and use of comparable behavioral outcomes.

Despite this, there is evidence that the task is tractable. For example, it has been possible to identify BCTs involved in behavioral support for smoking cessation that have been associated with higher success rates of local stop smoking services in England [ 17 ].

This has formed the basis for guidance on service provision and learning objectives in training courses, and the use of this guidance and training has been found to be associated with increased success rates [ 18 ]. Progress in behavioral science and its application depends on the success of this kind of exercise. Without it, we cannot build generalizable knowledge or create new interventions that have a high likelihood of success.

There have also been developments in linking the key constructs of behavior change interventions BCTs, their mode of delivery, mechanisms of action, target behavior and context into what is known as behavior modification exercise adherence literature review ontology of behavior change interventions [ 19 ]. Linking constructs into one knowledge structure recognizes that BCTs may be differentially effective according to their mode of delivery, type of target behavior and context.

An informal assessment of the research literature shows that methods that are used to establish effectiveness of complete behavior change interventions are also often used to identify effective BCTs.

In terms of primary studies, these include randomized controlled trials RCTs and comparative observational studies, behavior modification exercise adherence literature review.

In terms of evidence synthesis, they include meta-analyses. Other methods are also used such as meta-regressions. How far these methods can be successfully applied to identifying effective BCTs is not clear, however. We set out to establish what methods had been used and to analyze their strengths and limitations. The task is different from that of identifying effective interventions for the reasons given above. The task is essentially an identification problem in a complex environment with limited resources.

We can therefore draw on concepts from signal detection theory [ 20 ] and applied research methodology [ 21 ] for criteria to use in evaluating the methods.

Applicability: How well does the method allow generalization to populations and settings of interest? Sensitivity: How well suited is the method to picking up potentially effective BCTs for a given behavior and context if these are present? Specificity: How well does the method identify BCTs that will not be effective for a given behavior and context? This paper aimed to review methods used to identify effective BCTs or BCT combinations and analyze their strengths and limitations according to the above criteria.

Titles and abstracts were screened, and articles were selected for full-text analysis if they were written in English and contained a quantitative evaluation of the effectiveness of individual BCTs or specific BCT combinations within interventions aimed at changing health behavior. The process involved initial screening by K. and C. and R. See Fig. The goal was not to find every BCT evaluation that had been conducted but to have reasonable confidence that the different methods used had been canvassed and to have a general indication as to their relative frequency of use.

Evaluation methods coded were as follows: experimental manipulation of BCTs including RCTs, observational studies comparing interventions with or without targeted BCTs, meta-analyses of comparisons of BCTs, meta-regressions assessing relative effect sizes of interventions with or without specific BCTs, and characterizing effective interventions in terms of their BCTs.

An additional category was identified and added during the course of the current review: meta-classification and regression trees CART. Studies were each assigned to one evaluation method category by K. in consultation with S. The authors first engaged in a process of identifying in broad terms the strengths and limitations of the methods found in the review, specifically for the task of identifying potentially effective BCTs for particular behaviors in particular contexts, using the PASS criteria set out earlier.

The process of analyzing strengths and limitations of the methods involved complex judgments, combining a range of factors. The PASS criteria were designed to provide a framework for judgments about strengths and limitations, but a degree of subjectivity was unavoidable. The results were checked by R, behavior modification exercise adherence literature review. Of the studies identified by our search, met our inclusion criteria, reported in articles, behavior modification exercise adherence literature review.

Of the behavior modification exercise adherence literature review studies, were irrelevant to the topic of this review, behavior modification exercise adherence literature review, and were relevant to behavior change but did not include an assessment of the effectiveness of BCTs.

The latter included 24 review articles that had used a taxonomy of BCTs to code intervention content regardless of effectiveness and 37 study protocols or intervention development articles.

Table 1 shows the methods found in the review to investigate effectiveness and the number of studies that used each method. References to studies categorized as using each method can be found in the online Supplementary Material, behavior modification exercise adherence literature review.

As might be expected, the most commonly used method was the use of individual empirical studies. However, studies characterizing what had been found to be effective interventions in terms of their component BCTs, meta-analyses, and meta-regressions were also common, behavior modification exercise adherence literature review.

Comparative observational studies were rare and only one example was found of use of meta-CART. BCTs behavior change techniques; RCTs randomized controlled trials; P Practicability; A Applicability; Se Sensitivity; Sp Specificity. Table 1 summarizes an analysis of strengths and limitations of the different methods using the steps described above. Individual experimental studies can provide the strongest indication of causal relationship between specific BCTs or BCT combinations and effect sizes in a given set of circumstances, at least when there are no biasing factors such as loss to follow-up.

However, this approach has major limitations. It is not feasible when comparing large numbers of individual BCTs or their combinations.

Expected effect sizes of individual BCTs are usually small, so large sample sizes are required for adequate power and, even with factorial or fractionated factorial designs, the resources needed to undertake such behavior modification exercise adherence literature review are typically prohibitive [ 2324 ].

Generalization beyond behavior modification exercise adherence literature review specific circumstance is likely to be limited. Effectiveness is influenced by implementation fidelity, which is often low [ 25behavior modification exercise adherence literature review, 26 ]. Ethical and practical considerations often preclude random allocation of participants to experimental and comparison conditions [ 2527 ].

By examining naturally occurring covariation, comparative observational studies avoid many of the problems with experimental studies, such as ethical and practical constraints in randomly allocating participants to conditions. Because they do not involve setting up interventions, but rather record inputs, processes and outcomes for interventions that are already in existence are typically much less expensive to run.

Where there is naturally occurring variation within very large regional or national programs, they can involve large number of participants and thus have power to detect small effect sizes [ 1728 ]. They typically involve interventions that are being delivered in the real world where fidelity is likely to be lower than in experimental studies, behavior modification exercise adherence literature review.

Their key limitation is in the confidence with which behavior modification exercise adherence literature review can be ascribed to BCTs. This can be addressed to some degree by statistical adjustment for potential confounding variables and establishing that factors that determine application of different BCTs to different members of the target group are not likely to be confounded with outcome.

In addition, the quality of data is often lower than in experimental studies, with large amounts of missing data and measures that are poorly applied [ 29 ]. This can add both to random error and bias. Meta-analyses of experimental studies can provide generalizable conclusions with a high degree of confidence in causal inference but are limited by all the factors that limit the studies that contribute to them and several others in addition [ 3031 ].

Firstly, the approach is limited by the viability of assumptions underpinning the aggregation of data from those studies. For example, if a category of target behavior is chosen that is heterogeneous with regard to effectiveness of BCTs, it will produce misleading results.

Equally important, a given category of BCT may be implemented very differently in one study versus another. Secondly, the approach is limited by the quality of the studies contributing to the meta-analyses and the difficulties in taking account of variations in methodological quality, behavior modification exercise adherence literature review.

The common approach of assigning a quality score and weighting studies accordingly can fail to remedy this because specific deficiencies can fatally undermine a study while only reducing its score by a certain amount. Thirdly, the approach is limited by the small number of relevant experimental studies [ 32 ].

Meta-regressions allow pooling of data from experimental studies to draw conclusions about associations between BCTs included in interventions and effect size. Their main strength is in the ability to aggregate data over many different studies to behavior modification exercise adherence literature review patterns of association [ 1633 ].

A major limitation is that when comparing effect sizes across studies, one is moving from an experimental to a correlational design. This means that there may be unmeasured confounding that accounts for associations observed such as variations in combinations of BCTs, mode of delivery, population and setting [ 34 ].

Another important limitation is that meta-regressions are reliant on descriptions of the key variables. Yet, there is good evidence that published descriptions of intervention and control conditions are very incomplete [ 3435 ]. A third limitation is that one requires a large number of studies and sufficient variation among the studies in terms of intervention components and effect sizes in order to have a chance of detecting relevant associations [ 36 ].

DN A355 Diet, Exercise, and Behavior Modification - 1

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Review of Computer-generated Outpatient Health Behavior Interventions

Behavior Modification Exercise Adherence Literature Review for College Students Finding services that write essays for money is easy, but identifying the ones that are reliable is not. here are the tips to /10() Mar 01,  · In this review, we consider the extant literature dealing with the influential roles of self-efficacy and attitudes in adherence to exercise. In so doing, we provide a brief overview of the tenets of each theory followed by the primary review of each model as it has been applied to exercise behavior in both diseased and asymptomatic population Objective: To identify and categorize barriers, facilitators, and strategies to boost exercise therapy adherence in youth with musculoskeletal conditions to inform research and clinical practice. Study design: Scoping review. Literature search: We searched MEDLINE, CINAHL, SPORTDiscus, Scopus, PEDro, and ProQuest from inception to October 1,