A community-based positive psychology group intervention to promote physical activity among people with metabolic syndrome: Proof of concept results to inform a pilot randomized controlled trial protocol

Patient Perspectives on Lifestyle Medicine Virtual Group Visits

Lifestyle Medicine Virtual Group Visits (LMVGVs) have potential for providing effective lifestyle education and counseling to patients who have or are at risk for chronic disease. The purpose of this study was to assess primary care patients' motivations for participation in and preferences for future engagement with LMVGVs. This was a cross-sectional survey conducted in an academic community-based clinic. A total of 111 patients who signed up for LMVGVs between September 2020 and August 2021 completed the survey between February and April 2022. Patient demographics and LMVGV attendance data were collected from the medical record. The most common reported reasons for signing up for LMVGVs were to focus on lifestyle changes and to lower chronic disease risk. The most common reasons for attending subsequent LMVGVs were the focus on healthy lifestyle changes and the positive focus of the groups. Almost all (98%) respondents who attended ≥5 LMVGVs indicated they would recommend LMVGVs to family or friends. Most respondents preferred monthly LMVGVs, including 71% of those who attended ≥5 LMVGVs. These findings inform efforts to develop LMVGVs that are feasible and acceptable to patients, contributing to the promotion of lifestyle behaviors that aid in the prevention and treatment of chronic disease.

A novel health behaviour intervention to promote adherence in kidney failure

BACKGROUND

Health behaviour adherence is associated with improved survival in kidney failure (KF); however, most patients with KF do not adhere to one or more health behaviours. Existing health behaviour interventions have significant limitations and do not focus on psychological factors that are associated with adherence and health.

OBJECTIVES

To examine the feasibility, acceptability, and preliminary efficacy of a 12-week, phone-delivered, positive psychology-motivational interviewing (MI) intervention to promote psychological well-being and adherence in KF.

DESIGN

Single-arm, proof-of-concept trial (N = 10).

PARTICIPANTS

Participants were adults with KF undergoing haemodialysis and reporting suboptimal adherence to physical activity, diet, and/or medications. Participants attended weekly phone sessions with a study trainer, completed weekly positive psychology exercises (focused on gratitude, strengths, and meaning), and worked towards physical activity, diet, and/or medication goals.

MEASUREMENTS

Feasibility was measured by the percentage of sessions completed, while acceptability was assessed through participant ratings of positive psychology and MI session ease and utility (0-10 Likert scales). We explored the intervention's impact on psychological outcomes and health behaviour adherence using validated scales and accelerometers.

RESULTS

Participants completed 78% of sessions and rated the program's components as easy to complete (positive psychology: 8.7 ± 1.5; MI: 8.3 ± 2.0) and subjectively helpful (positive psychology: 8.8 ± 1.2; MI: 8.8 ± 1.6). The intervention led to promising but nonsignificant improvements in psychological and adherence measures.

CONCLUSIONS

This 12-week, phone-delivered program was feasible, well-accepted, and associated with nonsignificant improvements health behaviour adherence, highlighting the need for a larger efficacy trial.

Can positive psychological interventions improve health behaviors? A systematic review of the literature

Positive psychological interventions (PPIs), which aim to cultivate psychological well-being, have the potential to improve health behavior adherence. This systematic review summarized the existing literature on PPI studies with a health behavior outcome to examine study methodology, quality, and efficacy. Of the 27 identified studies, 20 measured physical activity, eight measured medication adherence, seven measured diet, and three measured smoking (eight targeted multiple behaviors). Twenty studies were randomized controlled trials (RCTs; 13 fully powered), and seven had a single-arm design. Study samples were usually adults (n = 21), majority non-Hispanic white (n = 15) and female (n = 14), and with a specific disease (e.g., diabetes, n = 16). Most interventions combined a PPI with health behavior-focused content (n = 17), used a remote delivery method (n = 17), and received a moderate or low study quality rating. Overall, 19/27 studies found a health behavior improvement of at least medium effect size, while six of the 13 studies powered to detect significant effects were statistically significant. Of the behaviors measured, physical activity was most likely to improve (14/20 studies). In summary, PPIs are being increasingly studied as a strategy to enhance health behavior adherence. The existing literature is limited by small sample size, low study quality and inconsistent intervention content and outcome measurement. Future research should establish the most effective components of PPIs that can be tailored to different populations, use objective health behavior measurement, and robustly examine the effects of PPIs on health behaviors in fully powered RCTs.

The role of positive psychological constructs in diet and eating behavior among people with metabolic syndrome: A qualitative study

Positive Psychological (PP) constructs (e.g., optimism and gratitude) may impact the adherence to healthy behaviors, including diet, though prior studies have shown mixed findings. This qualitative study explored the relationships between PP constructs and dietary behaviors among 21 adults with metabolic syndrome through semi-structured interviews. Directed content analysis led to five themes: eating healthfully leads to PP constructs, PP constructs lead to eating healthfully, eating healthfully prevents negative emotions, healthy behaviors associated with diet, and an upward healthy spiral. Given the close relationship between PP constructs and diet, these may be targeted to improve diet in risk populations through interventions that promote well-being.

Fostering Positive Communities: A Scoping Review of Community-Level Positive Psychology Interventions

Historically, positive psychology research and practice have focused on studying and promoting well-being among individuals. While positive psychology interventions focusing on the well-being of communities and marginalized groups have recently been developed, studies reporting on their nature and characteristics are lacking. The aim of this paper is to examine the nature of community-level positive psychology interventions. It reviews the target populations, intervention modalities, objectives, and desired effects of 25 community-level positive psychology interventions found in 31 studies. This scoping review shows that community-level programs based on positive psychology vary greatly in all these aspects. However, most interventions are aimed at individual-level changes to achieve target group outcomes. Contextual issues such as social conditions, values, and fairness affecting well-being are rarely considered. Discrepancies between community-level positive psychology interventions and community psychology in terms of values and social change are discussed.