Kangasniemi, Lappalainen, Kulmala Hakonen, Kankaanpää & Tammelin "The Role of Acceptance and Commitment Therapy (ACT)
in encouraging a physically active lifestyle"
Slides captured at the conference 2012.
1. Nordic ACBS Forum 8.-10.11.2012
The Role of Acceptance and
Commitment Therapy (ACT)
in encouraging a physically active
lifestyle
Kangasniemi Anu1,2, Lappalainen Raimo2,
Kulmala Janne1, Hakonen Harto1, Kankaanpää,
Anna1 & Tammelin Tuija1
1 LIKES Research center, Jyväskylä, Finland
2 University of Jyväskylä
www.likes.fi
3. 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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4. 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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6. 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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7. Eligible participants
(n=70)
Randomization
Control
ACT group
group
(n=35):
(n=35)
Outlier
(n=1) Drop out (n=6) Drop out (n=3)
Invalid
Participated in
data
the ACT group
(n=1)
(N=29)
Drop
out n=1) Included in Included in
analysis (N=26) analysis (n=32)
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8. Timeline of the study
Post Follow up 3
Baseline measurements months,
12/2011 03/2012
09/2011
ACT
Intervention,
6 sessions
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9. 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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10. 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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11. Measurements
• Physical activity (PA):
- was measured objectively by
accelerometer (ActiGraph GT1M):
MVPA, moderate to vigorous intensity
PA
HEPA, health enhancing PA
Steps in a day
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13. Measurements
• 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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14. The ACT program
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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15. 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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17. 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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18. 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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19. Changes in the health enhancing
16
time (HEPA)
min/day
14
12
p=.045, d=.667
10
8 Control group
6
ACT group
4
2
0
Baseline After the Follow up 3 months
intervention
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20. Psychological well-being:
decrease in the symptoms, (GHQ-12)
16
P=.001, d=.601
14
12
10
Control
8
group
6 ACT group
4
2
0
Baseline After the intervention Follow up 3 months
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21. 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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22. 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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23. 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.
Thank you!
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