Oral Papers: Medical Specialties I: Cardiology, Endorine, Renal
Background/Significance: Positive psychological constructs (e.g., optimism, positive affect) have been linked to greater physical activity and better health outcomes in persons with type 2 diabetes (Moskowitz, 2008) . However, there has been minimal study to determine whether cultivating these characteristics results in improved activity and health (Celano, 2019). Methods: The BEHOLD trials were a pair of randomized controlled trials that compared a phone-delivered, combined positive psychology (PP)-motivational interviewing (MI) intervention to a control condition. In both studies, participants were patients with a diagnosis of type 2 diabetes with suboptimal baseline physical activity as measured by accelerometer, and participants in all groups received a condition-specific treatment manual and a pedometer to promote physical activity. In trial 1, a 16 week PP-MI intervention was compared to an attention-matched educational control condition, and in trial 2 and 8 week PP-MI intervention was compared to an 8 week MI alone condition. This design allowed us to make comparisons within each trial, and also to compare the impact of the 8 week and 16 week PP-MI programs across the two studies to efficiently identify the optimal intervention type and duration. For both studies, the primary outcome measure was moderate to vigorous physical activity as measured by accelerometer, with secondary psychological, behavioral, and medical outcomes. IRB approval was obtained for both studies and all participants provided written informed consent. Both studies were pre-registered on clinicaltrials.gov. Results: We have completed enrollment (N=130) across the two trials, and we will have study results--both the individual study results and the comparison of the impact of the 8 vs. 16 week PP-MI program across studies--by the time of the ACLP annual meeting. Discussion: These trials aim to determine whether a combined PP-MI intervention leads to greater physical activity than an attention-matched education condition or MI alone, and if it is effective, which intervention duration appears most beneficial Conclusion/Implications: If efficacious, such an intervention could be both applicable and powerful, given the simple phone-based delivery of the intervention and the relationship between physical activity and adverse events in type 2 diabetes.
References: Moskowitz JT, Epel ES, Acree M. Positive affect uniquely predicts lower risk of mortality in people with diabetes. Health Psychol. 2008 Jan;27(1S):S73-82.
Celano CM, Gianangelo TA, Millstein RA, Chung WJ, Wexler DJ, Park ER, Huffman JC. A positive psychology-motivational interviewing intervention for patients with type 2 diabetes: Proof-of-concept trial. Int J Psychiatry Med. 2019 Mar;54(2):97-114