Telephone Counseling Increases Cessation Rates Among Young Adult Smokers.

During June 2000-May 2001, the American Cancer Society conducted a randomized trial of telephone counseling among more than 3,500 current smokers who called to seek assistance in quitting. All eligible callers were randomized to receive either self-help booklets through the mail or booklets and up to 5 sessions of telephone counseling. Approximately 12% (420/3,522) of study participants were 18-25 years of age. Using intent to treat analyses, 3- and 6-month quit rates among both younger and older smokers were significantly higher among those who received telephone counseling than among those who received self-help booklets only. Three-month rates were 20% versus 9% for 18-25 year olds and 15% versus 10% for older adults. Results indicate that younger smokers can benefit from telephone counseling. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhancing the efficacy of behavior therapy for obesity: Effects of aerobic exercise and a multicomponent maintenance program.

Tested whether the efficacy of behavior therapy for obesity might be improved by the programmatic additions of an aerobic exercise regimen during treatment and a multicomponent maintenance program following treatment. 14 male and 76 female obese 22–60 yr olds were randomly assigned to 2 treatment conditions (behavior therapy or behavior therapy plus aerobic exercise) and 2 posttreatment conditions (no further contact or a multicomponent maintenance program). The exercise regimen consisted of 80 min/week of brisk walking or stationary cycling. The maintenance program included therapist contact by telephone and mail and peer self-help group meetings. At posttreatment, Ss in the behavior therapy plus aerobic exercise condition lost significantly more weight than those who received behavior therapy only. Over an 18-mo follow-up period, maintenance program participants demonstrated significantly better weight-loss progress than Ss in the no-further-contact condition. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telephone versus print delivery of an individualized motivationally tailored physical activity intervention: Project STRIDE.

Objective: Given that only 25% of Americans meet physical activity recommendations, there is a need to develop and disseminate effective, evidence-based interventions to promote physical activity. The authors tested 2 delivery channels, telephone and print, to determine whether one was more effective in promoting physical activity. Design: The authors randomly assigned 239 healthy, sedentary adults to (a) telephone-based individualized feedback, (b) print-based individualized feedback, or (c) contact control. Both intervention arms were guided by a motivationally tailored, theoretically driven computer expert system. Main outcome measures: Physical activity as measured by the 7-day Physical Activity Recall interview. Results: At 6 months, both telephone and print arms significantly increased in minutes of moderate intensity physical activity compared with control, with no differences between the intervention arms. At 12 months, print participants reported a significantly greater number of moderate intensity minutes than both telephone and control participants, who did not differ. Conclusion: Results suggest that both telephone and print enhance the adoption of physical activity among sedentary adults; however, print interventions may be particularly effective in maintaining physical activity in the longer term. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maintenance strategies for the treatment of obesity: An evaluation of relapse prevention training and posttreatment contact by mail and telephone.

129 21–57 yr old moderately obese volunteers who averaged 57% over ideal weight were randomly assigned to 1 of 6 experimental conditions in a 3?×?2 factorial design. Three treatment conditions (nonbehavioral therapy, behavior therapy, or behavior therapy plus relapse prevention training) were crossed with 2 posttreatment conditions (posttreatment client–therapist contact by telephone and mail or no posttreatment contact). All treatments produced substantial initial weight losses, but Ss tended to regain weight during the follow-up period. Posttreatment client–therapist contact by mail and telephone significantly enhanced the maintenance of weight loss for groups that received nonbehavioral treatment or behavior therapy plus relapse prevention training, but it did not improve maintenance for groups that received behavior therapy only. At 12-mo follow-up, the only condition that maintained its mean posttreatment weight loss was the one that received behavior therapy plus relapse prevention training and posttreatment contact. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding readiness for regular physical activity in older individuals: An application of the theory of planned behavior.

This study examined whether stage of readiness for regular physical activity (i.e., discrete phases from inactive to active) was related to beliefs concerning perceived social pressure, attitude, perceived control, and intention. Data were collected from 288 older people through the mail. Frequency data indicated that over 50% of the sample had been engaging in regular physical activity for longer than 6 months. Analysis of variance (ANOVA) results showed that all selected variables shared significant variance with stage of readiness, and discrimination among the stages by the selected variables was successful. Path analysis indicated that intention, attitude, and perceived control had direct relationships with stage of readiness. Discussion focused on the utility of these variables for understanding individual differences in stage of readiness for regular physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of group counseling on self-esteem.

Investigated the influence of group counseling on self-esteem, anxiety, depression, and hostility in 3 groups of adult women: 24 middle-class women; 9 women who received provincial social assistance (i.e., longer than 3 mo); and 15 who received city social assistance (i.e., less than 3 mo). All Ss completed pre- and posttests of the Tennessee Self-Concept Scale and the Multiple Affect Adjective Check List before and after a series of group counseling sessions on practical, personal, and social issues. Results show that the women receiving provincial social assistance had significant changes in the level of self-esteem; it is suggested that these women, nearly half of whom were either single or divorced (compared with Ss who received city social assistance who were almost all separated and the middle-class Ss who were almost all married), perceived a need change in their lives. Because of their relatively stable marital and financial status (i.e., husbands gone for some time and social assistance providing funds), they were not forced to spend a good deal of time in self-exploration and were consequently responsive to treatment. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes, knowledge, and stages of change: A survey of exercise patterns in older Australian women.

Describes a telephone survey of attitudes and behavior relevant to exercise adoption among 286 Australian women (aged 50–64 yrs). Stages of change identified by the transtheoretical model of behavior change were related to attitudes, knowledge, and demographic variables. In comparison with exercisers, precontemplators were older, had lower exercise knowledge, perceived lower levels of family support for exercise, expected fewer psychological benefits from exercise, and rated exercise as less important than avoiding smoking. The main significant difference between contemplators and those in the action or maintenance stage involved the perception of practical barriers. Despite the limitations of this cross-sectional self-report study, it identifies attitudes and knowledge as potential targets for intervention with middle-aged women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Matching addiction outpatient counseling to client readiness for change: The role of structured relapse prevention counseling.

The clinical importance of matching counseling procedures to the client's readiness for change is gaining increased recognition in the addictions treatment field. This article describes a comprehensive cognitive-behavioral outpatient counseling program for substance abusers that consists of 5 components (i.e., assessment, motivational interviewing, preparation of an individualized treatment plan, 'initiation of change" counseling procedures, and "maintenance of change" counseling procedures). The relationship of these treatment components to 5 client stages of change (i.e., precontemplation, contemplation, preparation, action, and maintenance) is discussed. A simple assessment tool for determining the client's stage of change, the Commitment to Change Algorithm, is described. Finally, the difference between initiation and maintenance of change homework assignments in structured relapse prevention counseling is highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lifestyle physical activity interventions. History, short- and long-term effects, and recommendations

INTRODUCTION: Lifestyle physical activity interventions have resulted in response to the public health problem of promoting regular amounts of physical activity to the majority of U.S. adults who remain inadequately or completely inactive. These lifestyle interventions allow a person to individualize his/her physical activity programs to include a wide variety of activities that are at least of moderate intensity and to accumulate bouts of these activities in a manner befitting his/her life circumstances. METHODS: We reviewed the history of lifestyle physical activity interventions and defined lifestyle physical activity based on this review. We located 14 studies that met this definition. RESULTS: Lifestyle physical activity interventions are effective at increasing and maintaining levels of physical activity that meet or exceed public health guidelines for physical activity in representative samples of previously sedentary adults and obese children. The majority of these interventions have been delivered by face-to-face contact in small groups, which limits their public health impact. However, a small number of studies demonstrate that these interventions can be delivered by mail and telephone, which may enhance their generalizability. Most of these studies utilized behavior change theories such as Social Cognitive Theory, the Transtheoretical Model, and Behavior Learning to shape the interventions. Lifestyle interventions aimed at modifying the environment, such as signs posted to increase stair climbing, also have been shown to be effective over the short term. CONCLUSIONS: The major issues concerning lifestyle physical activity interventions are: (1) testing their ability to be implemented on a large scale; (2) examining cost-effectiveness for different modes of delivery; and (3) researching the efficacy in populations such as the elderly, minorities, economically disadvantaged, and individuals with concurrent disease. More studies aimed at manipulating the environment to increase physical activity need to be tested over periods of one year or longer. It is possible that lifestyle interventions could be integrated and delivered by new technologies such as interactive computer-mediated programs, telephone, or computer web-based formats. All of these recommended approaches should utilize valid and reliable measures of physical activity and should examine the health effects, particularly on a longitudinal basis. Basic dose-response studies in controlled settings also are needed to help us understand the health effects of accumulated moderate intensity activity.     

The effects of aerobic exercise on psychological and behavioral variables of individuals with developmental disabilities: a critical review

Physical fitness of persons who are developmentally disabled has received relatively little attention in the special education literature when compared to intellectual functioning (e.g., learning, memory, and language) and to acquisition of functional skills (e.g., self-care, community, and vocational). Despite an increased interest in recreational programming stimulated by the concept of functional curricula, teachers may still be reluctant to include physical fitness activities in their students' schedules. Perhaps physical fitness programming for those with developmental disabilities would have wider appeal and application if it were embedded in the broader context of psychological and behavioral change (i.e., engagement in exercise produces generalized changes beyond direct improvement in physical well-being). This article is a review and critique of literature that focuses on the effects of participation in aerobic exercise on three classes of psychological/behavioral variables for persons with mental retardation and associated disabilities. The methodology that characterizes this literature is analyzed, and recommendations for future research are proposed.     

Asian international students' intentions to seek counseling: Integrating cognitive and cultural predictors.

This study integrated several cognitive and cultural predictors of Asian international students' intentions to seek counseling. Data from 295 Asian international students were used to determine whether help-seeking intentions could be predicted by a combination of cognitive variables (i.e., counseling attitudes and stigma concerns) and cultural factors (i.e., acculturation, Asian values, and loss-of-face concerns). Data supported a partially mediated model, such that participants who endorsed more traditional Asian values reported less positive counseling attitudes and lower help-seeking intentions. Contrary to expectations, however, loss-of-face and stigma concerns were associated with stronger intentions to seek counseling, which may have been due to participants' fears of sharing psychological problems with significant others and preference for the confidential nature of the counseling relationship. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Can we identify who will adhere to long-term physical activity? Signal detection methodology as a potential aid to clinical decision making.

Signal detection methodology was used to identify the best combination of predictors of long-term exercise adherence in 269 healthy, initially sedentary adults ages 50-65 years. Less educated individuals who were assigned to supervised home-based exercise of either higher or lower intensity and who were less stressed and less fit at baseline than other individuals had the greatest probability of successful adherence by the 2nd year. Overweight individuals assigned to a group-based exercise program were the least likely to be successful 2 years later. Predictors of short-term (1-year) adherence were generally similar to predictors of 2-year adherence. Signal detection analysis may be useful for identifying subgroups of people at risk for underadherence who subsequently might be targeted for intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of a multicomponent maintenance program on long-term weight loss.

Following a standard regimen of behavioral weight loss treatment, 43 21–60 yr old moderately obese clients received either 6 booster sessions or 6 sessions of training in the use of a maintenance program consisting of self-help group meetings and client–therapist contacts by mail and telephone. Results of 15- and 21-mo follow-up assessments revealed that the multicomponent program significantly enhanced the maintenance of weight loss. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mail consultations in ophthalmology. The Tenth Richard E. Hoover Lecture

BACKGROUND: Although a number of diagnostic and therapeutic methods are available to assist the ophthalmologist, relatively little attention has been given to mail consultations. By this method, a clinical summary and photographs, fluorescein angiograms, ultrasonograms, and/or other relevant materials are mailed to a consultant who then renders an opinion by telephone and/or return mail. MATERIALS AND METHODS: The records of all mail consultations that were sent to the senior author and his colleagues during a 20 year period were reviewed to determine the total number of mail consultations, the reasons for the consultations, and the diagnoses and therapeutic recommendations that were made by the consultant. RESULTS: A total of 1357 mail consultations were received during the 20 year period, with a progressively increasing number of consultations each year. Consultations were received from 757 physicians representing all 50 states in the United States and 32 other countries. Because of the authors' subspecialty in ocular oncology and medical retinal diseases, the majority of the consultations received were related to those topics. In many cases, the initial diagnosis and treatment plan were altered based on our opinion through mail consultation. Based on the material received, the recommendations that we made included observation in 635 cases, enucleation in 152, surgical excision of a lesion in 120, plaque radiotherapy in 102, laser photocoagulation in 81, systemic evaluation in 40, external beam irradiation in 36, fine needle aspiration biopsy in 33, orbital exenteration in 25, chemotherapy in 21, and cryotherapy in 14. CONCLUSION: Although not as ideal as direct patient examination, mail consultation can be an effective method of making or confirming a diagnosis and obtaining a therapeutic opinion. Although the authors have received mail consultations related to ocular oncology, this method may be applicable to other subspecialties in ophthalmology and to general medicine.     

Biting force and physical fitness in athletes

The maximum biting force in 82 male athletes and 12 male subjects without any particular athletic activity (nonathletes) were measured in order to evaluate the relationship between biting force and physical fitness in athletes. The results obtained were as follows. 1. The maximum biting force in athletes (50.8 +/- 17.4kg) were significantly (p < 0.01) higher than that in the nonathletes (28.1 +/- 9.1kg). The maximum biting forces in the men who belonged to the rugby or judo clubs were predominantly higher than in other subjects. 2. In men who masticated on the left side of the mouth, the habitual (i. e., left) biting force was significantly higher than the nonhabitual (i. e., right) biting force. In men who masticated on the right side of the mouth, the habitual (i. e., right) biting force was also higher than the nonhabitual (i. e., left) biting force, but was not significantly so. 3. There was a significant positive correlation between the biting force and grip strength and back strength in athletes. In athletes, there was a significant correlation between biting force and the numbers of chin-ups, the numbers for the side-step tests and the time for 50m running.     

Using motivational interviewing as a supplement to obesity treatment: A stepped-care approach.

Objective: This investigation was designed to improve behavioral weight loss program (BWLP) treatment outcomes by providing stepped care (SC) to individuals experiencing difficulties with weight loss during treatment. SC entails transition to more intensive treatments when less intensive treatments fail to meet treatment goals. In a BWLP, motivational interviewing (MI) may increase participants' motivation toward behavioral change and thus complement the acquisition of behavioral change skills. It was hypothesized that BWLP + SC (MI) participants (i.e., participants who failed to meet weight loss goals and received MI) would demonstrate superior treatment outcomes when compared with BWLP (SC matched) participants (i.e., participants who failed to meet weight loss goals but did not receive MI). Design: Fifty-five obese, sedentary adults were randomly assigned to a BWLP + SC or a BWLP. Main outcome measures: Changes in weight, cardiorespiratory fitness, self-reported physical activity, and diet (i.e., calories, percentage daily intake of fat, protein, and carbohydrates) in response to treatment were assessed. Results: Participants significantly decreased their weight, increased physical activity/fitness, and improved dietary intake (ps     

Behavioral couples therapy for male substance-abusing patients: A cost outcomes analysis.

The cost outcomes for married or cohabiting substance-abusing male patients (N?=?80) who were randomly assigned to receive either behavioral couples therapy (BCT) or individual-based treatment (IBT) were compared. Social costs incurred by patients in several areas (e.g., cost of substance abuse treatment, support from public assistance) during the year before and the year after treatment were estimated. BCT was more cost-beneficial than IBT; although the monetary outlays for delivering IBT and BCT were not different, the average reduction in aggregate social costs from baseline to follow-up was greater for patients who received BCT (i.e., $6,628) than for patients who received IBT (i.e., $1,904). BCT was also more cost-effective than IBT; for each $100 spent on treatment, BCT produced greater improvements than IBT on several indicators of treatment outcome (e.g., fewer days of substance use, fewer legal problems). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Collagen-related markers of bone turnover reflect the severity of liver fibrosis in patients with primary biliary cirrhosis

In vitro studies have connected immune cell function to Peptide F. The primary purpose of this investigation was to examine the responses of plasma Peptide F and epinephrine along with the changes in B cell antibody production in vivo in physically fit and unfit women in response to physical exercise on a cycle ergometer at 60% and 80% of peak oxygen consumption. Seven aerobically fit and eight untrained (i.e., unfit) women between the ages of 18 and 30 volunteered to participate in this investigation. Blood samples (analyzed for plasma Peptide F and epinephrine along with the number of antibody-producing B cells) were obtained 24 hours prior to the exercise session, pre-exercise, during each exercise intensity, and five minutes post-exercise. The fit group had a significantly higher plasma Peptide F concentration after the 80% exercise intensity along with significantly higher numbers of antibody producing B cells compared to the unfit group. The results of this investigation show that physically fit women have an enhanced secondary response of B cells to a specific antigen under conditions where Peptide F is increased. Such data demonstrate that physical fitness as promoted by the Public Health Service (e.g., Healthy People 2000) influences the underlying hormonal and immune cell responses when challenged by physical exercise stress.     

Results of the Healthy Body Healthy Spirit Trial.

Healthy Body Healthy Spirit was a multicomponent intervention to increase fruit and vegetable (F & V) consumption and physical activity (PA) delivered through Black churches. Sixteen churches were randomly assigned to 3 intervention conditions. At baseline, 1,056 individuals were recruited across the 16 churches, of which 906 (86%) were assessed at 1-year follow-up. Group 1 received standard educational materials, Group 2 received culturally targeted self-help nutrition and PA materials, and Group 3 received the same intervention as did Group 2 as well as 4 telephone counseling calls based on motivational interviewing (MI) delivered over the course of 1 year. At 1-year follow-up, Groups 2 and 3 showed significant changes in both F & V intake and PA. Changes were somewhat larger for F & V. For F & V, but not PA, there was a clear additive effect for the MI intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of physical exercise on old rats: changes in patterns of spontaneous activity and connective tissues

It has been shown that life-long, regular physical exercise has benefits for humans as well as laboratory animals. Population studies have shown that the longevity of humans is increased due to the decrease in all-cause mortality. Further, the functional capacities of organ systems, especially the cardiovascular, are maintained better. Body fat content stays lower. Similar conclusions have been drawn from animal studies, most of them using voluntary exercise in running wheels. We have previously shown that spontaneous activity, measured in an open field setting, is better preserved, suggesting a slowing of sensorimotor impairment with age, and possibly improved maintenance of dopaminergic and cholinergic systems. Further, the systemic effect on connective tissues was a slowing of the age-dependent increase of stability by changes in the cross-linking patterns. The purpose of the present investigation was to analyze whether late-onset training programs had any such effects, i.e., whether the aging effects seen in sedentary animals could be reversed to some extent. We trained male Sprague-Dawley rats from the age of 18 and 20 months until the age of 22 months, i.e., for 4 and 2 months, in a treadmill for 800 m/day. Spontaneous activity in an open field was assessed at the ages of 18, 20, and 22 months. For systemic changes in connective tissues, tail tendons were analyzed with respect to thermal stability and biomechanical strength parameters. The rats trained for 4 months lost weight significantly, which suggests that most of the fat accumulated during a sedentary life can be removed by physical exercise. Two months of training, either from the age of 18 or 20 months, had a positive effect on spontaneous activity, while the last 2 months of a 4-month training period had a negative influence. We conclude that the exercise program was too strenuous to be maintained for 4 months, which should be interpreted as a failure to increase the functional capacity sufficiently. Analysis of the thermal stability and biomechanical properties showed that both training programs moved these properties in a "younger" direction. We conclude that training starting late in life also influences the aging rat in a positive way, although there are limitations to the intensity of training that is beneficial.