Development and Evaluation of ACT on Health: An Online Health Promotion Program

This project will develop and test an online health promotion program that augments diet and physical activity behavior change methods using acceptance and commitment therapy (ACT). ACT is an evidence-based cognitive behavioral therapy found to be effective in over 200 randomized controlled trials (RCTs) in improving a wide range of psychological and behavioral health problems. Recently, several clinical trials have found ACT enhances diet and exercise behavior as well as long term weight management. These studies have focused on testing ACT provided by experts in face-to-face interventions, which limits broad dissemination. Delivering an ACT health promotion program online could potentially provide a low-cost resource to improve health across Utah. The specific aims are to:

1. Develop a canvas-based online course (ACT on Health) that teaches how to improve diet and physical activity as well as ACT-based skills to enhance behavior change efforts.
2. Evaluate ACT on Health relative to a waitlist in a RCT with 60 overweight/obese adults on outcomes including self-reported physical activity, diet, and quality of life.

If successful, this project will both provide an ongoing canvas extension course delivered throughout Utah to improve health behaviors.

Background and Significance Obesity and its contributing behaviors (i.e., physical inactivity, poor diet) are significant public health issues. Obesity is associated with a range of serious medical conditions, decreased life expectancy, and impaired quality of life. Physical inactivity contributes to premature mortality and cardiovascular disease above and beyond its impact on obesity. In contrast, healthy diet and exercise decreases risk for a wide range of medical conditions and premature mortality. Epidemiological research indicates 69% of US adults are obese or overweight. Furthermore, only 23% of adults meet recommended guidelines for physical activity, and only 24% of adults eat five or more serving of fruits and vegetables per day. The prevalence of obesity and poor health behaviors, despite their negative consequences, highlight how difficult it is to make sustained changes to health behaviors.

Motivation is a key factor for improving and maintaining healthy diet and physical activity. There is a substantial literature on the importance of intrinsic motivation for health behavior change, in which individuals are personally motivated for positive reasons inherent to them or the activity (e.g., enjoyment, values). For example, intrinsic motivation predicts healthier exercise and diet and improvements in intrinsic motivation mediate obesity intervention effects.