“Push it!” or “Hold it!”? A comparison of nicotine-avoidance training and nicotine-inhibition training in smokers motivated to quit

Rationale Recently, experimental paradigms have been developed to strengthen automatic avoidance or inhibitory responses for smoking cues. However, these procedures have not yet been directly compared regarding their effectiveness and mechanisms of action. Objective This study compared the effects of avoidance vs. inhibitory training as an add-on to a brief smoking cessation intervention. The standard Approach-Avoidance-Task (AAT) was adapted for both training types and control conditions. Methods One hundred twenty-four smokers attended behavioral counseling for smoking cessation and were thereafter randomized to one of four training conditions: avoidance-AAT, sham-avoidance-AAT, inhibition-AAT, sham-inhibition-AAT. During a 2-week training period including five training sessions, smokers in the avoidance-AAT trained to implicitly avoid all smoking-related cues, while smokers in the inhibition-AAT trained to implicitly inhibit behavioral response to smoking cues. During sham training, no such contingencies appeared. Self-report and behavioral data were assessed before and after training. Cigarette smoking and nicotine dependence were also assessed at 4- and 12-week follow-ups. Results At posttest, avoidance training was more effective in reducing daily smoking than inhibition training. However, this difference was no longer evident in follow-up assessments. All training conditions improved other smoking- and health-related outcomes. Neither training changed smoking-related approach biases or associations, but approach biases for smoking-unrelated pictures increased and Stroop interference decreased in all conditions. Smoking devaluation was also comparable in all groups. Conclusions Avoidance training might be slightly more effective in reducing smoking than inhibitory training. Overall, however, all four training types yielded equivalent therapy and training effects. Hence, a clear preference for one type of training remains premature.

The Effect of Incorporating an Exergame Application in a Multidisciplinary Weight Management Program on Physical Activity and Fitness Indices in Children with Overweight and Obesity

Children with overweight/obese (OW/OB) have low physical activity (PA) levels and excessive daily screen times. Although access to personal smartphones may complicate restricting sedentary screen time, these devices may be used to promote PA and improve fitness. Therefore, we aim to examine the impact of incorporating an exergame application (APP) into an existing weight management program on BMI, physical activity, fitness levels, and attitude toward PA among OW/OB children. Seventy-nine children (51% girls), median age 10 years, completed an established 5-month weight management program. The intervention included structured PA sessions (2/week), nutritional, and behavioral counseling. An exergame app was installed on the smartphones of the intervention group (APP, n = 32). BMI, physical fitness, PA level, and attitudes toward PA were assessed before and after the intervention. BMI decreased (p < 0.0001) in both groups by 0.67 kg/m2 (Q1, Q3: −1.36–0.12). There were improvements in more fitness components in the APP group than controls, with significantly greater improvements in aerobic fitness (p = 0.038), speed and agility (p = 0.01), and leg strength endurance (p = 0.05) compared to controls. PA levels increased similarly in both groups during the intervention period. The incorporation of an exergame application leads to more significant improvements in fitness components. These findings support the use of exergame apps to improve fitness in OW/OB children.

Group Behavioral Counseling Using Assertive Techniques to Reduce Procrastination in Junior High School Students

This study aimed to reduce procrastination in eighth grade students at Junior High School 7 Baubau through group behavioral counseling using assertive techniques. A one group pre-test/post-test design was used. Based on the descriptive analysis results, students’ procrastination before treatment was categorized as ‘high’ with an average score of 70.43%; after treatment, the average score was 31.92%, which was classified as ‘low’; this difference was significant (p = 0.012). From these results, it can be concluded that group behavioral counseling using assertive techniques can reduce academic procrastination in eighth grade students. It is hoped that these results can be used to help guidance and counseling teachers to carry out services to reduce procrastinaton in students. Keywords: academic procrastination, group counseling, behavioral, assertive

Feasibility of combining noninvasive brain stimulation and personalized counseling to increase physical activity

Few older adults meet recommended physical activity guidelines. Behavioral interventions may be more effective when combined with other modalities to promote activity. Transcranial direct current stimulation (tDCS) designed to increase the excitability of the left dorsolateral prefrontal cortex (dlPFC) — a brain region subserving motivation and executive function — has the potential to augment behavioral interventions. We designed a randomized, double-blinded trial to examine the feasibility of combining personalized behavioral counseling and tDCS targeting the left dlPFC to improve physical activity and related outcomes in sedentary older adults living within the supportive housing. Participants wore a Fit-Bit throughout the study period. Baseline step counts were determined for two weeks, then participants completed four bi-weekly personalized counseling sessions over eight weeks. They were also randomized to receive 10 sessions of tDCS or sham stimulation over the two weeks after the baseline. Physical, cognitive, and patient-reported outcomes were assessed at baseline, after ten brain stimulation sessions, and after four behavioral sessions. 33 individuals were screened and 16 enrolled (age=80±7, 13 females). 13 participants completed the study, including 100% of study assessments, 99±5% of brain stimulation sessions, and 98±7% of behavioral sessions. Fit-Bit adherence rate was 93±13%. Daily step counts were 3197±1480 at baseline and 4722±2553 over the last two weeks of the intervention. While the study is ongoing and blinded, these preliminary results indicate that it is feasible to conduct a controlled study of tDCS combined with personalized behavioral counseling to increase physical activity in sedentary older adults living within supportive housing.

Behavioral Counseling of Theory of Planned Behavior-Based to Increase Sufferers' Intention in Preventing Recurrent Ischemic Stroke: A Randomized Control Trial

Introduction: Ischemic stroke has become the leading cause of premature death in the last two decades. The biggest problem in preventing recurrence ischemic stroke is the compliance of the sufferers and the obedient behavior will arise only if they are consistent and have a strong intention. This study aims to determine the effect of behavioral counseling in increasing the intention to prevent recurrent ischemic stroke by using the theory of planned behavior model approach. Methods: Randomized Control Trial was conducted on 64 patients after an ischemic stroke that was managed by a public health center in East Java, Indonesia. Simple random sampling technique was used to take samples in this study. We provided behavioral counseling regarding the prevention of ischemic stroke recurrence to the treatment group using the Behavioral module which was compiled based on the guidelines from the Theory of Planned Behavior (TPB), while the intention variable was measured using the intention measurement instrument from the TPB Questionaries. The data obtained were then analyzed by using an independent t test. Results: The result revealed that there was a significant difference in the mean value of the intention variable between the control group and the treatment group after the TPB-based behavioral counseling intervention for 1 month (p=0.015). Discussion: The behavioral counseling of TPB-based can be implemented as an alternative way in increasing the sufferers’ intention to prevent recurrence ischemic stroke. Further research in a broader scope is needed to prove the effectiveness of behavioral counseling on the structural values of the Theory of Planned Behavior.

Health Behavior Change Programs in Primary Care and Community Practices for Cardiovascular Disease Prevention and Risk Factor Management Among Midlife and Older Adults: A Scientific Statement From the American Heart Association

Cardiovascular disease predominates as the leading health burden among middle-aged and older American adults, but progress in improving cardiovascular health remains slow. Comprehensive, evidenced-based behavioral counseling interventions in primary care are a recommended first-line approach for promoting healthy behaviors and preventing poor cardiovascular disease outcomes in adults with cardiovascular risk factors. Assisting patients to adopt and achieve their health promotion goals and arranging follow-up support are critical tenets of the 5A Model for behavior counseling in primary care. These 2 steps in behavior counseling are considered essential to effectively promote meaningful and lasting behavior change for primary cardiovascular disease prevention. However, adoption and implementation of behavioral counseling interventions in clinical settings can be challenging. The purpose of this scientific statement from the American Heart Association is to guide primary health care professional efforts to offer or refer patients for behavioral counseling, beyond what can be done during brief and infrequent office visits. This scientific statement presents evidence of effective behavioral intervention programs that are feasible for adoption in primary care settings for cardiovascular disease prevention and risk management in middle-aged and older adults. Furthermore, examples are provided of resources available to facilitate the widespread adoption and implementation of behavioral intervention programs in primary care or community-based settings and practical approaches to appropriately engage and refer patients to these programs. In addition, current national models that influence translation of evidence-based behavioral counseling in primary care and community settings are described. Finally, this scientific statement highlights opportunities to enhance the delivery of equitable and preventive care that prioritizes effective behavioral counseling of patients with varying levels of cardiovascular disease risk.

Listen to Me: Parents’ Satisfaction with Special Needs Services in Syria – A Descriptive and Exploratory Study

Parents’ involvement in their child’s educational and therapy choices is an important aspect of their therapy. This involvement may be related to their satisfaction with their child’s service providers’ direct child services family-related involvement. Additionally, civil unrest may influence parents’ satisfaction. For example, the Syrian civil war, which began in 2011, has influenced families with children in schools, and specifically children who have disabilities. The purpose of this descriptive and exploratory study was to investigate parents’ perceptions of current services provided in Syria for their children with disabilities, and to identify the services provided to Syrian children with ASD and other developmental disabilities. A total of 466 parents completed the study’s survey, with about half of the participants reporting that their child received early intervention and fewer that their child received other therapies (e.g., speech, behavioral, counseling). Parents also reported feeling unwelcome to contribute to their child’s individualized education program (IEP), and were not satisfied with the services their child received. In addition, some demographic factors, such as place of residence, the child’s current age, the child’s diagnosis, the child’s attending age at school, and which program the child was enrolled in, increased the parents’ satisfaction level. Implications and future research are discussed.

The Effectiveness of Behavioral Counseling with Modeling Techniques to Improve Student’s Self Autonomy and Self Endurance

This study aims to determine the effectiveness of the behavioral counseling model with modeling techniques to improve self-autonomy and self-endurance for senior high school students. This experimental study used a pretest-posttest nonequivalent control group design. Through random sampling, 34 students were placed in the experimental group and 32 students were placed in the control group. Data collection used the main data collection method (questionnaire) and complementary data collection methods (observations, interviews, and diaries). The data were analyzed by One-way MANOVA. The results show that there are differences in self-autonomy and self-endurance in the experimental class and control class ( sig = 0.039). The results of Cohen D analysis showed a high level of effectiveness (ES = 0.8). These results prove that behavioral counseling with modeling techniques is effective for improving student’s self-autonomy and self-endurance.