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Qualitative research building real-life interventions: user-involving development of a mindfulness-based lifestyle change support program for overweight citizens

Abstract

Background/objectives:

This study is an experiment of putting social sciences to work in developing a support intervention for healthy lifestyle changes that would be attractive and manageable in real-life settings. Starting with a hypothesis that a class of intervention methods based on an unconventional ‘low-tension’ strategy may offer an effective support of stable, long-term changes well integrated in everyday life, difficult to maintain with conventional dieting and self-control approaches, this study focuses on designing and optimizing an intervention model combining several low-tension methods: mindfulness, small steps and group support.

Subjects/Methods:

In three consecutive ‘action research’ cycles, the intervention was run in practice with groups of 20 overweight or obese citizens. Qualitative data, mainly in the form of recorded group sessions and individual interviews with group participants and group leaders, were systematically collected and analyzed, using a framework of social psychological theory to focus on difficulties, resources and meanings connected with habits and everyday life. This information was recycled into the design process for the next version of the intervention.

Results:

We describe the user-involving development processes toward a more attractive and manageable intervention model. The model now exists as a well-articulated package whose effectiveness is being tested in a randomized controlled trial study.

Conclusions:

Social science can be put to work in systematically integrating real-life experience in a development process. It answers a very different kind of question than clinical trials—filling another place in an overall research program to create useful knowledge of what helps—in complex, everyday, real life.

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References

  1. WHO Global health risks: mortality and burden of disease attributable to selected major risks [Internet]. World Health Organization, 2009. Available from: http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf.

  2. Morgen CS, Mortensen LH, Rasmussen M, Andersen A-MN, Sørensen TI, Due P . Parental socioeconomic position and development of overweight in adolescence: longitudinal study of Danish adolescents. BMC Public Health 2010; 10: 520.

    Article  Google Scholar 

  3. Jensen MD, Ryan DH, Hu FB, Stevens FJ, Hubbard VS, Stevens VJ et al. AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol 2013; e-pub ahead of print 7 November 2013; doi:10.1016/j.jacc.2013.

  4. Thomas SL, Hyde J, Karunaratne A, Kausman R, Komesaroff PA . ‘They all work when you stick to them’: a qualitative investigation of dieting, weight loss, and physical exercise, in obese individuals. Nutr J 2008; 7: 34.

    Article  Google Scholar 

  5. Elfhag K, Rössner S . Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obes Rev 2005; 6: 67–85.

    Article  CAS  Google Scholar 

  6. Pietiläinen KH, Saarni SE, Kaprio J, Rissanen A . Does dieting make you fat? A twin study. Int J Obes 2012; 36: 456–464.

    Article  Google Scholar 

  7. Bacon L, Stern JS, Van Loan MD, Keim NL . Size acceptance and intuitive eating improve health for obese, female chronic dieters. J Am Diet Assoc 2005; 105: 929–936.

    Article  Google Scholar 

  8. Shai I, Stampfer MJ . Weight-loss diets—can you keep it off? Am J Clin Nutr 2008; 88: 1185–1186.

    CAS  PubMed  Google Scholar 

  9. Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ . Comparison of the atkins, ornish, weight watchers, and zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA 2005; 293: 43–53.

    Article  CAS  Google Scholar 

  10. Sabaté E, Adherence to long-term therapies: evidence for action [Internet]. World Health Organization, 2003. Available from http://www.who.int/chp/knowledge/publications/adherence_introduction.pdf.

  11. Harrington M, Gibson S, Cottrell RC . A review and meta-analysis of the effect of weight loss on all-cause mortality risk. Nutr Res Rev 2009; 22: 93–108.

    Article  Google Scholar 

  12. Simonsen MK, Hundrup YA, Obel EB, Grønbaek M, Heitmann BL . Intentional weight loss and mortality among initially healthy men and women. Nutr Rev 2008; 66: 375–386.

    Article  Google Scholar 

  13. Bacon L, Stern JS, Van Loan MD, Keim NL . Size acceptance and intuitive eating improve health for obese, female chronic dieters. J Am Diet Assoc 2005; 105: 929–936.

    Article  Google Scholar 

  14. Lewin K Selected Papers on Group Dynamics. Harper & Row: New York, NY, USA, 1948, pp 5–41.

    Google Scholar 

  15. Bowen S, Marlatt A . Surfing the urge: brief mindfulness-based intervention for college student smokers. Psychol Addict Behav 2009; 23: 666.

    Article  Google Scholar 

  16. Lillis J, Hayes SC, Bunting K, Masuda A . Teaching acceptance and mindfulness to improve the lives of the obese: a preliminary test of a theoretical model. Ann Behav Med 2009; 37: 58–69.

    Article  Google Scholar 

  17. Kabat-Zinn J Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. Dell New York, NY, USA, 1990.

    Google Scholar 

  18. Sbrocco T, Nedegaard RC, Stone JM, Lewis EL . Behavioral choice treatment promotes continuing weight loss: preliminary results of a cognitive-behavioral decision-based treatment for obesity. J Consult Clin Psychol 1999; 67: 260–266.

    Article  CAS  Google Scholar 

  19. Lutes LD, Daiss SR, Barger SD, Read M, Steinbaugh E, Winett RA . Small changes approach promotes initial and continued weight loss with a phone-based follow-up: nine-month outcomes from ASPIRES II. Am J Health Promot 2012; 26: 235–238.

    Article  Google Scholar 

  20. Bandura A . Social cognitive theory: an agentic perspective. Annu Rev Psychol 2001; 52: 1–26.

    Article  CAS  Google Scholar 

  21. Elzen H, Slaets JP, Snijders TA, Steverink N . Evaluation of the chronic disease self-management program (CDSMP) among chronically ill older people in the Netherlands. Soc Sci Med 2007; 64: 1832–1841.

    Article  Google Scholar 

  22. Fjorback LO, Arendt M, Ornbøl E, Fink P, Walach H 2011. Mindfulness-based stress reduction and mindfulness-based cognitive therapy: a systematic review of randomized controlled trials. Acta Psychiatr Scand 2011; 124: 102–119.

    Article  CAS  Google Scholar 

  23. Fjorback LO, Walach H . Meditation based therapies—a systematic review and some critical observations. Religions 2012; 3: 1–18.

    Article  Google Scholar 

  24. Zgierska A, Rabago D, Chawla N, Kushner K, Koehler R, Marlatt A et al. Mindfulness meditation for substance use disorders: a systematic review. Subst Abus 2009; 30: 266–294.

    Article  Google Scholar 

  25. Kristeller JL, Hallett B . An exploratory study of a meditation-based intervention for binge eating disorder. J Health Psychol 1999; 4: 357–363.

    Article  CAS  Google Scholar 

  26. Kristeller J, Wolever RQ . Mindfulness-based eating awareness training for treating binge eating disorder: the conceptual foundation. Eat Disord 2011; 19: 49–61.

    Article  Google Scholar 

  27. Tapper K, Shaw C, Ilsley J, Hill AJ, Bond FW, Moore L . Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. Appetite 2009; 52: 396–404.

    Article  Google Scholar 

  28. Lewin K . Action research and minority problems. J Soc Issues 1946; 2: 34–46.

    Article  Google Scholar 

  29. Whitehead J, McNiff J . Action Research Living Theory. Sage: London, UK, 2006.

    Book  Google Scholar 

  30. Holzkamp K . Alltägliche Lebensführung als subjektwissenschaftliches Grundkonzept. Das Argument 1995; 37: 817–856.

    Google Scholar 

  31. Dreier O . Personal locations and perspectives—psychological aspects of social practice. In: Mortensen A (ed). Psychological Yearbook, (vol. 1), Copenhagen, 1994, pp 63–90.

  32. Dreier O . Personality and the conduct of everyday life. Nord Psychol 2011; 63: 4–23.

    Article  Google Scholar 

  33. Payne P, Crane-Godreau MA, Meditative movement for depression and anxiety. front psychiatry. Front Psychiatry 2013; 4: 71.

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by the Danish Ministry of Research through a ‘UNIK’ network grant (‘Food, Fitness, Pharma’) and by the IMK Foundation.

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Correspondence to N V Hansen.

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Hansen, N., Brændgaard, P., Hjørnholm, C. et al. Qualitative research building real-life interventions: user-involving development of a mindfulness-based lifestyle change support program for overweight citizens. Eur J Clin Nutr 68, 1129–1133 (2014). https://doi.org/10.1038/ejcn.2014.106

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