Browsing by Author "von Ranson, Kristin M"

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    Behavioral weight-loss treatment plus motivational interviewing versus attention control: lessons learned from a randomized controlled trial
    (2017-07-25) Moss, Erin L; Tobin, Leah N; Campbell, Tavis S; von Ranson, Kristin M
    Abstract Background Studies evaluating the benefit of adding motivational interviewing (MI) to behavioral weight-loss programs (BWLPs) have yielded mixed findings. Methods The aims of this randomized controlled trial were to: (1) assess the efficacy of adding MI to a BWLP on weight loss and adherence among 135 individuals with overweight and obesity (77.8% female; mean BMI = 33.6 kg/m2) enrolled in a 12-week BWLP and (2) explore levels of importance, confidence, and readiness for change ratings. Results Participants, who were randomized to receive two MI sessions or two attention control sessions, were assessed at baseline, the end of the BWLP, and 6 months post BWLP. Both groups decreased their weight from baseline to the end of the BWLP; however, there was no weight change in either group when measured between baseline and 6 months post BWLP. We observed no group differences in importance, confidence, and readiness for change after each session. Conclusions We highlight some important lessons learned from the present trial that can be applied to MI + BWLP research. Participants may not have benefited from MI because they were already highly motivated to change, which highlights the importance of pretreatment assessment. Findings also suggest that treatment monitoring may help to enhance MI + BWLP efficacy by guiding a stepped-care approach that identifies individuals for whom additional MI sessions are needed, and when. A focus on refining elements of treatment remains an important direction. Trial registration ClinicalTrials.gov, Identifier: NCT02649634 . Retrospectively registered on 5 January 2016.
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    Design and Evaluation of a Brief Motivational Intervention to Promote Enrolment in Outpatient Cardiac Rehabilitation: A Mixed-Methods Feasibility Study
    (2017) Rouleau, Codie R; Campbell, Tavis S.; King-Shier, Kathryn M; Tomfohr-Madsen, Lianne; von Ranson, Kristin M; Russell-Mayhew, Michelle K; Oh, Paul I
    Objective: Patients who are referred to exercise-based cardiac rehabilitation (CR) following an acute coronary syndrome (ACS) event stand to benefit from a range of positive CR-related outcomes, including reduced morbidity and mortality. Yet, only 19-34% of eligible patients participate in CR in the United States and Canada. Motivational interviewing could be useful for encouraging CR enrolment, but empirical support does not exist. Research that examines patients’ decision-making about CR enrolment is needed to inform effective motivational intervention in this context. Methods: A two-part study was conducted to design and evaluate a brief motivational intervention to enhance intention to attend a 12-week CR program. Part 1 involved a qualitative examination of decision-making about CR enrolment using semi-structured interviews with ACS patients following CR referral but prior to enrolment (n = 14). A brief motivational intervention was subsequently designed to target obstacles to CR identified by patients in Part 1. Part 2 involved a two-group randomized controlled trial to examine preliminary efficacy and mechanisms of the intervention, using a usual care control group (n = 96). The primary outcome was intention to attend CR. Secondary outcomes included CR beliefs, CR barriers, self-efficacy, illness perception, social support, CR enrolment/adherence, and intervention acceptability. Results: Thematic analysis of qualitative data in Part 1 suggested the intervention should aim to bolster anticipated benefits of CR; assist patients in overcoming concerns about exercise, transportation, finances, and scheduling; and address contextual variables such as emotional distress and knowledge gaps. Randomization to the motivational intervention was associated with greater intention to attend CR (p = .001), greater perceived necessity of CR (p = .036), lower exercise concerns (p = .011), and higher CR adherence (p = .008), compared to usual care. Conclusions: Results provide preliminary evidence for the efficacy of a brief motivational intervention to enhance intention to attend CR. Implementing strategies that enhance the perceived necessity of CR and reduce exercise concerns may help improve adherence to CR following an ACS event. This body of work will help optimize efforts to promote participation in an under-utilized, cost-effective program that significantly improves ACS outcomes.
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    Fitspiration and thinspiration: a comparison across three social networking sites
    (2018-11-26) Alberga, Angela S; Withnell, Samantha J; von Ranson, Kristin M
    Abstract Background Fitspiration, or images and text promoting health and fitness, and thinspiration, or images and text promoting thinness, have both received criticism for their negative effects on body image and dieting behaviors. In this study, we critically examined and compared the content of fitspiration and thinspiration on three social networking sites (SNS). Methods Fitspiration and thinspiration posts (N = 360) from three photo-sharing SNS (Instagram, Tumblr, and Twitter) were collected quasi-randomly on four days over two weeks. Image and associated text content were coded for variables related to weight and shape, muscularity, thin ideal, and eating. Chi-square and Fisher’s exact tests compared content of fitspiration and thinspiration posts overall and among the three SNS. Results Thinspiration images portrayed body parts more frequently than fitspiration (69.8% vs. 30.2%). Similarly, posts highlighting bony body features and references to mental illness appeared only in thinspiration. No differences were found between fitspiration and thinspiration posts with regard to sexual suggestiveness, appearance comparison, and messages encouraging restrictive eating. Fitspiration and thinspiration posts included similar images across the three SNS—focusing on appearance, sexually suggestive images, and restrictive eating—with three exceptions. Fitspiration posts exhibiting body positivity were found only on Tumblr. In thinspiration posts, references to mental illness were more frequent on Tumblr and Instagram than on Twitter, and bone emphasis was coded more frequently on Twitter than on Instagram. Conclusions Although fitspiration posts were less extreme than thinspiration posts on the whole, notable similarities in their content support that fitspiration endorses problematic attitudes towards fitness, body image, and restrictive eating in pursuit of a fit-and-thin body ideal.