Guided Imagery for Exercise Adherence

(GETActiveHIT Trial)

Overseen By Morgan Brucks

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Kansas Medical Center

Must be taking: Statins

Disqualifiers: Arrhythmias, Acute cardiac events, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 15

Duration: 6 weeks

160 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if guided imagery can boost enthusiasm for exercise in mid-life adults who exercise infrequently. Participants will use mental pictures to make exercise more enjoyable during a 6-week program. The study will compare different types of imagery, including Episodic Future Thinking (a mental strategy involving envisioning future events), to identify which method best motivates individuals to maintain their workout routines. Ideal participants speak English, can exercise independently, and are open to trying MRI scans and blood draws. As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could enhance exercise motivation strategies.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, it mentions that participants must have stable blood pressure and statin medication doses for 30 days before joining, which suggests you may need to continue these medications.

What prior data suggests that this guided imagery technique is safe for increasing exercise adherence?

Research shows that thinking about future events, known as episodic future thinking (EFT), is generally safe. Previous studies have demonstrated that EFT helps people adopt healthier habits, like exercising regularly, without major safety concerns or serious side effects.

In this trial, researchers use guided imagery, which involves creating mental pictures to boost motivation. This technique has been safely used in many situations and serves as a mental exercise, not a physical or medical treatment.

Based on this information, the methods in the current trial are expected to be safe for participants. Participants will engage in mental exercises designed to encourage physical activity without physical risks. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Guided Imagery for Exercise Adherence trial because it explores how different types of mental imagery can boost exercise commitment. Unlike standard methods that focus on physical exercises alone, this trial adds a mental component by using guided imagery. One unique feature is the use of "Episodic Future Thinking" (EFT), which encourages participants to imagine future scenarios to stay motivated. Additionally, the trial compares EFT with "Episodic Recent Thinking" (ERT) and pairs these with positive or neutral affective imagery to see which combination best enhances exercise adherence. This innovative approach could reveal how mental imagery influences motivation, potentially offering new strategies for sticking to exercise routines.

What evidence suggests that this trial's treatments could be effective for increasing physical activity in mid-life adults?

Research has shown that thinking about future events, known as episodic future thinking (EFT), can help people maintain healthy habits, such as regular exercise. Studies have found that EFT, which involves picturing specific future scenarios, helps individuals avoid choosing smaller, immediate rewards over larger, future ones, leading to better exercise decisions. In this trial, some participants will receive EFT combined with Positive Affective Imagery (PAI) or Neutral Affective Imagery (NAI) during exercise sessions. Others will receive Episodic Recent Thinking (ERT) combined with PAI or NAI. Imagining positive and happy thoughts can also make exercise more enjoyable. When combined with EFT, it may further increase motivation. These findings suggest that guided imagery techniques could help people feel excited about working out and adhere to their exercise routines. ^{1 6 7 8 9}

Who Is on the Research Team?

Laura Martin

Principal Investigator

University of Kansas Medical Center

Are You a Good Fit for This Trial?

This trial is for mid-life adults who speak English, can use a phone, have normal vision and hearing (with aids if needed), can walk without help, are not very active physically, and can safely do some exercise. They must be able to understand the study and agree to participate.

Inclusion Criteria

Be physically underactive

Have access to reliable communication (a telephone or cell phone, computer, etc.)

Be able to give informed consent

Exclusion Criteria

At risk for hazard due to magnetic fields due to MR safety concerns

I do not have heart rhythm problems or recent heart issues.

I have depression or anxiety but no other mental health conditions.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants complete baseline testing including exercise test, MRI, questionnaires, computer tasks, and a blood draw

1 week

1 visit (in-person)

Treatment

Participants undergo a 6-week in-person exercise program with guided imagery during exercise sessions

6 weeks

12 visits (in-person)

Post-Treatment Assessment

Participants complete testing including exercise test, MRI, questionnaires, and computer tasks immediately following the exercise program

1 week

1 visit (in-person)

Follow-up

Participants are monitored for changes in physical activity and complete final assessments 6 weeks after the exercise program

6 weeks

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Episodic Future Thinking

Trial Overview The study tests if imagining future events or positive images makes people more excited about exercising. It includes high-intensity interval training (HIIT) workouts over six weeks with mental exercises like thinking about the future or happy thoughts.

How Is the Trial Designed?

Group I: Episodic Recent Thinking (ERT) + Positive Affective Imagery (PAI) Experimental Treatment 3 Interventions

Assigned guided imagery will be delivered during each exercise session throughout the 6-week exercise program. The guided imagery recordings will be delivered via audio recording during warm-up and cool-down periods during in-lab exercise sessions. The ERT will always be delivered during warm-up and the PAI will always be delivered during cool-down.

Group II: Episodic Future Thinking (EFT) + Positive Affective Imagery (PAI) Experimental Treatment 3 Interventions

Assigned guided imagery will be delivered during each exercise session throughout the 6-week exercise program. The guided imagery recordings will be delivered via audio recording during warm-up and cool-down periods during in-lab exercise sessions. The EFT will always be delivered during warm-up and the PAI will always be delivered during cool-down.

Group III: Episodic Future Thinking (EFT) + Neutral Affective Imagery (NAI) Experimental Treatment 3 Interventions

Assigned guided imagery will be delivered during each exercise session throughout the 6-week exercise program. The guided imagery recordings will be delivered via audio recording during warm-up and cool-down periods during in-lab exercise sessions. The EFT will always be delivered during warm-up and the NAI will always be delivered during cool-down.

Group IV: Episodic Recent Thinking (ERT) + Neutral Affective Imagery (NAI) Active Control 3 Interventions

Assigned guided imagery will be delivered during each exercise session throughout the 6-week exercise program. The guided imagery recordings will be delivered via audio recording during warm-up and cool-down periods during in-lab exercise sessions. The ERT will always be delivered during warm-up and the NAI will always be delivered during cool-down.

Who Is Running the Clinical Trial?

University of Kansas Medical Center

Lead Sponsor

Trials

527

Recruited

181,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Published Research Related to This Trial

A mental imagery-based self-regulation intervention significantly increased physical activity by an average of 19.5 minutes per week over 90 days compared to a control group focused on sleep hygiene, with the most notable increase of 54.8 minutes in participants who received risk information in a risk ladder format.

Goal planning was identified as a key factor that positively influenced physical activity behavior, suggesting that setting specific goals can enhance the effectiveness of such interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mental imagery-based self-regulation: Effects on physical activity behaviour and its cognitive and affective precursors over time. Ackermann, N., Cameron, LD., Maki, J., et al.[2023]

Mental simulation techniques can effectively increase both the intention to exercise and actual engagement in physical activity, as confirmed by multiple studies.

Video-primed mental simulation was found to be the most effective method for promoting exercise intentions, especially when combining process-based and outcome-based simulations to balance emotional responses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mental Simulation to Promote Exercise Intentions and Behaviors. Zhong, W., Zhang, G.[2021]

The Active Adult Mentoring Program (AAMP) involved 24 older adults (average age 65) and utilized mental imagery to encourage exercise behavior, revealing that 13 participants found the imagery helpful for motivation.

Despite some positive experiences, 9 participants expressed negative impressions about the imagery, indicating that while mental imagery can be beneficial for some, it may not be effective for everyone.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Content and Perceived Utility of Mental Imagery by Older Adults in a Peer-Delivered Physical Activity Intervention. Giacobbi, PR., Buman, MP., Dzierzewski, J., et al.[2022]

In a study of 299 middle-aged and older adults, self-regulatory imagery was found to positively influence self-efficacy and self-regulatory behaviors related to physical activity, suggesting it can enhance motivation to exercise.

The research indicates that using self-regulatory imagery can help overcome perceived barriers to exercise and increase enjoyment, ultimately leading to higher levels of physical activity among older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-Regulatory Imagery and Physical Activity in Middle-Aged and Older Adults: A Social-Cognitive Perspective. Kosteli, MC., Cumming, J., Williams, SE.[2019]

The pilot goal-oriented episodic future thinking (GoEFT) intervention was well-accepted by low-income overweight or obese mothers, with participants appreciating the structured approach to setting and evaluating goals.

The intervention demonstrated significant efficacy in promoting weight loss, increasing fruit and vegetable intake, and improving emotional control, along with reducing fat and sugar intake and alleviating stress, indicating its potential as an effective weight management strategy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Pilot Goal-Oriented Episodic Future Thinking Weight Loss Intervention for Low-Income Overweight or Obese Young Mothers. Chang, MW., Tan, A., Wegener, DT., et al.[2023]

The GeT Active study aims to develop a scalable audio-based intervention to promote physical activity by using guided thinking tasks, including episodic future thinking, positive affective imagery, and planning, with 192 participants over a 6-week period.

This study employs a full factorial randomized trial design to evaluate the effectiveness of different combinations and doses of these guided thinking components, which could lead to more efficient physical activity interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Testing and Optimizing Guided Thinking Tasks to Promote Physical Activity: Protocol for a Randomized Factorial Trial. Baldwin, AS., Lamb, CL., Geary, BA., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8344362/

Episodic future thinking, delay discounting, and exercise ... This study is the first to test whether EFT improves DD within the context of weight loss maintenance.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10993675/

Perceptions and effectiveness of episodic future thinking as ... Prior research has shown that EFT is effective at reducing DD and in promoting healthy behaviors in the context of reducing the risk of T2DM, overeating, ...

3. trialx.com trialx.com/clinical-trials/listings/285285/guided-episodic-future-thinking-to-increase-physical-activity-adherence-and-promote-healthy-brain-aging/?&geo_lat=39.0405608&geo_lng=-94.6169013&radius=10&place=Westwood&user_country=United%20States

Guided Episodic Future Thinking to Increase Physical ... The proposed project will target regulation and reward systems using guided imagery to increase exercise adherence by increasing positive affect ...

4. researchprotocols.org researchprotocols.org/2022/9/e40908/

Testing and Optimizing Guided Thinking Tasks to Promote ... We will evaluate effects of the components on physical activity over 6 weeks in a 2 (EFT vs recent thinking) × 2 (PAI vs neutral imagery) × 2 ( ...

5. frontiersin.org frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.742989/full

Mindfulness-Informed Guided Imagery to Target Physical ... The episodic future thinking condition (audio length: 3 min 26 s) targets non-evaluative future thinking and visualization of physical activity ...

6. centerwatch.com centerwatch.com/clinical-trials/listings/NCT06123182/guided-episodic-future-thinking-to-increase-physical-activity-adherence-and-promote-healthy-brain-aging

Guided Episodic Future Thinking to Increase Physical ... Study Description. The proposed project will target regulation and reward systems using guided imagery to increase exercise adherence by ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8719519/

Mindfulness-Informed Guided Imagery to Target Physical ... This 2-phase study includes an initial development process to create brief (∼4 min) mindfulness informed guided imagery audio files that target distinct ...

8. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0272735822000472

Characteristics of episodic future thinking in anxiety This article reports a systematic review and meta-analysis of research examining associations between anxiety and these EFT characteristics.

9. frontiersin.org frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.1020171/full

Methodological considerations in the use of episodic future ... Episodic future thinking (EFT) has emerged as a promising behavioral intervention to reduce delay discounting or maladaptive health behaviors.