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

Trial Summary

What is the purpose of this trial?

The goal of this behavioral clinical trial is to learn how to increase physical activity in mid-life adults. Specifically, can guided imagery that includes creating mental pictures increase excitement about working out. Participants will be asked to complete testing at the beginning of the study, following 6-weeks of an in-person exercise program, and 6-weeks after finishing the exercise program. Testing will include an exercise test, MRI, questionnaires, computer tasks, and a blood draw.

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 data supports the effectiveness of the treatment Episodic Future Thinking for exercise adherence?

Episodic Future Thinking (EFT) has been effective in helping people lose weight in real-world settings, suggesting it may also help with exercise adherence. Additionally, mental simulation, which includes EFT, has been shown to increase exercise intentions and actual engagement in exercise. ^{1 2 3 4 5}

Is guided imagery safe for humans?

The research on guided imagery, including episodic future thinking and mental simulation, does not report any safety concerns, suggesting it is generally safe for humans. ^{1 2 3 5 6}

How is the treatment Episodic Future Thinking different from other treatments for exercise adherence?

Episodic Future Thinking (EFT) is unique because it uses guided imagery to help people imagine future scenarios where they successfully engage in exercise, which can increase motivation and adherence to physical activity. Unlike traditional exercise programs, EFT focuses on mental simulation to enhance exercise intentions and behaviors by creating positive emotional connections to future exercise outcomes. ^{1 2 3 5 6}

Research Team

Laura Martin

Principal Investigator

University of Kansas Medical Center

Eligibility Criteria

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 had seizures or head injuries affecting brain scan quality.

Timeline

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)

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Content and Perceived Utility of Mental Imagery by Older Adults in a Peer-Delivered Physical Activity Intervention. [2022]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Mental Simulation to Promote Exercise Intentions and Behaviors. [2021]

3. England pubmed.ncbi.nlm.nih.gov

Mental imagery-based self-regulation: Effects on physical activity behaviour and its cognitive and affective precursors over time. [2023]

4. Switzerland pubmed.ncbi.nlm.nih.gov

A Pilot Goal-Oriented Episodic Future Thinking Weight Loss Intervention for Low-Income Overweight or Obese Young Mothers. [2023]

5. Canada pubmed.ncbi.nlm.nih.gov

Testing and Optimizing Guided Thinking Tasks to Promote Physical Activity: Protocol for a Randomized Factorial Trial. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Self-Regulatory Imagery and Physical Activity in Middle-Aged and Older Adults: A Social-Cognitive Perspective. [2019]