New York University Grossman School of Medicine.
New York University Grossman School of Medicine.
Behav Ther. 2023 Jul;54(4):610-622. doi: 10.1016/j.beth.2022.12.010. Epub 2023 Jan 5.
Most U.S. adults, even more so those with psychiatric conditions like obsessive-compulsive disorder (OCD), do not engage in the recommended amount of physical activity (PA), despite the wide array of physical and mental health benefits associated with exercise. Therefore, it is essential to identify mechanistic factors that drive long-term exercise engagement so they can be targeted. Using the science of behavior change (SOBC) framework, this study examined potential predictors of long-term exercise engagement as a first step towards identifying modifiable mechanisms, in individuals with OCD, such as PA enjoyment, positive or negative affect, and behavioral activation. Fifty-six low-active patients (mean age = 38.8 ± 13.0, 64% female) with a primary diagnosis of OCD were randomized to either aerobic exercise (AE; n = 28) or health education (HE; n = 28), and completed measures of exercise engagement, PA enjoyment, behavioral activation, and positive and negative affect at baseline, postintervention, and 3-, 6-, and 12-month follow-up. Significant predictors of long-term exercise engagement up to 6-months postintervention were baseline PA (Estimate = 0.29, 95%CI [0.09, 0.49], p = .005) and higher baseline PA enjoyment (Estimate = 1.09, 95%CI [0.30, 1.89], p = .008). Change in PA enjoyment from baseline to postintervention was greater in AE vs. HE, t(44) = -2.06, p = .046, d = -0.61, but endpoint PA enjoyment did not predict follow-up exercise engagement above and beyond baseline PA enjoyment. Other hypothesized potential mechanisms (baseline affect or behavioral activation) did not significantly predict exercise engagement. Results suggest that PA enjoyment may be an important modifiable target mechanism for intervention, even prior to a formal exercise intervention. Next steps aligned with the SOBC framework are discussed, including examining intervention strategies to target PA enjoyment, particularly among individuals with OCD or other psychiatric conditions, who may benefit most from long-term exercise engagement's effects on physical and mental health.
大多数美国成年人，尤其是那些患有强迫症 (OCD) 等精神疾病的成年人，并没有进行推荐的体育锻炼量，尽管锻炼与身心健康益处广泛相关。因此，确定推动长期锻炼参与的机制因素至关重要，以便针对这些因素进行干预。本研究使用行为改变科学 (SOBC) 框架，检查了长期锻炼参与的潜在预测因素，作为识别 OCD 患者中可改变机制的第一步，如 PA 享受、积极或消极情绪以及行为激活。56 名低活动水平的 OCD 患者（平均年龄 38.8±13.0，64%为女性）被随机分为有氧运动 (AE) 组（n=28）或健康教育 (HE) 组（n=28），并在基线、干预后以及 3、6 和 12 个月随访时完成锻炼参与度、PA 享受、行为激活以及积极和消极情绪的测量。至干预后 6 个月的长期锻炼参与的显著预测因素为基线 PA（估计值=0.29，95%CI [0.09, 0.49]，p=0.005）和较高的基线 PA 享受（估计值=1.09，95%CI [0.30, 1.89]，p=0.008）。AE 组从基线到干预后的 PA 享受变化大于 HE 组，t(44)=-2.06，p=0.046，d=-0.61，但终点 PA 享受并不能预测基线 PA 享受之外的后续锻炼参与。其他假设的潜在机制（基线情绪或行为激活）并未显著预测锻炼参与。结果表明，PA 享受可能是干预的一个重要的可改变的目标机制，甚至在正式的锻炼干预之前。接下来的步骤与 SOBC 框架一致，包括检查干预策略，以针对 PA 享受，特别是针对 OCD 或其他精神疾病患者，他们可能从长期锻炼对身心健康的影响中获益最多。
