Movement-Oriented Behavioral Activation (MOBA)
Condition: Sedentary Behavior
Study type: Interventional

Summary: 
      The purpose of this research study is to determine the acceptability, feasibility, and
      effectiveness of behavioral activation to increase everyday movement and reduce the amount of
      time spent daily in positions of prolonged standing and sitting. This intervention is call
      Movement-Oriented Behavioral Activation (MOBA). Participants will undergo a 60-minute
      screening that includes health and lifestyle questionnaires, mobility testing and a
      six-minute walk. Participants will complete the same procedures after completing MOBA. Each
      participant will be randomly assigned to an intervention group or a wait-list group. Both
      groups will participate in the same 12-week MOBA group protocol, but the intervention group
      participates first. During MOBA sessions, participants will set movement goals to reduce
      total time spent sitting and standing, and learn exercises and strategies to get more
      physical activity throughout the day and evening. At the end of the 12-week group, all
      participants, including those on the wait-list will be asked to complete the same
      questionnaires, mobility testing, and 6-minute walk as the beginning of the study. Total
      study duration for the intervention group is about 4 months. Total study duration for
      wait-list group will be about 8 months, which about half of that time spent in the waiting
      period.

      Separate from the intervention there will be a focus group with prospective participants (N =
      4-8) to collect information about physical activity perspectives and experiences to better
      align delivery of the intervention to the target cohort (participation in the focus group
      does not obligate participation in the intervention). A focus group will be conducted post
      intervention also. Participants enrolled in the intervention can participate in the focus
      groups.
    

Detailed description: 
      Overview. The study uses randomized waitlist-control design. We propose to randomly assign
      half of participants to (a) 10 weeks of MOBA intervention, and half of participants to (b) a
      10-week waitlist, followed by 10 weeks of MOBA.

      Intervention. MOBA is adapted from established protocols to integrate traditional behavioral
      activation (BA) principles with strategies to incorporate values-based, goal-directed
      movement into daily routines. The BA content of MOBA is adapted from co-investigator Dr.
      Smoski's intervention Behavioral Activation Therapy for Anhedonia (BATA). MOBA reduces
      depression-related content relative to BATA and increases focus on values that engage
      individuals in movement-related activity. MOBA is designed as a group intervention to
      leverage the reward value of social contact, and the positive influence of group
      problem-solving and accountability on behavior change. MOBA preserves the principles and
      general sequence of sessions used in BATA, but incorporates movement-oriented content: (a)
      provide psychoeducation about risks of physical inactivity, behavioral barriers to activity,
      and rationale for the treatment approach; (b) explore personal values, non-stationary,
      movement-oriented activities that support those values, and a hierarchical plan for goal
      attainment; (c) identify and assign weekly activities related to the valued goals; (d)
      address common barriers to engagement with valued activities including avoidance, low
      behavioral initiation, and an overemphasis on felt motivation as a prerequisite for action;
      and (e) monitor, support, and reward achieving behavioral goals. Content unique to MOBA
      includes: 1) demonstration and participation in physical activities that provide alternatives
      to stationary behavior, including select activities used in a previous study with the Dining
      Services cohort (e.g., stairs, body-weight squats, knee raises), and 2) generation of
      person-centered strategies for integrating movement-oriented activities into daily routines
      across the three domains of the Behavior Settings Model: 1) workplace sitting/prolonged
      standing, 2) screen-focused home activities, 3) time spent sitting in automobiles. Weeks 1-4
      address topics a-c; weeks 5-12 address topics d-e. MOBA will be facilitated by a clinician
      (Dr. Potter) and a wellness educator (Dr. Tittle), who will be trained on the MOBA treatment
      manual. The facilitators' role is to provide teaching, support, encouragement, and guidance
      throughout the intervention. Weekly sessions will take place in a dedicated conference room
      near the workplace, during the last hour of the workday (4-5 pm), and is counted as paid time
      at work.
    

Intervention name(s): Mobility-Oriented Behavioral Activation
Intervention type(s): Behavioral
Intervention description(s): 12-weeks of mobility-oriented behavioral activation group
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Wait-list control
Masking: None (Open Label)
Primary purpose: Treatment