Skip to main content
Top
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Study protocol

The effectiveness and applicability of different lifestyle interventions for enhancing wellbeing: the study design for a randomized controlled trial for persons with metabolic syndrome risk factors and psychological distress

Authors: Raimo Lappalainen, Essi Sairanen, Elina Järvelä, Sanni Rantala, Riitta Korpela, Sampsa Puttonen, Urho M Kujala, Tero Myllymäki, Katri Peuhkuri, Elina Mattila, Kirsikka Kaipainen, Aino Ahtinen, Leila Karhunen, Jussi Pihlajamäki, Heli Järnefelt, Jaana Laitinen, Eija Kutinlahti, Osmo Saarelma, Miikka Ermes, Marjukka Kolehmainen

Published in: BMC Public Health | Issue 1/2014

Login to get access

Abstract

Background

Obesity and stress are among the most common lifestyle-related health problems. Most of the current disease prevention and management models are not satisfactorily cost-effective and hardly reach those who need them the most. Therefore, novel evidence-based controlled interventions are necessary to evaluate models for prevention and treatment based on self-management. This randomized controlled trial examines the effectiveness, applicability, and acceptability of different lifestyle interventions with individuals having symptoms of metabolic syndrome and psychological distress. The offered interventions are based on cognitive behavioral approaches, and are designed for enhancing general well-being and supporting personalized lifestyle changes.

Methods/Design

339 obese individuals reporting stress symptoms were recruited and randomized to either (1) a minimal contact web-guided Cognitive Behavioral Therapy-based (CBT) intervention including an approach of health assessment and coaching methods, (2) a mobile-guided intervention comprising of mindfulness, acceptance and value-based exercises, (3) a face-to-face group intervention using mindfulness, acceptance and value-based approach, or (4) a control group. The participants were measured three times during the study (pre = week 0, post = week 10, and follow-up = week 36). Psychological well-being, lifestyles and habits, eating behaviors, and user experiences were measured using online surveys. Laboratory measurements for physical well-being and general health were performed including e.g. liver function, thyroid glands, kidney function, blood lipids and glucose levels and body composition analysis. In addition, a 3-day ambulatory heart rate and 7-day movement data were collected for analyzing stress, recovery, physical activity, and sleep patterns. Food intake data were collected with a 48 -hour diet recall interview via telephone. Differences in the effects of the interventions would be examined using multiple-group modeling techniques, and effect-size calculations.

Discussion

This study will provide additional knowledge about the effects of three low intensity interventions for improving general well-being among individuals with obesity and stress symptoms. The study will show effects of two technology guided self-help interventions as well as effect of an acceptance and value–based brief group intervention. Those who might benefit from the aforesaid interventions will increase knowledge base to better understand what mechanisms facilitate effects of the interventions.

Trial registration

Current Clinical Trials NCT01738256, Registered 17 August, 2012.
Appendix
Available only for authorised users
Literature
1.
go back to reference Eckel RH, Grundy SM, Zimmet PZ: The metabolic syndrome. Lancet. 2005, 365 (9468): 1415-1428. 10.1016/S0140-6736(05)66378-7.CrossRefPubMed Eckel RH, Grundy SM, Zimmet PZ: The metabolic syndrome. Lancet. 2005, 365 (9468): 1415-1428. 10.1016/S0140-6736(05)66378-7.CrossRefPubMed
2.
go back to reference Galassi A, Reynolds K, He J: Metabolic syndrome and risk of cardiovascular disease: A meta-analysis. Am J Med. 2006, 119 (10): 812-819. 10.1016/j.amjmed.2006.02.031.CrossRefPubMed Galassi A, Reynolds K, He J: Metabolic syndrome and risk of cardiovascular disease: A meta-analysis. Am J Med. 2006, 119 (10): 812-819. 10.1016/j.amjmed.2006.02.031.CrossRefPubMed
3.
go back to reference Lindström J, Peltonen M, Eriksson J, Ilanne-Parikka P, Aunola S, Keinänen-Kiukaanniemi S, Uusitupa M, Tuomilehto J: Improved lifestyle and decreased diabetes risk over 13 years: Long-term follow-up of the randomised finnish diabetes prevention study (DPS). Diabetologia. 2013, 56 (2): 284-293. 10.1007/s00125-012-2752-5.CrossRefPubMed Lindström J, Peltonen M, Eriksson J, Ilanne-Parikka P, Aunola S, Keinänen-Kiukaanniemi S, Uusitupa M, Tuomilehto J: Improved lifestyle and decreased diabetes risk over 13 years: Long-term follow-up of the randomised finnish diabetes prevention study (DPS). Diabetologia. 2013, 56 (2): 284-293. 10.1007/s00125-012-2752-5.CrossRefPubMed
4.
go back to reference Gillies CL, Lambert PC, Abrams KR, Sutton AJ, Cooper NJ, Hsu RT, Davies MJ, Khunti K: Different strategies for screening and prevention of type 2 diabetes in adults: Cost effectiveness analysis. Br Med J. 2008, 336 (7654): 1180-1185. 10.1136/bmj.39545.585289.25.CrossRef Gillies CL, Lambert PC, Abrams KR, Sutton AJ, Cooper NJ, Hsu RT, Davies MJ, Khunti K: Different strategies for screening and prevention of type 2 diabetes in adults: Cost effectiveness analysis. Br Med J. 2008, 336 (7654): 1180-1185. 10.1136/bmj.39545.585289.25.CrossRef
5.
go back to reference Kouvonen A, Kivimaki M, Cox SJ, Cox T, Vahtera J: Relationship between work stress and body mass index among 45,810 female and male employees. Psychosom Med. 2005, 67 (4): 577-583. 10.1097/01.psy.0000170330.08704.62.CrossRefPubMed Kouvonen A, Kivimaki M, Cox SJ, Cox T, Vahtera J: Relationship between work stress and body mass index among 45,810 female and male employees. Psychosom Med. 2005, 67 (4): 577-583. 10.1097/01.psy.0000170330.08704.62.CrossRefPubMed
6.
go back to reference Iversen LB, Strandberg-Larsen K, Prescott E, Schnohr P, Rod NH: Psychosocial risk factors, weight changes and risk of obesity: The copenhagen city heart study. Eur J Epidemiol. 2012, 27 (2): 119-130. 10.1007/s10654-012-9659-9.CrossRefPubMed Iversen LB, Strandberg-Larsen K, Prescott E, Schnohr P, Rod NH: Psychosocial risk factors, weight changes and risk of obesity: The copenhagen city heart study. Eur J Epidemiol. 2012, 27 (2): 119-130. 10.1007/s10654-012-9659-9.CrossRefPubMed
7.
go back to reference Kottwitz MU, Grebner S, Semmer NK, Tschan F, Elfering A: Social stress at work and change in women's body weight. Ind Health. 2014 Kottwitz MU, Grebner S, Semmer NK, Tschan F, Elfering A: Social stress at work and change in women's body weight. Ind Health. 2014
8.
go back to reference Milczarek M, Schneider E, Rial González E: OSH in figures: Stress at work – facts and figures. European Risk Observatory Report. 2009, Luxembourg: Office for Official Publications of the European Communities: European Agency for Safety and Health at Work, 9- Milczarek M, Schneider E, Rial González E: OSH in figures: Stress at work – facts and figures. European Risk Observatory Report. 2009, Luxembourg: Office for Official Publications of the European Communities: European Agency for Safety and Health at Work, 9-
9.
go back to reference Kypri K, Saunders JB, Williams SM, McGee RO, Langley JD, Cashell Smith ML, Gallagher SJ: Web based screening and brief intervention for hazardous drinking: A double blind randomized controlled trial. Addiction. 2004, 99 (11): 1410-7. 10.1111/j.1360-0443.2004.00847.x.CrossRefPubMed Kypri K, Saunders JB, Williams SM, McGee RO, Langley JD, Cashell Smith ML, Gallagher SJ: Web based screening and brief intervention for hazardous drinking: A double blind randomized controlled trial. Addiction. 2004, 99 (11): 1410-7. 10.1111/j.1360-0443.2004.00847.x.CrossRefPubMed
10.
go back to reference Hurling R, Catt M, Boni MD, Fairley BW, Hurst T, Murray P, Richardson A, Sodhi JS: Using internet and mobile phone technology to deliver an automated physical activity program: Randomized controlled trial. J Med Intern Res. 2007, 9 (2): e7- Hurling R, Catt M, Boni MD, Fairley BW, Hurst T, Murray P, Richardson A, Sodhi JS: Using internet and mobile phone technology to deliver an automated physical activity program: Randomized controlled trial. J Med Intern Res. 2007, 9 (2): e7-
11.
go back to reference Shahab L, McEwen A: Online support for smoking cessation: A systematic review of the literature. Addiction. 2009, 104 (11): 1792-804. 10.1111/j.1360-0443.2009.02710.x.CrossRefPubMed Shahab L, McEwen A: Online support for smoking cessation: A systematic review of the literature. Addiction. 2009, 104 (11): 1792-804. 10.1111/j.1360-0443.2009.02710.x.CrossRefPubMed
12.
go back to reference Arem H, Irwin M: A review of web-based weight loss interventions in adults. Obes Rev. 2011, 12 (5): e236-43. 10.1111/j.1467-789X.2010.00787.x.CrossRefPubMed Arem H, Irwin M: A review of web-based weight loss interventions in adults. Obes Rev. 2011, 12 (5): e236-43. 10.1111/j.1467-789X.2010.00787.x.CrossRefPubMed
13.
go back to reference Webb TL, Joseph J, Yardley L, Michie S: Using the internet to promote health behavior change: A systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. 2010, 12 (1): 97-114.CrossRef Webb TL, Joseph J, Yardley L, Michie S: Using the internet to promote health behavior change: A systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. 2010, 12 (1): 97-114.CrossRef
14.
go back to reference Spring B, Schneider K, McFadden HG, Vaughn J, Kozak AT, Smith M, Moller AC, Epstein LH, DeMott A, Hedeker D: Multiple behavior changes in diet and activity: A randomized controlled trial using mobile technology. Arch Intern Med. 2012, 172 (10): 789-96.CrossRefPubMedPubMedCentral Spring B, Schneider K, McFadden HG, Vaughn J, Kozak AT, Smith M, Moller AC, Epstein LH, DeMott A, Hedeker D: Multiple behavior changes in diet and activity: A randomized controlled trial using mobile technology. Arch Intern Med. 2012, 172 (10): 789-96.CrossRefPubMedPubMedCentral
15.
go back to reference Cuijpers P, van Straten A, Andersson G: Internet-administered cognitive behavior therapy for health problems: A systematic review. J Behav Med. 2008, 31 (2): 169-77. 10.1007/s10865-007-9144-1.CrossRefPubMed Cuijpers P, van Straten A, Andersson G: Internet-administered cognitive behavior therapy for health problems: A systematic review. J Behav Med. 2008, 31 (2): 169-77. 10.1007/s10865-007-9144-1.CrossRefPubMed
16.
go back to reference Bennett GG, Glasgow RE: The delivery of public health interventions via the internet: Actualizing their potential. Annu Rev Public Health. 2009, 30: 273-92. 10.1146/annurev.publhealth.031308.100235.CrossRefPubMed Bennett GG, Glasgow RE: The delivery of public health interventions via the internet: Actualizing their potential. Annu Rev Public Health. 2009, 30: 273-92. 10.1146/annurev.publhealth.031308.100235.CrossRefPubMed
17.
go back to reference Bennett-Levy J, Richards D, Farrand P, Christensen H, Griffiths K: Oxford Guide to Low Intensity CBT Interventions. 2010, New York, NY: Oxford University PressCrossRef Bennett-Levy J, Richards D, Farrand P, Christensen H, Griffiths K: Oxford Guide to Low Intensity CBT Interventions. 2010, New York, NY: Oxford University PressCrossRef
18.
go back to reference Kashdan TB, Rottenberg J: Psychological flexibility as a fundamental aspect of health. Clin Psychol Rev. 2010, 30 (7): 865-78. 10.1016/j.cpr.2010.03.001.CrossRefPubMedPubMedCentral Kashdan TB, Rottenberg J: Psychological flexibility as a fundamental aspect of health. Clin Psychol Rev. 2010, 30 (7): 865-78. 10.1016/j.cpr.2010.03.001.CrossRefPubMedPubMedCentral
19.
go back to reference Cavanagh K, Strauss C, Forder L, Jones F: Can mindfulness and acceptance be learnt by self-help?: A systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions. Clin Psychol Rev. 2014, 34 (2): 118-129. 10.1016/j.cpr.2014.01.001.CrossRefPubMed Cavanagh K, Strauss C, Forder L, Jones F: Can mindfulness and acceptance be learnt by self-help?: A systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions. Clin Psychol Rev. 2014, 34 (2): 118-129. 10.1016/j.cpr.2014.01.001.CrossRefPubMed
20.
go back to reference Nevanperä N, Lappalainen R, Kuosma E, Hopsu L, Uitti J, Laitinen J: Psychological flexibility, occupational burnout and eating behavior among working women. Open J Prev Med. 2013, 3 (4): 355-361. 10.4236/ojpm.2013.34048.CrossRef Nevanperä N, Lappalainen R, Kuosma E, Hopsu L, Uitti J, Laitinen J: Psychological flexibility, occupational burnout and eating behavior among working women. Open J Prev Med. 2013, 3 (4): 355-361. 10.4236/ojpm.2013.34048.CrossRef
21.
go back to reference Hayes SC, Strosahl KD, Wilson KG: Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. 2011, New York, NY: Guilford Press Hayes SC, Strosahl KD, Wilson KG: Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. 2011, New York, NY: Guilford Press
22.
go back to reference Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL: Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial. J Consult Clin Psychol. 2007, 75 (2): 336-43.CrossRefPubMed Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL: Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial. J Consult Clin Psychol. 2007, 75 (2): 336-43.CrossRefPubMed
23.
go back to reference Nes AAG, Eide H, Kristjánsdóttir ÓB, van Dulmen S: Web-based, self-management enhancing interventions with e-diaries and personalized feedback for persons with chronic illness: A tale of three studies. Patient Educ Couns. 2013, 93 (3): 451-8. 10.1016/j.pec.2013.01.022.CrossRefPubMed Nes AAG, Eide H, Kristjánsdóttir ÓB, van Dulmen S: Web-based, self-management enhancing interventions with e-diaries and personalized feedback for persons with chronic illness: A tale of three studies. Patient Educ Couns. 2013, 93 (3): 451-8. 10.1016/j.pec.2013.01.022.CrossRefPubMed
24.
go back to reference Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J: Acceptance and commitment therapy: Model, processes and outcomes. Behav Res Ther. 2006, 44 (1): 1-25. 10.1016/j.brat.2005.06.006.CrossRefPubMed Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J: Acceptance and commitment therapy: Model, processes and outcomes. Behav Res Ther. 2006, 44 (1): 1-25. 10.1016/j.brat.2005.06.006.CrossRefPubMed
25.
go back to reference Ruiz FJ: Acceptance and commitment therapy versus traditional cognitive behavioral therapy: A systematic review and meta-analysis of current empirical evidence. Int J Psychol Psychol Ther. 2012, 12 (3): 333-357. Ruiz FJ: Acceptance and commitment therapy versus traditional cognitive behavioral therapy: A systematic review and meta-analysis of current empirical evidence. Int J Psychol Psychol Ther. 2012, 12 (3): 333-357.
26.
go back to reference Hesser H, Gustafsson T, Lundén C, Henrikson O, Fattahi K, Johnsson E, Bendelin N, Furmark T, Anderson G: A randomized controlled trial of internet-delivered cognitive behavior therapy and acceptance and commitment therapy in the treatment of tinnitus. J Consult Clin Psychol. 2012, 80 (4): 649-CrossRefPubMed Hesser H, Gustafsson T, Lundén C, Henrikson O, Fattahi K, Johnsson E, Bendelin N, Furmark T, Anderson G: A randomized controlled trial of internet-delivered cognitive behavior therapy and acceptance and commitment therapy in the treatment of tinnitus. J Consult Clin Psychol. 2012, 80 (4): 649-CrossRefPubMed
27.
go back to reference Buhrman M, Skoglund A, Husell J, Bergström K, Gordh T, Hursti T, Bendelin N, Furmark T, Anderson G: Guided internet-delivered acceptance and commitment therapy for chronic pain patients: A randomized controlled trial. Behav Res Ther. 2013, 51 (6): 307-15. 10.1016/j.brat.2013.02.010.CrossRefPubMed Buhrman M, Skoglund A, Husell J, Bergström K, Gordh T, Hursti T, Bendelin N, Furmark T, Anderson G: Guided internet-delivered acceptance and commitment therapy for chronic pain patients: A randomized controlled trial. Behav Res Ther. 2013, 51 (6): 307-15. 10.1016/j.brat.2013.02.010.CrossRefPubMed
28.
go back to reference Lappalainen P, Kaipainen K, Lappalainen R, Hoffren H, Myllymaki T, Kinnunen M, Mattila E, Happonen AP, Rusko H, Korhonen I: Feasibility of a personal health technology-based psychological intervention for men with stress and mood problems: Randomized controlled pilot trial. J Med Intern Res. 2013, 2 (1): e1- Lappalainen P, Kaipainen K, Lappalainen R, Hoffren H, Myllymaki T, Kinnunen M, Mattila E, Happonen AP, Rusko H, Korhonen I: Feasibility of a personal health technology-based psychological intervention for men with stress and mood problems: Randomized controlled pilot trial. J Med Intern Res. 2013, 2 (1): e1-
29.
go back to reference Ahtinen A, Mattila E, Välkkynen P, Kaipainen K, Vanhala T, Ermes M, Sairanen E, Myllymäki T, Lappalainen R: Mobile mental wellness training for stress management: Feasibility and design implications based on a one-month field study. J Med Internet Res. 2013, 1 (2): Ahtinen A, Mattila E, Välkkynen P, Kaipainen K, Vanhala T, Ermes M, Sairanen E, Myllymäki T, Lappalainen R: Mobile mental wellness training for stress management: Feasibility and design implications based on a one-month field study. J Med Internet Res. 2013, 1 (2):
30.
go back to reference Ly KH, Dahl J, Carlbring P, Andersson G: Development and initial evaluation of a smartphone application based on acceptance and commitment therapy. SpringerPlus. 2012, 1: 11-10.1186/2193-1801-1-11.CrossRefPubMedPubMedCentral Ly KH, Dahl J, Carlbring P, Andersson G: Development and initial evaluation of a smartphone application based on acceptance and commitment therapy. SpringerPlus. 2012, 1: 11-10.1186/2193-1801-1-11.CrossRefPubMedPubMedCentral
31.
go back to reference Free C, Phillips G, Galli L, Watson L, Felix L, Edwards P, Patel V, Haines A: The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: A systematic review. PLoS Med. 2013, 10 (1): n/a-e1001362-10.1371/journal.pmed.1001362.CrossRef Free C, Phillips G, Galli L, Watson L, Felix L, Edwards P, Patel V, Haines A: The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: A systematic review. PLoS Med. 2013, 10 (1): n/a-e1001362-10.1371/journal.pmed.1001362.CrossRef
32.
go back to reference Makowska Z, Merecz D, Moscicka A, Kolasa W: The validity of general health questionnaires, GHQ-12 and GHQ-28, in mental health studies of working people. Int J Occup Med Environ Health. 2002, 15 (4): 353-62.PubMed Makowska Z, Merecz D, Moscicka A, Kolasa W: The validity of general health questionnaires, GHQ-12 and GHQ-28, in mental health studies of working people. Int J Occup Med Environ Health. 2002, 15 (4): 353-62.PubMed
33.
go back to reference Peltonen M, Saarikoski L, Lund L, Salminen I, Laatikainen T, Jousilahti P, Männistö S, Vartiainen E: Kansallinen FINRISKI 2007-terveystutkimus: Tutkimuksen toteutus ja tulokset: Menetelmät. 2008, Helsinki, Finland: National Public Health Institute, Finland. B36/2008 Peltonen M, Saarikoski L, Lund L, Salminen I, Laatikainen T, Jousilahti P, Männistö S, Vartiainen E: Kansallinen FINRISKI 2007-terveystutkimus: Tutkimuksen toteutus ja tulokset: Menetelmät. 2008, Helsinki, Finland: National Public Health Institute, Finland. B36/2008
34.
go back to reference Laliberte M, McCabe RE, Taylor V: The Cognitive Behavioral Workbook for Weight Management: A Step-By-Step Program. 2009, Oakland, CA: New Harbinger Publications Laliberte M, McCabe RE, Taylor V: The Cognitive Behavioral Workbook for Weight Management: A Step-By-Step Program. 2009, Oakland, CA: New Harbinger Publications
35.
go back to reference Edinger JD, Carney CE: Overcoming Insomnia: A Cognitive-Behavioral Therapy Approach Therapist Guide: A Cognitive-Behavioral Therapy Approach Therapist Guide. 2008, New York, NY: Oxford University Press Edinger JD, Carney CE: Overcoming Insomnia: A Cognitive-Behavioral Therapy Approach Therapist Guide: A Cognitive-Behavioral Therapy Approach Therapist Guide. 2008, New York, NY: Oxford University Press
36.
go back to reference Epstein EE, McCrady BS: A Cognitive-Behavioral Treatment Program for Overcoming Alcohol Problems: Therapist Guide. 2009, New York, NY, US: Oxford University Press, New York, NYCrossRef Epstein EE, McCrady BS: A Cognitive-Behavioral Treatment Program for Overcoming Alcohol Problems: Therapist Guide. 2009, New York, NY, US: Oxford University Press, New York, NYCrossRef
37.
go back to reference Perkins KA, Conklin CA, Levine MD: Cognitive-Behavioral Therapy for Smoking Cessation: A Practical Guidebook to the Most Effective Treatments. 2008, New York, NY: CRC Press Perkins KA, Conklin CA, Levine MD: Cognitive-Behavioral Therapy for Smoking Cessation: A Practical Guidebook to the Most Effective Treatments. 2008, New York, NY: CRC Press
38.
go back to reference Emmons RA, McCulough ME: Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. J Pers Soc Psychol. 2003, 84 (2): 377-389.CrossRefPubMed Emmons RA, McCulough ME: Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. J Pers Soc Psychol. 2003, 84 (2): 377-389.CrossRefPubMed
39.
go back to reference King LA: The health benefits of writing about life goals. Person Soc Psychol Bull. 2001, 27 (7): 798-807. 10.1177/0146167201277003.CrossRef King LA: The health benefits of writing about life goals. Person Soc Psychol Bull. 2001, 27 (7): 798-807. 10.1177/0146167201277003.CrossRef
40.
go back to reference Seligman MEP: Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment. 2002, New York, NY, US: Free Press, New York, NY Seligman MEP: Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment. 2002, New York, NY, US: Free Press, New York, NY
41.
go back to reference Seligman MEP, Steen TA, Park N, Peterson C: Positive psychology progress: Empirical validation of interventions. Am Psychol. 2005, 60 (5): 410-21.CrossRefPubMed Seligman MEP, Steen TA, Park N, Peterson C: Positive psychology progress: Empirical validation of interventions. Am Psychol. 2005, 60 (5): 410-21.CrossRefPubMed
42.
go back to reference Joutsenniemi K, Langinvainio H, Mattila A, Saarelma O, Pankakoski M, Lönnqvist J, Mustonen P: Happiness, health and work. 2012, In press Joutsenniemi K, Langinvainio H, Mattila A, Saarelma O, Pankakoski M, Lönnqvist J, Mustonen P: Happiness, health and work. 2012, In press
43.
go back to reference Cohen S, Kamarck T, Mermelstein R: A global measure of perceived stress. J Health Soc Behav. 1983, 24 (4): 385-96. 10.2307/2136404.CrossRefPubMed Cohen S, Kamarck T, Mermelstein R: A global measure of perceived stress. J Health Soc Behav. 1983, 24 (4): 385-96. 10.2307/2136404.CrossRefPubMed
44.
go back to reference Beck AT, Steer RA, Ball R, Ranieri WF: Comparison of beck depression inventories-IA and-II in psychiatric outpatients. J Pers Assess. 1996, 67 (3): 588-97. 10.1207/s15327752jpa6703_13.CrossRefPubMed Beck AT, Steer RA, Ball R, Ranieri WF: Comparison of beck depression inventories-IA and-II in psychiatric outpatients. J Pers Assess. 1996, 67 (3): 588-97. 10.1207/s15327752jpa6703_13.CrossRefPubMed
45.
go back to reference Antonovsky A: Unraveling the Mystery of Health: How People Manage Stress and Stay Well. 1987, San Francisco, CA: Jossey-Bass Antonovsky A: Unraveling the Mystery of Health: How People Manage Stress and Stay Well. 1987, San Francisco, CA: Jossey-Bass
46.
go back to reference Antonovsky A: The structure and properties of the sense of coherence scale. Soc Sci Med. 1993, 36 (6): 725-733. 10.1016/0277-9536(93)90033-Z.CrossRefPubMed Antonovsky A: The structure and properties of the sense of coherence scale. Soc Sci Med. 1993, 36 (6): 725-733. 10.1016/0277-9536(93)90033-Z.CrossRefPubMed
47.
go back to reference Aalto A, Aro AR, Teperi J: RAND-36 terveyteen liittyvän elämänlaadun mittarina: Mittarin luotettavuus ja suomalaiset väestöarvot. 1999, Helsinki: Stakes Aalto A, Aro AR, Teperi J: RAND-36 terveyteen liittyvän elämänlaadun mittarina: Mittarin luotettavuus ja suomalaiset väestöarvot. 1999, Helsinki: Stakes
48.
go back to reference Hays RD, Sherbourne CD, Mazel RM: The rand 36‒item health survey 1.0. Health Econ. 1993, 2 (3): 217-27. 10.1002/hec.4730020305.CrossRefPubMed Hays RD, Sherbourne CD, Mazel RM: The rand 36‒item health survey 1.0. Health Econ. 1993, 2 (3): 217-27. 10.1002/hec.4730020305.CrossRefPubMed
49.
go back to reference Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, Waltz T, Zettle RD: Preliminary psychometric properties of the acceptance and action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behav Ther. 2011, 42 (4): 676-88. 10.1016/j.beth.2011.03.007.CrossRefPubMed Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, Waltz T, Zettle RD: Preliminary psychometric properties of the acceptance and action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behav Ther. 2011, 42 (4): 676-88. 10.1016/j.beth.2011.03.007.CrossRefPubMed
50.
go back to reference Lillis J, Hayes SC: Measuring avoidance and inflexibility in weight related problems. Int J Behav Consult Ther. 2007, 4 (1): 30-40.CrossRef Lillis J, Hayes SC: Measuring avoidance and inflexibility in weight related problems. Int J Behav Consult Ther. 2007, 4 (1): 30-40.CrossRef
51.
go back to reference Gifford EV, Kohlenberg BS, Hayes SC, Antonuccio DO, Piasecki MM, Rasmussen-Hall ML, Palm KM: Acceptance-based treatment for smoking cessation. Behav Ther. 2004, 35 (4): 689-705. 10.1016/S0005-7894(04)80015-7.CrossRef Gifford EV, Kohlenberg BS, Hayes SC, Antonuccio DO, Piasecki MM, Rasmussen-Hall ML, Palm KM: Acceptance-based treatment for smoking cessation. Behav Ther. 2004, 35 (4): 689-705. 10.1016/S0005-7894(04)80015-7.CrossRef
52.
go back to reference Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L: Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006, 13 (1): 27-45. 10.1177/1073191105283504.CrossRefPubMed Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L: Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006, 13 (1): 27-45. 10.1177/1073191105283504.CrossRefPubMed
53.
go back to reference Kujala UM, Kaprio J, Sarna S, Koskenvuo M: Relationship of leisure-time physical activity and mortality: The finnish twin cohort. JAMA. 1998, 279 (6): 440-4. 10.1001/jama.279.6.440.CrossRefPubMed Kujala UM, Kaprio J, Sarna S, Koskenvuo M: Relationship of leisure-time physical activity and mortality: The finnish twin cohort. JAMA. 1998, 279 (6): 440-4. 10.1001/jama.279.6.440.CrossRefPubMed
54.
go back to reference Waller K, Kaprio J, Kujala U: Associations between long-term physical activity, waist circumference and weight gain: A 30-year longitudinal twin study. Int J Obes. 2008, 32 (2): 353-61. 10.1038/sj.ijo.0803692.CrossRef Waller K, Kaprio J, Kujala U: Associations between long-term physical activity, waist circumference and weight gain: A 30-year longitudinal twin study. Int J Obes. 2008, 32 (2): 353-61. 10.1038/sj.ijo.0803692.CrossRef
55.
go back to reference Buysse DJ, Ancoli-lsrael S, Edinger JD, Lichstein KL, Morin CM: Recommendations for a standard research assessment of insomnia. J Sleep Sleep Disord Res. 2006, 29 (9): 1155-73. Buysse DJ, Ancoli-lsrael S, Edinger JD, Lichstein KL, Morin CM: Recommendations for a standard research assessment of insomnia. J Sleep Sleep Disord Res. 2006, 29 (9): 1155-73.
56.
go back to reference Partinen M, Gislason T: Basic nordic sleep questionnaire (BNSQ): A quantitated measure of subjective sleep complaints. J Sleep Res. 1995, 4 (s1): 150-5.CrossRefPubMed Partinen M, Gislason T: Basic nordic sleep questionnaire (BNSQ): A quantitated measure of subjective sleep complaints. J Sleep Res. 1995, 4 (s1): 150-5.CrossRefPubMed
57.
go back to reference Johns MW: A new method for measuring daytime sleepiness: The epworth sleepiness scale. J Sleep Sleep Disord Res. 1991, 14 (6): 540-5. Johns MW: A new method for measuring daytime sleepiness: The epworth sleepiness scale. J Sleep Sleep Disord Res. 1991, 14 (6): 540-5.
58.
go back to reference Paturi M: Ruokien annoskuvakirja. 2006, Helsinki: National Public Health Institute Paturi M: Ruokien annoskuvakirja. 2006, Helsinki: National Public Health Institute
59.
go back to reference Leppälä J, Lagström H, Kaljonen A, Laitinen K: Construction and evaluation of a self-contained index for assessment of diet quality. Scand J Public Health. 2010, 38 (8): 794-802. 10.1177/1403494810382476.CrossRefPubMed Leppälä J, Lagström H, Kaljonen A, Laitinen K: Construction and evaluation of a self-contained index for assessment of diet quality. Scand J Public Health. 2010, 38 (8): 794-802. 10.1177/1403494810382476.CrossRefPubMed
60.
go back to reference Tylka TL, Wilcox JA: Are intuitive eating and eating disorder symptomatology opposite poles of the same construct?. J Couns Psychol. 2006, 53 (4): 474-CrossRef Tylka TL, Wilcox JA: Are intuitive eating and eating disorder symptomatology opposite poles of the same construct?. J Couns Psychol. 2006, 53 (4): 474-CrossRef
61.
go back to reference Karlsson J, Persson L, Sjöström L, Sullivan M: Psychometric properties and factor structure of the three-factor eating questionnaire (TFEQ) in obese men and women. results from the swedish obese subjects (SOS) study. Int J Obes Relat Metab Disord. 2000, 24 (12): 1715-1725. 10.1038/sj.ijo.0801442.CrossRefPubMed Karlsson J, Persson L, Sjöström L, Sullivan M: Psychometric properties and factor structure of the three-factor eating questionnaire (TFEQ) in obese men and women. results from the swedish obese subjects (SOS) study. Int J Obes Relat Metab Disord. 2000, 24 (12): 1715-1725. 10.1038/sj.ijo.0801442.CrossRefPubMed
62.
go back to reference Krall JS, Lohse B: Cognitive testing with female nutrition and education assistance program participants informs validity of the satter eating competence inventory. J Nutr Educ Behav. 2010, 42 (4): 277-83. 10.1016/j.jneb.2009.08.003.CrossRefPubMed Krall JS, Lohse B: Cognitive testing with female nutrition and education assistance program participants informs validity of the satter eating competence inventory. J Nutr Educ Behav. 2010, 42 (4): 277-83. 10.1016/j.jneb.2009.08.003.CrossRefPubMed
63.
go back to reference Krall JS, Lohse B: Validation of a measure of the satter eating competence model with low-income females. Int J Behav Nutr Phys Act. 2011, 8 (1): 26-10.1186/1479-5868-8-26.CrossRefPubMedPubMedCentral Krall JS, Lohse B: Validation of a measure of the satter eating competence model with low-income females. Int J Behav Nutr Phys Act. 2011, 8 (1): 26-10.1186/1479-5868-8-26.CrossRefPubMedPubMedCentral
64.
go back to reference Satter E: Eating competence: Definition and evidence for the satter eating competence model. J Nutr Educ Behav. 2007, 39 (5): S142-53. 10.1016/j.jneb.2007.01.006.CrossRefPubMed Satter E: Eating competence: Definition and evidence for the satter eating competence model. J Nutr Educ Behav. 2007, 39 (5): S142-53. 10.1016/j.jneb.2007.01.006.CrossRefPubMed
65.
go back to reference Roininen K, Lähteenmäki L, Tuorila H: Quantification of consumer attitudes to health and hedonic characteristics of foods. Appetite. 1999, 33 (1): 71-88. 10.1006/appe.1999.0232.CrossRefPubMed Roininen K, Lähteenmäki L, Tuorila H: Quantification of consumer attitudes to health and hedonic characteristics of foods. Appetite. 1999, 33 (1): 71-88. 10.1006/appe.1999.0232.CrossRefPubMed
66.
go back to reference Tuomi K, Oja G: Work Ability Index. 1998, Helsinki: Finnish Institute of Occupational Health Helsinki Tuomi K, Oja G: Work Ability Index. 1998, Helsinki: Finnish Institute of Occupational Health Helsinki
67.
go back to reference Camm A, Malik M, Bigger J, Breithardt G, Cerutti S, Cohen R, Coumel P, Fallen EL, Kennedy HL, Kleiger RE: Heart rate variability: Standards of measurement, physiological interpretation and clinical use. task force of the european society of cardiology and the north american society of pacing and electrophysiology. Circulation. 1996, 93 (5): 1043-65. 10.1161/01.CIR.93.5.1043.CrossRef Camm A, Malik M, Bigger J, Breithardt G, Cerutti S, Cohen R, Coumel P, Fallen EL, Kennedy HL, Kleiger RE: Heart rate variability: Standards of measurement, physiological interpretation and clinical use. task force of the european society of cardiology and the north american society of pacing and electrophysiology. Circulation. 1996, 93 (5): 1043-65. 10.1161/01.CIR.93.5.1043.CrossRef
68.
go back to reference Lamminmäki E, Saarinen A, Lötjönen J, Partinen M, Korhonen I: Differences in light sleep and deep sleep measured with IST vivago® WristCare. EMBEC Proc. 2005, 11 (1): Lamminmäki E, Saarinen A, Lötjönen J, Partinen M, Korhonen I: Differences in light sleep and deep sleep measured with IST vivago® WristCare. EMBEC Proc. 2005, 11 (1):
69.
go back to reference Lotjonen J, Korhonen I, Hirvonen K, Eskelinen S, Myllymaki M, Partinen M: Automatic sleep-wake and nap analysis with a new wrist worn online activity monitoring device vivago WristCare®. Sleep-New York Then Westchester. 2003, 26 (1): 86-90. Lotjonen J, Korhonen I, Hirvonen K, Eskelinen S, Myllymaki M, Partinen M: Automatic sleep-wake and nap analysis with a new wrist worn online activity monitoring device vivago WristCare®. Sleep-New York Then Westchester. 2003, 26 (1): 86-90.
70.
go back to reference Muthén LK, Muthén BO: Mplus User’s Guide. Statistical analysis with latent variables. 1998, Los Angeles, CA: Muthén & Muthén, 1998-2012. Muthén LK, Muthén BO: Mplus User’s Guide. Statistical analysis with latent variables. 1998, Los Angeles, CA: Muthén & Muthén, 1998-2012.
71.
go back to reference Cohen J: Statistical Power Analysis for the Behavioral Sciences (Rev. ed.). 1977, Hillsdale, NJ, England: Lawrence Erlbaum Associates, Inc, Hillsdale, NJ Cohen J: Statistical Power Analysis for the Behavioral Sciences (Rev. ed.). 1977, Hillsdale, NJ, England: Lawrence Erlbaum Associates, Inc, Hillsdale, NJ
72.
go back to reference Kohtala A, Lappalainen R, Savonen L, Timo E, Tolvanen A: A four-session acceptance and commitment therapy based intervention for depressive symptoms delivered by masters degree level psychology students: A preliminary study. Behav Cogn Psychother. 2013, 11 (11): 1-14. Kohtala A, Lappalainen R, Savonen L, Timo E, Tolvanen A: A four-session acceptance and commitment therapy based intervention for depressive symptoms delivered by masters degree level psychology students: A preliminary study. Behav Cogn Psychother. 2013, 11 (11): 1-14.
73.
go back to reference World Health Organization: Regional Office for Europe. Mental health: Facing the challenges, building solutions: Report from the WHO European Ministerial Conference of Helsinki. 2005, Copenhagen: WHO Regional Office for Europe World Health Organization: Regional Office for Europe. Mental health: Facing the challenges, building solutions: Report from the WHO European Ministerial Conference of Helsinki. 2005, Copenhagen: WHO Regional Office for Europe
74.
go back to reference Blumenthal R, Endicott J: Barriers to seeking treatment for major depression. Depress Anxiety. 1997, 4 (6): 273-8.CrossRef Blumenthal R, Endicott J: Barriers to seeking treatment for major depression. Depress Anxiety. 1997, 4 (6): 273-8.CrossRef
75.
go back to reference Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS: Lifetime and 12-month prevalence of DSM-III—R psychiatric disorders in the united states: Results from the national comorbidity study. Arch Gen Psychiatry. 1994, 51 (1): 8-19.CrossRefPubMed Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS: Lifetime and 12-month prevalence of DSM-III—R psychiatric disorders in the united states: Results from the national comorbidity study. Arch Gen Psychiatry. 1994, 51 (1): 8-19.CrossRefPubMed
76.
go back to reference Herbert JD, Forman EM: Acceptance and Mindfulness in Cognitive Behavior Therapy: Understanding and Applying the New Therapies. 2011, Hoboken, New Jersey: John Wiley & SonsCrossRef Herbert JD, Forman EM: Acceptance and Mindfulness in Cognitive Behavior Therapy: Understanding and Applying the New Therapies. 2011, Hoboken, New Jersey: John Wiley & SonsCrossRef
77.
go back to reference McCracken L: Mindfulness and Acceptance in Behavioral Medicine: Current Theory and Practice. 2011, Oakland, CA: New Harbinger Publications McCracken L: Mindfulness and Acceptance in Behavioral Medicine: Current Theory and Practice. 2011, Oakland, CA: New Harbinger Publications
Metadata
Title
The effectiveness and applicability of different lifestyle interventions for enhancing wellbeing: the study design for a randomized controlled trial for persons with metabolic syndrome risk factors and psychological distress
Authors
Raimo Lappalainen
Essi Sairanen
Elina Järvelä
Sanni Rantala
Riitta Korpela
Sampsa Puttonen
Urho M Kujala
Tero Myllymäki
Katri Peuhkuri
Elina Mattila
Kirsikka Kaipainen
Aino Ahtinen
Leila Karhunen
Jussi Pihlajamäki
Heli Järnefelt
Jaana Laitinen
Eija Kutinlahti
Osmo Saarelma
Miikka Ermes
Marjukka Kolehmainen
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-310

Other articles of this Issue 1/2014

BMC Public Health 1/2014 Go to the issue