An experimental test of reframing counselling to attenuate biased exercise thoughts for individuals about to begin a diabetes prevention program


BACKGROUND: Exercise-related cognitive errors (ECEs) represent a bias in information processing which distorts individuals' view of exercise. Such thinking can inhibit individuals' behaviour change efforts. Reframing is an evidence-based counselling strategy used to help individuals evaluate the evidence for and against their biased thoughts. The goal of reframing is to modify biased cognitions not to directly change an outcome behaviour for which behavioural strategies would be used. OBJECTIVE: To examine reframing as a pre-intervention strategy to attenuate ECE thinking as individuals begin a diet and exercise diabetes prevention program. METHODS: Prior to beginning a 3-week program, individuals diagnosed with prediabetes (N = 26, 18 female, Mage=58) were randomized to either 15-minutes of reframing counselling (REF) or attention control (AC). Those receiving REF were prompted to identify, challenge, and reframe their negative exercise thoughts. Changes in ECEs were measured at pre-test, post-test, and 4 weeks post-program using the exercise-related cognitive errors scale (range: 1-9). RESULTS: REF participants (n=14) experienced greater decreases in their ECE scores compared to AC (n=12) from baseline (REF =5.2, AC=5.0) to immediately post-program (REF=4.4, AC=5.1) and 4-weeks post-program (REF=3.2, AC=4.1). There was a significant main effect for time (p=.001, partial eta squared=.43). Those in REF experienced a greater ECE decrease across the study (Cohen's d =.71). CONCLUSION: A reduction in ECEs was observed immediately post-program for REF. The REF group also experienced greater reductions 4 weeks post-program. REF may be an effective means to help individuals reduce their biased exercise thoughts when making behaviour change efforts.

Acknowledgments: Diabetes Canada Postdoctoral Fellowship; Michael Smith Foundation for Health Research Postdoctoral Fellowship