(PS1-97) Use of Cognitive, Behavioral, and Acceptance-based Skills in Daily Life: Intensive Assessment During an 8-week Physical Activity Behavior Change Program

Psychological skills taught in behavior change programs are only effective if participants use them in daily life, between intervention sessions. Yet, little is known about participants’ use of skills in daily life. Additional information using methods that address recall biases inherent in global, retrospective self-reports would (1) deepen our understanding of mechanistic pathways underlying intervention effects, and (2) identify gaps in the translation of skill acquisition to regular practice. In the present study, women with elevated risk for cardiovascular disease (ages 40-65 with hypertension, high cholesterol; N=62, MAge=52, MBMI=31 kg/m2, 40% racial/ethnic minority identification) engaged in an 8-week physical activity (PA) promotion program that taught 9 distinct behavioral, cognitive, and acceptance-based psychological skills (e.g., problem-solving, cognitive reframing, cognitive defusion). Participants completed 6 weekly sessions with a PA coach to learn and review these skills, with assessment only in Weeks 1 and 8; they also received a PA partner, who was another woman in the program, for day-to-day support (31 dyads). Partners communicated as desired for support between the 6 intervention sessions; daily experiences were assessed with an end-of-day survey each day in Weeks 1-8. After the initial session with their coach and partner (i.e., in Weeks 2-8), participants reported using an average of 1.7 psychological PA skills per day and discussing an average of 1.2 with their partner each day; correspondence between individual use and discussion with their partner was 0.37. Skills used individually most often in daily life were willingness (“even if” vs. “only if” thinking; 86% of days after introduction in session), time management (58% of days), effective goal-setting (46% of days), and re-connecting with/”voting up for” values (34% of days). The number of skills used individually per day was positively associated with both the number of steps taken that day (as assessed by a PA monitoring device) and subjective satisfaction with PA engagement that day (Rs=0.49, 0.47, ps< 0.01). Participants reported engaging partner support as a skill on only 27% of days, though they reported contact with their partner on 52% of days. Skills most commonly discussed with partners were goal-setting (39% of contact days), time management (36% of contact days), willingness (34% of contact days), and effective communication as partners (29% of contact days). Further, end-of-treatment feedback showed that reporting on skill use each day was highly acceptable (M=4.25/5) and that participants perceived benefitting from skills used less frequently (e.g., cognitive defusion). Findings show that participants can report on their use of behavioral, cognitive, and acceptance-based skills taught in behavior change interventions in an intensive manner between sessions. Importantly, use of these skills in daily life is associated with the intended behavior change and subjective responses in real time (i.e., PA in steps per day, satisfaction). Additional examination of associations between daily skill use and behavior change will enable improvements to intervention programs, to better engage or remove lesser-used skills as appropriate.