Two types of financial incentives can help improve healthy lifestyles: carrots (a reward where one can gain something) and sticks (a deposit contract where one can lose something). In a deposit... Show moreTwo types of financial incentives can help improve healthy lifestyles: carrots (a reward where one can gain something) and sticks (a deposit contract where one can lose something). In a deposit contract, participants deposit own money and can lose or earn it back depending on lifestyle changes. We studied the potential of deposit contracts to stimulate a healthy lifestyle.A smartphone app was developed together with the Swiss university ETH Zurich to conduct experimental research into the effects of deposit contracts. In addition, we collaborated with the American company WayBetter to observe the effects of commercially available deposit contracts. Finally, the opinion of people with cardiovascular disease and healthcare professionals regarding financial incentives and deposit contracts for lifestyle change was investigated.The results show that deposit contracts can have strong effects on exercise behavior (daily step counts) in the short term. The results also show that voluntary participation in deposit contracts is limited, but can be increased by doubling the amount deposited and by allowing participants to determine the amount themselves. Finally, healthcare providers think it is a good idea to use financial incentives, but people with cardiovascular disease themselves are skeptical about the use of deposit contracts. Show less
Unexplained Chronic Fatigue (CF) is of unknown aetiology, but research suggests a multifactorial nature in which biological/physical, psychological and social fators interact. Treatment approaches... Show moreUnexplained Chronic Fatigue (CF) is of unknown aetiology, but research suggests a multifactorial nature in which biological/physical, psychological and social fators interact. Treatment approaches for CF target mainly perpetuating factors of fatigue chronicity, such as lack of physical activity. This thesis describes a brief self-regulation-based intervention targeting physical activity for patients with CF. Prior to this intervention study we conducted a series of studies that were important for the development of the trial: (1) a validation of a measure of fatigue severity for the language and population in which we intended to implement the intervention, (2) a comparison of clinical characteristics and behavioural and cognitive determinants of CFS in a Dutch and a Portuguese patient sample, and (3) a systematic review and meta-analysis of behavioural interventions with a graded activity component conducted with CF patients. In a randomized controlled trial (n=91), the self-regulation based intervention led to significant sustained effects (1 year) on fatigue severity, quality of life and physical activity. Sustained benefits on fatigue severity were partially explained by progress on a personal physical activity goal, and use of self-regulation skills. Findings are discussed in terms of its implications for practice, methodological considerations and avenues for future research. Show less
Regular participation in moderate-intensity physical activity (PA) is beneficial for patients with rheumatoid arthritis (RA); however, a large proportion of patients with RA are not physically... Show moreRegular participation in moderate-intensity physical activity (PA) is beneficial for patients with rheumatoid arthritis (RA); however, a large proportion of patients with RA are not physically active. In this dissertation, we describe the pilot-testing of an intervention to promote PA among patients with RA, as well as several preliminary studies which informed the development of the intervention. These preliminary investigations identified autonomous motivation, self-efficacy, PA goal achievement and use of self-regulation techniques as important predictors of PA behavior change. As such, and based on existing literature, motivational interviewing (MI) and self-regulation coaching (SR) were selected as intervention techniques which could impact upon these variables. In a randomized controlled trial, the combined MI+SR intervention led to increased autonomous motivation, self-efficacy and physical activity comp ared to a patient education control group over 32 weeks. Process analyses revealed that autonomous motivation and use of self-regulation skills explained the sustained increases in PA behavior, and that certain characteristics of MI sessions explained changes in autonomous motivation and PA. Despite increasing their PA, patients who received the intervention did not improve on any disease related variables. Practical implications of the findings are discussed. Show less
