ABSTRACT
Resumen En los últimos años, Colombia registra un aumento tanto de sobrepeso como de obesidad, aspecto que produce el establecimiento de modelos complejos de intervención que generen cambios de actitud, compromiso en las personas y el mejoramiento de hábitos alimenticios y de actividad física. Este estudio pretendió comparar la efectividad entre dos componentes psicológicos (estrategias conductuales tradicionales y un entrenamiento en aceptación y compromiso), sumados al entrenamiento físico concurrente y la educación nutricional (junto con una dieta hipocalórica), sobre variables antropométricas, la aptitud física, los aspectos de la conducta alimentaria y la sintomatología de salud mental. El diseño de investigación fue de caso único ABA (línea base-intervención-línea base) para cada condición de tratamiento. La muestra estuvo conformada por cinco mujeres y un hombre, entre los 33 y 49 años de edad, con preobesidad y obesidad tipo I, asignados entre los grupos de coaching conductual y entrenamiento en aceptación y compromiso. Los hallazgos muestran un mejoramiento en: composición corporal, resistencia aeróbica, fuerza prensil, compromiso y fusión cognitiva frente a situación de alimentación y actividad física en dos participantes de la estrategia de aceptación y compromiso, mientras que hubo mayor variación en los resultados de los participantes de coaching conductual. Este es un pilotaje de un estudio con mayor capacidad de inferencia.
Abstract There is an increase in both overweight and obesity in the world, aspect that tends for the approach of integral models of intervention, that generate changes in attitude, and commitment in people towards their eating habits and physical activity, that counteract a sedentary lifestyle and the influence of counterproductive processed foods for energy balance. This study aimed to compare the effectiveness between two psychological components (traditional behavioral strategies and a 6-session acceptance and commitment training), added together, each one: a) concurrent physical training (strength/endurance) with bioadaptation process, b) hypocaloric diet and c) Nutritional education. Measurements of anthropometric variables were obtained, physical fitness and mental health symptoms, while the average of steps was measured during the whole process, constituting this part in a single ABA case design for each treatment condition. The sample consisted of five women and one man, between 33 and 49 years of age, with pre-obesity and type I obesity, assigned in a non-random way between the behavioral coaching and acceptance and commitment training groups. In physical training, priority was initially given to the conditional capacity of strength, being an incident in the mobilization of large muscle groups (multi-joint) in order to generate a greater caloric expenditure, directly influencing exercises that optimize postural hygiene by working in the core zone and complementing training with synergistic or accompanying biarticular exercises in the movement of daily physical activities, subsequently the execution of aerobic resistance in search of the increase in the maximum oxygen consumption capacity ( max), ending with the implementation of vital flexibility exercises for physical exercise releasing muscle tension, favoring conditional physical ability. Regarding the intervention of the nutritional component, the most important input to begin to identify eating habits and subsequently modify them was the 24-hour reminder, applying in the first week of the baseline and the reversal phase. The nutritional intervention consisted of: (a) education so that participants understood and generated greater adherence to the nutritional proposal and (b) hypocaloric diet, reducing daily intake between 500 and 600 kilocalories per day. A follow-up anthropometric assessment was also carried out towards the third week of the intervention phase to obtain feedback on the incidence of their behavior on the anthropometric variables. Regarding the record of the number of steps, both in the baseline and reversion phases the monitor screens were covered, contrary to the intervention phase, since its observation allows self-monitoring towards the weekly personal goal of steps that was established and accompanied by a professional, who in turn generated a graph with the results of the week and gave feedback to each participant. The findings show an improvement in: body composition, aerobic endurance (VO2 max) and grip strength, being the main factor of result in the realization of the physical exercise. Likewise, an increase in the number of steps from the baseline is identified in both groups (X = 9 228.07; S = 1 985.89) to the intervention phase (X = 9 734.22; S = 1 660.86) and a decrease in reversion (X = 9 099.88; S = 2 328.69). In the acceptance and commitment group, no increase in mental health symptoms was identified, increased or sustained cognitive restriction and decreased scores for uncontrolled eating and emotional eating, while there was greater variation in the results of the behavioral coaching participants. This is a pilot of a study with greater capacity for inference.
ABSTRACT
Abstract Background Self-efficacy refers to an individual's belief in his or her capacity to execute certain behaviors and determines changes in the lifestyle of persons with chronic diseases such as obesity. There is currently no instrument with optimal psychometric properties measuring self-efficacy for a healthy diet. HAPA is a theoretical framework that can describe, explain, and predict health behavior changes and its relationship with self-efficacy, and it that is useful for the development of interventions, particularly in the area of healthy diets. Objective The purpose of this study was to develop an instrument to measure self-efficacy for a healthy diet in Mexican population with obesity and the evaluation of the psychometric properties of the Self-Efficacy Scale for a Healthy Diet (SSHD). Method The sample included 202 participants receiving care in public obesity clinics. The SSHD applied is a Likert-type scale developed from the Health Action Process Approach containing 45 items. Omega coefficient and Confirmatory Factor Analyses were estimated to evaluate the psychometric properties. Results The scale has good measures of goodness of fit χ2 = 66.49; p < .001; χ2 SB/gl = 41; CFIS = .955; NFI = .893; RMSEAS = .056 (95% CI [.029, .079]) and total scale reliability of ω = .896 (CI 95% [.876, .915]). Discussion and conclusion The SSHD is a reliable, valid instrument for measuring the three types of self-efficacies proposed in HAPA in people with obesity who require changes to adhere to a healthier diet.
Resumen Antecedentes La autoeficacia es la creencia en las capacidades percibidas para realizar cualquier comportamiento; determina cambios en el estilo de vida de personas con enfermedades crónicas como la obesidad. Actualmente no existe un instrumento con propiedades psicométricas adecuadas que mida la autoeficacia para seguir una dieta saludable. El Modelo Procesual de Acciones en Salud (HAPA, por sus siglas en inglés) es un modelo teórico que describe, explica y predice cambios en la conducta y su relación con la autoeficacia, especialmente en el área de la alimentación saludable. Objetivo Desarrollar un instrumento que mida la autoeficacia para una alimentación saludable en población mexicana con obesidad. Con ello se obtuvieron las propiedades psicométricas de la Escala de Autoeficacia para una Alimentación Saludable (EAAS). Método La muestra incluyó 202 personas adultas con obesidad que se encontraban en tratamiento para reducir su peso corporal. Se aplicó la EAAS; ésta es una Escala tipo Likert desarrollada con base en el Modelo Procesual de Acciones en Salud (HAPA, por sus siglas en inglés) y consta de 45 reactivos. Se obtuvo la validez de constructo, se estimaron coeficiente omega y análisis factorial confirmatorio para obtener las propiedades psicométricas. Resultados La escala tiene buenas medidas de bondad de ajuste χ2 = 66.49; p < .001; χ2 S-B/gl = 41; CFIS = .955; NFI = .893; RMSEAS = .056 (IC 95% [.029, .079]) y de confiabilidad de la escala total ω = .896 (IC 95% [.876, .915]). Discusión y conclusión La EAAS es un instrumento válido y confiable para medir los tres tipos de autoeficacia que propone el modelo HAPA en personas con obesidad que requieren cambios en la conducta alimentaria.
ABSTRACT
Se aplica un programa de economía de fichas para modificar algunos comportamientos disruptivos de un niño. Se pretende decrementar el contestar de manera inadecuada, así como hacer pataletas y propiciar la ocurrencia del seguimiento de instrucciones relacionadas con conductas como arreglar la cama, recoger y organizar los juguetes, recoger y organizar la ropa, hacer sus deberes escolares. Se hace una profunda revisión de la aplicación del programa de Economía de Fichas en diversos campos y problemas de conducta. Siguiendo un diseño ABA, los resultados confirman el cambio de comportamiento y logran un mejor ajuste de la conducta del niño en la escuela y el ambiente familiar. Se hace un análisis desde algunos principios de la economía conductual.
It applies a token economy program to modify some disruptive behaviors of a child. It is intended to decrease the answer in an inappropriate manner and make tantrums and encourage the occurrence of follow-up instructions for behaviors such as to fix the bed, collecting and organizing toys, collect and organize your clothes, do their homework. It is a thorough review of the implementation of the token economy in various fields and behavioral problems. Following an ABA design, the results confirm the behavior change made a better adjustment of the child's behavior at school and home environment. An analysis is made from some of the principles of behavioral economics.
ABSTRACT
En la presente investigación se empleó un diseño cuasi-experimental de caso único AB para evaluar la consistencia del reporte verbal basado en Unidades Subjetivas de Ansiedad (USAS) y los efectos psicofisiológicos registrados en la aplicación de la técnica de la Desensibilización Sistemática, empleando el componente imaginario de ésta en un caso de fobia específica a las aves. Los resultados no mostraron una consistencia entre el informe verbal del sujeto, en el cual reportó, tanto cero USAS para 10 escenas ansiógenas, como una disminución en la activación fisiológica, y las medidas obtenidas en los equipos que registraban el pulso y la RGP. El pulso mostró una tendencia al aumento mientras que la RGP una tendencia a mantener los mismos niveles.
In the present research a quasi- experimental AB single case research design was used to assess the consistency of a verbal report based on Subjective Units of Discomfort (SUDS) and the psycho-physiological measures of pulse and galvanic skin response (GSR) when applying the systematic desensitization technique and using only its imaginary component in the treatment of a specific phobia to birds. The results found didnt show a consistency between the participants verbal report, in which both cero SUDS were reported for 10 ansiogenic scenes and a decrease in the physiological arousal, and the measurements obtained by the equipment that registered pulse and GSR. In contrast, the pulse showed an increasing tendency and the GSR registered a tendency to maintain the same levels.