Using Intervention Mapping in the Systematic Development of a Behaviour Change Intervention to Enhance Exercise Adherence among People with Persistent Musculoskeletal Pain

Purpose: This article describes the first four steps of the intervention mapping framework used to design a programme aimed at increasing adherence to prescribed exercise by people with persistent musculoskeletal pain. Method: In Step 1, a systematic review and qualitative study was completed to inform Step 2 and the identification of the Health Action Process Approach as an appropriate theoretical framework for establishing two programme objectives: enhancing self-management and providing tailored and accessible exercise instructions. Step 3 encompassed the selection of the programme methods, and the programme is described in Step 4. The resulting programme provides virtually delivered motivational interviewing and an app-based exercise programme to support individuals’ adherence to exercise. Results: The resulting intervention was assessed in a proof-of-concept feasibility and acceptability study and was shown to be feasible and acceptable. Refinements to the programme included additional tailoring of the exercise app and modifying the motivational interviewing schedule. Conclusions: Using the intervention mapping approach enabled us to successfully develop an intervention aimed at supporting the development of self-management behaviours and addressing maladaptive beliefs as a means of enhancing individuals’ adherence to exercise. Evaluation and implementation of the intervention should now be carried out. Objectif : décrire les quatre premières étapes du cadre de modélisation d’une intervention, utilisé pour concevoir un programme visant à accroître l’adhésion à une prescription d’exercices chez les personnes souffrant de douleurs musculosquelettiques persistantes. Méthodologie : à la première étape, les chercheurs ont effectué une analyse systématique et une étude qualitative pour étayer la deuxième étape et déterminer le processus d’action en santé dans un cadre théorique approprié qui permettrait de formuler les deux objectifs du programme : améliorer l’autogestion et fournir des directives d’exercices adaptées et accessibles. L’étape trois englobait le choix de la méthodologie du programme, décrite à l’étape quatre. Le programme qui en découle comprend des entrevues motivationnelles virtuelles et un programme d’exercices fondé sur une application pour renforcer l’adhésion à l’exercice. Résultats : l’intervention obtenue, évaluée dans une étude de validation de la faisabilité et de l’acceptabilité, s’est révélée faisable et acceptable. Les améliorations au programme ont inclus de nouvelles adaptations à l’application d’exercices et des modifications au calendrier d’entrevues motivationnelles. Conclusion : grâce à la démarche de modélisation de l’intervention, il a été possible d’élaborer une intervention visant à promouvoir l’acquisition de comportements d’autogestion et à corriger des convictions mésadaptées pour accroître l’adhésion à l’exercice. Il reste maintenant à évaluer et à mettre en œuvre l’intervention

Behaviour change techniques associated with adherence to prescribed exercise in patients with persistent musculoskeletal pain: Systematic review.

PURPOSE: Exercise (planned, structured, repetitive movement) improves pain and function in people with persistent musculoskeletal pain (PMSK), but adherence is often poor. This systematic review evaluates the evidence from randomized controlled trials (RCTs) on the effectiveness of interventions to improve exercise adherence in people with PMSK and describes the content, context, and theoretical underpinning of behaviour change interventions designed to increase adherence. METHODS: Nine electronic databases were searched from inception dates to August 2017. Studies were included if they were RCTs that included adults with PMSK ≥3 months; ≥one measure of exercise adherence, exercise prescribed to both groups, and employed ≥one behaviour change technique (BCT) in the treatment group. Independent data extraction, theory coding, BCT taxonomy coding, and quality assessment using Cochrane Risk of Bias (RoB) tool was conducted by two reviewers. RESULTS: Eight RCTs (five low, three high RoB) met inclusion criteria. Five trials reported between-group differences in exercise adherence, favouring the treatment group. Three trials reported theoretical underpinning. There was moderate evidence that five BCTs, social support, goal setting, instruction of behaviour, demonstration of behaviour, and practice/rehearsal, improved exercise adherence. Interventions employing ≤seven BCTs, unique to those included in the control group, were most effective at enhancing exercise adherence. CONCLUSIONS: Limited moderate-quality evidence supports using a small number of BCTs to enhance exercise adherence in people with PMSK. Further research should explore the associations and synergies between BCTs and explicitly report how theory was utilized. This may inform recommendations for health care professionals working with this population. Statement of contribution What is already known on this subject? Exercise (i.e., planned, structured, repetitive movements) improves pain and function in people with persistent musculoskeletal pain (PMSK). Many people with PMSK do not adhere to exercises prescribed by a health care professional. Little research has explored how to enhance adherence to prescribed exercise in people with PMSK. What does this study add? Moderate-quality evidence from eight trials suggests behaviour change interventions enhance exercise adherence. Social support, goal setting, demonstration, instruction, and rehearsal were employed in effective interventions. Interventions with ≤7 behaviour change techniques were more effective at improving adherence than those employing >7

Tame D-tadpoles in gauge mediation

We revisit models of gauge mediated supersymmetry breaking where messenger parity is violated. Such a symmetry is usually invoked in order to set to zero potentially dangerous hypercharge D-term tadpoles. A milder hypothesis is that the D-tadpole vanishes only at the first order in the gauge coupling constant. Then the next order leads to a contribution to the sfermion masses which is of the same magnitude as the usual radiative one. This enlarges the parameter space of gauge mediated models. We first give a completely general characterization of this contribution, in terms of particular three-point functions of hidden sector current multiplet operators. We then explore the parameter space by means of two simple weakly coupled models, where the D-tadpole arising at two-loops has actually a mild logarithmic divergence.Comment: 13 pages + 9 pages of appendix, 1 figure; v2: some clarifying comments added, version to appear in JHE

Dirac Gauginos, Negative Supertraces and Gauge Mediation

In an attempt to maximize General Gauge Mediated parameter space, I propose simple models in which gauginos and scalars are generated from disconnected mechanisms. In my models Dirac gauginos are generated through the supersoft mechanism, while independent R-symmetric scalar masses are generated through operators involving non-zero messenger supertrace. I propose several new methods for generating negative messenger supertraces which result in viable positive mass squareds for MSSM scalars. The resultant spectra are novel, compressed and may contain light fermionic SM adjoint fields.Comment: 16 pages 3 figure

The Status of GMSB After 1/fb at the LHC

We thoroughly investigate the current status of supersymmetry in light of the latest searches at the LHC, using General Gauge Mediation (GGM) as a well-motivated signature generator that leads to many different simplified models. We consider all possible promptly-decaying NLSPs in GGM, and by carefully reinterpreting the existing LHC searches, we derive limits on both colored and electroweak SUSY production. Overall, the coverage of GGM parameter space is quite good, but much discovery potential still remains even at 7 TeV. We identify several regions of parameter space where the current searches are the weakest, typically in models with electroweak production, third generation sfermions or squeezed spectra, and we suggest how ATLAS and CMS might modify their search strategies given the understanding of GMSB at 1/fb. In particular, we propose the use of leptonic $M_{T2}$ to suppress $t{\bar t}$ backgrounds. Because we express our results in terms of simplified models, they have broader applicability beyond the GGM framework, and give a global view of the current LHC reach. Our results on 3rd generation squark NLSPs in particular can be viewed as setting direct limits on naturalness.Comment: 44 pages, refs added, typos fixed, improved MC statistics in fig 1

Phenomenological Aspects of Gauge Mediation with Sequestered Supersymmetry Breaking in light of Dark Matter Detection

In a recent work, a model of gauge mediation with sequestered supersymmetry (SUSY) breaking was proposed. In this model, the mass of the gravitino is O(100) GeV without causing the flavor-changing neutral-current problem. In contrast to traditional gauge mediation, the gravitino is not the lightest SUSY particle and the neutralino is the candidate of the dark matter. In this paper, we investigate phenomenological aspects of this model and discuss the possibility of the direct detection of the dark matter. In particular, we focus on the light neutralino case and find that the light-Higgsino scenario such as the focus point is interesting, taking account of the recent CDMS result.Comment: 17 pages, 8 figures; v2:references added, some corrections; v3:version accepted for publication in JHE

Soft Spectrum in Yukawa-Gauge Mediation

We introduce a model independent parametrization for a subclass of gauge mediated theories, which we refer to as Yukawa-gauge mediation. Within this formalism we study the resulting soft masses in the visible spectrum. We find general expressions for the gaugino and scalar masses. Under generic conditions, the gaugino mass is screened, vanishing at first order in the SUSY breaking scale.Comment: 22 pages, 4 figures; v2: minor corrections, published versio

General Messenger Gauge Mediation

We discuss theories of gauge mediation in which the hidden sector consists of two subsectors which are weakly coupled to each other. One sector is made up of messengers and the other breaks supersymmetry. Each sector by itself may be strongly coupled. We provide a unifying framework for such theories and discuss their predictions in different settings. We show how this framework incorporates all known models of messengers. In the case of weakly-coupled messengers interacting with spurions through the superpotential, we prove that the sfermion mass-squared is positive, and furthermore, that there is a lower bound on the ratio of the sfermion mass to the gaugino mass.Comment: 37 pages; minor change

The present-day number of tectonic plates

The number of tectonic plates on Earth described in the literature has expanded greatly since the start of the plate tectonic era, when only about a dozen plates were considered in global models of present-day plate motions. With new techniques of more accurate earthquake epicenter locations, modern ways of measuring ocean bathymetry using swath mapping, and the use of space based geodetic techniques, there has been a huge growth in the number of plates thought to exist. The study by Bird (2003) proposed 52 plates, many of which were delineated on the basis of earthquake locations. Because of the pattern of areas of these plates, he suggested that there should be more small plates than he could identify. In this paper, I gather together publications that have proposed a total of 107 new plates, giving 159 plates in all. The largest plate (Pacific) is about 20 % of the Earth's area or 104 Mm (super 2) , and the smallest of which (Plate number 5 from Hammond et al. 2011) is only 273 km (super 2) in area. Sorting the plates by size allows us to investigate how size varies as a function of order. There are several changes of slope in the plots of plate number organized by size against plate size order which are discussed. The sizes of the largest seven plates is constrained by the area of the Earth. A middle set of 73 plates down to an area of 97,563 km (super 2) (the Danakil plate at number 80, is the plate of median size) follows a fairly regular pattern of plate size as a function of plate number. For smaller plates, there is a break in the slope of the plate size/plate number plot and the next 32 plates follow a pattern of plate size proposed by the models of Koehn et al. (2008) down to an area of 11,638 km (super 2) (West Mojave plate # 112). Smaller plates do not follow any regular pattern of area as a function of plate number, probably because we have not sampled enough of these very small plates to reveal any clear pattern. Copyright 2016 The Author(s) and Harrison

Simplified R-Symmetry Breaking and Low-Scale Gauge Mediation

We argue that some of the difficulties in constructing realistic models of low-scale gauge mediation are artifacts of the narrow set of models that have been studied. In particular, much attention has been payed to the scenario in which the Goldstino superfield in an O'Raifeartaigh model is responsible for both supersymmetry breaking and R-symmetry breaking. In such models, the competing problems of generating sufficiently massive gauginos while preserving an acceptably light gravitino can be quite challenging. We show that by sharing the burdens of breaking supersymmetry and R-symmetry with a second field, these problems are easily solved even within the O'Raifeartaigh framework. We present explicit models realizing minimal gauge mediation with a gravitino mass in the eV range that are both calculable and falsifiable.Comment: 31 pages, 4 figures, references added, minor change