Research Updates

Small Steps for Big Changesimage of small steps for big changes manual on a table with a stethoscope

Small Steps for Big Changes is a lifestyle counselling program that can help people make lasting dietary and exercise changes in order to lower their risk of developing type 2 diabetes in the future.  Small Steps for Big Changes is a personalized, one-on-one, 3-week training and counselling program.  Participants have the choice of various types of aerobic exercise, including exercise at a steady pace for 20-30 minutes, and interval exercise that involves alternating between bouts of up to 1 minute of brisk activity and 1 minute of light activity for 12-15 minutes.  They also learn to start making small but sustainable changes to their dietary behaviours.

The Small Steps for Big Changes program has been examined in our laboratory at the University of British Columbia with over 140 people at risk for type 2 diabetes. We examined whether individuals who are not exercising regularly enjoyed Small Steps for Big Changes, and if the program helps individuals to stick to exercise in the long run. We found that adults who are not exercising regularly and who are at risk for type 2 diabetes enjoyed the Small Steps for Big Changes exercise training. When we followed up, we also found that majority of individuals continued to be physically active months after the program ended, as assessed by accelerometry and app data.  Those who participated in the Small Steps for Big Changes program also improved their fitness levels, showed evidence of reduced inflammation, decreased their waist circumference and experienced weight loss.

Want to learn more about the program? Visit the study website at:


Reframing Negative Exercise Thoughts

This research study explores the unhelpful thoughts that we have from time-to-time when deciding to exercise.  For example, sometimes we feel too busy, and automatically think, “GAH!  There’s just not enough time in the week to exercise!!” This thought has truth to it – you are busy – but you may have automatically jumped to the conclusion without considering the whole situation.  Maybe you are busy, but not as busy at you feel?  The point is, did you really think through the decision?  The purpose of this research study is to examine whether a counselling technique called reframing can help individuals identify and challenge their negative exercise thoughts.

Want to learn more? Email postdoctoral fellow, Dr. Sean Locke.


image of woman exercising on an ellipticalExploring Women’s Experiences In A Prediabetes Community-Based Exercise Intervention

This study explores women’s experiences throughout their participation in the Small Steps for Big Changes lifestyle counseling program, a community-based exercise intervention for individuals who are living with prediabetes. Interviews with participating women aim to provide an understanding of women’s attitudes, beliefs, experiences and behaviours related to engaging in a lifestyle community program. This will help better understand the facilitators and barriers to intervention engagement and completion, as well as exercise adherence over the course of one year.

Want to learn more? Email postdoctoral fellow, Dr. Corliss Bean.


The Power of Choice

This study aims to address whether providing low-active adults with exercise training choices compared to exercise training that is imposed is important for physical activity adherence, motivation, exercise-enjoyment, and health outcomes over time. We are randomizing low active adults to a 2-week supervised exercise intervention, where some individuals are able to select their exercise training – moderate-intensity continuous training (MICT) or high-intensity interval training (HIIT), while others have their exercise imposed, either MICT (imposed-MICT) or HIIT (imposed-HIIT). The participant sample includes low active men and women between the ages of 30 to 55 years old. We are currently in the data recruitment and data collection phase, and we expect to be complete data collection in Spring 2018. This study is supported in part by the American College of Sports Medicine Research Endowment grant (2017).


Booster Buddyimage of a woman talking with a healthcare professional

Booster Buddy is a free mental health app targeted at a youth audience with those who have schizophrenia, bipolar disorder, and/or major depressive disorder. The app is designed to provide users with coping skills, medication reminders, an emergency crisis plan, and daily challenges, all while featuring a gamification aspect of a “Buddy” character to help the user along with their everyday lives. With the original target audience in mind, the app has grown to attract those who look to maintain their personal wellbeing as well. Booster Buddy has become a popular download for thousands of users, internationally. The purpose of this study is to understand user experience of the app. In association with Booster Buddy, Vancouver Island Health Authority, and their funders, an end goal of the study is to implement the research findings to further improve the quality of the app to tailor it specifically to what users need.


Increasing Household Purchase and Child Consumption of Calcium Products: A Randomized Controlled Trial

Adequate consumption of milk and milk products is crucial for bone and growth development in children. However, 37% of children between 4 and 9 years old fail to consume the recommended number of dairy servings per day. Children under the age of 10 acquire their eating habits predominantly from whiting what their parents consume, following parental rules regarding what needs to be consumed at meals and snacks, and consuming what food has been purchased for the household by the parents. Accordingly, parents have been appropriately labeled the “gatekeepers” to household food consumption, with over 70% of young children’s food choices being determined by the parents. The objective of this research is to create and test persuasive messages targeted at parents who have children who consume inadequate amounts of calcium. The content of these messages will aim to increase calcium-rich product purchase behaviour in parents, and consumption of calcium in both parents and their under consuming children. These objectives will be met in 3 phases over two years. Phase I will consist of a series of in-depth interviews with parents to determine salient expected outcomes (perceived benefits and barriers) to calcium-rich purchases and consumption for the parent and child and to determine strategies used to role model healthy consumption behaviour as well as overcome barriers to purchasing and consuming calcium will also be identified. Phase II will integrate the findings from Phase I in the development of targeted messages. These materials will then be pilot tested in parents whose children do not consume adequate calcium so that we may further optimize the material to ensure saliency in the targeted population. In phase III, the effectiveness of the intervention material on increasing a) the purchase of calcium by parents, and b) the consumption of calcium in the parent and child will be examined in 400 families across Canada.


image of an older man exercising outdoors on a bikeA Brief SCT intervention, combined with high-intensity interval training, to improve exercise adherence in individuals with pre diabetes. 

Exercise prevents the development of T2D in individuals with prediabetes, but adherence to exercise is extremely poor in this population. High-intensity interval training (HIT) has garnered attention recently because it elicits outcomes associated with T2D prevention but takes less time. Whether time-efficiency will actually promote exercise adherence and adoption over the long-term is unknown. Countless studies show that merely participating in an exercise intervention is unlikely to have a lasting change on exercise behaviour. Behaviour change interventions grounded in social cognitive theory (SCT) can effectively increase exercise adherence. Self-efficacy, the main tenet within SCT, predicts future exercise behaviour through directly influencing the amount of effort, persistence, and type of goals one sets. We have developed a two-week SCT-based exercise counselling intervention that, when partnered with the novel exercise strategy of time-efficient high-intensity interval training (HIT), leads to robust changes in self-efficacy. Exercise adherence following SCT-HIT appears greater at one-month follow-up when compared to an SCT-based intervention utilizing standard care continuous moderate-intensity exercise (SCT-MOD). Further, our pilot study shows that gains in cardiorespiratory fitness following our brief SCT-HIT intervention are double the gains seen after SCT-MOD, which are maintained at one-month follow-up. These promising findings suggest that an SCT-based exercise counselling intervention that employs the exercise modality of HIT may be a novel, effective behavioural strategy to increase long-term exercise adherence, improve health status, and help prevent T2D.

Overall Research Question: Does a SCT-based behaviour modification counseling intervention utilizing HIT (SCT-HIT) lead to greater exercise adherence than SCT-MOD in pre diabetes?


Upward Health: A Pilot Study to Assess the Utility of a Mobile Application to Promote Self-Monitoring and Exercise Behaviour

The majority of Canadians do not meet current physical activity guidelines. A novel technology, the UpwardHealth motivation engine, provides real-time records of physical activity behaviour and has the potential to be used as a self-monitoring tool to enable individuals to achieve their exercise goals. Self-monitoring increases exercise adherence and promotes attainment of exercise goals. The purpose of this study is to test the ability of the UpwardHealth motivaiton engine to enhance exercise adherence in order to achieve a specified exercise goal through self-monitoring in healthy adults. The usability of the UpwardHealth application will also be evaluated.


image of a woman talking with a healthcare trainer and holding a heart rate monitorExploring Relations Between Physiological Reactions and Cognitive Stimulus: A Pilot Study Investigating Self-Regulation and Canada’s Physical Activity Recommendations 

Self-regulation is used for any task that requires a person to override an automatic, or habitual instinct in an attempt to change his/her behaviour, such as resisting a tempting food or regulating his/her emotions. Making everyday choices also draws from this same self-regulatory resource. Planning an exercise bout can require a large amount of self-regulation, particularly for people who are not regularly active. Inactive individuals attempting to begin an exercise regime must make the difficult decision to fit bouts of exercise into their daily routine, possibly at the expense of more habitually desirable activities. This is an issue because self-regulation is believed to be a limited resource that is depleted each time a person attempts to regulate behaviour. When this resource becomes exhausted, a person becomes significantly more likely to exhibit poor self control in future behaviour (Muraven & Baumeister, 2000). It can therefore be posited that planning for multiple bouts of exercise coupled with all the other daily tasks requiring self-regulation (e.g. resisting temptations, making choices) may lead to a dysfunctional depletion of self-regulation. For a person struggling to make consistently healthy choices, this depletion could lead to failure to adhere to exercise guidelines in the future (Martin Ginis & Bray, 2010).

If planning for multiple exercise bouts decreases one’s self-regulatory strength, it is problematic that this strategy is being recommended to Canadians. Therefore, in addition to examining physiological benefits derived from shorter, more frequent bouts of exercise, it is also important to explore how dividing exercise time impacts psychological factors such as self-regulation. These psychological constructs play a large role in determining whether one will maintain an exercise routine. Presently, there is very little research that has examined adherence to 10-minute bouts of exercise. By examining self-regulation depletion we will be able to better advise whether the suggestions put forward within Canada’s Physical Activity Guidelines are appropriate recommendations.

The purpose of the proposed study is to assess the degree of self-regulation depletion that occurs as a result of planning for exercise bouts for the following day. Specifically, we are interested in whether self-regulation depletion differs depending on if one is planning for a single, longer exercise bout, versus planning for multiple, shorter exercise bouts. It is hypothesized that planning for multiple, shorter exercise bouts will deplete self-regulation strength to a greater extent than planning for a single, longer exercise bout.


Program evaluation of an Community based program designed to increase healthy eating and physical activity in Canadian children. 

Childhood obesity is an important health issue requiring urgent attention. Overweight and obesity can negatively impact health and puts children at risk for future health problems,  including heart disease, high blood pressure, and diabetes. One particular segment of our younger Canadian population who are at disproportionately higher risk of overwegith and obesity and overall poorer health is young people in the care of the government. This subset of our youth experience more trauma and displacement as well as transitional activity than that of the mainstream population. The Healthy Together program was developed by The Bridge Youth and Family Services in Kelowna to address this issue. The aim of the Healthy Together program is to promote the achievement and maintenance of healthier weights for children by enhancing knowledge, skills and attitudes surrounding healthy eating and physical activity behaviours, encouraging learning on how to make healthy dietary and activity choices, and building relationships within families that will foster these health behaviours. Additionally, the project plans to create a sustainable framework for integrating this program within core population health policy and practice interventions, to help achieve the long-term outcome of healthier weights in Canadian children. The program will now be implemented in 10 different community sites across Canada. The UBC team will conduct a comprehensive evaluation of the program across all implementation sites. This evaluation will include assessing the efficacy of the program on more than 300 children and 300 caregviers across Canada. This project (implementation of the program and evaluation) is one of nine national strategies funded by the Public Health Agency of Canada.

The Healthy Together site is up and running and introduces our fantastic research team.


For more information on research projects please contact us at: