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Table 2 Cognitive adaptations in the ACHIEVE intervention

From: Randomized trial of achieving healthy lifestyles in psychiatric rehabilitation: the ACHIEVE trial

Self-monitoring -Tracker: participants mark fruits/vegetables, sugar drinks, junk food, smart portions, smart snacks and exercise. Detailed food and calorie log not required so complexity of recording is simplified.
-Weigh-in one time per week during the intensive phase, and once per month during the maintenance phase. Frequent weigh-ins provide opportunity for reinforcement and repetition.
Group weight-management sessions -Highly structured, emphasis on behavioral rehearsal.
-Material taught in small content units. Frequent meetings (1 session per week during the intensive phase, 1 session per month during the maintenance phase) allow repetition of concepts.
-Program materials are written at 5th-8th grade reading level.
-Hands-on activities emphasized. Taste testing, label reading, portion measuring.
- Role-playing emphasized. Practicing saying no to junk food, or choosing smarter portions at a birthday party. Increases self-efficacy to adhere to healthier eating habits.
-Worksheets review topic of the week.
Individual sessions -Allow for individualized cognitive tailoring as needed.
-Opportunity to emphasize an individualized high impact behavior based upon the concepts learned in groups.
Physical activity classes -Provide opportunity for modeling and building physical activity skills in supportive setting to increase cardiovascular fitness and exercise self efficacy
Environmental prompts -Refrigerator magnets, preprinted grocery lists, watches, water bottle, measuring cups, lunch bag as reminders to be used at home.
Reinforcements -Participation is rewarded with varying levels of gifts relative to the number of classes attended.