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Table 1 Exercise Counselling Protocol

From: Protocol for: Sheffield Obesity Trial (SHOT): A randomised controlled trial of exercise therapy and mental health outcomes in obese adolescents [ISRCNT83888112]

Weeks Process of change Exercise Counselling framework: Examples of skills and techniques used
1–2 Cognitive Consciousness Raising a. Review first session:
      • How did it feel? Was it difficult/easy?
      • Did you enjoy it?
  Dramatic Relief    • Importance of exercise, why do we need to warm up & cool down
  Decisional Balance    • Heart rate monitoring, what to wear, what & when to drink
      • What to expect in the coming weeks.
      • Any questions
   b. Healthy eating
      • What is it?
      • When should I eat?
      • What type of foods are good/not so good?
      • Hand out standard dietary information sheet
   c. Benefits of exercise
      • How often?
      • How hard?
      • Where and when?
3–4 Cognitive Self Re-evaluation d. Which physical exercises do I prefer?
  Decisional Balance    • Previous exercise experiences, why this worked / failed.
      • What other exercises might you like to try?
  Consciousness Raising e. Do you know?
      • Benefits of exercise
      • Importance of healthy eating
   f. Are you enjoying the sessions?
      • What do you like?
      • What do you dislike?
      • What would you change?
      • Is it what you had expected?
   g. Active and healthy living
      • Food groups, choices, portion sizes.
      • The breakfast challenge
      • Review healthy eating card.
5–6 Cognitive and Behavioural Self Re-evaluation h. Evaluate sessions so far
      • How do you feel about exercise now?
  Goal setting/Self-regulation    • How comfortable do you feel exercising?
      • Which exercises do you enjoy the most?
  Social Support i. Introduce goal setting
      • What is it?
      • How might it help?
      • Set one exercise goal and one healthy eating goal for the week
   j. Findings support for exercise
      • Thinking of others who might encourage participation in exercise
      • Finding someone to talk to when exercising is difficult
      • Consider ways in which to exercise with other people
7–8 Behavioural Goal setting/Self-regulation k. Review goals
      • Did you achieve them?
      • If yes then well done!
  Stimulus Control    • If not then why not? What can we do to help change this?
  Reinforcement Management and Self-Liberation l. Cues for action
      • Thinking of tasks that might prompt participation in exercise
   m. Thinking about moving on from the programme
      • Home programme phase
      • Future exercise options
   n. Looking and planning ahead. SWOT analysis
      • What will help me to exercise in the future?
      • What will stop me?
   o. What have I achieved so far
      • Review exercise
      • Review healthy eating
      • What do I want to achieve from here?
      • Thinking positively and taking positive action
      • What has been learned