<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03255291</url>
  </required_header>
  <id_info>
    <org_study_id>201706063</org_study_id>
    <secondary_id>R01CA190391</secondary_id>
    <nct_id>NCT03255291</nct_id>
  </id_info>
  <brief_title>Communicating Multiple Disease Risks: A Translation of Risk Prediction Science</brief_title>
  <official_title>Communicating Multiple Disease Risks: A Translation of Risk Prediction Science</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Washington University School of Medicine</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>National Institutes of Health (NIH)</agency>
      <agency_class>NIH</agency_class>
    </collaborator>
    <collaborator>
      <agency>National Cancer Institute (NCI)</agency>
      <agency_class>NIH</agency_class>
    </collaborator>
  </sponsors>
  <source>Washington University School of Medicine</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Epidemiology seeks to improve public health by identifying risk factors for cancer and other&#xD;
      diseases and conveying that information to relevant audiences (e.g., physicians, the public).&#xD;
      The audience is presumed to understand and use that information to make appropriate decisions&#xD;
      about lifestyle behaviors and medical treatments. Yet, even though a single risk factor can&#xD;
      affect the risk of multiple health outcomes, this information is seldom communicated to&#xD;
      people in a way that optimizes their understanding of the importance of engaging in a single&#xD;
      healthy behavior. Providing individuals with the ability to understand how a single behavior&#xD;
      (obtaining sufficient physical activity) could affect their risk of developing multiple&#xD;
      diseases could foster a more coherent and meaningful picture of the behavior's importance in&#xD;
      reducing health risks, increase motivation and intentions to engage in the behavior, and over&#xD;
      time improve public health.&#xD;
&#xD;
      The proposed study translates epidemiological data about five diseases that cause significant&#xD;
      morbidity and mortality (i.e., colon cancer, breast cancer (women), heart disease, diabetes,&#xD;
      and stroke) into a visual display that conveys individualized risk estimates in a&#xD;
      comprehensible, meaningful, and useful way to diverse lay audiences.&#xD;
    </textblock>
  </brief_summary>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">June 27, 2017</start_date>
  <completion_date type="Actual">January 3, 2019</completion_date>
  <primary_completion_date type="Actual">January 3, 2019</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Factorial Assignment</intervention_model>
    <intervention_model_description>Participants were randomly assigned by a computer algorithm to one of six intervention arms according to a 3 (risk display format: text, table, ladder) x 2 (imagery behavior: exercise, sleep) between-subjects factorial design. Although randomization was done at the same time and at the beginning of the study, participants received the risk display intervention first, then answered a survey containing two of the primary outcomes, then received the mental imagery intervention followed by another survey.</intervention_model_description>
    <primary_purpose>Prevention</primary_purpose>
    <masking>Single (Investigator)</masking>
    <masking_description>The research staff will be blinded to participants' risk display format conditions, but they will be unblinded to mental imagery behavior condition</masking_description>
  </study_design_info>
  <primary_outcome>
    <measure>Change From Baseline to 90-day Follow-up in Self Reported Weekly Minutes of Exercise</measure>
    <time_frame>Baseline and up to 90 days</time_frame>
  </primary_outcome>
  <primary_outcome>
    <measure>Difference in Gist Comprehension of Risk Information by Risk Display Format</measure>
    <time_frame>Baseline</time_frame>
    <description>Risk display format = risk ladder, table, or text&#xD;
Gist comprehension of risk information: being able to extract the bottom-line meaning of information provided by the website (e.g., if exercising decreased heath risk)&#xD;
Measured by the sum of (4) questions coded as correctly comprehending risk information (1 point) or incorrectly comprehending risk information (0 points), with a total score range of 0=low comprehension to 4=high comprehension. Higher comprehension is considered a better outcome.&#xD;
All comprehension questions have an additional &quot;don't know&quot; option, which is counted as incorrect.&#xD;
To limit participant burden, the investigators assessed comprehension for diabetes only, instead of all diseases as planned.&#xD;
Comprehension will not be assessed for people who report a history of diabetes because they are not given risk information.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Difference in Verbatim Comprehension of Risk Information by Risk Communication Strategy</measure>
    <time_frame>Baseline</time_frame>
    <description>Risk communication strategy = risk ladder, table, or text&#xD;
Verbatim comprehension of risk information: being able to recall the exact information specific to diabetes risk and hours of recommended weekly physical activity&#xD;
Measured by the sum of (3) questions coded as correctly comprehending information (1 point) or incorrectly comprehending information (0 points), with a total score range of 0=low comprehension to 3=high comprehension. Higher comprehension is considered a better outcome.&#xD;
All comprehension questions have an additional &quot;don't know&quot; option, which is counted as incorrect.&#xD;
To limit participant burden, the investigators assessed comprehension for diabetes only, instead of all diseases as planned.&#xD;
Comprehension will not be assessed for people who report a history of diabetes because they are not given risk information.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Difference in Self-reported Intentions to Engage in Physical Activity by Risk Display Format</measure>
    <time_frame>Baseline</time_frame>
    <description>Risk display format = risk ladder, table, or text&#xD;
Self-reported physical activity intentions is defined as intentions to engage in physical activity in the next 3 months&#xD;
Measured as an average of three variables, each measured on a 5 point Likert Scale (range: 1=lower intentions to 5=higher intentions)&#xD;
Higher intentions are considered a better outcome</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Effect of the Intervention on Physical Activity Levels as Measured by Maintenance Self-efficacy</measure>
    <time_frame>90 days</time_frame>
    <description>Maintenance Self-efficacy is defined as being sure one can engage in physical activity even when it is hard&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Maintenance Self-efficacy to 4=higher Maintenance Self-efficacy)&#xD;
Higher maintenance self-efficacy is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Effect of the Intervention on Physical Activity Levels as Measured by Recovery Self-efficacy</measure>
    <time_frame>90 days</time_frame>
    <description>Recovery Self-efficacy is defined as being sure one can re-engage in physical activity after putting it off&#xD;
Measured on a 4 point Likert Scale (range: 1=lower recovery Self-efficacy to 4=higher recovery Self-efficacy)&#xD;
Higher recovery self-efficacy is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Effect of the Intervention on Physical Activity Levels as Measured by Affective Attitudes to Exercise - Enjoying Behavior</measure>
    <time_frame>90 days</time_frame>
    <description>Affective Attitudes to Exercise - Enjoying Behavior is defined as thinking getting regular exercise is enjoyable&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Affective Attitudes to Exercise to 4=higher Affective Attitudes to Exercise)&#xD;
Higher Affective Attitudes to Exercise - Enjoying Behavior is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Effect of the Intervention on Physical Activity Levels as Measured by Affective Attitudes to Exercise - Thinking Behavior is Unpleasant</measure>
    <time_frame>90 days</time_frame>
    <description>Affective Attitudes to Exercise - Thinking Behavior is Unpleasant is defined as not thinking getting regular exercise is unpleasant&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Affective Attitudes to Exercise to 4=higher Affective Attitudes to Exercise)&#xD;
Higher Affective Attitudes to Exercise - Thinking Behavior is Unpleasant is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Effect of the Intervention on Physical Activity Levels as Measured by Perceived Vividness of Self-regulatory Imagery</measure>
    <time_frame>90 days</time_frame>
    <description>Perceived Vividness of Self-regulatory Imagery is defined as having clear and vivid images of steps towards getting physical activity&#xD;
Measured as an average of two variables measured on a 4 point Likert Scale (range: 1=lower Perceived Vividness of Self-regulatory Imagery to 4=higher Perceived Vividness of Self-regulatory Imagery)&#xD;
Higher Perceived Vividness of Self-regulatory Imagery is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Effect of the Intervention on Physical Activity Levels as Measured by Action Planning</measure>
    <time_frame>90 days</time_frame>
    <description>Action planning is defined as having a detailed plan about getting adequate physical activity&#xD;
Measured as an average of three variables measured on a 4 point Likert Scale (range: 1=lower action planning to 4=higher action planning)&#xD;
Higher action planning is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Effect of the Intervention on Physical Activity Levels as Measured by Coping Planning</measure>
    <time_frame>90 days</time_frame>
    <description>Coping planning is defined as having a detailed plan of solving problems that may prevent getting adequate physical activity&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Coping Planning to 4=higher Coping Planning)&#xD;
Higher coping planning is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Effect of the Intervention on Physical Activity Levels as Measured by Action Self-efficacy</measure>
    <time_frame>90 days</time_frame>
    <description>Action self-efficacy is defined as having the confidence to engage in physical activity&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Action Self-efficacy to 4=higher Action Self-efficacy)&#xD;
Higher Action Self-efficacy is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
  </secondary_outcome>
  <number_of_arms>6</number_of_arms>
  <enrollment type="Actual">554</enrollment>
  <condition>Healthy Volunteers</condition>
  <arm_group>
    <arm_group_label>Risk Display Format:Risk Ladder:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Risk Display Format:Risk Ladder:Imagery Behavior:Sleep</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Risk Display Format:Table:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Risk Display Format:Table: Imagery Behavior:Sleep</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Risk Display Format:Text:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Risk Display Format:Text:Imagery Behavior:Sleep</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Risk Assessment App</intervention_name>
    <description>The App provides participants with personalized risk results for colon cancer, breast cancer (women), heart disease, diabetes, and stroke.</description>
    <arm_group_label>Risk Display Format:Risk Ladder:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Risk Ladder:Imagery Behavior:Sleep</arm_group_label>
    <arm_group_label>Risk Display Format:Table: Imagery Behavior:Sleep</arm_group_label>
    <arm_group_label>Risk Display Format:Table:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Text:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Text:Imagery Behavior:Sleep</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Audio Recording - Sleep</intervention_name>
    <description>-Participants imagine themselves improving sleep hygiene</description>
    <arm_group_label>Risk Display Format:Risk Ladder:Imagery Behavior:Sleep</arm_group_label>
    <arm_group_label>Risk Display Format:Table: Imagery Behavior:Sleep</arm_group_label>
    <arm_group_label>Risk Display Format:Text:Imagery Behavior:Sleep</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Surveys</intervention_name>
    <description>Assesses information comprehension, intentions, perceived risk and severity worry, self- efficacy, response efficacy, affect, race, education, age, numeracy, graph literacy, and exercise and sleep behaviors.</description>
    <arm_group_label>Risk Display Format:Risk Ladder:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Risk Ladder:Imagery Behavior:Sleep</arm_group_label>
    <arm_group_label>Risk Display Format:Table: Imagery Behavior:Sleep</arm_group_label>
    <arm_group_label>Risk Display Format:Table:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Text:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Text:Imagery Behavior:Sleep</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Audio Recording - Exercise</intervention_name>
    <description>Participants imagine themselves improving exercise</description>
    <arm_group_label>Risk Display Format:Risk Ladder:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Table:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Text:Imagery Behavior:Exercise</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Text message reminders</intervention_name>
    <description>-Reminders to practice mental imagery</description>
    <arm_group_label>Risk Display Format:Risk Ladder:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Risk Ladder:Imagery Behavior:Sleep</arm_group_label>
    <arm_group_label>Risk Display Format:Table: Imagery Behavior:Sleep</arm_group_label>
    <arm_group_label>Risk Display Format:Table:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Text:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Text:Imagery Behavior:Sleep</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Text Message Survey</intervention_name>
    <description>-Assesses exercise behavior, intentions, actions plans, self-efficacy, affect, imagery vividness, and practice.</description>
    <arm_group_label>Risk Display Format:Risk Ladder:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Risk Ladder:Imagery Behavior:Sleep</arm_group_label>
    <arm_group_label>Risk Display Format:Table: Imagery Behavior:Sleep</arm_group_label>
    <arm_group_label>Risk Display Format:Table:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Text:Imagery Behavior:Exercise</arm_group_label>
    <arm_group_label>Risk Display Format:Text:Imagery Behavior:Sleep</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  30-64 years of age&#xD;
&#xD;
          -  Less than (3) relevant comorbidities (diabetes, heart disease, stroke, and cancer,&#xD;
             where cancer counts as (2) comorbidities for women but (1) for men)&#xD;
&#xD;
          -  Having a SMS capable mobile phone that is not shared with anyone else&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Not meeting national guidelines for aerobic physical activity (i.e., at least 150&#xD;
             minutes per week of moderate intensity aerobic physical activity)&#xD;
&#xD;
          -  Participants from HRPO# 201501028 will be ineligible for this study&#xD;
&#xD;
          -  Uses text messaging less than once per month&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>30 Years</minimum_age>
    <maximum_age>64 Years</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Erika Waters, MPH, Ph.D.</last_name>
    <role>Principal Investigator</role>
    <affiliation>Washington University School of Medicine</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Washington University School of Medicine</name>
      <address>
        <city>Saint Louis</city>
        <state>Missouri</state>
        <zip>63110</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <link>
    <url>http://www.siteman.wustl.edu</url>
    <description>Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine</description>
  </link>
  <verification_date>January 2020</verification_date>
  <study_first_submitted>August 7, 2017</study_first_submitted>
  <study_first_submitted_qc>August 18, 2017</study_first_submitted_qc>
  <study_first_posted type="Actual">August 21, 2017</study_first_posted>
  <results_first_submitted>December 12, 2019</results_first_submitted>
  <results_first_submitted_qc>January 9, 2020</results_first_submitted_qc>
  <results_first_posted type="Actual">January 18, 2020</results_first_posted>
  <last_update_submitted>January 9, 2020</last_update_submitted>
  <last_update_submitted_qc>January 9, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">January 18, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <provided_document_section>
    <provided_document>
      <document_type>Study Protocol and Statistical Analysis Plan</document_type>
      <document_has_protocol>Yes</document_has_protocol>
      <document_has_icf>No</document_has_icf>
      <document_has_sap>Yes</document_has_sap>
      <document_date>May 4, 2017</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/91/NCT03255291/Prot_SAP_000.pdf</document_url>
    </provided_document>
  </provided_document_section>

  <clinical_results>

    <participant_flow>
      <group_list>
        <group group_id="P1">
          <title>Risk Display Format:Risk Ladder:Imagery Behavior:Exercise</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="P2">
          <title>Risk Display Format:Risk Ladder:Imagery Behavior:Sleep</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="P3">
          <title>Risk Display Format:Table:Imagery Behavior:Exercise</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="P4">
          <title>Risk Display Format:Table: Imagery Behavior:Sleep</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="P5">
          <title>Risk Display Format:Text:Imagery Behavior:Exercise</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="P6">
          <title>Risk Display Format:Text:Imagery Behavior:Sleep</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
      </group_list>
      <period_list>
        <period>
          <title>Overall Study</title>
          <milestone_list>
            <milestone>
              <title>STARTED</title>
              <participants_list>
                <participants group_id="P1" count="93"/>
                <participants group_id="P2" count="90"/>
                <participants group_id="P3" count="91"/>
                <participants group_id="P4" count="90"/>
                <participants group_id="P5" count="95"/>
                <participants group_id="P6" count="95"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="80"/>
                <participants group_id="P2" count="78"/>
                <participants group_id="P3" count="85"/>
                <participants group_id="P4" count="84"/>
                <participants group_id="P5" count="88"/>
                <participants group_id="P6" count="85"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>NOT COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="13"/>
                <participants group_id="P2" count="12"/>
                <participants group_id="P3" count="6"/>
                <participants group_id="P4" count="6"/>
                <participants group_id="P5" count="7"/>
                <participants group_id="P6" count="10"/>
              </participants_list>
            </milestone>
          </milestone_list>
          <drop_withdraw_reason_list>
            <drop_withdraw_reason>
              <title>Determined to be ineligible</title>
              <participants_list>
                <participants group_id="P1" count="10"/>
                <participants group_id="P2" count="12"/>
                <participants group_id="P3" count="6"/>
                <participants group_id="P4" count="6"/>
                <participants group_id="P5" count="5"/>
                <participants group_id="P6" count="10"/>
              </participants_list>
            </drop_withdraw_reason>
            <drop_withdraw_reason>
              <title>Baseline data collection issues</title>
              <participants_list>
                <participants group_id="P1" count="3"/>
                <participants group_id="P2" count="0"/>
                <participants group_id="P3" count="0"/>
                <participants group_id="P4" count="0"/>
                <participants group_id="P5" count="2"/>
                <participants group_id="P6" count="0"/>
              </participants_list>
            </drop_withdraw_reason>
          </drop_withdraw_reason_list>
        </period>
      </period_list>
    </participant_flow>

    <baseline>
      <group_list>
        <group group_id="B1">
          <title>Risk Display Format:Risk Ladder:Imagery Behavior:Exercise</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="B2">
          <title>Risk Display Format:Risk Ladder:Imagery Behavior:Sleep</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="B3">
          <title>Risk Display Format:Table:Imagery Behavior:Exercise</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="B4">
          <title>Risk Display Format:Table:Imagery Behavior:Sleep</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="B5">
          <title>Risk Display Format:Text:Imagery Behavior:Exercise</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="B6">
          <title>Risk Display Format:Text:Imagery Behavior:Sleep</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="B7">
          <title>Total</title>
          <description>Total of all reporting groups</description>
        </group>
      </group_list>
      <analyzed_list>
        <analyzed>
          <units>Participants</units>
          <scope>Overall</scope>
          <count_list>
            <count group_id="B1" value="80"/>
            <count group_id="B2" value="78"/>
            <count group_id="B3" value="85"/>
            <count group_id="B4" value="84"/>
            <count group_id="B5" value="88"/>
            <count group_id="B6" value="85"/>
            <count group_id="B7" value="500"/>
          </count_list>
        </analyzed>
      </analyzed_list>
      <measure_list>
        <measure>
          <title>Age</title>
          <units>years</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="47.2" spread="9.8"/>
                    <measurement group_id="B2" value="47.3" spread="8.7"/>
                    <measurement group_id="B3" value="50.3" spread="9.9"/>
                    <measurement group_id="B4" value="49.8" spread="9.9"/>
                    <measurement group_id="B5" value="46.8" spread="10.7"/>
                    <measurement group_id="B6" value="47.2" spread="10.5"/>
                    <measurement group_id="B7" value="48.1" spread="10.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Sex: Female, Male</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Female</title>
                  <measurement_list>
                    <measurement group_id="B1" value="63"/>
                    <measurement group_id="B2" value="67"/>
                    <measurement group_id="B3" value="68"/>
                    <measurement group_id="B4" value="67"/>
                    <measurement group_id="B5" value="69"/>
                    <measurement group_id="B6" value="73"/>
                    <measurement group_id="B7" value="407"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Male</title>
                  <measurement_list>
                    <measurement group_id="B1" value="17"/>
                    <measurement group_id="B2" value="11"/>
                    <measurement group_id="B3" value="17"/>
                    <measurement group_id="B4" value="17"/>
                    <measurement group_id="B5" value="19"/>
                    <measurement group_id="B6" value="12"/>
                    <measurement group_id="B7" value="93"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Ethnicity (NIH/OMB)</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Hispanic or Latino</title>
                  <measurement_list>
                    <measurement group_id="B1" value="4"/>
                    <measurement group_id="B2" value="1"/>
                    <measurement group_id="B3" value="1"/>
                    <measurement group_id="B4" value="5"/>
                    <measurement group_id="B5" value="4"/>
                    <measurement group_id="B6" value="2"/>
                    <measurement group_id="B7" value="17"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not Hispanic or Latino</title>
                  <measurement_list>
                    <measurement group_id="B1" value="76"/>
                    <measurement group_id="B2" value="77"/>
                    <measurement group_id="B3" value="84"/>
                    <measurement group_id="B4" value="79"/>
                    <measurement group_id="B5" value="84"/>
                    <measurement group_id="B6" value="83"/>
                    <measurement group_id="B7" value="483"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Unknown or Not Reported</title>
                  <measurement_list>
                    <measurement group_id="B1" value="0"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="0"/>
                    <measurement group_id="B4" value="0"/>
                    <measurement group_id="B5" value="0"/>
                    <measurement group_id="B6" value="0"/>
                    <measurement group_id="B7" value="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Race/Ethnicity, Customized</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <title>American Indian/Alaskan Native</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="1"/>
                    <measurement group_id="B4" value="0"/>
                    <measurement group_id="B5" value="0"/>
                    <measurement group_id="B6" value="0"/>
                    <measurement group_id="B7" value="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Asian/Pacific Islander</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="2"/>
                    <measurement group_id="B4" value="0"/>
                    <measurement group_id="B5" value="1"/>
                    <measurement group_id="B6" value="2"/>
                    <measurement group_id="B7" value="6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Black/African American</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="27"/>
                    <measurement group_id="B2" value="35"/>
                    <measurement group_id="B3" value="26"/>
                    <measurement group_id="B4" value="37"/>
                    <measurement group_id="B5" value="37"/>
                    <measurement group_id="B6" value="23"/>
                    <measurement group_id="B7" value="185"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>White/Caucasian</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="49"/>
                    <measurement group_id="B2" value="43"/>
                    <measurement group_id="B3" value="50"/>
                    <measurement group_id="B4" value="40"/>
                    <measurement group_id="B5" value="46"/>
                    <measurement group_id="B6" value="56"/>
                    <measurement group_id="B7" value="284"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Multiracial/Other</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="2"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="6"/>
                    <measurement group_id="B4" value="7"/>
                    <measurement group_id="B5" value="4"/>
                    <measurement group_id="B6" value="4"/>
                    <measurement group_id="B7" value="23"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Region of Enrollment</title>
          <units>participants</units>
          <param>Number</param>
          <class_list>
            <class>
              <title>United States</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="80"/>
                    <measurement group_id="B2" value="78"/>
                    <measurement group_id="B3" value="85"/>
                    <measurement group_id="B4" value="84"/>
                    <measurement group_id="B5" value="88"/>
                    <measurement group_id="B6" value="85"/>
                    <measurement group_id="B7" value="500"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Vocational-technical training or less</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="20"/>
                    <measurement group_id="B2" value="20"/>
                    <measurement group_id="B3" value="14"/>
                    <measurement group_id="B4" value="14"/>
                    <measurement group_id="B5" value="15"/>
                    <measurement group_id="B6" value="14"/>
                    <measurement group_id="B7" value="97"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Body mass index (BMI) - Obese</title>
          <description>-Having a BMI of 30 or greater</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="38"/>
                    <measurement group_id="B2" value="32"/>
                    <measurement group_id="B3" value="46"/>
                    <measurement group_id="B4" value="52"/>
                    <measurement group_id="B5" value="48"/>
                    <measurement group_id="B6" value="42"/>
                    <measurement group_id="B7" value="258"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Body mass index (BMI) - Overweight</title>
          <description>-Having a BMI of 25 - less than 30</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="21"/>
                    <measurement group_id="B2" value="23"/>
                    <measurement group_id="B3" value="19"/>
                    <measurement group_id="B4" value="15"/>
                    <measurement group_id="B5" value="24"/>
                    <measurement group_id="B6" value="25"/>
                    <measurement group_id="B7" value="127"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>1+ comorbidity</title>
          <description>-Does the participant have one more serious comorbidities (cancer, diabetes, heart disease, stroke)?</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="14"/>
                    <measurement group_id="B2" value="6"/>
                    <measurement group_id="B3" value="21"/>
                    <measurement group_id="B4" value="17"/>
                    <measurement group_id="B5" value="19"/>
                    <measurement group_id="B6" value="15"/>
                    <measurement group_id="B7" value="92"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Baseline Exercise (minutes per week in last 7 days)</title>
          <units>minutes</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="56.7" spread="44.8"/>
                    <measurement group_id="B2" value="56.9" spread="45.1"/>
                    <measurement group_id="B3" value="53.9" spread="47.4"/>
                    <measurement group_id="B4" value="50.2" spread="45.4"/>
                    <measurement group_id="B5" value="41.3" spread="41.1"/>
                    <measurement group_id="B6" value="56.0" spread="43.4"/>
                    <measurement group_id="B7" value="52.3" spread="44.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Self-Reported Health</title>
          <description>-Self-reported health consisted of question asking &quot;In general, would you say that your health is.&quot; with choices of Excellent, Very good, Good, Fair, or Poor. Measured on a scale of 1-5, with 5 being higher self-reported health.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="3.0" spread="1.0"/>
                    <measurement group_id="B2" value="3.1" spread="0.9"/>
                    <measurement group_id="B3" value="3.0" spread="1.0"/>
                    <measurement group_id="B4" value="3.1" spread="0.9"/>
                    <measurement group_id="B5" value="3.0" spread="0.9"/>
                    <measurement group_id="B6" value="3.0" spread="0.9"/>
                    <measurement group_id="B7" value="3.0" spread="0.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Numeracy</title>
          <description>Scale of 0-3; Measured as a sum score of (correct/incorrect) of 3 questions, participant answers each question as fill in the blank.&#xD;
&quot;Imagine that we flip a fair coin 1,000 times. What is your best guess about how many times the coin would come up heads in 1,000 flips?&quot;&#xD;
&quot;Image that the chance of getting a disease is 1%. If there were 1,000 people, about how many would be expected to get the disease?&quot;&#xD;
&quot;Image that the chance of getting an infection is 1 in 1,000. What percent of people would be expected to get the infection?&quot;</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="1.6" spread="1.0"/>
                    <measurement group_id="B2" value="1.3" spread="0.9"/>
                    <measurement group_id="B3" value="1.7" spread="1.0"/>
                    <measurement group_id="B4" value="1.5" spread="1.1"/>
                    <measurement group_id="B5" value="1.5" spread="1.1"/>
                    <measurement group_id="B6" value="1.6" spread="1.0"/>
                    <measurement group_id="B7" value="1.5" spread="1.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Graph literacy</title>
          <description>Scale of 1-4; Measured as a sum score of (correct/incorrect) of 4 questions. An example item is:&#xD;
&quot;The graph below shows the percentage of people who die from different types of cancer. About what percentage of people who die from cancer die from cancer B, cancer C, and cancer D combined?&quot;</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="2.5" spread="1.1"/>
                    <measurement group_id="B2" value="2.1" spread="1.2"/>
                    <measurement group_id="B3" value="2.2" spread="1.2"/>
                    <measurement group_id="B4" value="2.3" spread="1.1"/>
                    <measurement group_id="B5" value="2.2" spread="1.2"/>
                    <measurement group_id="B6" value="2.6" spread="1.0"/>
                    <measurement group_id="B7" value="2.3" spread="1.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </measure_list>
    </baseline>

    <outcome_list>
      <outcome>
        <type>Primary</type>
        <title>Change From Baseline to 90-day Follow-up in Self Reported Weekly Minutes of Exercise</title>
        <time_frame>Baseline and up to 90 days</time_frame>
        <population>Additional participants who did not complete the 90 day follow up survey or completed the survey over 8 weeks late, were inattentive responders, had text messaging errors, or were considered an outlier (&gt;99th percentile) in change in minutes of exercise per week were excluded for analysis</population>
        <group_list>
          <group group_id="O1">
            <title>Risk Display Format:Risk Ladder:Imagery Behavior:Exercise</title>
            <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
          </group>
          <group group_id="O2">
            <title>Risk Display Format:Risk Ladder:Imagery Behavior:Sleep</title>
            <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
          </group>
          <group group_id="O3">
            <title>Risk Display Format:Table:Imagery Behavior:Exercise</title>
            <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
          </group>
          <group group_id="O4">
            <title>Risk Display Format:Table: Imagery Behavior:Sleep</title>
            <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
          </group>
          <group group_id="O5">
            <title>Risk Display Format:Text:Imagery Behavior:Exercise</title>
            <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
          </group>
          <group group_id="O6">
            <title>Risk Display Format:Text:Imagery Behavior:Sleep</title>
            <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
          </group>
        </group_list>
        <measure>
          <title>Change From Baseline to 90-day Follow-up in Self Reported Weekly Minutes of Exercise</title>
          <population>Additional participants who did not complete the 90 day follow up survey or completed the survey over 8 weeks late, were inattentive responders, had text messaging errors, or were considered an outlier (&gt;99th percentile) in change in minutes of exercise per week were excluded for analysis</population>
          <units>minutes</units>
          <param>Least Squares Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="70"/>
                <count group_id="O2" value="66"/>
                <count group_id="O3" value="72"/>
                <count group_id="O4" value="67"/>
                <count group_id="O5" value="73"/>
                <count group_id="O6" value="72"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="92.2" spread="12.7"/>
                    <measurement group_id="O2" value="37.5" spread="13.4"/>
                    <measurement group_id="O3" value="63.1" spread="12.4"/>
                    <measurement group_id="O4" value="60.0" spread="12.9"/>
                    <measurement group_id="O5" value="50.1" spread="12.5"/>
                    <measurement group_id="O6" value="49.3" spread="13.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
              <group_id>O4</group_id>
              <group_id>O6</group_id>
            </group_id_list>
            <groups_desc>The investigators tested whether weekly minutes of exercise at 90 day follow-up was higher in the exercise mental imagery condition than in the sleep mental imagery condition</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <non_inferiority_desc>A Dunnett adjustment was used to adjust for multiple comparisons</non_inferiority_desc>
            <p_value>0.0288</p_value>
            <method>ANCOVA</method>
            <method_desc>Covariates: sex, race, age, education, health literacy, season, risk display problem, acceptability, self-reported health, and baseline exercise.</method_desc>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O5</group_id>
              <group_id>O6</group_id>
            </group_id_list>
            <groups_desc>-The investigators tested whether weekly minutes of exercise differed among the three risk display formats: risk ladder, table, and alphanumeric text.</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <non_inferiority_desc>-A Dunnett adjustment was used to adjust for multiple comparisons</non_inferiority_desc>
            <p_value>0.3329</p_value>
            <method>ANCOVA</method>
            <method_desc>Covariates: sex, race, age, education, health literacy, season, risk display problem, acceptability, self-reported health, and baseline exercise.</method_desc>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O6</group_id>
            </group_id_list>
            <groups_desc>-The investigators tested whether weekly minutes of exercise was influenced by an interaction between risk display format and mental imagery behavior</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <non_inferiority_desc>-A Dunnett adjustment was used to adjust for multiple comparisons</non_inferiority_desc>
            <p_value>0.0215</p_value>
            <method>ANCOVA</method>
            <method_desc>Covariates: sex, race, age, education, health literacy, season, risk display problem, acceptability, self-reported health, and baseline exercise.</method_desc>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Difference in Gist Comprehension of Risk Information by Risk Display Format</title>
        <description>Risk display format = risk ladder, table, or text&#xD;
Gist comprehension of risk information: being able to extract the bottom-line meaning of information provided by the website (e.g., if exercising decreased heath risk)&#xD;
Measured by the sum of (4) questions coded as correctly comprehending risk information (1 point) or incorrectly comprehending risk information (0 points), with a total score range of 0=low comprehension to 4=high comprehension. Higher comprehension is considered a better outcome.&#xD;
All comprehension questions have an additional &quot;don't know&quot; option, which is counted as incorrect.&#xD;
To limit participant burden, the investigators assessed comprehension for diabetes only, instead of all diseases as planned.&#xD;
Comprehension will not be assessed for people who report a history of diabetes because they are not given risk information.</description>
        <time_frame>Baseline</time_frame>
        <population>This study was designed as a 3X2 factorial design &amp; only the risk display format intervention (risk ladder, table, or text) was looked at for this outcome, as participants had not yet received the mental imagery intervention, thus it could not affect this outcome.</population>
        <group_list>
          <group group_id="O1">
            <title>Risk Display Format: Risk Ladder</title>
            <description>-The personalized risk estimates were shown to participants as a risk ladder.</description>
          </group>
          <group group_id="O2">
            <title>Risk Display Format: Table</title>
            <description>-The personalized risk estimates were shown to participants as a table.</description>
          </group>
          <group group_id="O3">
            <title>Risk Display Format: Text</title>
            <description>-The personalized risk estimates were shown to participants as text.</description>
          </group>
        </group_list>
        <measure>
          <title>Difference in Gist Comprehension of Risk Information by Risk Display Format</title>
          <description>Risk display format = risk ladder, table, or text&#xD;
Gist comprehension of risk information: being able to extract the bottom-line meaning of information provided by the website (e.g., if exercising decreased heath risk)&#xD;
Measured by the sum of (4) questions coded as correctly comprehending risk information (1 point) or incorrectly comprehending risk information (0 points), with a total score range of 0=low comprehension to 4=high comprehension. Higher comprehension is considered a better outcome.&#xD;
All comprehension questions have an additional &quot;don't know&quot; option, which is counted as incorrect.&#xD;
To limit participant burden, the investigators assessed comprehension for diabetes only, instead of all diseases as planned.&#xD;
Comprehension will not be assessed for people who report a history of diabetes because they are not given risk information.</description>
          <population>This study was designed as a 3X2 factorial design &amp; only the risk display format intervention (risk ladder, table, or text) was looked at for this outcome, as participants had not yet received the mental imagery intervention, thus it could not affect this outcome.</population>
          <units>score on a scale</units>
          <param>Least Squares Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="125"/>
                <count group_id="O2" value="120"/>
                <count group_id="O3" value="127"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.6" spread="0.1"/>
                    <measurement group_id="O2" value="3.4" spread="0.1"/>
                    <measurement group_id="O3" value="3.2" spread="0.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
              <group_id>O3</group_id>
            </group_id_list>
            <groups_desc>-This study was designed as a 3X2 factorial design and only the risk display format intervention (risk ladder, table, or text) was looked at for this outcome, as participants had not yet received the mental imagery intervention, thus it could not affect this outcome. A Dunnett adjustment was used to adjust for multiple comparisons.</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <p_value>0.0333</p_value>
            <p_value_desc>-A Dunnett adjustment was used to adjust for multiple comparisons</p_value_desc>
            <method>ANCOVA</method>
            <method_desc>Covariates were sex, race, age, education, numeracy, and graph literacy.</method_desc>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Difference in Verbatim Comprehension of Risk Information by Risk Communication Strategy</title>
        <description>Risk communication strategy = risk ladder, table, or text&#xD;
Verbatim comprehension of risk information: being able to recall the exact information specific to diabetes risk and hours of recommended weekly physical activity&#xD;
Measured by the sum of (3) questions coded as correctly comprehending information (1 point) or incorrectly comprehending information (0 points), with a total score range of 0=low comprehension to 3=high comprehension. Higher comprehension is considered a better outcome.&#xD;
All comprehension questions have an additional &quot;don't know&quot; option, which is counted as incorrect.&#xD;
To limit participant burden, the investigators assessed comprehension for diabetes only, instead of all diseases as planned.&#xD;
Comprehension will not be assessed for people who report a history of diabetes because they are not given risk information.</description>
        <time_frame>Baseline</time_frame>
        <population>This study was designed as a 3X2 factorial design &amp; only the risk display format intervention (risk ladder, table, or text) was looked at for this outcome, as participants had not yet received the mental imagery intervention, thus it could not affect this outcome.</population>
        <group_list>
          <group group_id="O1">
            <title>Risk Display Format: Risk Ladder</title>
            <description>-The personalized risk estimates were shown to participants as a risk ladder.</description>
          </group>
          <group group_id="O2">
            <title>Risk Display Format: Table</title>
            <description>-The personalized risk estimates were shown to participants as a table.</description>
          </group>
          <group group_id="O3">
            <title>Risk Display Format: Text</title>
            <description>-The personalized risk estimates were shown to participants as text.</description>
          </group>
        </group_list>
        <measure>
          <title>Difference in Verbatim Comprehension of Risk Information by Risk Communication Strategy</title>
          <description>Risk communication strategy = risk ladder, table, or text&#xD;
Verbatim comprehension of risk information: being able to recall the exact information specific to diabetes risk and hours of recommended weekly physical activity&#xD;
Measured by the sum of (3) questions coded as correctly comprehending information (1 point) or incorrectly comprehending information (0 points), with a total score range of 0=low comprehension to 3=high comprehension. Higher comprehension is considered a better outcome.&#xD;
All comprehension questions have an additional &quot;don't know&quot; option, which is counted as incorrect.&#xD;
To limit participant burden, the investigators assessed comprehension for diabetes only, instead of all diseases as planned.&#xD;
Comprehension will not be assessed for people who report a history of diabetes because they are not given risk information.</description>
          <population>This study was designed as a 3X2 factorial design &amp; only the risk display format intervention (risk ladder, table, or text) was looked at for this outcome, as participants had not yet received the mental imagery intervention, thus it could not affect this outcome.</population>
          <units>score on a scale</units>
          <param>Least Squares Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="125"/>
                <count group_id="O2" value="120"/>
                <count group_id="O3" value="127"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.6" spread="0.1"/>
                    <measurement group_id="O2" value="1.6" spread="0.1"/>
                    <measurement group_id="O3" value="1.5" spread="0.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
              <group_id>O3</group_id>
            </group_id_list>
            <groups_desc>This study was designed as a 3X2 factorial design &amp; only the risk display format intervention (risk ladder, table, or text) was looked at for this outcome, as participants had not yet received the mental imagery intervention, thus it could not affect this outcome.</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <p_value>0.4946</p_value>
            <p_value_desc>-A Dunnett adjustment was used to adjust for multiple comparisons</p_value_desc>
            <method>ANCOVA</method>
            <method_desc>Covariates were sex, race, age, education, numeracy, and graph literacy.</method_desc>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Difference in Self-reported Intentions to Engage in Physical Activity by Risk Display Format</title>
        <description>Risk display format = risk ladder, table, or text&#xD;
Self-reported physical activity intentions is defined as intentions to engage in physical activity in the next 3 months&#xD;
Measured as an average of three variables, each measured on a 5 point Likert Scale (range: 1=lower intentions to 5=higher intentions)&#xD;
Higher intentions are considered a better outcome</description>
        <time_frame>Baseline</time_frame>
        <population>This study was designed as a 3X2 factorial design &amp; only the risk display format intervention (risk ladder, table, or text) was looked at for this outcome, as participants had not yet received the mental imagery intervention, thus it could not affect this outcome.</population>
        <group_list>
          <group group_id="O1">
            <title>Risk Display Format: Risk Ladder</title>
            <description>-The personalized risk estimates were shown to participants as a risk ladder.</description>
          </group>
          <group group_id="O2">
            <title>Risk Display Format: Table</title>
            <description>-The personalized risk estimates were shown to participants as a table.</description>
          </group>
          <group group_id="O3">
            <title>Risk Display Format: Text</title>
            <description>-The personalized risk estimates were shown to participants as text.</description>
          </group>
        </group_list>
        <measure>
          <title>Difference in Self-reported Intentions to Engage in Physical Activity by Risk Display Format</title>
          <description>Risk display format = risk ladder, table, or text&#xD;
Self-reported physical activity intentions is defined as intentions to engage in physical activity in the next 3 months&#xD;
Measured as an average of three variables, each measured on a 5 point Likert Scale (range: 1=lower intentions to 5=higher intentions)&#xD;
Higher intentions are considered a better outcome</description>
          <population>This study was designed as a 3X2 factorial design &amp; only the risk display format intervention (risk ladder, table, or text) was looked at for this outcome, as participants had not yet received the mental imagery intervention, thus it could not affect this outcome.</population>
          <units>score on a scale</units>
          <param>Least Squares Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="125"/>
                <count group_id="O2" value="120"/>
                <count group_id="O3" value="127"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.9" spread="0.1"/>
                    <measurement group_id="O2" value="4.0" spread="0.1"/>
                    <measurement group_id="O3" value="3.8" spread="0.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
              <group_id>O3</group_id>
            </group_id_list>
            <groups_desc>This study was designed as a 3X2 factorial design &amp; only the risk display format intervention (risk ladder, table, or text) was looked at for this outcome, as participants had not yet received the mental imagery intervention, thus it could not affect this outcome.</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <p_value>0.1397</p_value>
            <method>ANCOVA</method>
            <method_desc>Covariates were sex, race, age, education, numeracy, and graph literacy.</method_desc>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Effect of the Intervention on Physical Activity Levels as Measured by Maintenance Self-efficacy</title>
        <description>Maintenance Self-efficacy is defined as being sure one can engage in physical activity even when it is hard&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Maintenance Self-efficacy to 4=higher Maintenance Self-efficacy)&#xD;
Higher maintenance self-efficacy is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
        <time_frame>90 days</time_frame>
        <population>Due to the limitations of data collection &amp; concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related maintenance self-efficacy among participants who engaged in the exercise-related mental imagery condition.</population>
        <group_list>
          <group group_id="O1">
            <title>Mental Imagery Behavior: Exercise</title>
            <description>-Participants engaged in mental imagery related to exercise goals</description>
          </group>
        </group_list>
        <measure>
          <title>Effect of the Intervention on Physical Activity Levels as Measured by Maintenance Self-efficacy</title>
          <description>Maintenance Self-efficacy is defined as being sure one can engage in physical activity even when it is hard&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Maintenance Self-efficacy to 4=higher Maintenance Self-efficacy)&#xD;
Higher maintenance self-efficacy is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
          <population>Due to the limitations of data collection &amp; concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related maintenance self-efficacy among participants who engaged in the exercise-related mental imagery condition.</population>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="229"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.95" spread="0.05"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>The secondary outcomes are hypothesized mediators of the effect of exercise-related mental imagery activities on future exercise behavior (e.g., exercise mental imagery will increase future exercise behavior by increasing exercise maintenance self-efficacy). Because these analyses are relevant only for the exercise condition, and the dichotomous mental imagery variable includes both exercise and sleep, it is not appropriate to include the dichtomous mental imagery variable in this analysis.</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <p_value>0.0070</p_value>
            <p_value_desc>Covariates: sex, race, age, education, risk display issue, health literacy, season, acceptability, self-reported health, adherence, baseline exercise</p_value_desc>
            <method>Mixed Models Analysis</method>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Effect of the Intervention on Physical Activity Levels as Measured by Recovery Self-efficacy</title>
        <description>Recovery Self-efficacy is defined as being sure one can re-engage in physical activity after putting it off&#xD;
Measured on a 4 point Likert Scale (range: 1=lower recovery Self-efficacy to 4=higher recovery Self-efficacy)&#xD;
Higher recovery self-efficacy is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
        <time_frame>90 days</time_frame>
        <population>Due to the limitations of data collection &amp; concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related recovery self-efficacy among participants who engaged in the exercise-related mental imagery condition.</population>
        <group_list>
          <group group_id="O1">
            <title>Mental Imagery Behavior: Exercise</title>
            <description>-Participants engaged in mental imagery related to exercise goals</description>
          </group>
        </group_list>
        <measure>
          <title>Effect of the Intervention on Physical Activity Levels as Measured by Recovery Self-efficacy</title>
          <description>Recovery Self-efficacy is defined as being sure one can re-engage in physical activity after putting it off&#xD;
Measured on a 4 point Likert Scale (range: 1=lower recovery Self-efficacy to 4=higher recovery Self-efficacy)&#xD;
Higher recovery self-efficacy is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
          <population>Due to the limitations of data collection &amp; concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related recovery self-efficacy among participants who engaged in the exercise-related mental imagery condition.</population>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="229"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.26" spread="0.05"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>The secondary outcomes are hypothesized mediators of the effect of exercise-related mental imagery activities on future exercise behavior (e.g., exercise mental imagery will increase future exercise behavior by increasing exercise recovery self-efficacy). Because these analyses are relevant only for the exercise condition, and the dichotomous mental imagery variable includes both exercise and sleep, it is not appropriate to include the dichtomous mental imagery variable in this analysis.</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <p_value>0.8793</p_value>
            <p_value_desc>Covariates: sex, race, age, education, risk display issue, health literacy, season, acceptability, self-reported health, adherence, baseline exercise</p_value_desc>
            <method>Mixed Models Analysis</method>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Effect of the Intervention on Physical Activity Levels as Measured by Affective Attitudes to Exercise - Enjoying Behavior</title>
        <description>Affective Attitudes to Exercise - Enjoying Behavior is defined as thinking getting regular exercise is enjoyable&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Affective Attitudes to Exercise to 4=higher Affective Attitudes to Exercise)&#xD;
Higher Affective Attitudes to Exercise - Enjoying Behavior is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
        <time_frame>90 days</time_frame>
        <population>Due to the limitations of data collection and concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related affective attitudes among participants who engaged in the exercise-related mental imagery condition.</population>
        <group_list>
          <group group_id="O1">
            <title>Mental Imagery Behavior: Exercise</title>
            <description>-Participants engaged in mental imagery related to exercise goals</description>
          </group>
        </group_list>
        <measure>
          <title>Effect of the Intervention on Physical Activity Levels as Measured by Affective Attitudes to Exercise - Enjoying Behavior</title>
          <description>Affective Attitudes to Exercise - Enjoying Behavior is defined as thinking getting regular exercise is enjoyable&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Affective Attitudes to Exercise to 4=higher Affective Attitudes to Exercise)&#xD;
Higher Affective Attitudes to Exercise - Enjoying Behavior is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
          <population>Due to the limitations of data collection and concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related affective attitudes among participants who engaged in the exercise-related mental imagery condition.</population>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="229"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.05" spread="0.05"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>The secondary outcomes are hypothesized mediators of the effect of the exercise-related mental imagery activities on future exercise behavior (e.g., exercise mental imagery will increase future exercise behavior by increasing exercise affective attitudes). Because these analyses are relevant only for the exercise condition, and the dichotomous mental imagery variable includes both exercise and sleep, it is not appropriate to include the dichotomous mental imagery variable in this analysis.</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <p_value>0.4673</p_value>
            <p_value_desc>Covariates: sex, race, age, education, risk display issue, health literacy, season, acceptability, self-reported health, adherence, baseline exercise</p_value_desc>
            <method>Mixed Models Analysis</method>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Effect of the Intervention on Physical Activity Levels as Measured by Affective Attitudes to Exercise - Thinking Behavior is Unpleasant</title>
        <description>Affective Attitudes to Exercise - Thinking Behavior is Unpleasant is defined as not thinking getting regular exercise is unpleasant&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Affective Attitudes to Exercise to 4=higher Affective Attitudes to Exercise)&#xD;
Higher Affective Attitudes to Exercise - Thinking Behavior is Unpleasant is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
        <time_frame>90 days</time_frame>
        <population>Due to the limitations of data collection and concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related affective attitudes among participants who engaged in the exercise-related mental imagery condition.</population>
        <group_list>
          <group group_id="O1">
            <title>Mental Imagery Behavior: Exercise</title>
            <description>-Participants engaged in mental imagery related to exercise goals</description>
          </group>
        </group_list>
        <measure>
          <title>Effect of the Intervention on Physical Activity Levels as Measured by Affective Attitudes to Exercise - Thinking Behavior is Unpleasant</title>
          <description>Affective Attitudes to Exercise - Thinking Behavior is Unpleasant is defined as not thinking getting regular exercise is unpleasant&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Affective Attitudes to Exercise to 4=higher Affective Attitudes to Exercise)&#xD;
Higher Affective Attitudes to Exercise - Thinking Behavior is Unpleasant is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
          <population>Due to the limitations of data collection and concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related affective attitudes among participants who engaged in the exercise-related mental imagery condition.</population>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="229"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.19" spread="0.05"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>The secondary outcomes are hypothesized mediators of the effect of the exercise-related mental imagery activities on future exercise behavior (e.g., exercise mental imagery will increase future exercise behavior by increasing exercise unpleasant feelings). Because these analyses are relevant only for the exercise condition, and the dichotomous mental imagery variable includes both exercise and sleep, it is not appropriate to include the dichotomous mental imagery variable in this analysis.</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <p_value>0.1916</p_value>
            <p_value_desc>Covariates: sex, race, age, education, risk display issue, health literacy, season, acceptability, self-reported health, adherence, baseline exercise</p_value_desc>
            <method>Mixed Models Analysis</method>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Effect of the Intervention on Physical Activity Levels as Measured by Perceived Vividness of Self-regulatory Imagery</title>
        <description>Perceived Vividness of Self-regulatory Imagery is defined as having clear and vivid images of steps towards getting physical activity&#xD;
Measured as an average of two variables measured on a 4 point Likert Scale (range: 1=lower Perceived Vividness of Self-regulatory Imagery to 4=higher Perceived Vividness of Self-regulatory Imagery)&#xD;
Higher Perceived Vividness of Self-regulatory Imagery is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
        <time_frame>90 days</time_frame>
        <population>Due to the limitations of data collection and concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related perceived vividness of self-regulatory imagery among participants who engaged in the exercise-related mental imagery condition.</population>
        <group_list>
          <group group_id="O1">
            <title>Mental Imagery Behavior: Exercise</title>
            <description>-Participants engaged in mental imagery related to exercise goals</description>
          </group>
        </group_list>
        <measure>
          <title>Effect of the Intervention on Physical Activity Levels as Measured by Perceived Vividness of Self-regulatory Imagery</title>
          <description>Perceived Vividness of Self-regulatory Imagery is defined as having clear and vivid images of steps towards getting physical activity&#xD;
Measured as an average of two variables measured on a 4 point Likert Scale (range: 1=lower Perceived Vividness of Self-regulatory Imagery to 4=higher Perceived Vividness of Self-regulatory Imagery)&#xD;
Higher Perceived Vividness of Self-regulatory Imagery is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
          <population>Due to the limitations of data collection and concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related perceived vividness of self-regulatory imagery among participants who engaged in the exercise-related mental imagery condition.</population>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="229"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.36" spread="0.04"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>The secondary outcomes are hypothesized mediators of the effect of the exercise-related mental imagery activities on future exercise behavior (e.g., exercise mental imagery will increase future exercise behavior by increasing exercise imagery vividness). Because these analyses are relevant only for the exercise condition, and the dichotomous mental imagery variable includes both exercise and sleep, it is not appropriate to include the dichotomous mental imagery variable in this analysis.</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <p_value>0.8661</p_value>
            <p_value_desc>Covariates: sex, race, age, education, risk display issue, health literacy, season, acceptability, self-reported health, adherence, baseline exercise</p_value_desc>
            <method>Mixed Models Analysis</method>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Effect of the Intervention on Physical Activity Levels as Measured by Action Planning</title>
        <description>Action planning is defined as having a detailed plan about getting adequate physical activity&#xD;
Measured as an average of three variables measured on a 4 point Likert Scale (range: 1=lower action planning to 4=higher action planning)&#xD;
Higher action planning is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
        <time_frame>90 days</time_frame>
        <population>Due to the limitations of data collection and concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related action planning among participants who engaged in the exercise-related mental imagery condition.</population>
        <group_list>
          <group group_id="O1">
            <title>Mental Imagery Behavior: Exercise</title>
            <description>-Participants engaged in mental imagery related to exercise goals</description>
          </group>
        </group_list>
        <measure>
          <title>Effect of the Intervention on Physical Activity Levels as Measured by Action Planning</title>
          <description>Action planning is defined as having a detailed plan about getting adequate physical activity&#xD;
Measured as an average of three variables measured on a 4 point Likert Scale (range: 1=lower action planning to 4=higher action planning)&#xD;
Higher action planning is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
          <population>Due to the limitations of data collection and concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related action planning among participants who engaged in the exercise-related mental imagery condition.</population>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="229"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.52" spread="0.03"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>The secondary outcomes are hypothesized mediators of the effect of the exercise-related mental imagery activities on future exercise behavior (e.g., exercise mental imagery will increase future exercise behavior by increasing exercise action planning). Because these analyses are relevant only for the exercise condition, and the dichotomous mental imagery variable includes both exercise and sleep, it is not appropriate to include the dichotomous mental imagery variable in this analysis.</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <p_value>0.0711</p_value>
            <p_value_desc>Covariates: sex, race, age, education, risk display issue, health literacy, season, acceptability, self-reported health, adherence, baseline exercise</p_value_desc>
            <method>Mixed Models Analysis</method>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Effect of the Intervention on Physical Activity Levels as Measured by Coping Planning</title>
        <description>Coping planning is defined as having a detailed plan of solving problems that may prevent getting adequate physical activity&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Coping Planning to 4=higher Coping Planning)&#xD;
Higher coping planning is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
        <time_frame>90 days</time_frame>
        <population>Due to the limitations of data collection and concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related coping planning among participants who engaged in the exercise-related mental imagery condition.</population>
        <group_list>
          <group group_id="O1">
            <title>Mental Imagery Behavior: Exercise</title>
            <description>-Participants engaged in mental imagery related to exercise goals</description>
          </group>
        </group_list>
        <measure>
          <title>Effect of the Intervention on Physical Activity Levels as Measured by Coping Planning</title>
          <description>Coping planning is defined as having a detailed plan of solving problems that may prevent getting adequate physical activity&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Coping Planning to 4=higher Coping Planning)&#xD;
Higher coping planning is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
          <population>Due to the limitations of data collection and concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related coping planning among participants who engaged in the exercise-related mental imagery condition.</population>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="229"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.98" spread="0.04"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>The secondary outcomes are hypothesized mediators of the effect of the exercise-related mental imagery activities on future exercise behavior (e.g., exercise mental imagery will increase future exercise behavior by increasing exercise coping planning). Because these analyses are relevant only for the exercise condition, and the dichotomous mental imagery variable includes both exercise and sleep, it is not appropriate to include the dichotomous mental imagery variable in this analysis.</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <p_value>0.0365</p_value>
            <p_value_desc>Covariates: sex, race, age, education, risk display issue, health literacy, season, acceptability, self-reported health, adherence, baseline exercise</p_value_desc>
            <method>Mixed Models Analysis</method>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Effect of the Intervention on Physical Activity Levels as Measured by Action Self-efficacy</title>
        <description>Action self-efficacy is defined as having the confidence to engage in physical activity&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Action Self-efficacy to 4=higher Action Self-efficacy)&#xD;
Higher Action Self-efficacy is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
        <time_frame>90 days</time_frame>
        <population>Due to the limitations of data collection and concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related action self-efficacy among participants who engaged in the exercise-related mental imagery condition.</population>
        <group_list>
          <group group_id="O1">
            <title>Mental Imagery Behavior: Exercise</title>
            <description>-Participants engaged in mental imagery related to exercise goals</description>
          </group>
        </group_list>
        <measure>
          <title>Effect of the Intervention on Physical Activity Levels as Measured by Action Self-efficacy</title>
          <description>Action self-efficacy is defined as having the confidence to engage in physical activity&#xD;
Measured on a 4 point Likert Scale (range: 1=lower Action Self-efficacy to 4=higher Action Self-efficacy)&#xD;
Higher Action Self-efficacy is considered a better outcome&#xD;
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items</description>
          <population>Due to the limitations of data collection and concerns about overburdening participants with too many survey questions, the investigators only assessed exercise-related action self-efficacy among participants who engaged in the exercise-related mental imagery condition.</population>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="229"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.36" spread="0.04"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>The secondary outcomes are hypothesized mediators of the effect of the exercise-related mental imagery activities on future exercise behavior (e.g., exercise mental imagery will increase future exercise behavior by increasing exercise action self-efficacy). Because these analyses are relevant only for the exercise condition, and the dichotomous mental imagery variable includes both exercise and sleep, it is not appropriate to include the dichotomous mental imagery variable in this analysis.</groups_desc>
            <non_inferiority_type>Superiority</non_inferiority_type>
            <p_value>0.1511</p_value>
            <p_value_desc>Covariates: sex, race, age, education, risk display issue, health literacy, season, acceptability, self-reported health, adherence, baseline exercise</p_value_desc>
            <method>Mixed Models Analysis</method>
          </analysis>
        </analysis_list>
      </outcome>
    </outcome_list>

    <reported_events>
      <time_frame>Adverse events were not collected for this study.</time_frame>
      <desc>Adverse events were not collected for this study.</desc>
      <group_list>
        <group group_id="E1">
          <title>Risk Display Format:Risk Ladder:Imagery Behavior:Exercise</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="E2">
          <title>Risk Display Format:Risk Ladder:Imagery Behavior:Sleep</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="E3">
          <title>Risk Display Format:Table:Imagery Behavior:Exercise</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="E4">
          <title>Risk Display Format:Table:Imagery Behavior:Sleep</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="E5">
          <title>Risk Display Format:Text:Imagery Behavior:Exercise</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
        <group group_id="E6">
          <title>Risk Display Format:Text:Imagery Behavior:Sleep</title>
          <description>With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic &amp; health questions. It then provides personalized risk estimates for participants' current activity level &amp; how it would change with regular exercise.&#xD;
Participants take Baseline Survey 1.&#xD;
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal &amp; are asked to practice the mental imagery twice a day for 3 weeks.&#xD;
Participants take Baseline Survey 2.&#xD;
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).&#xD;
Participants take surveys via text at the end of each week for 4 weeks.&#xD;
90 days post-baseline, participants complete a survey sent through the mail.&#xD;
Participants may be contacted for another survey 1 year later.</description>
        </group>
      </group_list>
      <serious_events>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, all-cause mortality</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="80"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="78"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="85"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="84"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="88"/>
                <counts group_id="E6" subjects_affected="0" subjects_at_risk="85"/>
              </event>
              <event>
                <sub_title>Total, serious adverse events</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="0"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="0"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="0"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="0"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="0"/>
                <counts group_id="E6" subjects_affected="0" subjects_at_risk="0"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </serious_events>
      <other_events>
        <frequency_threshold>0</frequency_threshold>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, other adverse events</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="0"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="0"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="0"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="0"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="0"/>
                <counts group_id="E6" subjects_affected="0" subjects_at_risk="0"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </other_events>
    </reported_events>

    <certain_agreements>
      <pi_employee>All Principal Investigators ARE employed by the organization sponsoring the study.</pi_employee>
      <restrictive_agreement>There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed. </restrictive_agreement>
    </certain_agreements>
    <point_of_contact>
      <name_or_title>Erika Waters, MPH, Ph.D.</name_or_title>
      <organization>Washington University School of Medicine</organization>
      <phone>314-286-2757</phone>
      <email>waterse@wustl.edu</email>
    </point_of_contact>
  </clinical_results>
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03255291
org study id: 201706063
secondary id: R01CA190391
nct id: NCT03255291
lead sponsor: 
collaborator: 
collaborator: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
Epidemiology seeks to improve public health by identifying risk factors for cancer and other
      diseases and conveying that information to relevant audiences (e.g., physicians, the public).
      The audience is presumed to understand and use that information to make appropriate decisions
      about lifestyle behaviors and medical treatments. Yet, even though a single risk factor can
      affect the risk of multiple health outcomes, this information is seldom communicated to
      people in a way that optimizes their understanding of the importance of engaging in a single
      healthy behavior. Providing individuals with the ability to understand how a single behavior
      (obtaining sufficient physical activity) could affect their risk of developing multiple
      diseases could foster a more coherent and meaningful picture of the behavior's importance in
      reducing health risks, increase motivation and intentions to engage in the behavior, and over
      time improve public health.

      The proposed study translates epidemiological data about five diseases that cause significant
      morbidity and mortality (i.e., colon cancer, breast cancer (women), heart disease, diabetes,
      and stroke) into a visual display that conveys individualized risk estimates in a
      comprehensible, meaningful, and useful way to diverse lay audiences.
allocation: Randomized
intervention model: Factorial Assignment
intervention model description: Participants were randomly assigned by a computer algorithm to one of six intervention arms according to a 3 (risk display format: text, table, ladder) x 2 (imagery behavior: exercise, sleep) between-subjects factorial design. Although randomization was done at the same time and at the beginning of the study, participants received the risk display intervention first, then answered a survey containing two of the primary outcomes, then received the mental imagery intervention followed by another survey.
primary purpose: Prevention
masking: Single (Investigator)
masking description: The research staff will be blinded to participants' risk display format conditions, but they will be unblinded to mental imagery behavior condition
measure: Change From Baseline to 90-day Follow-up in Self Reported Weekly Minutes of Exercise
time frame: Baseline and up to 90 days
measure: Difference in Gist Comprehension of Risk Information by Risk Display Format
time frame: Baseline
description: Risk display format = risk ladder, table, or text
Gist comprehension of risk information: being able to extract the bottom-line meaning of information provided by the website (e.g., if exercising decreased heath risk)
Measured by the sum of (4) questions coded as correctly comprehending risk information (1 point) or incorrectly comprehending risk information (0 points), with a total score range of 0=low comprehension to 4=high comprehension. Higher comprehension is considered a better outcome.
All comprehension questions have an additional "don't know" option, which is counted as incorrect.
To limit participant burden, the investigators assessed comprehension for diabetes only, instead of all diseases as planned.
Comprehension will not be assessed for people who report a history of diabetes because they are not given risk information.
measure: Difference in Verbatim Comprehension of Risk Information by Risk Communication Strategy
time frame: Baseline
description: Risk communication strategy = risk ladder, table, or text
Verbatim comprehension of risk information: being able to recall the exact information specific to diabetes risk and hours of recommended weekly physical activity
Measured by the sum of (3) questions coded as correctly comprehending information (1 point) or incorrectly comprehending information (0 points), with a total score range of 0=low comprehension to 3=high comprehension. Higher comprehension is considered a better outcome.
All comprehension questions have an additional "don't know" option, which is counted as incorrect.
To limit participant burden, the investigators assessed comprehension for diabetes only, instead of all diseases as planned.
Comprehension will not be assessed for people who report a history of diabetes because they are not given risk information.
measure: Difference in Self-reported Intentions to Engage in Physical Activity by Risk Display Format
time frame: Baseline
description: Risk display format = risk ladder, table, or text
Self-reported physical activity intentions is defined as intentions to engage in physical activity in the next 3 months
Measured as an average of three variables, each measured on a 5 point Likert Scale (range: 1=lower intentions to 5=higher intentions)
Higher intentions are considered a better outcome
measure: Effect of the Intervention on Physical Activity Levels as Measured by Maintenance Self-efficacy
time frame: 90 days
description: Maintenance Self-efficacy is defined as being sure one can engage in physical activity even when it is hard
Measured on a 4 point Likert Scale (range: 1=lower Maintenance Self-efficacy to 4=higher Maintenance Self-efficacy)
Higher maintenance self-efficacy is considered a better outcome
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items
measure: Effect of the Intervention on Physical Activity Levels as Measured by Recovery Self-efficacy
time frame: 90 days
description: Recovery Self-efficacy is defined as being sure one can re-engage in physical activity after putting it off
Measured on a 4 point Likert Scale (range: 1=lower recovery Self-efficacy to 4=higher recovery Self-efficacy)
Higher recovery self-efficacy is considered a better outcome
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items
measure: Effect of the Intervention on Physical Activity Levels as Measured by Affective Attitudes to Exercise - Enjoying Behavior
time frame: 90 days
description: Affective Attitudes to Exercise - Enjoying Behavior is defined as thinking getting regular exercise is enjoyable
Measured on a 4 point Likert Scale (range: 1=lower Affective Attitudes to Exercise to 4=higher Affective Attitudes to Exercise)
Higher Affective Attitudes to Exercise - Enjoying Behavior is considered a better outcome
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items
measure: Effect of the Intervention on Physical Activity Levels as Measured by Affective Attitudes to Exercise - Thinking Behavior is Unpleasant
time frame: 90 days
description: Affective Attitudes to Exercise - Thinking Behavior is Unpleasant is defined as not thinking getting regular exercise is unpleasant
Measured on a 4 point Likert Scale (range: 1=lower Affective Attitudes to Exercise to 4=higher Affective Attitudes to Exercise)
Higher Affective Attitudes to Exercise - Thinking Behavior is Unpleasant is considered a better outcome
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items
measure: Effect of the Intervention on Physical Activity Levels as Measured by Perceived Vividness of Self-regulatory Imagery
time frame: 90 days
description: Perceived Vividness of Self-regulatory Imagery is defined as having clear and vivid images of steps towards getting physical activity
Measured as an average of two variables measured on a 4 point Likert Scale (range: 1=lower Perceived Vividness of Self-regulatory Imagery to 4=higher Perceived Vividness of Self-regulatory Imagery)
Higher Perceived Vividness of Self-regulatory Imagery is considered a better outcome
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items
measure: Effect of the Intervention on Physical Activity Levels as Measured by Action Planning
time frame: 90 days
description: Action planning is defined as having a detailed plan about getting adequate physical activity
Measured as an average of three variables measured on a 4 point Likert Scale (range: 1=lower action planning to 4=higher action planning)
Higher action planning is considered a better outcome
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items
measure: Effect of the Intervention on Physical Activity Levels as Measured by Coping Planning
time frame: 90 days
description: Coping planning is defined as having a detailed plan of solving problems that may prevent getting adequate physical activity
Measured on a 4 point Likert Scale (range: 1=lower Coping Planning to 4=higher Coping Planning)
Higher coping planning is considered a better outcome
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items
measure: Effect of the Intervention on Physical Activity Levels as Measured by Action Self-efficacy
time frame: 90 days
description: Action self-efficacy is defined as having the confidence to engage in physical activity
Measured on a 4 point Likert Scale (range: 1=lower Action Self-efficacy to 4=higher Action Self-efficacy)
Higher Action Self-efficacy is considered a better outcome
Note: to limit participant burden, the investigators used a single item instead of averaging across multiple items
arm group label: Risk Display Format:Risk Ladder:Imagery Behavior:Exercise
arm group type: Experimental
description: With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic & health questions. It then provides personalized risk estimates for participants' current activity level & how it would change with regular exercise.
Participants take Baseline Survey 1.
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal & are asked to practice the mental imagery twice a day for 3 weeks.
Participants take Baseline Survey 2.
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).
Participants take surveys via text at the end of each week for 4 weeks.
90 days post-baseline, participants complete a survey sent through the mail.
Participants may be contacted for another survey 1 year later.
arm group label: Risk Display Format:Risk Ladder:Imagery Behavior:Sleep
arm group type: Experimental
description: With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic & health questions. It then provides personalized risk estimates for participants' current activity level & how it would change with regular exercise.
Participants take Baseline Survey 1.
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal & are asked to practice the mental imagery twice a day for 3 weeks.
Participants take Baseline Survey 2.
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).
Participants take surveys via text at the end of each week for 4 weeks.
90 days post-baseline, participants complete a survey sent through the mail.
Participants may be contacted for another survey 1 year later.
arm group label: Risk Display Format:Table:Imagery Behavior:Exercise
arm group type: Experimental
description: With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic & health questions. It then provides personalized risk estimates for participants' current activity level & how it would change with regular exercise.
Participants take Baseline Survey 1.
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal & are asked to practice the mental imagery twice a day for 3 weeks.
Participants take Baseline Survey 2.
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).
Participants take surveys via text at the end of each week for 4 weeks.
90 days post-baseline, participants complete a survey sent through the mail.
Participants may be contacted for another survey 1 year later.
arm group label: Risk Display Format:Table: Imagery Behavior:Sleep
arm group type: Experimental
description: With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic & health questions. It then provides personalized risk estimates for participants' current activity level & how it would change with regular exercise.
Participants take Baseline Survey 1.
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal & are asked to practice the mental imagery twice a day for 3 weeks.
Participants take Baseline Survey 2.
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).
Participants take surveys via text at the end of each week for 4 weeks.
90 days post-baseline, participants complete a survey sent through the mail.
Participants may be contacted for another survey 1 year later.
arm group label: Risk Display Format:Text:Imagery Behavior:Exercise
arm group type: Experimental
description: With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic & health questions. It then provides personalized risk estimates for participants' current activity level & how it would change with regular exercise.
Participants take Baseline Survey 1.
Participants listen to an audio recording that guides them through a mental imagery activity. They write down an exercise goal & are asked to practice the mental imagery twice a day for 3 weeks.
Participants take Baseline Survey 2.
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).
Participants take surveys via text at the end of each week for 4 weeks.
90 days post-baseline, participants complete a survey sent through the mail.
Participants may be contacted for another survey 1 year later.
arm group label: Risk Display Format:Text:Imagery Behavior:Sleep
arm group type: Experimental
description: With help from a research assistant, participants complete the Risk Assessment App. The App asks demographic & health questions. It then provides personalized risk estimates for participants' current activity level & how it would change with regular exercise.
Participants take Baseline Survey 1.
Participants listen to an audio recording that guides them through a mental imagery activity. They write down a sleep goal & are asked to practice the mental imagery twice a day for 3 weeks.
Participants take Baseline Survey 2.
Participants receive text messages reminding them to practice the mental imagery twice daily for 5 minutes each time (3 texts a week for 3 weeks).
Participants take surveys via text at the end of each week for 4 weeks.
90 days post-baseline, participants complete a survey sent through the mail.
Participants may be contacted for another survey 1 year later.
intervention type: Behavioral
intervention name: Risk Assessment App
description: The App provides participants with personalized risk results for colon cancer, breast cancer (women), heart disease, diabetes, and stroke.
arm group label: Risk Display Format:Risk Ladder:Imagery Behavior:Exercise
arm group label: Risk Display Format:Risk Ladder:Imagery Behavior:Sleep
arm group label: Risk Display Format:Table: Imagery Behavior:Sleep
arm group label: Risk Display Format:Table:Imagery Behavior:Exercise
arm group label: Risk Display Format:Text:Imagery Behavior:Exercise
arm group label: Risk Display Format:Text:Imagery Behavior:Sleep
intervention type: Behavioral
intervention name: Audio Recording - Sleep
description: -Participants imagine themselves improving sleep hygiene
arm group label: Risk Display Format:Risk Ladder:Imagery Behavior:Sleep
arm group label: Risk Display Format:Table: Imagery Behavior:Sleep
arm group label: Risk Display Format:Text:Imagery Behavior:Sleep
intervention type: Other
intervention name: Surveys
description: Assesses information comprehension, intentions, perceived risk and severity worry, self- efficacy, response efficacy, affect, race, education, age, numeracy, graph literacy, and exercise and sleep behaviors.
arm group label: Risk Display Format:Risk Ladder:Imagery Behavior:Exercise
arm group label: Risk Display Format:Risk Ladder:Imagery Behavior:Sleep
arm group label: Risk Display Format:Table: Imagery Behavior:Sleep
arm group label: Risk Display Format:Table:Imagery Behavior:Exercise
arm group label: Risk Display Format:Text:Imagery Behavior:Exercise
arm group label: Risk Display Format:Text:Imagery Behavior:Sleep
intervention type: Behavioral
intervention name: Audio Recording - Exercise
description: Participants imagine themselves improving exercise
arm group label: Risk Display Format:Risk Ladder:Imagery Behavior:Exercise
arm group label: Risk Display Format:Table:Imagery Behavior:Exercise
arm group label: Risk Display Format:Text:Imagery Behavior:Exercise
intervention type: Other
intervention name: Text message reminders
description: -Reminders to practice mental imagery
arm group label: Risk Display Format:Risk Ladder:Imagery Behavior:Exercise
arm group label: Risk Display Format:Risk Ladder:Imagery Behavior:Sleep
arm group label: Risk Display Format:Table: Imagery Behavior:Sleep
arm group label: Risk Display Format:Table:Imagery Behavior:Exercise
arm group label: Risk Display Format:Text:Imagery Behavior:Exercise
arm group label: Risk Display Format:Text:Imagery Behavior:Sleep
intervention type: Other
intervention name: Text Message Survey
description: -Assesses exercise behavior, intentions, actions plans, self-efficacy, affect, imagery vividness, and practice.
arm group label: Risk Display Format:Risk Ladder:Imagery Behavior:Exercise
arm group label: Risk Display Format:Risk Ladder:Imagery Behavior:Sleep
arm group label: Risk Display Format:Table: Imagery Behavior:Sleep
arm group label: Risk Display Format:Table:Imagery Behavior:Exercise
arm group label: Risk Display Format:Text:Imagery Behavior:Exercise
arm group label: Risk Display Format:Text:Imagery Behavior:Sleep
criteria: 
gender: All
minimum age: 30 Years
maximum age: 64 Years
healthy volunteers: Accepts Healthy Volunteers
last name: Erika Waters, MPH, Ph.D.
role: Principal Investigator
affiliation: Washington University School of Medicine
facility: 
country: United States
url: http://www.siteman.wustl.edu
description: Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
responsible party type: Sponsor
sharing ipd: No
provided document: 
participant flow: 
baseline: 
outcome list: 
reported events: 
certain agreements: 
point of contact: 