Self-compassion training within a workplace physical activity program: A pilot study

Abstract

BACKGROUND:

Desire2Move (D2M) is an 8-week team-based, workplace program that incorporates competition and self-monitoring to encourage physical activity (PA).

OBJECTIVE:

The purpose of this pilot study was to evaluate the effectiveness of a self-compassion (SC) intervention within the existing workplace PA program.

METHODS:

University employees (n = 20) were assigned to a SC treatment group or an attention control group. Participants logged their PA minutes using MapMyRun. Treatment group. participants received a 7-week, SC podcast intervention. Participants self-reported PA, SC, and demographic information at pre- and post-intervention. Separate ANOVAs were used to determine group differences.

RESULTS:

There was not a statistically significant group x time interaction for SC, F(1, 18) = 0.02, p = 0.90, or main effects for time, F(1, 18) = 0.28, p = 0.61, or group, F(1, 18) = 1.70, p = 0.21, g = –0.42 [95%CI = –3.13, 2.29]. There were not significant differences between groups for total PA minutes during D2M, F(1, 18) = 2.15, p = 0.16, g = –0.63 [–1.53,0.27]. Overall, participants engaged in more than the recommended levels of PA each week.

CONCLUSIONS:

This pilot study provided feedback and guidance for future online SC training within a workplace PA intervention.

Keywords

Mindfulness self-regulation physical activity workplace

1 Introduction

Physical inactivity is a contributing factor to various chronic diseases and health problems in the United States such as cardiovascular disease, type 2 diabetes, stroke, various cancers, and depression and anxiety [1, 2]. Reducing the risk of chronic disease is possible by engaging in regular physical activity (PA), which is defined as meeting the current guidelines of at least 150 weekly minutes of moderate or 75 minutes of vigorous aerobic activity (or a combination of the two) and two days of muscle strengthening activities [3]. Nearly 79%of American adults are not meeting the recommended levels of PA [4] partially due to an increase in sedentary jobs [5]. With an estimated 140 million employed adults spending more than half of their waking hours in the workplace, it is an important setting in which to implement PA interventions [3, 6].

One reason why working adults may struggle to adhere to PA is a failure to self-regulate their healthy behaviors. Self-regulation is an individual’s ability to engage in and adhere to a behavior [7]. Self-regulation is a four-step process that includes: (a) setting goals (i.e., creating a specific vision or standard by which an individual wants to measure their success); (b) engaging in goal-directed behavior (i.e., PA); (c) monitoring goals and resultant behavior (i.e., failing to monitor progress towards goals can lead to overestimation of PA participation); and (d) adjusting goals when necessary (i.e., as an individual becomes more intentional with their goals and understands their progress towards regular PA, they will become more aware of and equipped to overcome barriers) [7, 8]. Self-regulation is a limited, internal resource, but if self-regulation could be enhanced through an intervention, intended and actual behavior may increase.

Focusing on self-compassion to improve behavioral self-regulation of PA may be an effective intervention strategy [9, 10]. Self-compassion is the ability to treat oneself in the same manner as a best friend going through the same situation [10]. Self-compassionate individuals respond more favorably to criticism, recover more effectively following failure and setbacks, and set more intrinsic goals when compared to less self-compassionate individuals [10 –12]. Self-compassion is positively related to positive affect, improved self-efficacy, and health behavior motivation [13]. A recent systematic review provided preliminary evidence about the effectiveness of self-compassion for health behavior regulation [9]. Adults who treat themselves with self-kindness, common humanity, and mindfulness learn that they deserve to engage in behaviors that will promote their personal health and well-being. For example, individuals suffering from binge eating disorder who underwent self-compassion training experienced a reduction in the number of binging episodes because they learned that they were worthy to be treated with care. Rather than judging or criticizing themselves for struggling with an eating disorder, clinical patients learned to mindfully treat themselves with kindness and common humanity in a way that would promote personal health by reducing their binging behaviors [9]. Self-compassion training promotes goal-setting, goal-directed behavior, and goal monitoring, all of which are components of the self-regulation feedback loop. However, further research is necessary to examine the impact of self-compassion training on the self-regulation of PA.

Desire2Move (D2M) was an annual 8-week team-based PA program designed to encourage university employees to engage in moderate-to-vigorous physical activity (MVPA). A program evaluation of the first implementation of D2M revealed positive results for effectiveness [14]. Specifically, 58 employees recorded a weekly average of 192 minutes of PA during the 8-week program. After the program, D2M participants self-reported greater weekly average PA minutes than non-D2M participants via the MapMyRun mobile application. Based on these findings and the identified relationships between self-compassion and self-regulation of health behavior, the primary objective of the proposed study was to adapt and evaluate the effectiveness of implementing a self-compassion intervention within an existing workplace PA intervention (e.g. D2M). It was hypothesized that participants completing the self-compassion training (treatment group) would report significantly greater PA behavior and self-compassion during D2M program compared with participants who only participated in the D2M program without self-compassion training (i.e., attention control group). To our knowledge, this was the first study to employ online, self-compassion training in a workplace PA intervention.

2 Methodology

2.1 Participants

Eligible participants were 147 employees from 11 university departments that were invited and agreed to participate in the fourth annual D2M program. Of the D2M participants, 20 volunteered for this study (13.6%participation rate).

2.2 Measures

Demographic questionnaire. This measure solicited self-reported age, gender, race and/or ethnicity, education, income, employment status, and department affiliation. Self-reported height and weight was used to calculate participant body mass index (BMI).

Self-compassion scale-short form (SCS-SF). The SCS-SF was a 12-item short form of the self-compassion scale that measured one’s level of self-compassion [15]. Self-compassion was measured by items on a 5-point scale ranging from 1 (almost never) to 5 (almost always). An example item for self-kindness included, “I try to be understanding and patient towards those aspects of my personality I don’t like.” Common humanity was measured using items such as, “When I feel inadequate in some way, I try to remind myself that feelings of inadequacy are shared by most people.” Lastly, mindfulness was assessed through items such as “When something painful happens I try to take a balanced view of the situation.” The SCS-SF demonstrated high internal consistency (α= 0.86) and strong retest reliability over 5 months (0.71). The SCS-SF is highly correlated with the long form (r = 0.98) [15].

MapMyRun. During D2M, participants logged their daily minutes and modes of PA on either the MapMyRun website (www.mapmyrun.com) or smartphone application. MapMyRun is a PA self-monitoring application allows manual logging of PA mode, intensity, and duration. A preliminary validation study indicated a strong correlation between minutes of PA on the MapMyRun PA self-monitoring application and the FitBit Zip accelerometer (r = 0.79) [16];).

Intervention adherence. The frequency of podcast use was tracked on a private YouTube account. The length of use and frequency of use per participant for each podcast was confidentially tracked. When a participant accessed a podcast each day, the data was monitored so the research team could understand whether participants were adhering to the intervention over the course of the seven weeks. A meta-analytic review of mindfulness-based interventions has found website, online, smartphone, and podcasts formats to be effective implementation strategies [25].

2.3 Procedures

Employees from eleven departments were invited to participate in the fourth annual D2M program. Employees who volunteered for D2M received an email invitation to participate in the research study that included a link to an IRB approved electronic consent form and the pre-intervention questionnaires (i.e., demographics & SCS-SF). After anticipated declinations and exclusions, group assignment was performed at the department level to control for contamination such that half of the participating departments were assigned to the treatment group and half to the attention control group. Individuals were excluded from participation if they were not a staff or faculty member, if they were unwilling to log their PA minutes using MapMyRun, or if they were the only willing faculty or staff member from their department. Although analyses of previous D2M data did not reveal statistical differences among departments on the primary outcome variables, with the addition of new departments to the D2M program, attempts were made to match departments across the treatment and attention control groups based on comparable demographic qualities including department size and past D2M participation. Group placement, whether attention control or treatment, was not advertised or made known to all departments so as to try and reduce communication between the intervention and attention control groups.

During the 8-week D2M program, participants in both the self-compassion treatment group and the attention control group logged their PA minutes and modes using the MapMyRun website or smartphone application. A bout of PA had to be a minimum of 10 consecutive minutes of MVPA. Additionally, team captains emailed all participants weekly motivational tips, team standings, and program reminders. Participants were able to send a “friend request” to other team members, which would allow them to see each other’s daily minutes of PA and total weekly minutes of PA.

In addition to the D2M procedures, treatment group participants completed a 7-week self-compassion intervention that started the second week of D2M. The intervention aimed to improve self-kindness and understanding in face of perceived shortcomings or difficulties (i.e. missing a day of exercise), thereby, increasing PA motivation and behavior by using self-compassion meditation strategies. Employees in the treatment group were emailed an electronic link every day of the intervention to access the information via mp3 audio file podcast. The validated self-compassion intervention and a detailed description of each meditation podcast is in Table 1 and on the following website (www.selfcompassion.org) [10]. Participants were instructed to listen to the podcast at least once per week for the following week, with the goal of listening to it as often as once per day. At the end of the D2M challenge, participants should have received seven different SC podcasts.

Table 1
Intervention description

Podcast title Self-compassion podcast description

Affectionate Breathing Meditation Participants bring kind attention to the burdens they are carrying. Participants are instructed to notice how nourishing their breath can be, soothing them without effort. Participants gently savor and appreciate the stillness of their body.

Compassionate Body Scan Participants progress their attention through every individual part of their body, noticing the sensations and bringing compassion to any area with negative or uncomfortable sensations.

Loving-Kindness Meditation Focusing on the breath with loving awareness, participants bring to mind a self that naturally makes them smile and brings happiness to them. Participants create a mantra such as “May I be safe, may I be peaceful, may I be healthy, may I live with ease.”

SC/Loving kindness Meditation This meditation helps the participant become aware and in touch with their physical bodily sensations, bringing a sense of compassion and peace to their body.

Noting Your Emotions Meditation Participants become aware of various emotions they feel, and treat or release them with self-compassion.

Soften, Soothe, Allow: Working with Emotions Participants become aware of difficult experiences, emotions and tension in their body. Participants then repeat the mantra, “soften, soothe, and allow,” while releasing physical and psychological tension.

SC Break Participants become mindful of physical and emotional stress, expressing common humanity, and extending loving kindness to themselves.

Podcast title	Self-compassion podcast description
Affectionate Breathing Meditation	Participants bring kind attention to the burdens they are carrying. Participants are instructed to notice how nourishing their breath can be, soothing them without effort. Participants gently savor and appreciate the stillness of their body.
Compassionate Body Scan	Participants progress their attention through every individual part of their body, noticing the sensations and bringing compassion to any area with negative or uncomfortable sensations.
Loving-Kindness Meditation	Focusing on the breath with loving awareness, participants bring to mind a self that naturally makes them smile and brings happiness to them. Participants create a mantra such as “May I be safe, may I be peaceful, may I be healthy, may I live with ease.”
SC/Loving kindness Meditation	This meditation helps the participant become aware and in touch with their physical bodily sensations, bringing a sense of compassion and peace to their body.
Noting Your Emotions Meditation	Participants become aware of various emotions they feel, and treat or release them with self-compassion.
Soften, Soothe, Allow: Working with Emotions	Participants become aware of difficult experiences, emotions and tension in their body. Participants then repeat the mantra, “soften, soothe, and allow,” while releasing physical and psychological tension.
SC Break	Participants become mindful of physical and emotional stress, expressing common humanity, and extending loving kindness to themselves.

Liaisons assigned to each team collected the PA minutes for all D2M participants and were blinded to SC group assignment. Each week, the team liaisons entered the individual team member’s total PA minutes and calculated the individual’s average total PA minutes throughout the D2M program. At the end of the 8-weeks, the team with the greatest overall average of PA minutes was the winner. Top, individual minute-earners were identified for each team as well. One week after D2M, all study participants received a link to an online survey that included the outcome measure (SCS-SF).

3 Data analysis

Tests of normality were performed, and possible outliers were removed from the sample. Intention-to-treat (ITT) procedures were used to account for follow-up data missing due to participant attrition. The imputation approach was used for missing data in which missing values were filled in with estimations.

All variables were summarized with frequencies, means, and standard deviations. Separate ANOVAs with Bonferonni correction were used to determine group differences for continuous variables (age, BMI & SCS-SF) and Chi-square was used to determine group differences for the categorical variables (gender, race, education, employee status, and income) between the treatment and attention control groups at baseline. Separate ANOVAs were conducted to determine whether group differences existed in SC and PA independently. Scale reliabilities (i.e., Cronbach’s alpha; α) were calculated for the SCS-SF questionnaire. Alphas greater than or equal to 0.70 were classified as acceptable, 0.60–69 were considered questionable, 0.50–59 were classified as poor, and below 0.50 were considered unacceptable [17]. Pearson correlations examined the associations among self-compassion and self-reported PA (MMR). Correlations between 0.10–0.29 were considered small, between 0.30–49 were considered moderate, and 0.50 and greater were considered large [18].

Evaluation measurements included intervention adherence with total and mean listen time, listen frequency, and percentage listened for each podcast. Practicality assessed intervention implementation with lack of resources, time, or participant commitment. Lastly, limited-efficacy testing measured changes in self-compassion from pre- to post-intervention between the groups, using repeated measures ANOVA with Bonferroni correction with group assignment (treatment and attention control) as the between-groups variable and time (pre-intervention and post-intervention) as the within-groups variable was used. An independent samples t-test determined group differences in total PA minutes (MapMyRun) between the treatment and attention control groups during D2M. Hedges’ g determined meaningfulness of between-subject differences at pre-intervention and post-intervention [19]. Effect sizes around 0.20 were considered small, around 0.50 were considered moderate, and 0.80 and greater were considered large [20].

4 Results

Twenty-six employees expressed interest in participating in the study and were emailed the link to the electronic consent form and pre-intervention survey. Four individuals who expressed interest did not consent to participate and two individuals consented to participate but did not complete the survey. The final sample included 20 employees who were participating in D2M (see Table 2 for participant demographics). Participants represented 6 of the 11 university departments that competed in D2M. Eleven participants were in the treatment group and nine participants were in the attention control group to balance groups according to department size and previous D2M participation.

Table 2
Participant characteristics

Characteristic Treatment (n = 11) Attention control (n = 9) Total (N = 20)

M SD M SD M SD

Age (years) 39.82 11.92 46.11 14.50 42.65 13.18

Body Mass Index 23.75 2.82 24.24 3.65 23.97 3.14

n % n % N %

Gender Male 3 27.30 1 11.11 4 20.00

Female 8 72.70 8 88.89 16 80.00

Race White 8 72.70 8 88.89 16 80.00

Other 3 27.30 1 11.11 4 20.00

Education Bachelor’s 2 18.18 0 00.00 2 10.00

Graduate/profess. 9 81.82 9 100.00 18 90.00

Employee status Graduate assistant 4 36.36 3 33.33 7 35.00

Staff 3 27.27 3 33.33 6 30.00

Faculty 4 36.36 3 33.33 7 35.00

Annual income Less than $25,000 3 27.27 1 11.11 4 20.00

$25,000–$49,000 3 27.27 3 33.33 6 30.00

$50,000–$99,000 4 36.36 3 33.33 7 35.00

$100,000–$149,000 1 9.10 2 22.22 3 15.00

Characteristic	Treatment (n = 11)	Attention control (n = 9)	Total (N = 20)
Age (years)		39.82	11.92	46.11	14.50	42.65	13.18
Body Mass Index		23.75	2.82	24.24	3.65	23.97	3.14
		n	%	n	%	N	%
Gender	Male	3	27.30	1	11.11	4	20.00
	Female	8	72.70	8	88.89	16	80.00
Race	White	8	72.70	8	88.89	16	80.00
	Other	3	27.30	1	11.11	4	20.00
Education	Bachelor’s	2	18.18	0	00.00	2	10.00
	Graduate/profess.	9	81.82	9	100.00	18	90.00
Employee status	Graduate assistant	4	36.36	3	33.33	7	35.00
	Staff	3	27.27	3	33.33	6	30.00
	Faculty	4	36.36	3	33.33	7	35.00
Annual income	Less than $25,000	3	27.27	1	11.11	4	20.00
	$25,000–$49,000	3	27.27	3	33.33	6	30.00
	$50,000–$99,000	4	36.36	3	33.33	7	35.00
	$100,000–$149,000	1	9.10	2	22.22	3	15.00

There were no missing values and no univariate or multivariate outliers were identified. The data were normally distributed based on skewness and kurtosis values (i.e., skew < 3.00 and kurtosis < 10.00) [21]. There were no statistically significant differences between the groups for any of the demographic variables or self-compassion at baseline. Two participants did not complete the post-intervention survey and ITT procedures (i.e., last observation carried forward) replaced the missing data.

The SCS-SF had acceptable internal consistency with Cronbach’s alpha of 0.92 at pre-intervention and 0.79 at post-intervention. There was not a significant correlation between pre-intervention SC and PA (r = 0.48), or pre-intervention SC and post-intervention SC (r = 0.54). Pearson correlations found a large association between total PA during D2M (MapMyRun) and post-intervention self-compassion (r = 0.51, p < 0.05). Intervention adherence was high. During the 7-week self-compassion intervention, participants listened to the podcasts an average of 12.57 times per week for a total listen time of 868 minutes (M = 124 minutes per participant, SD = 17.86). Overall, participants listened to 63%of the podcasts’ duration (M = 9:35 minutes, SD = 5.79; see Table 3).

Table 3

Self-compassion intervention adherence

	Podcast length (mins)	Group listen frequency (Total)	Group listen time (Total mins)	Listen time (M)	Percentage listened (M)
Week 1	21	19	196	10:19	48%
Week 2	24	15	123	8:11	49%
Week 3	20	10	107	10:41	51%
Week 4	20	14	184	13:08	65%
Week 5	18	10	99	9:56	49%
Week 6	15	16	132	8:15	51%
Week 7	5	4	27	6:40	100%
Total M	17.57	12.57	124	9:35	63%

Practicality of the intervention was high as it was an online, self-directed, free-to-use podcast intervention with an average time requirement of 17.5 minutes per week, making it a practical option for personnel with limited time, budget, and resources. The self-compassion intervention is valid and effectively improves self-compassion when implemented as a standalone program and participants only needed access to the internet to comply with the intervention [22].

Limited-efficacy testing evaluated changes in self-compassion from pre- to post-intervention as well as differences in total PA minutes between the groups. There was not a statistically significant group x time interaction for self-compassion, F(1, 18) = 0.02, p = 0.90, or significant main effects for time, F(1, 18) = 0.28, p = 0.61, or group, F(1, 18) = 1.70, p = 0.21, g = –0.42 95%CI LL rUL">95%CI = –3.13, 2.29; see Table 4). Furthermore, there was not a statistically significant difference between the treatment and attention control groups for total minutes of MVPA during D2M, t(18) = –1.47, p = 0.16, g = –0.63 95%CI = –2154.51, 383.74; see Table 5). Overall, participants in the attention control (M = 350.76, SD = 46.27) and treatment group (M = 240.09, SD = 37.92) engaged in more than the recommended levels of PA each week.

Table 4

Means and standard deviations for self-compassion by group

Variable		Treatment (n = 11)		Attention control (n = 9)		Effect size (n = 20)	CI
		M	SD	M	SD	Hedges’ g	[95%CI LL, UL]
SCS-12	Pre	3.07	0.83	3.44	0.64	–0.47	[–1.36,0.42]
	Post	3.17	0.73	3.51	0.55	–0.50	[–1.39,0.40]

^*Groups significantly different, p < 0.05. Note: SCS-12 = self-compassion short-form-12.

Table 5

Average minutes of physical activity during D2M by group

Variable	Treatment (n = 11)		Attention control (n = 9)		Effect size (n = 20)
MapMyRun minutes	M	SD	M	SD	Hedges’ g
Per week	240.09	37.92	350.76	46.27	–2.53
Total	1920.72	1137.53	2806.11	1564.20	–0.63

^*Groups significantly different, p < 0.05.

5 Discussion

A recent systematic review found interventions incorporating self-compassion training improved healthy behavior regulation as effectively as other behavioral techniques [9]. This pilot study evaluated the effectiveness of a self-compassion intervention within an existing workplace PA intervention. Overall, this study demonstrates that the methods and procedures can work and warrant replication with a larger sample size. Results for intervention adherence and practicality of implementation were high. While there was a strong correlation between SC and PA, there were no significant differences between the treatment and attention control groups for changes in self-compassion or minutes of PA during D2M. That said, participants engaged in more than the recommended level of PA per week during the workplace intervention. The results provide direction for the design and implementation of future SC interventions in a workplace PA setting.

The mean adherence to the self-compassion podcasts, or percent of each podcast listened (63%), was consistent with previous mobile-based self-compassion interventions (39%–95%adherence) [23 –25] and greater than other internet-based treatment therapies (not including self-compassion) (48%adherence) [26 –28]. The current SC intervention was more practical than other psychosocial interventions in terms of level of complexity, time and aid required for adherence, minimal training of personnel needed, and low cost of implementation [29]. However, because no significant group differences were found, higher adherence to SC podcasts may be needed to reveal change. The online format and moderate duration of the podcasts, ease of implementation by researchers, and access by participants support the practicality of a SC intervention alongside a workplace PA program. Participant usage data ranging from individual participant access to each module, time spent on each lesson/module, or number of participants who completed the entire intervention, needs to be tracked to better understand implementation and practicality [30 –32].

In regard to limited-efficacy testing, the intervention did not significantly improve SC in the treatment group, nor was there a significant difference between groups for SC. The results were contrary to the hypothesis and inconsistent with previous self-compassion training that used the same intervention [9 , 33). However, the confidence intervals at baseline indicate a potential difference in SC 95%CI = –3.13, 2.29] that went undetected, since groups were assigned rather than randomized to either treatment or attention control. It is possible that participants in the treatment group struggled to self-regulate SC training and PA participation simultaneously, whereas, the participants in the attention control group did not experience conflict in choosing between two behaviors to self-regulate [34]. Self-regulatory differences and non-randomization provide potential evidence for undetected baseline differences, which could impact results. The result for self-reported PA trends in the expected direction and the small effect size may be explained by the small sample size and thus, low statistical power. However, when adequately powered, self-compassion interventions can effectively improve self-regulation and self-compassion using a variety of implementation modes and durations [9, 35].

Despite these results, it is important to note that participants in both groups engaged in the recommended amount of PA with an average of more than 150 minutes of MVPA per week [36]. This is consistent with previous years of D2M in which participants engaged in more than the recommended levels of PA during program implementation [14]. Overall, the results for limited-efficacy support the hypothesis that multiple health behaviors are difficult to simultaneously self-regulate [8]. It could also be hypothesized that physically active individuals already have the self-regulatory abilities to engage in healthy behaviors [37]. Future research could examine the SC intervention effects on faculty and staff who are not physical active. The SC podcasts have been proven effective in increasing feelings and behaviors of self-compassion (i.e., self-kindness, common humanity, and mindfulness) with interventions ranging from one-week to eight-weeks [22]. Future implementation should consider tailoring the SC training to PA behavior, which may improve the effectiveness of and adherence to the intervention, potentially increasing SC [38].

6 Limitations

Although this was the first study to examine the impact of SC training on PA, there were several additional limitations beyond sample size that may have impacted the results. First, PA was measured indirectly using a self-reported mobile application (MapMyRun). Adults tend to over-report PA on self-report measures [39, 40]. Future studies may want to assess PA with direct measures to more accurately assess the effectiveness of the intervention.

Another limitation was selection bias. Most of the study volunteers were from departments that had previously participated in D2M. In addition, there may have been departments with previous training in meditation or self-compassion, making individuals more likely to volunteer for this study. Although volunteers were assigned to the study groups based on department affiliations and groups were balanced according the department’s prior D2M participation, prior experience with self-compassion training was not taken into consideration, which affects the generalizability of results. Furthermore, the weekly motivational tips did not include suggestions on how to improve self-compassion. This could help explain why both the treatment and attention control group saw similar increases in self-compassion following the intervention.

The present study did not operationally define criteria for engagement or completion of the intervention like other studies recommend, making individual adherence difficult to determine [26]. Future self-compassion interventions need to track and define adherence to individual sessions and concentration during each session for participants to determine if self-compassion is the mechanism of change and the dose-response needed for change in PA.

Lastly, the participants were randomized to either the treatment or attention control group based on their department’s previous D2M participation and demographics. While there were no significant differences between the two groups at baseline for outcome variable scores, future interventions should randomize participants to either group to achieve true randomization.

7 Conclusions

This was the first study to examine the feasibility of a self-compassion intervention as part of a workplace PA program. Practicality of the intervention and participant adherence to the self-compassion intervention and mean listen time was consistent with previous mindfulness-based interventions. Participants also engaged in the recommended levels of PA throughout the 8-week program. Although the results did not reveal statistically significant differences between the self-compassion and attention control groups in self-compassion or PA behavior, this pilot study provided feedback and guidance for future online self-compassion training within a workplace PA intervention.

Authors’ contributions

BE and DB helped develop and implement the intervention. KR, BE, and DB analyzed and interpreted the patient data regarding the impact of self-compassion on physical activity between groups. DB and BE were major contributors in writing the manuscript. All authors read and approved the final manuscript.

Availability of data and material

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Conflict of interest

The authors declare that they have no competing interests

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by Georgia State University (IRB #: H17302).

Funding

This study was not funded by a grant nor are there any other funding sources to report.

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