Evaluating the Feasibility, Acceptability, And Preliminary Efficacy of an Online Acceptance and Commitment Therapy Program to Improve Dietary Quality in Highly Stressed Adults

Stress can negatively affect both mental and physical health, which can increase the risk for chronic illness. When people feel stressed, they may also find it harder to make healthy food choices, which can further impact their health. Despite this, there are limited treatments designed to help people improve their dietary quality while managing stress. Acceptance and commitment therapy (ACT) is an evidence-based psychological approach that helps people respond more effectively to difficult thoughts and emotions while behaving in ways that are aligned with their personal values. This study tested whether a brief, online ACT-based program, combined with coaching phone calls, could help adults experiencing high levels of stress improve their diet and related psychological skills. Sixty-one adults participated in this study. They were randomly assigned to either complete the ACT program or be placed on a waitlist. Results showed that participants found the program to be reasonable to deliver online and rated it highly. Compared to the waitlist control group, participants who completed the ACT program showed improvements in their ability to manage difficult thoughts and feelings (psychological flexibility), motivation to eat healthfully, and confidence in their ability to make healthy food choices. However, the program did not lead to improvements in overall dietary quality. Additional analyses suggest that improvements in psychological skills may have contributed to small improvement in diet over time, though more research is needed. This study suggests that a brief, online ACT program may be a helpful resource for highly stressed adults to improve psychological skills. Future research should explore whether longer or more personalized programs can lead to stronger improvements in dietary quality.