Imagine for better diabetes management: Modifying Delay Discounting and Physical Activity via Episodic Future Thinking: An Evaluation in adults with type 2 diabetes.

Episodic Future Thinking (EFT) imagery plus standard care This project presents a novel intervention combining mental imagery and episodic future thinking in diabetes management, targeting Type 2 diabetes. Modifying delay discounting to help people with Type 2 diabetes focus on the future rather than immediate rewards is an innovative and low-cost approach which can be adopted by individuals easily once they have learnt to generate the future-oriented mental pictures. Episodic future thinking (EFT) is a conceptual tool simulating the experience of the future. By cognitively simulating future outcomes and making them salient, it can motivate goal-directed health behaviours through enhanced consideration and valuation of the future. Through the process of EFT, individuals are more likely to make choices that focus on long-term outcomes. The EFT condition focuses on thinking about future personalised events that participants look forward to and can imagine at different time frames. These events may be linked directly or indirectly to their participation in regular physical activity. Participants will be contacted by the research team to schedule an in-person (at La Trobe University or Western Sydney University) or virtual appointment (of their choice) which they will attend a psychologist-led session and learn a mental imagery technique and generate the corresponding imagery. Duration of the initial appointment would be around 30-45 minutes. The intervention group will be sent reminders to practice their future thinking imageries 3 times a day (15minutes per day) for 1 month. One week after the initial imagery session, each participant will be followed up via telephone call to check their imagery generation progress. At 1-, 3- and 6-months participants will be contacted again by telephone with instructions on how to complete a short follow-up questionnaire and be provided with and accelerometer via post. A link will be sent to participants for follow up questionnaires and they will be about 10 min to complete. They will wear the accelerometer for 1 week, they wear it when they wake up and take off before bed and shower and then return to the research team via pre-paid postage. The mobile application will record the cues that participants generated at the initial session and send reminders for imagery practice. The app will have data on engagement (log on frequency, how long they stay to read the cues before generating the imagery). The standard care for who are not randomised is whatever the doctor asks the patient to do, which may include medication or lifestyle behaviours.