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The effect of motivational interviewing-based intervention using self-determination theory on promotion of physical activity among women in reproductive age: A randomized clinical trial.

ABSTRACT: Physical activity (PA) prevents chronic diseases. Self-determination theory (SDT) provides a useful framework to understand the nature of motivational interviewing (MI).This study aimed to determine the effect of MI-based intervention using SDT on the promotion of PA among women in reproductive age.Seventy women in reproductive age were selected by clustering sampling method for this randomized controlled trial. The questionnaire included the variables of physical fitness test, SDT, and global physical activity questionnaire (GPAQ). The validity of the questionnaires was approved using content validity ratio (CVR) and index (CVI). The reliability and internal consistency of the questionnaires and measures was approved using test-retest method and Cronbach's alpha test, respectively. The intervention group (n=35) received four MI sessions through theory and one standard education session about PA. The control group (n=35) received a standard education session about PA.Four months after the intervention, an increase in the mean scores of total PA (p<0.001, ES=4.77), physical fitness tests including flexibility (p<0.001, ES=1.59), muscular endurance (p<0.001, ES=2.0), cardiorespiratory endurance (p<0.001, ES=0.51), and a decrease in mean scores of agility test (p<0.001, ES= - 0.51) and sedentary behavior (p<0.01, ES=- 0.74) was observed in the intervention group compared to the control group. The intervention group reported an increase in the scores of intrinsic motivation (p<0.001, ES=3.34), identified regulation (p<0.001, ES= 1.28), perceptions of competence (p<0.001, ES=0.81) and autonomy (p<0.001, ES=2.01), enjoyment (p<0.001, ES=0.98) and health motives (p<0.01, ES=0.19), health care climate (p<0.001, ES=4.6), and a decreased score of external regulation (p<0.01, ES=-0.55) and amotivation (p<0.01, ES= -0.56) over time, compared to the control group.MI-based intervention using SDT was effective on the promotion of PA.The Trial was registered at the Iranian Registry of Clinical Trial (http://www.irct.ir) with the Irct ID: IRCT2015101924592N1.

SUBMITTER: Mahmoodabad SSM

PROVIDER: S-EPMC5498715 | biostudies-other | 2017 May

REPOSITORIES: biostudies-other

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The effect of motivational interviewing-based intervention using self-determination theory on promotion of physical activity among women in reproductive age: A randomized clinical trial.

Mahmoodabad Seyed Saeed Mazloomy SSM Tonekaboni Nooshin Rouhani NR Farmanbar Rabiollah R Fallahzadeh Hossein H Kamalikhah Tahereh T

Electronic physician 20170525 5

<h4>Background</h4>Physical activity (PA) prevents chronic diseases. Self-determination theory (SDT) provides a useful framework to understand the nature of motivational interviewing (MI).<h4>Objective</h4>This study aimed to determine the effect of MI-based intervention using SDT on the promotion of PA among women in reproductive age.<h4>Methods</h4>Seventy women in reproductive age were selected by clustering sampling method for this randomized controlled trial. The questionnaire included the ...[more]

PMID: 28713522

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Project description:BACKGROUND:Unhealthy dietary patterns and insufficient physical activity (PA) are associated with negative health outcomes, such as cardiovascular diseases, type 2 diabetes, cancer, overweight, and obesity. This makes the promotion of healthy dietary and PA behaviors a public health priority. OBJECTIVE:This paper describes the development, design, and evaluation protocol of a Web-based computer-tailored (CT) dietary and PA promotion intervention, MyLifestyleCoach. A Web-based format was chosen for its accessibility and large-scale reach and low-cost potential. To achieve effective and persistent behavioral change, this innovative intervention is tailored to individual characteristics and is based on the self-determination theory and motivational interviewing (MI). METHODS:The 6 steps of the intervention mapping protocol were used to systematically develop MyLifestyleCoach based on the existing effective CT PA promotion intervention I Move. The MyLifestyleCoach intervention consists of 2 modules: I Move, which is aimed at promoting PA, and I Eat, which is aimed at promoting healthy eating. Development of the I Eat module was informed by the previously developed I Move. Both modules were integrated to form the comprehensive MyLifestyleCoach program. Furthermore, I Move was slightly adapted, for example, the new Dutch PA guidelines were implemented. A randomized controlled trial consisting of an intervention condition and waiting list control group will be used to evaluate the effectiveness of the intervention on diet and PA. RESULTS:Self-reported measures take place at baseline, 6 months, and 12 months after baseline. Enrollment started in October 2018 and will be completed in June 2020. Data analysis is currently under way, and the first results are expected to be submitted for publication in 2020. CONCLUSIONS:MyLifestyleCoach is one of the first interventions to translate and apply self-determination theory and techniques from MI in Web-based computer tailoring for an intervention targeting PA and dietary behavior. Intervention mapping served as a blueprint for the development of this intervention. We will evaluate whether this approach is also successful in promoting eating healthier and increasing PA using an randomized controlled trial by comparing the intervention to a waiting list control condition. The results will provide an insight into the short- and long-term efficacy and will result in recommendations for the implementation and promotion of healthy eating and PA among adults in the Netherlands. TRIAL REGISTRATION:Dutch Trial Register NL7333; https://www.trialregister.nl/trial/7333. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):DERR1-10.2196/14491.

Project description:BACKGROUND:Arthritis is a leading cause of chronic pain and functional limitations. Exercise is beneficial for improving strength and function and decreasing pain. We evaluated the effect of a motivational interviewing-based lifestyle physical activity intervention on self-reported physical function in adults with knee osteoarthritis (KOA) or rheumatoid arthritis (RA). METHODS:Participants were randomized to intervention or control. Control participants received a brief physician recommendation to increase physical activity to meet national guidelines. Intervention participants received the same brief baseline physician recommendation in addition to motivational interviewing sessions at baseline, 3, 6, and 12 months. These sessions focused on facilitating individualized lifestyle physical activity goal setting. The primary outcome was change in self-reported physical function. Secondary outcomes were self-reported pain and accelerometer-measured physical activity. Self-reported KOA outcomes were evaluated by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for KOA (WOMAC scores range from 0 to 68 for function and 0 to 20 for pain) and the Health Assessment Questionnaire (HAQ) for RA. Outcomes were measured at baseline, 3, 6, 12, and 24 months. Multiple regression accounting for repeated measures was used to evaluate the overall intervention effect on outcomes controlling for baseline values. RESULTS:Participants included 155 adults with KOA (76 intervention and 79 control) and 185 adults with RA (93 intervention and 92 control). Among KOA participants, WOMAC physical function improvement was greater in the intervention group compared to the control group [difference = 2.21 (95% CI: 0.01, 4.41)]. WOMAC pain improvement was greater in the intervention group compared to the control group [difference = 0.70 (95% CI: -0.004, 1.41)]. There were no significant changes in physical activity. Among RA participants, no significant intervention effects were found. CONCLUSION:Participants with KOA receiving the lifestyle intervention experienced modest improvement in self-reported function and a trend toward improved pain compared to controls. There was no intervention effect for RA participants. Further refinement of this intervention is needed for more robust improvement in function, pain, and physical activity.

Project description:Background and purposeAdherence to medication is often suboptimal after stroke and transient ischemic attack (TIA), which increases the risk of recurrent stroke and death. Complex interventions and motivational interviewing (MI) have been proven effective in other areas of medicine. The objective of this study was to investigate the effectiveness of a multifaceted intervention including MI in improving medication adherence for secondary stroke prevention.MethodsIn this randomized controlled trial, TIA and stroke patients receiving a pharmacist intervention in a hospital setting were compared with patients receiving usual care. The intervention consisted of a focused medication review, an MI-approached consultation and 3 follow-up telephone calls and lasted for 6 months. The primary outcome was a composite medication possession ratio (MPR) for antiplatelets, anticoagulants and statins in the year after hospitalization, assessed by analyzing pharmacy records and reported as both a continuous rate and a binary outcome. Secondary outcomes included composite MPRs at 3, 6 and 9 months as well as adherence and persistence to specific thrombopreventive medications at 12 months. Clinical outcomes included a combined end point of cardiovascular death, stroke or acute myocardial infarction. Patient satisfaction with the service was assessed for the intervention patients.ResultsThe analyses included 102 intervention patients and 101 controls. At 12 months, the median MPRs (IQR) were 0.95 (0.77-1) in the intervention group and 0.91 (0.83-0.99) in the control group, and 28 and 21% of the patients, respectively, were nonadherent (MPR <0.80; risk difference: 7%; 95% CI: -5 to 19%). In both groups, the median MPR decreased over time. From 3 to 12 months, the MPR fell by 5% (p < 0.05) in the intervention group and by 9% (p < 0.05) in the control group, but between the groups, comparisons showed no statistically significant difference. No significant differences were found for adherence and persistence to specific thrombopreventive agents or for the clinical outcome. The intervention patients were satisfied with the service; about half of them reported increased knowledge about medication, and one third reported increased confidence with medication use. Pharmacists identified drug-related problems in one third of the patients.ConclusionsA multifaceted pharmacist intervention including MI did not improve adherence or persistence to secondary stroke prevention therapy and had no impact on clinical outcomes. However, due to the high adherence rates, only little room for improvement existed. Future studies should focus on patients at high risk of nonadherence and include outcomes more sensitive to the impact of behavioral interventions.

Dataset Information

The effect of motivational interviewing-based intervention using self-determination theory on promotion of physical activity among women in reproductive age: A randomized clinical trial.

Publications

The effect of motivational interviewing-based intervention using self-determination theory on promotion of physical activity among women in reproductive age: A randomized clinical trial.

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