No abstract

BackgroundIntensive diet and physical activity interventions have been found to reduce cardiovascular disease (CVD) risk, but are resource intensive. The American Heart Association recently recommended motivational interviewing (MI) as an effective approach for low-intensity interventions to promote health-related outcomes such as weight loss. However, there is limited research evaluating the long-term effectiveness of MI-based interventions on health-related outcomes associated with CVD risk. The current research evaluated the effectiveness of a six-month low-intensity MI intervention in a UK primary-care setting in maintaining reductions in CVD risk factors at12 months post-intervention.MethodsPrimary-care patients were randomised to an intervention group that received standard exercise and nutrition information plus up to five face-to-face MI sessions, delivered by a physical activity specialist and registered dietician over a 6-month period, or to a minimal intervention comparison group that received the standard information only. Follow-up measures of behavioural (vigorous and moderate physical activity, walking, physical activity stage-of-change, fruit and vegetable intake, and dietary fat intake) and biomedical (weight, body mass index [BMI], blood pressure, cholesterol) outcomes were taken immediately post-intervention and at a 12-month follow-up occasion.ResultsIntent-to-treat analyses revealed significant differences between groups for walking and cholesterol. Obese and hypercholesterolemic patients at baseline exhibited significant improvements in BMI and cholesterol respectively among those allocated to the intervention group compared to the comparison group. Post-intervention improvements in other health-related outcomes including blood pressure, weight, and BMI were not maintained.ConclusionsThe present study suggests that a low-intensity MI counselling intervention is effective in bringing about long-term changes in some, but not all, health-related outcomes (walking, cholesterol levels) associated with CVD risk. The intervention was particularly effective for patients with elevated levels of CVD risk factors at baseline. Based on these findings future interventions should be conducted in a primary care setting and target patients with high risk of CVD. Future research should investigate how the long-term gains in health-related outcomes brought about by the MI-counselling intervention in the current study could be extended to a wider range of health outcomes.

We contend that although SIT appears to be an effective exercise modality for physiological benefit, it is unlikely to be effective as a means to promote regular participation in physical activity in a largely sedentary population. We have argued that SIT is inappropriate for sedentary individuals because engaging in such training requires high levels of motivation and confidence. In addition, high intensity exercise is likely to evoke to negative affect which may lead to subsequent avoidance of further exercise. SIT programmes of exercise are also relatively complex and involve a high degree of self-regulation, which may also be a barrier to continuation in those who are uninitiated. we contend that SIT should not necessarily be considered time efficient as a session would likely last at least 30 min. We would like to see further research that addresses the motivational factors and responses of sedentary people to SIT. Specifically, we propose the following research agenda to improve knowledge of SIT in sedentary populations: (1) the acceptability of, and affective responses to, SIT programmes; (2) the social cognitive and motivational factors that may be related to participation in, and adherence to, SIT programmes; (3) the degree of adherence to SIT programmes compared to programmes of continuous aerobic exercise of moderate intensity; and (4) whether SIT programmes can be transferred to natural settings outside of the supervised laboratory environment

The purpose of the current study was to explore colorectal cancer survivors' information and support needs in relation to health concerns and health behaviour change.Face-to-face interviews were conducted with participants who had completed active treatment for cancer within the previous 2 years. Participants were colorectal cancer survivors (N = 24, men = 11, women = 13 M, age = 69.38 years, SD = 4.19) recruited from a hospital in Perth, Australia on the basis that they had existing morbidities that put them at increased risk of cardiovascular disease. Interview transcripts were analysed using thematic analysis. Results: Five main themes emerged: bowel changes; Lack of knowledge concerning healthy eating and physical activity; conflicting information; desire for support; and, need for simple messages and strategies to stay healthy. Where dietary recommendations were provided, these were to resolve bowel problems rather than to promote healthy eating. The provision of lifestyle advice from the oncologists is limited and patients' lack knowledge of guidelines for diet and physical activity.Oncologists could provide patients with clear messages from the World Cancer Research Fund (2011); that is to increase physical activity and dietary fibre and reduce consumption of red meat, processed meat, alcohol and body fatness. K E Y W O R D Scancer survivors, colorectal, diet, health behaviour, information, support

Motivational interviewing (MI) is a complex intervention comprising multiple techniques

Self-determination theory has been applied to the prediction of a number of health-related behaviors with self-determined or autonomous forms of motivation generally more effective in predicting health behavior than non-self-determined or controlled forms. Research has been confined to examining the motivational predictors in single health behaviors rather than comparing effects across multiple behaviors. The present study addressed this gap in the literature by testing the relative contribution of autonomous and controlling motivation to the prediction of a large number of health-related behaviors, and examining individual differences in self-determined motivation as a moderator of the effects of autonomous and controlling motivation on health behavior. Participants were undergraduate students (N = 140) who completed measures of autonomous and controlled motivational regulations and behavioral intention for 20 health-related behaviors at an initial occasion with follow-up behavioral measures taken four weeks later. Path analysis was used to test a process model for each behavior in which motivational regulations predicted behavior mediated by intentions. Some minor idiosyncratic findings aside, between-participants analyses revealed significant effects for autonomous motivational regulations on intentions and behavior across the 20 behaviors. Effects for controlled motivation on intentions and behavior were relatively modest by comparison. Intentions mediated the effect of autonomous motivation on behavior. Within-participants analyses were used to segregate the sample into individuals who based their intentions on autonomous motivation (autonomy-oriented) and controlled motivation (control-oriented). Replicating the between-participants path analyses for the process model in the autonomy- and control-oriented samples did not alter the relative effects of the motivational orientations on intention and behavior. Results provide evidence for consistent effects of autonomous motivation on intentions and behavior across multiple health-related behaviors with little evidence of moderation by individual differences. Findings have implications for the generalizability of proposed effects in self-determination theory and intentions as a mediator of distal motivational factors on health-related behavior.

We adopted a trans-contextual model of motivation to examine the processes by which school students' perceived autonomy support (defined as students' perceptions that their teachers' support their autonomous or self-determined motivation) and autonomous forms of motivation (defined as motivation to act out of a sense of choice, ownership, and personal agency) toward mathematics activities in an educational context predict autonomous motivation and intentions toward mathematics homework, and actual mathematics homework behavior and attainment, as measured by homework grades, in an out-of-school context. A three-wave prospective study design was adopted. High-school students (N = 216) completed self-report measures of perceived autonomy support and autonomous forms of motivation toward mathematics activities in school in the first wave of data collection. One-week later, participants completed measures of autonomous forms of motivation, attitudes, subjective norms, perceived behavioral control, and intentions with respect to mathematics homework outside school. Students' selfreported homework behavior and homework grades from students' class teachers were

No abstract