A positive psychology-motivational interviewing program to promote physical activity in type 2 diabetes: The BEHOLD-16 pilot randomized trial

Huffman, Jeff C.; Golden, Julia; Massey, Christina; Feig, Emily H.; Chung, Wei-Jean; Millstein, Rachel; Brown, L. David; Gianangelo, Taylor; Healy, Brian C.; Wexler, Deborah J.; Park, Elyse R.; Celano, Christopher M.

doi:10.1016/j.genhosppsych.2020.12.001

Cited by 18 publications

(15 citation statements)

References 51 publications

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“…Such results regarding session completion and intervention acceptability are consistent with previous studies of phone-based PP-MI interventions among midlife persons and those with medical illness (Huffman et al, 2021a ; Huffman, Feig, et al, 2019 ; Huffman et al, 2020 ). This trial extends prior work, as it represents only the second study to our knowledge that has used this PP-based approach specifically in midlife persons (Huffman et al, 2021b ).…”

Section: Discussionsupporting

confidence: 90%

A phone and text message intervention to improve physical activity in midlife: initial feasibility testing

Huffman

Harnedy

Massey

et al. 2022

Health Psychology and Behavioral Medicine

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Background Physical activity during midlife (ages 45-64) plays a major role in the prevention of chronic and serious medical conditions. Unfortunately, many midlife adults struggle to be physically active in the setting of low levels of psychological well-being and the management of multiple confluent sources of stress. Effective, scalable, midlife-specific interventions are needed to promote physical activity and prevent the development of chronic medical conditions. Objectives In an initial proof-of-concept trial, we assessed the feasibility and acceptability of a new, midlife-adapted, phone- and text message-based intervention using positive psychology (PP) skill-building and motivational interviewing (MI) techniques. We secondarily analyzed post-intervention changes in accelerometer-measured physical activity and self-reported outcomes. Methods The PP-MI intervention included six weekly phone sessions with a study trainer, with completion of PP activities and physical activity goals between calls, and in the subsequent six weeks briefer phone check-ins were conducted. Text messages over the 12-week intervention period were utilized to support participants and identify barriers to goal completion. Feasibility (session completion rates) and acceptability (participant ratings of intervention ease and utility) were assessed via descriptive statistics, and pre-post improvements in psychological, functional, and physical activity outcomes at 12 weeks were examined via mixed effects regression models. Results Twelve midlife adults with low baseline physical activity enrolled in the single-arm trial. Overall, 76.8% of all possible sessions were completed by participants, and mean ratings of weekly phone sessions were 8.9/10 (SD 1.6), exceeding our a priori thresholds for feasibility and acceptability. Participants demonstrated generally medium to large effect size magnitude improvements in accelerometer-measured physical activity, psychological outcomes, and function. Conclusions A novel, midlife-specific phone- and text-based PP-MI intervention was feasible and had promising effects on physical activity and other clinically relevant outcomes, supporting next-step testing of this program via a randomized controlled trial.

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Section: Discussionsupporting

confidence: 90%

A phone and text message intervention to improve physical activity in midlife: initial feasibility testing

Huffman

Harnedy

Massey

et al. 2022

Health Psychology and Behavioral Medicine

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“…The BEHOLD-8 and BEHOLD-16 randomized controlled trials examined the impact of a combined positive psychology (PP) and motivational interviewing (MI) phone-delivered intervention on improving PA in patients with T2D. The combination of PP with MI (PP-MI) was tested compared to time- and attention-matched control conditions, respectively (Huffman et al, 2020 ; Huffman et al, 2021 ; Zambrano et al, 2020 ). Both strategies employ straightforward activities that can enhance motivation for health behavior change (e.g.…”

Section: Methodsmentioning

confidence: 99%

“…Accordingly, the purpose of this secondary analysis was to identify subgroups of participants in two behavioral physical activity interventions for T2D and identify groups for whom the interventions were more and less helpful. The Boosting Emotional well-being and Happiness in Outpatients Living with Diabetes 8-week and 16-week (BEHOLD-8 and BEHOLD-16) were randomized controlled trials to promote physical activity in patients with T2D (Huffman et al, 2020 ; Huffman et al, 2021 ; Zambrano et al, 2020 ). Both BEHOLD-8 and BEHOLD-16 were previously found to be feasible, acceptable, and led to overall improvements in physical activity, with small to medium effect size (Huffman et al, 2020 ; Huffman et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

“…The Boosting Emotional well-being and Happiness in Outpatients Living with Diabetes 8-week and 16-week (BEHOLD-8 and BEHOLD-16) were randomized controlled trials to promote physical activity in patients with T2D (Huffman et al, 2020 ; Huffman et al, 2021 ; Zambrano et al, 2020 ). Both BEHOLD-8 and BEHOLD-16 were previously found to be feasible, acceptable, and led to overall improvements in physical activity, with small to medium effect size (Huffman et al, 2020 ; Huffman et al, 2021 ). With these promising findings at the intervention group level, it becomes important to understand how subgroups responded to the interventions.…”

Section: Introductionmentioning

confidence: 99%

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Latent growth curve modeling of physical activity trajectories in a positive-psychology and motivational interviewing intervention for people with type 2 diabetes

Millstein

Golden

Healy

et al. 2022

Health Psychology and Behavioral Medicine

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Background: Physical activity is critical for preventing and treating Type 2 diabetes (T2D). It is important to identify different profiles of physical activity change among those participating in behavioral interventions to optimize intervention-person fit. Methods: This study analyzes longitudinal trajectories of change in moderate-to-vigorous physical activity (MVPA) in a positive psychology (PP) and motivational interviewing (MI) intervention for T2D, using latent growth curve modeling (LGCM). Objective measures of MVPA were collected using accelerometers at three time points: pre-intervention, immediately post-intervention, and eight weeks post-intervention. LGCM analyses identified subpopulations of participants who responded similarly to the intervention and examined if sociodemographic, medical and psychosocial characteristics were associated with MVPA trajectories. Results: Analyses included 47 participants with complete follow-ups: 49% male, 81% non-Hispanic white, average age 66.1 ( SD = 10.1). Overall, 36% of the participants increased MVPA while 57% did not. LGCM identified three profiles with distinct MVPA trajectories. Profile 1 (‘Started Low, No Change’; 65.8% of participants) with a starting mean of 4.54 min of MVPA/day and decreased by −3.36 min. Profile 2 (‘Moderate-High Start, Minimal Change,’ 27.4% of participants) and had a starting mean of 22.86 min/day of MVPA with an average increase of 1.03 min. Profile 3 (‘Moderate Start, Ended High’; 6.8% of participants), had a starting mean of 7.33 min MVPA/day, and increased by 28.4 min. Being male, younger, having fewer medical and psychiatric comorbidities were associated with increases in MVPA. Conclusions: This secondary analysis detected three distinct physical activity profiles during and after a PP-MI intervention. Future interventions can target individuals with characteristics that showed the greatest benefit and add additional supports to people in groups that did not increase physical activity as much. These findings show a need for targeted and sustained behavior change strategies during and after physical activity interventions. Trial registration: ClinicalTrials.gov; identifier: NCT03001999.

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“…A tailored physical activity program supported by providers trained in MI techniques also fuelled sense of optimism for the future in people with mental health conditions [29]. Among patients with diabetes, combining information provision, MI techniques, and meaningful relationships led to improved sense of control [30], while others reported that it drove optimism [31]. Provision of information combined with MI techniques was also identified as two intervention components perceived as most beneficial in people receiving antiretroviral therapy [32].…”

Section: Key Findingsmentioning

confidence: 99%

Women with breast cancer’s perceptions of nurse-led telephone-based motivational interviewing consultations to enhance adherence to adjuvant endocrine therapy: a qualitative study

Gagné

Lauzier

Lemay

et al. 2022

Support Care Cancer

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Background Daily adjuvant endocrine therapy (AET) for 5 or 10 years is the standard of care for women diagnosed with non-metastatic hormone receptor-positive breast cancer. However, many women experience AET-related issues that may hamper quality of life and adherence. Here, we aimed to describe women's perceptions of motivational interviewing (MI)guided consultations delivered by a trained nurse navigator over the telephone to enhance AET adherence. Methods Eighteen women who were first prescribed AET for non-metastatic breast cancer in the last 5 years, who selfreported AET-related issues, and who participated in at least two MI-guided consultations over a year were interviewed about their perceptions of the intervention, using a semi-structured interview guide. Audio recordings were transcribed verbatim and analyzed using a thematic analysis approach. Results Three main themes emerged from the data about women's perceptions on MI-guided consultations. These consultations were described as (1) a person-centred experience, (2) providing key information about AET, and (3) supportive of present and future AET experience, by contributing to AET side-effect management, motivation, adherence, calming negative emotions, improving well-being and self-esteem, and making women to feel empowered. Conclusions Nurse-led telephone-based MI-guided consultations about AET were found to respond to participants' needs and to enhance participants' perceptions of being informed and being supported in experiencing various facets of AET. Telephone-based consultations for AET are perceived as a promising strategy in an increasing virtual care world.

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A positive psychology-motivational interviewing program to promote physical activity in type 2 diabetes: The BEHOLD-16 pilot randomized trial

Cited by 18 publications

References 51 publications

A phone and text message intervention to improve physical activity in midlife: initial feasibility testing

A phone and text message intervention to improve physical activity in midlife: initial feasibility testing

Latent growth curve modeling of physical activity trajectories in a positive-psychology and motivational interviewing intervention for people with type 2 diabetes

Women with breast cancer’s perceptions of nurse-led telephone-based motivational interviewing consultations to enhance adherence to adjuvant endocrine therapy: a qualitative study

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