Changes in determinants of physical activity during interventions for adults with chronic diseases: systematic review and meta-analysis of randomised controlled trials

Abstract

Introduction: A better understanding of how interventions can increase motivation towards physical activity in adults with chronic diseases is needed to improve their efficacy. The present meta-analysis aims to assess the efficacy of behaviour change interventions in impacting motivation for physical activity in adults with chronic respiratory, metabolic, and/or cardiovascular disease. In addition, this review seeks to identify clinical and intervention characteristics associated to efficacy, including disease, mode of delivery, nature of motivational outcome and behaviour change techniques (BCTs).Methods: The electronic bibliographic databases consulted were PubMed, PsycINFO, Web of Science and Open Grey. Studies involving adults (≥ 18 years) with chronic cardiovascular and/or respiratory and/or metabolic diseases were included. Only randomised control trials (RCT), explicitly targeting a change in motivation and assessing one or several motivational outcomes pre- and post-intervention were included. Results: The meta-analysis was conducted on 43 studies (202 effect sizes; N=15 361); the analyses revealed a medium effect of interventions on motivation at the end of the intervention (d=0.5; 95% CI [0.283;0.716]; p < .001; k=43; 200 effect sizes) and 3 months or more after (d=0.69 (95% CI [0.038, 1.347]; p < .001; k=8; 30 effect sizes). The presence of BCT 13.2 Framing/reframing led to a higher effect on physical activity motivation (d=1.586; 95% CI [1.055;2.117]; p < .001; k=5; 16 effect sizes).Conclusion: Physical activity interventions are effective to change motivation and the presence of framing/reframing in the intervention content leads to higher effects.