Perceptions of Physical Activity and Motivational Interviewing Among Rural African-American Women with Type 2 Diabetes

Abstract

Purpose Motivational interviewing (MI), a patient-centered behavioral counseling style, is a common behavioral intervention strategy. Since intervention outcomes are highly dependent on patient responsiveness to intervention strategy, we evaluated MI perceptions among rural African American women with Type 2 diabetes prior to a physical activity intervention. Methods Four moderator-led focus groups were conducted with patients age 21–50 who had never participated in a MI intervention and who receive diabetes care in a rural community health center. Patients were asked to share their perceptions of an MI consultation after viewing a DVD-based example. They were also asked to discuss their physical activity perceptions and readiness. A comprehensive content analysis based on grounded theory was performed by two raters in order to identify main themes. Main Findings Though patients (n=31) had an appreciation for physical activity benefits and high levels of physical activity readiness, themes related to physical activity barriers and lack of motivation were pervasive. Patients regarded the MI consultation as an effective health communication but the patient-centeredness of the approach was negatively perceived. Compared to MI, patients agreed that more traditional paternalistic approaches (i.e. physician-led interactions) were more representative of “good counseling” and more familiar to them. Patients shared deeply about personal experiences and provided words of encouragement to one another. Conclusion Physical activity interventions including rural African American women should include activities that focus on barrier management and increasing motivation. MI might be an appropriate behavioral counseling model when added to a more traditional cognitive-behavioral physical activity intervention that is group-based and tailored to patients’ communication preferences and the clinical setting.

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