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

BackgroundPhysical activity (PA) prevents chronic diseases. Self-determination theory (SDT) provides a useful framework to understand the nature of motivational interviewing (MI).ObjectiveThis study aimed to determine the effect of MI-based intervention using SDT on the promotion of PA among women in reproductive age.MethodsSeventy 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.ResultsFour 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.ConclusionMI-based intervention using SDT was effective on the promotion of PA.Trial registrationThe Trial was registered at the Iranian Registry of Clinical Trial (http://www.irct.ir) with the Irct ID: IRCT2015101924592N1.

Effects of Motivational Interviewing and Wearable Fitness Trackers on Motivation and Physical Activity: A Systematic Review

“…Our review indicated that MI is a powerful intervention to improve autonomous motivation for PA 27,33,35,36 and to reduce amotivation for PA. 27,28,36 Furthermore, these studies indicate that the delivery of the intervention can vary from telephone, 28 to internet, 31,34,37,38 and to one-on-one in-person coaching 32,36 and can still be effective in impacting motivation and PA, regardless of the delivery method.…”

“…In 6 of the included studies, increases in objectively measured or self-reported PA were seen. 27 -32 Other health-related improvements included increases in cardiorespiratory fitness, 27,33,34 decreases in body mass index, 27,28,34 and decreases in systolic blood pressure and non-high-density lipoprotein (HDL) cholesterol. 33…”

Significance of motivational interviewing in public health

“…The first group was given educational sessions with MI and pamphlets on PA significance while the other group received only educational sessions. Following a 4-month period after the intervention, the group with MI showed an increase in PAL, internal motivation, perceived competences, autonomy and satisfaction [24]. MI turned out to be helpful in the study of 80 females and males aged 40-65 years old in Australia who took part in a 4-month intervention aimed at introducing new habits of PA in order to fight against sedentary lifestyle.…”

<p>Psychometric properties of the Persian Health Care Climate Questionnaire (HCCQ-P): assessment of type 2 diabetes care supportiveness in Iran</p>

“…This theory tries to explain how the interplay between intrinsic and extrinsic factors could sustain individuals’ passions and their efforts to reach personal aspirations. A special focus of the theory is on sociocultural factors that could facilitate or undermine the individuals’ sense of autonomy, competence and relatedness, which were argued to be fundamental in maintaining motivation and performance 5,8,12. Perceived support for autonomy, self-care competence and psychological relatedness based on the theory are crucial for optimal functioning of a patient in accordance with the prescribed medications or behavioral pattern 5,7–9,12–14…”

“…The Health Care Climate Questionnaire (HCCQ) was developed by Williams et al17 and measures the perceived needs of patients and extent of HCPs' support with regard to independence and success in motivating patients to accept greater responsibility for their own health 12,18–20…”