The Newcastle exercise project: a randomised controlled trial of methods to promote physical activity in primary care

Abstract

Objective To evaluate the effectiveness of combinations of three methods to promote physical activity. Design Randomised controlled trial. Baseline assessment with post-intervention follow up at 12 weeks and 1 year. Setting One urban general practice, 1995-7. Participants 523 adults aged 40 to 64 years, randomised to four intervention groups and a control group. Interventions Brief (one interview) or intensive (six interviews over 12 weeks) motivational interviewing based on the stages of change model of behaviour change, with or without financial incentive (30 vouchers entitling free access to leisure facilities). Main outcome measures Physical activity score; sessions of moderate and vigorous activity in the preceding four weeks. Results Response rate was 81% at 12 weeks and 85% at one year. More participants in the intervention group reported increased physical activity scores at 12 weeks than controls (38% v 16%, difference 22%, 95% confidence interval for difference 13% to 32%), with a 55% increase observed in those offered six interviews plus vouchers. Vigorous activity increased in 29% of intervention participants and 11% of controls (difference 18%, 10% to 26%), but differences between the intervention groups were not significant. Short term increases in activity were not sustained, regardless of intensity of intervention.

Identifying content-based and relational techniques to change behaviour in motivational interviewing

“…In addition, reporting of the content of interventions adopting MI is often brief and lacking in specific detail making it difficult to replicate or pinpoint the precise techniques that may be affecting behavior change. Many MI studies lack detail in their descriptions of the precise techniques adopted, how they were delivered, practitioner training and competency in MI (Douaihy, Kelly, & Gold, 2014) and some do not provide any detailed description of the MI intervention components at all (e.g., Ackerman, Falsetti, Lewis, Hawkins, & Heinschel, 2011;Armit et al, 2009;Harland et al, 1999;Kerse, Elley, Robinson, & Arroll, 2005;Lawton et al, 2008;Penn et al, 2009;Whittemore et al, 2009). …”

Supporting Lifestyle Change With a Computerized Psychosocial Assessment Tool

“…MI has been successfully applied in the areas of alcoholism, substance abuse, and nicotine addiction. [29][30][31][32][33][34][35][36] Encouraging results have also been reported for interventions in diabetes, obesity, physical activity, hypertension, eating disorders and other psychiatric illnesses, pain, cardiac rehabilitation, and fruit and vegetable intake. 7,[37][38][39][40][41][42][43][44] In the MI approach, patients' perceived importance of change in selfcare and perceived self-efficacy are seen as key constructs underpinning their degree of motivation (or readiness) to change their health behavior.…”

Combinations of techniques that effectively change health behavior: Evidence from Meta-CART analysis.

“…In addition, the studies used an experimental or quasi-experimental design, and applied cognitive or BCTs. Examples of interventions were PA interventions (e.g., Harland et al, 1999), nutrition education (Oenema, Tan, & Brug, 2005), and interactive computertailored interventions for PA and HE (Vandelanotte, De Bourdeaudhuij, Sallis, Spittaels, & Brug, 2005). The target population in the studies varied from the general population to patients at spe- May involve a variety of specific techniques (e.g., progressive relaxation) that do not target the behavior but seek to reduce anxiety and stress 4…”