Efficacy of an individualized, motivationally-tailored physical activity intervention

Abstract

This study compared the efficacy of two low-cost interventions for physical activity adoption. Sedentary (N = 194) adults recruited through newspaper advertisements were randomized to receive either a motivationally-matched, individually-tailored intervention (IT) or a standard self-help intervention (ST). Assessments and interventions were delivered by repeated mailings at baseline, one, three, and six months. Participants were assessed regarding current physical activity behavior, motivational readiness to adopt regular physical activity, and psychological constructs associated with physical activity participation (e.g. self-efficacy, decisional balance). Repeated measures analyses of variance (ANOVAs) revealed significant increases in physical activity participation between baseline and six months for both groups with a significantly greater increase among IT participants. The IT group outperformed the ST group on all primary outcome measures: (a) minutes of physical activity per week, (b) reaching Centers for Disease Control and American College of Sports Medicine (CDC/ACSM) recommended minimum physical activity criteria, and (c) achieving the Action stage of motivational readiness for physical activity adoption. Both groups showed significant improvement between baseline and six months on the psychological constructs associated with physical activity adoption (e.g. self-efficacy), with no significant differences observed between the treatment groups. Utilizing computer expert systems and self-help manuals to provide individually-tailored, motivationally-matched interventions appears to be an effective, low-cost approach for enhancing physical activity participation in the community.

Examination of print and telephone channels for physical activity promotion: Rationale, design, and baseline data from Project STRIDE

“…The content of the expert system paragraphs covers two broad domains: 1) an assessment of the individual's current stage of motivational readiness for physical activity adoption (motivational feedback); 2) an assessment of the individual's self-efficacy [20], decisional balance [21], and use of cognitive and behavioral processes associated with physical activity adoption [22] (construct feedback). Following the completion of these questionnaires, the expert system generates two types of feedback: 1) how the participant compares to profiles of individuals who have successfully adopted and maintained physical activity (normative feedback); and 2) following the baseline assessment, feedback regarding progress made on: a) the above constructs and b) minutes of physical activity participation since the individual's prior assessment (progress feedback) [14].…”

“…Upon completion of the processing of these questionnaires by study staff, participants were mailed a printed report of the feedback generated by the computer expert system, a self-help manual matched to their Stage of Motivational Readiness for physical activity adoption [10,14], and a series of tip sheets. As described in more detail above, use of an expert-system derived feedback report was to enable the participant to have relevant, appropriate, and individualized counseling messages.…”

“…The expert system is composed of pre-written counseling messages written by Ph.D. level psychologists experienced in health behavior change. These messages were used to target detected deficiencies or reinforce successful efforts and appeared throughout each feedback report [14].…”

“…Several investigations have demonstrated that print-based interventions are effective for the adoption of physical activity [10,14]. For example, one study found that participants who received a 6-month individualized motivationally tailored print intervention (Tailored) spent more time exercising per week (151.4 min) and were more likely to achieve CDC/ACSM recommended levels of physical activity (p<0.01) than participants who received standard print materials (Standard; 97.6 min, p<0.05) [14]. Interestingly, at 12 months, both groups reported increases in their time spent in physical activity (Tailored: 187 min vs. Standard: 133 min), although these increases were not significant [15].…”

Initial efficacy of MI, TTM tailoring and HRI’s with multiple behaviors for employee health promotion

“…TTM tailored print feedback has been found to be effective with a broad range of single health behaviors including smoking (e.g., Prochaska et al, 1993, stress (Evers et al, 2006), medication adherence mammography (Rakowski et al, 1998), diet (Greene et al, in press), sun protection (Weinstock et al, 2002), exercise (Marcus et al, 1998;Velicer et al, 2006), and depression (Levesque et al, 2007). TTM tailored print feedback has also been found effective when treating: 1) three health behaviors in a population of parents whose teens were participating in health promotion at school (Prochaska et al, 2004); 2) four behaviors in a population of primary care patients (Prochaska et al, 2005); 3) three behaviors in a population of patients with diabetes (Jones et al, 2003) and 4) three behaviors in a population of overweight individuals (Johnson et al, in press).…”