Process evaluation of an exercise counseling intervention using motivational interviewing

Abstract

Aim To describe the results of the process evaluation of an exercise counseling intervention using motivational interviewing (MI). Background Exercise can safely be incorporated into heart failure self-care, but many lack access to cardiac rehabilitation. One alternative is to provide exercise counseling in the clinical setting. Methods This process evaluation was conducted according to previously established guidelines for health promotion programs. This includes an assessment of recruitment and retention, implementation, and reach. Results Desired number of subjects were recruited, but 25% dropped out during study. Good fidelity to the intervention was achieved; the use of MI was evaluated with improvement in adherence over time. Dose included initial session plus 12weekly phone calls. Subjects varied in participation of daily diary usage. Setting was conducive to recruitment and data collection. Conclusions Evaluating the process of an intervention provides valuable feedback on content, delivery and fidelity.

Assessment of fidelity in individual level behaviour change interventions promoting physical activity among adults: a systematic review

“…16 studies were RCT’s [ 32 – 48 ] and five were one arm (pre-post) trials [ 49 – 53 ]. All studies reported some form of behavioural support which aimed to increase the uptake of physical activity (e.g.…”

“…information about health benefits, goal setting, self-monitoring, and pedometers). Studies used motivational interviewing (MI) [ 34 , 37 , 39 , 48 , 52 , 53 ], Cognitive Behaviour Therapy (CBT) [ 39 ], and guided self-management based on a range of theoretical approaches including social cognitive theory (SCT) [ 36 , 44 , 48 , 50 , 51 ], theory of planned behaviour (TPB) [ 47 , 51 ], self-determination theory (SDT) [ 37 , 41 , 43 ], the trans-theoretical model (TTM) [ 36 , 39 , 40 , 42 , 47 ] and self-regulation theory [ 38 , 46 ]. Physical activity was assessed using self-report [ 32 – 34 , 36 , 37 , 39 – 41 , 44 , 47 , 48 , 50 , 52 ], or objective measures of physical activity (e.g.…”

“…Of the studies that reported outcomes relating to physical activity, nine reported an increase [ 32 , 34 – 36 , 38 , 41 , 47 , 48 , 50 ], and three reported no increase in physical activity [ 37 , 40 , 46 ]. Studies included participants with a range of ages (36 to 81) and consisted of inactive employees [ 32 ], university staff [ 40 ] inactive post-partum women [ 33 ], African American women [ 48 ] patients recovering from spinal cord injury [ 50 ], people with co morbid depression and multiple sclerosis [ 34 ], people aged over 50 [ 36 , 39 , 42 ], people from deprived communities [ 37 ], people with type 2 diabetes [ 38 , 51 ], people with intellectual disabilities [ 49 ], primary care patients [ 46 , 52 ]) overweight adults [ 35 ], inactive adults [ 41 , 44 , 47 ], people with heart failure [ 53 ] and people Huntington’s disease [ 43 ]. The mode of intervention delivery included face to face [ 32 , 34 , 36 – 38 , 42 – 44 , 46 , 48 – 53 ], online [ 33 , 35 , 40 , 44 , 47 , 51 ], email [ 32 , 40 ] post [ 41 ] and by telephone [ 33 , 34 , 36 , 39 , 48 , 53 ], with both individual (one to one) and group based intervention formats.…”

“…log books, worksheets, pedometers) (3) Participant Self report (2) [ 32 , 41 ] Automatically tracked (1) [ 48 ] Number of times intervention materials used (e.g. log books, worksheets, pedometers, online self-monitoring) (2) Automatically tracked (2) [ 35 , 53 ] Checklist of participant use of specified intervention techniques (e.g. action planning, self-monitoring) (2) Participant Self report (2) [ 35 , 38 ] Participant rating of agreement with using intervention techniques (1) Participant Self report (1) [ 50 ] a Some studies contain multiple measurement approaches …”

“…20 studies measured delivery of human providers. These included using self-report by providers to measure the presence or absence [ 38 , 42 , 43 , 52 ], frequency [ 36 ], or delivery quality [ 43 ] of intervention components, or using observation by researchers to assess the presence or absence [ 33 , 48 , 51 ], frequency, [ 34 , 37 , 38 , 48 , 53 ] or delivery quality [ 43 ] of intervention components. Two studies reported measuring the provider’s satisfaction with his or her own intervention delivery [ 50 , 52 ] and two studies reported measuring the participants’ satisfaction with intervention delivery [ 36 , 39 ].…”