The impact of signposting and group support pathways on a community-based physical activity intervention grounded in motivational interviewing

Abstract

Background: Brief advice is recommended to increase physical activity (PA) within primary care. This study assessed change in PA levels and mental wellbeing after a motivational interviewing (MI) community-based PA intervention and the impact of signposting [SP] and Social Action [SA] (i.e. weekly group support) pathways. Methods: Participants (n=2084) took part in a community-based, primary care PA programme using MI techniques. Self-reported PA and mental wellbeing data were collected at baseline (following an initial 30-minute MI appointment), 12-weeks, six-months, and 12-months. Participants were assigned based upon the surgery they attended to the SP or SA pathway. Multilevel models were used to derive point estimates and 95%CIs for outcomes at each time point and change scores. Results: Participants increased PA and mental wellbeing at each follow-up time point through both participant pathways and with little difference between pathways. Retention was similar between pathways at 12-weeks, but the SP pathway retained more participants at six-months and 12-months. Conclusions: Both pathways produced similar improvements in PA and mental wellbeing, suggesting the effectiveness of MI based PA interventions. However, due to lower resources required yet similar effects, SP pathways are recommended over SA to support PA in primary care settings.

The impact of signposting and group support pathways on a community-based physical activity intervention grounded in motivational interviewing

“…It could be that walking did not continually improve as more intensive PA displaced it over time, increasing overall improvements. Hardcastle et al 40 also reported significant changes in walking from baseline at six and 18-months, but is unclear if this plateaued from 12-weeks as found in the present study. Overall, PA levels were improved such that participants would be classified as having 'high' activity levels after 12-weeks, and this was maintained post six-months though without further improvement.…”

“…MI is a client centred direct approach to increase, guide, elicit, and strengthen intrinsic motivation to change, while exploring and resolving ambivalence 7,8 . MI was seen as an alternative to more directive and confrontational counselling 9 with client-cantered principles and techniques 10 . MI has been used to promote positive behaviour change in a number of domains and is one of few theory based interventions supported by evidence 11 .…”

“…However, previously they have not been typically incorporated into MI interventions for PA improvement. Individuals with chronic illnesses often join support groups to help with their emotional and practical challenges [23][24][25][26] . Group sessions may maximise opportunities for members to change behaviours 27 ; thus, they are an increasingly popular method for health improvement 28 .…”

‘A Lot of People Just Go for Walks, and Don’t Do Anything Else’: Older Adults in the UK Are Not Aware of the Strength Component Embedded in the Chief Medical Officers’ Physical Activity Guidelines—A Qualitative Study

“…The health care professional should be able to sufficiently explain the importance of strength and strength training. Ideally, they will also be able to direct their patient to a qualified clinical exercise physiologist, one with specific expertise that is matched to the ability of their patient [ 48 ]. However previous research confirms a lack of knowledge and confidence in this space to be a major barrier in doing so [ 46 ].…”