Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark.
Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
BMC Geriatr. 2020 Oct 20;20(1):412. doi: 10.1186/s12877-020-01815-1.
Physical Activity Monitors (PAMs) have been shown to effectively enhance level of physical activity (PA) in older adults. Motivational interviewing is a person-centred model where participants are guided using self-reflection and counselling, and addresses the behavioural and psychological aspects of why people initiate health behaviour change by prompting increases in motivation and self-efficacy. The addition of motivational interviewing to PA interventions may increase the effectiveness of PAMs for older adults.
This motivational interviewing and PA monitoring trial is designed as an investigator-blinded, two arm parallel group, randomized controlled superiority trial with primary endpoint after 12 weeks of intervention. The intervention group will receive a PAM-based intervention and motivational interviewing and the control group will only receive the PAM-based intervention. The primary outcome is PA, objectively measured as the average daily number of steps throughout the intervention period. Secondary outcome measures include self-reported PA health-related quality of life, loneliness, self-efficacy for exercise, outcome expectancy for exercise, and social relations. The outcomes will be analysed with a linear regression model investigating between-group differences, adjusted for baseline scores. Following the intention to treat principle, multiple imputation will be performed to handle missing values.
A moderate effect of daily PA measured using PAMs is expected in this superiority RCT investigating the effect of adding motivational interviewing to a PAM intervention. According to the World Health Organization, walking and cycling are key activities in regular PA and should be promoted. To increase the general public health and lower the burden of inactivity in older adults, cost-beneficial solutions should be investigated further. If this RCT shows that motivational interviewing can enhance the effect of PAM-based interventions, it might be included as an add-on intervention when appropriate. No matter what the results of this study will be, the conclusions will be relevant for clinicians as the dependence on technology is increasing, especially in relation to public health promotion.
NCT03906162 , April 1, 2019.
体力活动监测器(PAMs)已被证明可有效提高老年人的体力活动(PA)水平。动机性访谈是一种以人为中心的模式,通过自我反思和咨询指导参与者,解决人们发起健康行为改变的行为和心理方面的问题,通过提高动机和自我效能来促使更多的行为改变。将动机性访谈添加到 PA 干预中可能会提高 PAMs 对老年人的效果。
这项动机性访谈和 PA 监测试验设计为盲法、双臂平行组、随机对照优效试验,主要终点为干预 12 周后。干预组将接受基于 PAM 的干预和动机性访谈,对照组仅接受基于 PAM 的干预。主要结果是 PA,通过干预期间平均每天的步数进行客观测量。次要结果包括自我报告的 PA 健康相关生活质量、孤独感、运动自我效能感、运动结果预期和社会关系。将使用线性回归模型分析组间差异,调整基线评分。根据意向治疗原则,将进行多重插补处理缺失值。
根据世界卫生组织的建议,步行和骑自行车是常规 PA 的关键活动,应予以推广。为了提高公众健康水平,降低老年人不活动的负担,应进一步研究具有成本效益的解决方案。如果这项 RCT 表明动机性访谈可以增强基于 PAM 的干预效果,那么在适当的时候,它可以作为附加干预措施之一。无论这项研究的结果如何,结论都将与临床医生有关,因为对技术的依赖正在增加,尤其是在公共卫生促进方面。
NCT03906162,2019 年 4 月 1 日。