Institute for Health and Sport, Victoria University, Melbourne VIC Australia; Faculty of Nursing Science, Assumption University, Bangkok, Thailand.
Institute for Health and Sport, Victoria University, Melbourne VIC Australia; Department of Medicine - Western Health, The University of Melbourne, Melbourne VIC Australia; The Australian Institute for Musculoskeletal Science, The University of Melbourne, Victoria University and Western Health, Melbourne, VIC, Australia.
Maturitas. 2021 Oct;152:32-47. doi: 10.1016/j.maturitas.2021.06.008. Epub 2021 Jun 24.
Two behavioral change-based strategies for promoting adherence to physical activity (PA) suggested to have the greatest potential are the pedometer and Motivational Interviewing (MI). However, there are no comparisons between these two strategies identifying which one is more effective for improving PA adherence. This systematic review and meta-analysis aimed to determine which PA motivation strategy is more effective for promoting adherence to self-directed PA in female breast cancer survivors. Studies implementing self-directed PA which used a step tracker and/or MI for motivation in female breast cancer survivors were identified from the following databases at two timepoints, September 2019 and June 2020: CENTRAL, PubMed, CINAHL, PsycINFO, and Sportdiscuss. Sixteen randomized controlled trials (RCTs) were selected for data extraction, whereas ten RCTs were included in meta-analysis. Meta-analysis was performed on pooled data to estimate the standardized mean differences in PA duration and step count, and 95% confidence intervals. The number of participants meeting PA recommendations was also analyzed. Subgroup analysis was performed for three motivational strategies (pedometer combined with counselling, with print material or with motivational interviewing). Meta-analysis showed that pedometer combined with another intervention has a small effect on step count (p = 0.03) and a moderate effect on duration of moderate-vigorous physical activity (MVPA) (p = <0.0001) compared to controls. Additionally, motivational strategies increase the number of participants who meet a PA goal (p = 0.005). The findings of this review endorse the use of a step tracker combined with counselling, print material or MI based on behavioral change theory. This approach provided the most consistent positive effect on adherence to self-directed PA among breast cancer survivors. Future studies should evaluate differences between measures of adherence to self-directed PA, to identify the best motivation strategy for improving patient adherence and health outcomes. Systematic review registration: PROSPERO Registration number CRD42020148542.
两种基于行为改变的策略，即计步器和动机性访谈（MI），被认为在促进身体活动（PA）依从性方面具有最大的潜力。然而，目前尚无比较这两种策略的研究，以确定哪种策略更能有效地提高 PA 依从性。本系统评价和荟萃分析旨在确定哪种 PA 激励策略更能有效地促进女性乳腺癌幸存者自我指导的 PA 依从性。从以下数据库中，在两个时间点（2019 年 9 月和 2020 年 6 月）检索了实施自我指导的 PA 并使用计步器和/或 MI 来激励女性乳腺癌幸存者的研究：CENTRAL、PubMed、CINAHL、PsycINFO 和 Sportdiscuss。共选择了 16 项随机对照试验（RCT）进行数据提取，其中 10 项 RCT 纳入荟萃分析。对汇总数据进行荟萃分析，以估计 PA 持续时间和步数的标准化均数差，以及 95%置信区间。还分析了达到 PA 推荐量的参与者人数。对三种激励策略（计步器结合咨询、结合印刷材料或结合动机性访谈）进行了亚组分析。荟萃分析显示，与对照组相比，计步器结合其他干预措施对步数（p = 0.03）和中等至剧烈体力活动（MVPA）持续时间（p = <0.0001）有较小的影响。此外，激励策略增加了达到 PA 目标的参与者人数（p = 0.005）。本综述的结果支持使用基于行为改变理论的计步器结合咨询、印刷材料或 MI。这种方法对乳腺癌幸存者自我指导的 PA 依从性产生了最一致的积极影响。未来的研究应评估自我指导的 PA 依从性测量之间的差异，以确定改善患者依从性和健康结果的最佳激励策略。系统评价注册：PROSPERO 注册号 CRD42020148542。
Int J Environ Res Public Health. 2025-7-17
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