Communication Strategies
Amy J. Litterini, Christopher M. Wilson in Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Within the realm of prevention, wellness, and health coaching, a useful communication and behavior-change technique is motivational interviewing (MI).7 This technique, when employed in a healthcare setting, is a “skillful clinical style for eliciting from patients their own good motivations for making behavior changes in the interest of their health. It involves guiding more than directing, dancing rather than wrestling, listening at least as much as telling.”8 This technique has established a substantial body of knowledge behind its success in helping individuals achieve a number of different behavioral changes. In A Meta-analysis of Motivational Interviewing: Twenty-five Years of Empirical Studies, the authors examined 119 articles over 25 years on a variety of topics including substance use (tobacco, alcohol, drugs, marijuana), health-related behaviors (diet, exercise, safe sex), and gambling, and found statistically significant improvements in behavior changes using MI.7 In a systematic review of ten studies related to physical activity performance in those with chronic illnesses, MI demonstrated a moderate but statistically significant effect as compared to traditional advice or interventions in improving physical activity.9
Cognitive and Behavioral Approaches to Enhancing Physical Activity Participation and Decreasing Sedentary Behavior
James M. Rippe in Lifestyle Medicine, 2019
Another recent large-scale systematic review and meta-analysis used state-of-the-art methods to examine randomized controlled trials of PA and SB interventions conducted with healthy, inactive adults to assess the effectiveness of intervention in the promotion of behavior change and maintenance.19 Findings indicated that PA interventions were effective in PA behavior change and PA maintenance at follow-up.15 Unique aspects of this review included the distinction made between behavior change and maintenance of behavior, consideration of both PA and SB interventions, and use of the Behavior Change Technique Taxonomy (BCT Taxonomy)20 for evaluating active intervention ingredients using standardized definitions and descriptions. Additionally, to evaluate aspects of the interventions such as delivery mode, treatment delivery (and fidelity), duration, and frequency, the researchers used the Template for Intervention Description and Replication (TIDieR), a checklist detailing the intervention delivery approaches.21 Also of note is the fact that studies included in the review were conducted in a diverse representation of countries and intervention providers were mixed, most frequently an instructor or student interventionist. The most common intervention settings were at a primary care exercise facility or at other locations via mail delivery. Theoretical approaches varied, with the Transtheoretical Model used the most. A wide range of contact frequency and duration was observed, ranging from one print contact to 33 sessions over 14 months (mean length 21 weeks). Unfortunately, only 12 of the 26 studies reported ethnicity, with three-quarters of those reporting a majority of White participants.15 The most frequently reported behavior change techniques were goal-setting behavior and social support. Immediate post-intervention PA data suggested that participants randomized to intervention conditions had significantly more PA compared to control participants, although effects were on average relatively small (d = 0.32 (CI 0.16 to 0.48)). Interventions that were effective yielded improvements ranging from 606–1849 steps per day and 31–247 minutes of PA per week. Evaluation of follow-up data indicated that participants randomized to interventions continued to engage in more PA, but the effect was smaller (d = 0.21 (0.12 to 0.30)), with follow-up improvements ranging from 421–1370 steps per day and 5–95 minutes of PA per week. Intervention effectiveness for PA maintenance was associated with the presence of BCT Taxonomy and indicated use of action planning, specific performance instruction, use of prompts/cues, behavior practice and rehearsal, graded tasks, and self-rewards.15 Only one of the studies reported intervention treatment fidelity; the authors accordingly highlighted this as an important need in future examinations of PA intervention approach effectiveness.
Efficacy of face-to-face behavior change counseling interventions on physical activity behavior in cancer survivors – a systematic review and meta-analysis
Published in Disability and Rehabilitation, 2022
Corinna Meyer-Schwickerath, Christina Morawietz, Freerk T. Baumann, Gerhard Huber, Joachim Wiskemann
So far, it is not clear which behavior change techniques are most effective in changing a patient’s physical activity behavior. Behavior change counseling interventions are often complex, consisting of numerous interacting components. A reliable method has been developed to specify content in terms of behavior change techniques by Michie and colleagues [31]. The Behavior Change Technique Taxonomy (BCT Taxonomy), a hierarchical classification system, has already been used in numerous systematic reviews to reliably identify behavior change techniques associated with the most successful interventions. By coding behavior change techniques, and comparing these components across interventions with higher effect sizes compared to interventions with lower effect sizes [32], this systematic review and meta-analysis aims to identify successful “active ingredients” of interventions.
Psychosocial interventions to optimize recovery of physical function and facilitate engagement in physical activity during the first three months following CABG surgery: a systematic review
Published in Physical Therapy Reviews, 2020
Owen Draper, Isaiah Goh, Cong Huang, Thomas Kibblewhite, Poppy Le Quesne, Kate Smith, Emily Gray, Margot Skinner
All 13 interventions utilized in the included studies incorporated at least one form of behavior change technique within the psychosocial intervention (Table 2). Eight of the 26 behavior change techniques identified by Abraham and Michie [30] were used by the studies in this review (Table 2). “Patient education” was the predominant mode for delivering the interventions in most of the studies, with all but two studies having evidence of including the particular behavior change technique “Providing information about behavior-health link,” in the educational aspect of the intervention. “General encouragement” was provided (e.g. praising or encouraging the participants on their behaviors) in two of the interventions. “Encouragement” was provided by using one-way phone calls (for the two pilot, one main study, and three subanalyses that used the ‘health buddy’ intervention described by Barnason et al. [36]) and meeting with peer support volunteers. “Provide instruction” was used to teach and show participants how to engage in health behavior; how to lift; and ways to exercise (n = 5). “Provide opportunities for social comparison” was used in five studies where participants either attended peer education sessions in groups, or viewed videotapes featuring experiences being shared by peers (volunteers who had previously undergone CABG surgery). “Plan social support or social change” was delivered using one-on-one support from peers to provide support to engage in physical activity, including encouraging attendance at cardiac rehabilitation (n = 2). Two studies incorporated “prompting barrier identification” in their interventions. Lastly, “stress management” utilizing relaxation techniques [48], and “feedback on performance” [44] were each included in one intervention.
Exercise behaviors of persons with multiple sclerosis through the stepwise implementation lens of social cognitive theory
Published in Disability and Rehabilitation, 2020
Matthew Fifolt, Emma V. Richardson, Elizabeth Barstow, Robert W. Motl
Interventions might be further informed by the Behavior Change Technique Taxonomy (v1) developed by Mitchie et al. [30]. Mitchie and colleagues [30] described The Behavior Change Technique Taxonomy (v1) as a “hierarchically organized taxonomy of 93 distinct BCTs” that was developed through “a series of consensus exercises involving 54 experts in delivering and/or designing behavior change interventions” (p. 89). This taxonomy can be mapped with theory for streamlining the selection of specific techniques for optimizing behavior change such as exercise training in MS [31].
Related Knowledge Centers
- Behavior Change
- Health Belief Model
- Social Cognitive Theory
- Self-Efficacy
- Risk Factor
- Habit
- Elaboration Likelihood Model
- Extended Parallel Process Model
- Fear Appeal
- Persuasion