Impact of a physical activity intervention program on cognitive predictors of behaviour among adults at risk of Type 2 diabetes (<it>ProActive </it>randomised controlled trial)

<p>Abstract</p> <p>Background</p> <p>In the <it>ProActive </it>Trial an intensive theory-based intervention program was no more effective than theory-based brief advice in increasing objectively measured physical activity among adults at risk of Type 2 diabe...

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Main Authors: Sutton Stephen, Michie Susan, Kinmonth Ann, Hardeman Wendy
Format: Article
Language:English
Published: BMC 2009-03-01
Series:International Journal of Behavioral Nutrition and Physical Activity
Online Access:http://www.ijbnpa.org/content/6/1/16
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author Sutton Stephen
Michie Susan
Kinmonth Ann
Hardeman Wendy
author_facet Sutton Stephen
Michie Susan
Kinmonth Ann
Hardeman Wendy
author_sort Sutton Stephen
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>In the <it>ProActive </it>Trial an intensive theory-based intervention program was no more effective than theory-based brief advice in increasing objectively measured physical activity among adults at risk of Type 2 diabetes. We aimed to illuminate these findings by assessing whether the intervention program changed cognitions about increasing activity, defined by the Theory of Planned Behaviour, in ways consistent with the theory.</p> <p>Methods</p> <p><it>N </it>= 365 sedentary participants aged 30–50 years with a parental history of Type 2 diabetes were randomised to brief advice alone or to brief advice plus the intervention program delivered face-to-face or by telephone. Questionnaires at baseline, 6 and 12 months assessed cognitions about becoming more physically active. Analysis of covariance was used to test intervention impact. Bootstrapping was used to test multiple mediation of intervention impact.</p> <p>Results</p> <p>At 6 months, combined intervention groups (face-to-face and telephone) reported that they found increasing activity more enjoyable (affective attitude, <it>d </it>= .25), and they perceived more instrumental benefits (e.g., improving health) (<it>d </it>= .23) and more control (<it>d </it>= .32) over increasing activity than participants receiving brief advice alone. Stronger intentions (<it>d </it>= .50) in the intervention groups than the brief advice group at 6 months were partially explained by affective attitude and perceived control. At 12 months, intervention groups perceived more positive instrumental (<it>d </it>= .21) and affective benefits (<it>d </it>= .29) than brief advice participants. The intervention did not change perceived social pressure to increase activity.</p> <p>Conclusion</p> <p>Lack of effect of the intervention program on physical activity over and above brief advice was consistent with limited and mostly small short-term effects on cognitions. Targeting affective benefits (e.g., enjoyment, social interaction) and addressing barriers to physical activity may strengthen intentions, but stronger intentions did not result in more behaviour change. More powerful interventions which induce large changes in TPB cognitions may be needed. Other interventions deserving further evaluation include theory-based brief advice, intensive measurement of physical and psychological factors, and monitoring of physical activity. Future research should consider a wider range of mediators of physical activity change, assess participants' use of self-regulatory strategies taught in the intervention, and conduct experimental studies or statistical modelling prior to trial evaluation. ISRCTN61323766.</p>
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spelling doaj.art-b347b4171f1942f6b99c21300a9bd3972022-12-22T03:25:51ZengBMCInternational Journal of Behavioral Nutrition and Physical Activity1479-58682009-03-01611610.1186/1479-5868-6-16Impact of a physical activity intervention program on cognitive predictors of behaviour among adults at risk of Type 2 diabetes (<it>ProActive </it>randomised controlled trial)Sutton StephenMichie SusanKinmonth AnnHardeman Wendy<p>Abstract</p> <p>Background</p> <p>In the <it>ProActive </it>Trial an intensive theory-based intervention program was no more effective than theory-based brief advice in increasing objectively measured physical activity among adults at risk of Type 2 diabetes. We aimed to illuminate these findings by assessing whether the intervention program changed cognitions about increasing activity, defined by the Theory of Planned Behaviour, in ways consistent with the theory.</p> <p>Methods</p> <p><it>N </it>= 365 sedentary participants aged 30–50 years with a parental history of Type 2 diabetes were randomised to brief advice alone or to brief advice plus the intervention program delivered face-to-face or by telephone. Questionnaires at baseline, 6 and 12 months assessed cognitions about becoming more physically active. Analysis of covariance was used to test intervention impact. Bootstrapping was used to test multiple mediation of intervention impact.</p> <p>Results</p> <p>At 6 months, combined intervention groups (face-to-face and telephone) reported that they found increasing activity more enjoyable (affective attitude, <it>d </it>= .25), and they perceived more instrumental benefits (e.g., improving health) (<it>d </it>= .23) and more control (<it>d </it>= .32) over increasing activity than participants receiving brief advice alone. Stronger intentions (<it>d </it>= .50) in the intervention groups than the brief advice group at 6 months were partially explained by affective attitude and perceived control. At 12 months, intervention groups perceived more positive instrumental (<it>d </it>= .21) and affective benefits (<it>d </it>= .29) than brief advice participants. The intervention did not change perceived social pressure to increase activity.</p> <p>Conclusion</p> <p>Lack of effect of the intervention program on physical activity over and above brief advice was consistent with limited and mostly small short-term effects on cognitions. Targeting affective benefits (e.g., enjoyment, social interaction) and addressing barriers to physical activity may strengthen intentions, but stronger intentions did not result in more behaviour change. More powerful interventions which induce large changes in TPB cognitions may be needed. Other interventions deserving further evaluation include theory-based brief advice, intensive measurement of physical and psychological factors, and monitoring of physical activity. Future research should consider a wider range of mediators of physical activity change, assess participants' use of self-regulatory strategies taught in the intervention, and conduct experimental studies or statistical modelling prior to trial evaluation. ISRCTN61323766.</p>http://www.ijbnpa.org/content/6/1/16
spellingShingle Sutton Stephen
Michie Susan
Kinmonth Ann
Hardeman Wendy
Impact of a physical activity intervention program on cognitive predictors of behaviour among adults at risk of Type 2 diabetes (<it>ProActive </it>randomised controlled trial)
International Journal of Behavioral Nutrition and Physical Activity
title Impact of a physical activity intervention program on cognitive predictors of behaviour among adults at risk of Type 2 diabetes (<it>ProActive </it>randomised controlled trial)
title_full Impact of a physical activity intervention program on cognitive predictors of behaviour among adults at risk of Type 2 diabetes (<it>ProActive </it>randomised controlled trial)
title_fullStr Impact of a physical activity intervention program on cognitive predictors of behaviour among adults at risk of Type 2 diabetes (<it>ProActive </it>randomised controlled trial)
title_full_unstemmed Impact of a physical activity intervention program on cognitive predictors of behaviour among adults at risk of Type 2 diabetes (<it>ProActive </it>randomised controlled trial)
title_short Impact of a physical activity intervention program on cognitive predictors of behaviour among adults at risk of Type 2 diabetes (<it>ProActive </it>randomised controlled trial)
title_sort impact of a physical activity intervention program on cognitive predictors of behaviour among adults at risk of type 2 diabetes it proactive it randomised controlled trial
url http://www.ijbnpa.org/content/6/1/16
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