A brief report on the development of a theoretically-grounded intervention to promote patient autonomy and self-management of physiotherapy patients: face validity and feasibility of implementation

Background Clinical practice guidelines for the treatment of low back pain suggest the inclusion of a biopsychosocial approach in which patient self-management is prioritized. While many physiotherapists recognise the importance of evidence-based practice, there is an evidence practice gap that may in part be due to the fact that promoting self-management necessitates change in clinical behaviours. Evidence suggests that a patient’s motivation and maintenance of self-management behaviours can be positively influenced by the clinician’s use of an autonomy supportive communication style. Therefore, the aim of this study was to develop and pilot-test the feasibility of a theoretically derived implementation intervention to support physiotherapists in using an evidence-based autonomy supportive communication style in practice for promoting patient self-management in clinical practice. Methods A systematic process was used to develop the intervention and pilot-test its feasibility in primary care physiotherapy. The development steps included focus groups to identify barriers and enablers for implementation, the theoretical domains framework to classify determinants of change, a behaviour change technique taxonomy to select appropriate intervention components, and forming a testable theoretical model. Face validity and acceptability of the intervention was pilot-tested with two physiotherapists and monitoring their communication with patients over a three-month timeframe. Results Using the process described above, eight barriers and enablers for implementation were identified. To address these barriers and enablers, a number of intervention components were selected ranging from behaviour change techniques such as, goal-setting, self-monitoring and feedback to appropriate modes of intervention delivery (i.e. continued education meetings and audit and feedback focused coaching). Initial pilot-testing revealed the acceptability of the intervention to recipients and highlighted key areas for refinement prior to scaling up for a definitive trial. Conclusion The development process utilised in this study ensured the intervention was theory-informed and evidence-based, with recipients signalling its relevance and benefit to their clinical practice. Future research should consider additional intervention strategies to address barriers of social support and those beyond the clinician level

Stand More AT Work (SMArT Work): using the behaviour change wheel to develop an intervention to reduce sitting time in the workplace

Background: Sitting (sedentary behaviour) is widespread among desk-based office workers and a high level of sedentary behaviour is a risk factor for poor health. Reducing workplace sitting time is therefore an important prevention strategy. Interventions are more likely to be effective if they are theory and evidence-based. The Behaviour Change Wheel (BCW) provides a framework for intervention development. This article describes the development of the Stand More AT Work (SMArT Work) intervention, which aims to reduce sitting time among National Health Service (NHS) office-based workers in Leicester, UK. Methods: We followed the BCW guide and used the Capability, Opportunity and Motivation Behaviour (COM-B) model to conduct focus group discussions with 39 NHS office workers. With these data we used the taxonomy of Behaviour Change Techniques (BCTv1) to identify the most appropriate strategies for facilitating behaviour change in our intervention. To identify the best method for participants to self-monitor their sitting time, a sub-group of participants (n = 31) tested a number of electronic self-monitoring devices. Results: From our BCW steps and the BCT-Taxonomy we identified 10 behaviour change strategies addressing environmental (e.g. provision of height adjustable desks,), organisational (e.g. senior management support, seminar), and individual level (e.g. face-to-face coaching session) barriers. The Darma cushion scored the highest for practicality and acceptability for self-monitoring sitting. Conclusion: The BCW guide, COM-B model and BCT-Taxonomy can be applied successfully in the context of designing a workplace intervention for reducing sitting time through standing and moving more. The intervention was developed in collaboration with office workers (a participatory approach) to ensure relevance for them and their work situation. The effectiveness of this intervention is currently being evaluated in a randomised controlled trial

Effect of a self-determination theory-based communication skills training program on physiotherapists' psychological support for their patients with chronic low back pain: a randomized controlled trial

Objective: To examine the effects of communication skills training on physiotherapists' supportive behavior during clinical practice. Design: Randomized trial. Setting: Hospital outpatient physiotherapy clinics. Participants: Physiotherapists (N=24) and patients (N=24) with chronic low back pain. Interventions: Two hospital clinics were randomly assigned to the intervention arm. Physiotherapists (n=12) received 8 hours of communication skills training focused on supporting patients' psychological needs. Physiotherapists (n=12) from 2 other hospital clinics formed a waitlist control arm. Main Outcome Measures: Verbal communication between each physiotherapist and a patient was recorded on an audiotape, and independent, blinded raters used the Health Care Climate Questionnaire to assess physiotherapists' needs-supportive behavior (primary outcome). Results: Independent raters' Health Care Climate Questionnaire scores favored the intervention arm (Cohen's d=2.27; P<.01). Conclusions: Compared with controls, independent ratings demonstrated that physiotherapists who completed the Communication style and exercise compliance in physiotherapy training were found to provide greater support for patients' needs in a single assessed session. Long-term maintenance of this needs-supportive behavior should be examined

Providing NHS staff with height-adjustable workstations and behaviour change strategies to reduce workplace sitting time: protocol for the Stand More AT (SMArT) Work cluster randomised controlled trial

BACKGROUND. High levels of sedentary behaviour (i.e., sitting) are a risk factor for poor health. With high levels of sitting widespread in desk-based office workers, office workplaces are an appropriate setting for interventions aimed at reducing sedentary behaviour. This paper describes the development processes and proposed intervention procedures of Stand More AT (SMArT) Work, a multi-component randomised control (RCT) trial which aims to reduce occupational sitting time in desk-based office workers within the National Health Service (NHS). METHODS/DESIGN. SMArT Work consists of 2 phases: 1) intervention development: The development of the SMArT Work intervention takes a community-based participatory research approach using the Behaviour Change Wheel. Focus groups will collect detailed information to gain a better understanding of the most appropriate strategies, to sit alongside the provision of height-adjustable workstations, at the environmental, organisational and individual level that support less occupational sitting. 2) intervention delivery and evaluation: The 12 month cluster RCT aims to reduce workplace sitting in the University Hospitals of Leicester NHS Trust. Desk-based office workers (n = 238) will be randomised to control or intervention clusters, with the intervention group receiving height-adjustable workstations and supporting techniques based on the feedback received from the development phase. Data will be collected at four time points; baseline, 3, 6 and 12 months. The primary outcome is a reduction in sitting time, measured by the activPALTM micro at 12 months. Secondary outcomes include objectively measured physical activity and a variety of work-related health and psycho-social measures. A process evaluation will also take place. DISCUSSION. This study will be the first long-term, evidence-based, multi-component cluster RCT aimed at reducing occupational sitting within the NHS. This study will help form a better understanding and knowledge base of facilitators and barriers to creating a healthier work environment and contribute to health and wellbeing policy. TRIAL REGISTRATION. ISRCTN10967042. Registered 2 February 2015

SMArT Work: Stand more at Work: The development of behaviour changes strategies for increasing standing and movement among sedentary office workers

SMArT Work: Stand more at Work: The development of behaviour changes strategies for increasing standing and movement among sedentary office worker

On the same page in sporting dyads: does dissimilarity on 2 x 2 achievement goal constructs impair relationship functioning?

This study examined the extent to which 2 x 2 achievement goal constructs (Elliot, 1999) were associated with key relational perceptions (i.e., relationship commitment, relationship satisfaction) for members of athlete-athlete dyads. Both members from 82 regional-level partnerships (mean age = 22.72, SD = 3.83) were recruited from a variety of dyadic sports (e.g., tennis, badminton, rowing). Actor-partner interdependence model analyses revealed that greater dissimilarity between partners on mastery-approach and performance-approach goals was associated with lower commitment and satisfaction. Mastery goals displayed positive actor effects with respect to both relationship perceptions, whereas performance-avoidance goals were negatively related to commitment (i.e., actor and partner effects) and satisfaction (i.e., partner effect). These results indicate that achievement goal constructs may align with important interpersonal perceptions in athlete dyads

Relationships between social interactions, basic psychological needs, and wellbeing during the COVID-19 pandemic

Objective: Social lockdowns associated with COVID-19 have led individuals to increasingly rely on video conferencing and other technology-based interactions to fulfil social needs. The extent to which these interactions, as well as traditional face-to-face interactions, satisfied psychological needs and supported wellbeing during different periods of the COVID-19 pandemic is yet to be elucidated. In this study, university students’ social interactions (both technology-based and face-to-face), psychological needs, and wellbeing were assessed at six time points across four months of government-enforced restrictions in Australia. Design: Repeated survey assessment. Main outcome measures: Basic psychological need satisfaction; general wellbeing. Results: Results demonstrated that, at the within-subjects level, relatedness satisfaction (feeling understood by, cared for, and connected to others) significantly mediated the relationship between technology-based interaction and wellbeing. Autonomy satisfaction (self-initiation and feeling ownership over decisions and behaviours) mediated the relationship between face-to-face interactions and wellbeing at the within-person level. Conclusion: Discussion is centred on the importance of technology-based interactions for needs satisfaction and wellbeing during periods of social isolation

Music listening predicted improved life satisfaction in university students during early stages of the COVID-19 pandemic

Music Listening Predicted Improved Life Satisfaction in University Students. Quarantine and spatial distancing measures associated with COVID-19 resulted in substantial changes to individuals’ everyday lives. Prominent among these lifestyle changes was the way in which people interacted with media—including music listening. In this repeated assessment study, we assessed Australian university students’ media use (i.e., listening to music, playing video/computer games, watching TV/movies/streaming videos, and using social media) throughout early stages of the COVID-19 pandemic in Australia, and determined whether media use was related to changes in life satisfaction. Participants (N = 127) were asked to complete six online questionnaires, capturing pre- and during-pandemic experiences. The results indicated that media use varied substantially throughout the study period, and at the within-person level, life satisfaction was positively associated with music listening and negatively associated with watching TV/videos/movies. The findings highlight the potential benefits of music listening during COVID-19 and other periods of social isolation. © Copyright © 2021 Krause, Dimmock, Rebar and Jackso

Aggregate-level skewness, kurtosis, and zero-order correlations for all variables (including GPA) across the entire sample.

<p>Aggregate-level skewness, kurtosis, and zero-order correlations for all variables (including GPA) across the entire sample.</p

Descriptive statistics according to condition.

<p>Descriptive statistics according to condition.</p