Evaluation of Confidence Using Motivational Interviewing Skills Before and After In-Person Training Workshop

Motivational interviewing (MI) is a skill used to help individuals make positive behavior changes and may be beneficial for those who work with undergraduate students. A new training, comprised of online content followed by an in-person workshop, was created and offered to staff members working directly with students at Iowa State University. The aim of this study was to evaluate confidence for using MI-related components pre and post an in-person workshop. To do so, participants completed a survey regarding their confidence in using MI-related skills before and after the workshop. From the survey results, a paired t-test was conducted to examine differences, and effect size was calculated to examine the magnitude of this difference. A significant difference was found pre to post with a small-to-moderate effect size, suggesting the in-person workshop was an important component for building self-efficacy to implement principles of MI in future conversations with students

Peer Health Coach Training Practicum: Evidence from a Flipped Classroom

Health coaching is a popular and effective method to assist individuals in gaining motivation to engage in healthy lifestyle behavior changes. The utility has led to an increased demand for trained individuals within the health care field. A new flipped classroom practicum course was developed to offer undergraduate students the opportunity to learn a foundational skill called motivational interviewing (MI) commonly used in health coaching. The 16-week, 2-credit course (led by three trained, graduate student health coaches) consists of online video lectures, in-class activities, experiential training, and supervised practicum experiences in health coaching. The aim of this study is to evaluate the process, impact, and outcomes of this new health coaching practicum. Measures consisted of surveys to assess participant satisfaction and course impact using 6-point Likert scales and were analyzed descriptively (mean ± SD), along with obtaining recorded MI conversations to evaluate fidelity of the training. These preliminary results support the utility of a flipped classroom practicum course designed to teach undergraduate students the skills of MI; however, extended practice with the use of MI may be needed for students to meet all proficiency levels

Evaluating Motivational Interviewing and Habit Formation to Enhance the Effect of Activity Trackers on Healthy Adults’ Activity Levels: Randomized Intervention

Background: While widely used and endorsed, there is limited evidence supporting the benefits of activity trackers for increasing physical activity; these devices may be more effective when combined with additional strategies that promote sustained behavior change like motivational interviewing (MI) and habit development. Objective: This study aims to determine the utility of wearable activity trackers alone or in combination with these behavior change strategies for promoting improvements in active and sedentary behaviors. Methods: A sample of 91 adults (48/91 female, 53%) was randomized to receive a Fitbit Charge alone or in combination with MI and habit education for 12 weeks. Active and sedentary behaviors were assessed pre and post using research-grade activity monitors (ActiGraph and activPAL), and the development of habits surrounding the use of the trackers was assessed postintervention with the Self-Reported Habit Index. During the intervention, Fitbit wear time and activity levels were monitored with the activity trackers. Linear regression analyses were used to determine the influence of the trial on outcomes of physical activity and sedentary time. The influence of habits was examined using correlation coefficients relating habits of tracker use (wearing the tracker and checking data on the tracker and associated app) to Fitbit wear time and activity levels during the intervention and at follow-up. Results: Regression analyses revealed no significant differences by group in any of the primary outcomes (all P\u3e.05). However, personal characteristics, including lower baseline activity levels (beta=–.49, P=.01) and lack of previous experience with pedometers (beta=–.23, P=.03) were predictive of greater improvements in moderate and vigorous physical activity. Furthermore, for individuals with higher activity levels at the baseline, MI and habit education were more effective for maintaining these activity levels when compared with receiving a Fitbit alone (eg, small increase of ~48 steps/day, d=0.01, vs large decrease of ~1830 steps/day, d=0.95). Finally, habit development was significantly related to steps/day during (r=.30, P=.004) and following the intervention (r=.27, P=.03). Conclusions: This study suggests that activity trackers may have beneficial effects on physical activity in healthy adults, but benefits vary based on individual factors. Furthermore, this study highlights the importance of habit development surrounding the wear and use of activity trackers and the associated software to promote increases in physical activity

Understanding the importance of sedentary time in chronic pain

High sedentary time (SED) is a public health concern and reductions of SED may significantly improve health outcomes. Perceptions, determinants, and associations with other health aspects, such as pain, are understudied. The purpose of this dissertation was to 1) examine the relationship between SED and pain symptoms and pain processing in people with chronic low back pain (cLBP), 2) compare levels of self-efficacy for reducing SED to increasing moderate to vigorous physical activity (MVPA), and 3) explore perceived determinants of reducing SED in people with cLBP. Results from study one suggests no relationship between SED and pain in people with cLBP. Study two results show that people are more confident in their ability to reduce SED compared to increase MVPA, and adults have similar levels of confidence in meeting daily SED related goals. Study three found that common barriers for reducing SED include environmental constraints, social norms, and productivity, while helping individuals develop coping plans, restructure their physical environments, develop habits surround sitting less, and using self-monitoring tools are perceived as helpful. This dissertation adds to current literature on associations between SED and pain, and perceptions and determinants of reducing SED. This may help in the refinement of SED interventions for treatment of cBLP and other health outcomes, as well as in understanding confidence for changing SED and MVPA behaviors to potentially aid in refinement of current SED and MVPA guidelines.</p

Understanding the importance of sedentary time in chronic pain

High sedentary time (SED) is a public health concern and reductions of SED may significantly improve health outcomes. Perceptions, determinants, and associations with other health aspects, such as pain, are understudied. The purpose of this dissertation was to 1) examine the relationship between SED and pain symptoms and pain processing in people with chronic low back pain (cLBP), 2) compare levels of self-efficacy for reducing SED to increasing moderate to vigorous physical activity (MVPA), and 3) explore perceived determinants of reducing SED in people with cLBP. Results from study one suggests no relationship between SED and pain in people with cLBP. Study two results show that people are more confident in their ability to reduce SED compared to increase MVPA, and adults have similar levels of confidence in meeting daily SED related goals. Study three found that common barriers for reducing SED include environmental constraints, social norms, and productivity, while helping individuals develop coping plans, restructure their physical environments, develop habits surround sitting less, and using self-monitoring tools are perceived as helpful. This dissertation adds to current literature on associations between SED and pain, and perceptions and determinants of reducing SED. This may help in the refinement of SED interventions for treatment of cBLP and other health outcomes, as well as in understanding confidence for changing SED and MVPA behaviors to potentially aid in refinement of current SED and MVPA guidelines

An observational pilot evaluation of the Walk with Ease program for reducing fall risk among older adults

Abstract Background Physical activity is an effective method of reducing fall risk among older adults. Previous evaluations of the six-week Walk with Ease (WWE) program have documented benefits to functional outcomes, but the potential effects on reducing fall risk have not been evaluated. This pilot study evaluates outcomes of a community delivered WWE program for potential suitability as a fall risk reduction program. Methods A total of 59 older adults (age > 60) enrolled in a group version of WWE delivered by trained community-based leaders. Complete data (pre- and post-program) from functional fitness tests and behavioral instruments were obtained from 41 participants (aged 74.4 ± 6.6 years, 70% female). Functional outcomes included the 10-foot timed up and go (TUG), 30-second chair stand (CST) and 4-stage balance test (BT) included as part of STEADI, as well as a two-minute step test (ST) and normal gait speed test (GST). Survey assessments included STEADI fall risk screening, self-reported physical activity, and fear of falling measures. Analyses focused on reporting pre-post effect sizes, but paired t-tests were used to test statistical significance of differences. Results Improvements in functional performance approached significance for both CST (d = 0.31, p = 0.06) and ST (d = 0.26, p = 0.12), but all other tests were nonsignificant. Survey results demonstrated significant increases in self-reported walking (d = 0.54, p = 0.02) and moderate-to-vigorous physical activity (MVPA; d = 0.56, p = 0.004), but perceived fear of falling and overall fall risk scores had smaller, non-significant, effects (d ranging from 0.01 to 0.31). Stratified analysis suggested that participants screened at an elevated risk for falls at baseline consistently had larger effects on all functional and survey assessments, though the analysis was underpowered to test significance. Conclusions Walk with Ease participation significantly increased self-reported physical activity but did not significantly improve physical function or reduce fall risk. However, consistently larger effect sizes among participants screened as at-risk for falls suggest that the program may be beneficial for those with elevated risk for falls or functional limitations. Further research is needed to document the consistency of these effects among participants with elevated fall risk status

Peer Health Coach Training Practicum: Evidence from a Flipped Classroom

Health coaching is a popular and effective method to assist individuals in gaining motivation to engage in healthy lifestyle behavior changes. The utility has led to an increased demand for trained individuals within the health care field. A new flipped classroom practicum course was developed to offer undergraduate students the opportunity to learn a foundational skill called motivational interviewing (MI) commonly used in health coaching. The 16-week, 2-credit course (led by three trained, graduate student health coaches) consists of online video lectures, in-class activities, experiential training, and supervised practicum experiences in health coaching. The aim of this study is to evaluate the process, impact, and outcomes of this new health coaching practicum. Measures consisted of surveys to assess participant satisfaction and course impact using 6-point Likert scales and were analyzed descriptively (mean ± SD), along with obtaining recorded MI conversations to evaluate fidelity of the training. These preliminary results support the utility of a flipped classroom practicum course designed to teach undergraduate students the skills of MI; however, extended practice with the use of MI may be needed for students to meet all proficiency levels.</p

Evaluation of Confidence Using Motivational Interviewing Skills Before and After In-Person Training Workshop

Motivational interviewing (MI) is a skill used to help individuals make positive behavior changes and may be beneficial for those who work with undergraduate students. A new training, comprised of online content followed by an in-person workshop, was created and offered to staff members working directly with students at Iowa State University. The aim of this study was to evaluate confidence for using MI-related components pre and post an in-person workshop. To do so, participants completed a survey regarding their confidence in using MI-related skills before and after the workshop. From the survey results, a paired t-test was conducted to examine differences, and effect size was calculated to examine the magnitude of this difference. A significant difference was found pre to post with a small-to-moderate effect size, suggesting the in-person workshop was an important component for building self-efficacy to implement principles of MI in future conversations with students.</p

Working from home and job loss due to the COVID-19 pandemic are associated with greater time in sedentary behaviors

Objectives: Due to the COVID-19 pandemic, major changes to how, or even whether, we work have occurred. This study examines associations of changing COVID-19-related employment conditions with physical activity and sedentary behavior. Methods: Data from 2,303 US adults in employment prior to COVID-19 were collected April 3rd−7th, 2020. Participants reported whether their employment remained unchanged, they were working from home (WFH) when they had not been before, or they lost their job due to the pandemic. Validated questionnaires assessed physical activity, sitting time, and screen time. Linear regression quantified associations of COVID-19-related employment changes with physical activity, sitting time, and screen time, controlling for age, sex, race, BMI, smoking status, marital status, chronic conditions, household location, public health restrictions, and recalled physical activity, sitting time, and screen time prior to the COVID-19 pandemic