Are Aspects of a Motivational Interview Related to Subsequent Changes in Physical Activity and Regulatory Style? Examining Relationships among Patients with Rheumatoid Arthritis

Objectives: To determine whether the integrity of motivational interviewing (MI) delivery relates to short-term changes in physical activity (PA) and regulatory style within a sample of patients with rheumatoid arthritis, and to examine whether therapist proficiency in MI improves over time. Methods: During a randomized controlled trial to promote PA, 27 patients received a motivational interview from one of three trained physical therapists, which was coded with the Motivational Interviewing Treatment Integrity scales (MITI). Pearson correlations examined associations between MITI scores and changes in PA and regulatory style. Linear regression examined therapist proficiency over time. Results: Motivational interviews with greater reflection-to-question ratios and higher MI proficiency scores were related to increases in PA. Motivational interviews higher in global spirit and with a greater percentage of MI-adherent behaviors were associated with decreases in introjected regulation. Proficiency in MI delivery tended to improve over time. Conclusions: Characteristics of motivational interviews are related to favorable shifts in regulatory style and PA behavior. Although MI proficiency increases over time and with feedback, a 15-hour training course seems insufficient for physical therapists to obtain basic MI proficiency. Practice Implications: Providing feedback to therapists new to delivering MI seems to improve MI proficiency and should help therapists to avoid using MI-non-adherent techniques

Are Aspects of a Motivational Interview Related to Subsequent Changes in Physical Activity and Regulatory Style? Examining Relationships among Patients with Rheumatoid Arthritis

Objectives: To determine whether the integrity of motivational interviewing (MI) delivery relates to short-term changes in physical activity (PA) and regulatory style within a sample of patients with rheumatoid arthritis, and to examine whether therapist proficiency in MI improves over time. Methods: During a randomized controlled trial to promote PA, 27 patients received a MI from one of three trained physical therapists, which was coded with the Motivational Interviewing Treatment Integrity scales (MITI). Pearson correlations examined associations between MITI scores and changes in PA and regulatory style.  Linear regression examined therapist proficiency over time. Results: MIs with greater reflection-to-question ratios and higher MI proficiency scores were related to increases in PA. MIs higher in global spirit and with a greater percentage of MI-adherent behaviors were associated with decreases in introjected regulation. Therapist proficiency in MI delivery tended to improve over time. Conclusions: Characteristics of motivational interviews are related to favorable shifts in regulatory style and PA behavior.  Although MI proficiency increases over time and with feedback, a 15-hour training course seems insufficient for physical therapists to obtain basic MI proficiency. Practice Implications:  Providing feedback to therapists new to delivering MI seems to improve MI proficiency and should help therapists to avoid using MI-non-adherent techniques

Determinants of methotrexate adherence in rheumatoid arthritis patients

Abstract: In rheumatoid arthritis (RA) patients, weekly intake of methotrexate (MTX) is the basic drug treatment. This observational study aims to investigate how many RA patients are adherent in terms of MTX intake and to identify determinants of non-adherence. Intake of MTX (orally or via injection) was recorded in 129 RA patients with an electronic monitoring system (MEMS\uae) during 16 weeks. In addition, two adherence questionnaires, the Medication Adherence Report Scale (MARS-5) and the Compliance-Questionnaire-Rheumatology (CQR) as well as a visual analogue scale (VAS) measuring MTX adherence, were administered to these patients. As possible determinants of adherence, data on demographics, disease and treatment characteristics, depression, illness cognitions, motivation, and social support were collected. Of all participants, 58 % were fully adherent and 75 % skipped at most one dose during 16 weeks. A better mental health status and suffering from comorbidities had a positive effect on adherence, while living alone had a negative effect. These three predictors explained 30 % of the variance in MTX adherence. Of the three self-report medication adherence measures, the VAS correlated the highest with the results of the electronic monitoring system (r\u2009=\u20090.552, p\u2009=\u20090.01). A relatively high adherence rate was observed in RA patients treated with MTX. The determinants identified by this study could be used to screen patients at risk for non-adherence. A simple VAS scale seems to be an acceptable way for a preliminary screening of MTX adherence

Interpersonal and self-regulation determinants of healthy and unhealthy eating behavior in adolescents

The purpose of this study was to investigate the influence of interpersonal and personal factors on (un)healthy eating in adolescents. The study sample consisted of 473 adolescents. Regression analyses were conducted to examine the effect of family climate, peer influence and self-regulation cognitions (goal commitment, efficacy and ownership) on healthy and unhealthy eating. Self-regulation cognitions are positively related to healthy eating and negatively to unhealthy eating. We conclude that different aspects of family climate and peer influence are significantly related to both healthy and unhealthy eating. Interventions should be directed at self-regulation cognitions as well as at family and peer influence

Interpersonal and self-regulation determinants of healthy and unhealthy eating behavior in adolescents

The purpose of this study was to investigate the influence of interpersonal and personal factors on (un)healthy eating in adolescents. The study sample consisted of 473 adolescents. Regression analyses were conducted to examine the effect of family climate, peer influence and self-regulation cognitions (goal commitment, efficacy and ownership) on healthy and unhealthy eating. Self-regulation cognitions are positively related to healthy eating and negatively to unhealthy eating. We conclude that different aspects of family climate and peer influence are significantly related to both healthy and unhealthy eating. Interventions should be directed at self-regulation cognitions as well as at family and peer influence

Are Aspects of a Motivational Interview Related to Subsequent Changes in Physical Activity and Regulatory Style? Examining Relationships among Patients with Rheumatoid Arthritis

Objectives: To determine whether the integrity of motivational interviewing (MI) delivery relates to short-term changes in physical activity (PA) and regulatory style within a sample of patients with rheumatoid arthritis, and to examine whether therapist proficiency in MI improves over time. Methods: During a randomized controlled trial to promote PA, 27 patients received a motivational interview from one of three trained physical therapists, which was coded with the Motivational Interviewing Treatment Integrity scales (MITI). Pearson correlations examined associations between MITI scores and changes in PA and regulatory style. Linear regression examined therapist proficiency over time. Results: Motivational interviews with greater reflection-to-question ratios and higher MI proficiency scores were related to increases in PA. Motivational interviews higher in global spirit and with a greater percentage of MI-adherent behaviors were associated with decreases in introjected regulation. Proficiency in MI delivery tended to improve over time. Conclusions: Characteristics of motivational interviews are related to favorable shifts in regulatory style and PA behavior. Although MI proficiency increases over time and with feedback, a 15-hour training course seems insufficient for physical therapists to obtain basic MI proficiency. Practice Implications: Providing feedback to therapists new to delivering MI seems to improve MI proficiency and should help therapists to avoid using MI-non-adherent techniques

Effects Of Brief Self Regulation Trainings Aimed At Increasing Physical Activity Among Master Students In Health Psychology And In Their Volunteer Trainees

Competence in helping people to change their life styles through brief interventions based on sound psychological models can meet important societal needs (Maes and Karoly 2005). Students attending an 11 weeks course participated in a weekly laboratory in which they were trained to practice on themselves a self management program with integrated techniques. Students worked on their SMART goal in couples and trained each other following the CALO-RE model (Mitchi et al 2011). Each student was required to recruit 2 volunteers who might benefit from increasing their own PA with the help of their counselling and supervision. At random one of the two volunteers received the treatment (trainee) with a delay of 1-2 weeks, while the other served as a waiting list control. Before starting the trainings students and volunteers completed a questionnaire that assessed emotional well-being, self-efficacy, self-determination style and physical activity levels with reference to the previous month. After 10-8 weeks, the students and the volunteers completed again a retrospective questionnaire. A total of 95 questionnaires completed at T1 were used to assess reliability and validity of the measures. Valid questionnaires completed pre and post the intervention by 21 students, 23 trainees and 18 controls have been analysed. Among the students statistical analyses reveal a significant decrease of anxiety and in perceived fatigue. After 8 weeks the trainees reported to be more engaged in pursuing their PA goal and closer to achieve it. The majority in control group reported to have renounced to their physical goal, while trainees reported a persisting committed to their aims. However all participants reported a decrease in the levels of PA. The failure to increase PA can be due to the fact that the programmes were conducted in the fall