Integrated motivational interviewing and cognitive behaviour therapy can increase physical activity and improve health of adult ambulatory care patients in a regional hospital: the Healthy4U randomised controlled trial

Background: The aim of this study was to determine whether a twelve-week, health coaching intervention could result in changes in physical activity, anthropometrics and health-related outcomes in adults presenting to an ambulatory hospital clinic.

Methods: Seventy-two participants who reported being insufficiently active were recruited from an ambulatory hospital clinic and randomised to an intervention group that received an education session and eight 30-min telephone sessions of integrated motivational interviewing and cognitive behaviour therapy (MI-CBT), or to a control group that received the education session only. ActiGraph GT3X accelerometers were used to measure moderate-to-vigorous physical activity at baseline, post-intervention (3-months) and follow-up (6-months). Secondary outcome measures (anthropometrics, physical activity self-efficacy, health-related quality of life, type 2 diabetes risk) were also assessed at the three time points.

Results: At baseline, the mean age and body mass index of participants (n = 72, 75% females) were 53 ± 8 years and 30.8 ± 4.1 kg/m², respectively. Treatment group influenced the pattern of physical activity over time (p < 0.001). The intervention group increased moderate-to-vigorous physical activity from baseline to post-intervention and remained elevated at follow-up by 12.9 min/day (95%CI: 6.5 to 19.5 min/day). In contrast, at follow-up the control group decreased moderate-to-vigorous physical activity by 9.9 min/day (95%CI: -3.7 to -16.0 min/day). Relative to control, at follow-up the intervention group exhibited beneficial changes in body mass (p < 0.001), waist circumference (p < 0.001), body mass index (p < 0.001), physical activity self-efficacy (p < 0.001), type 2 diabetes risk (p < 0.001), and health-related quality of life (p < 0.001).

Conclusions: This study demonstrates that a low contact coaching intervention results in beneficial changes in physical activity, anthropometrics and health-related outcomes that were maintained at follow-up in adults who report being insufficiently active to an ambulatory care clinic.

Trial registration: ANZCTR: ACTRN12616001331426 . Registered 23 September 2016.