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Can a behavioural intervention targeting physical activity behaviour of adults with type 2 diabetes be delivered faithfully by healthcare professionals during routine primary care?

Lookup NU author(s): Dr Leah Avery, Dr Sarah Charman, Professor Roy Taylor, Professor Falko Sniehotta, Professor Mike TrenellORCiD


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Background: Behavioural interventions are effective for increasing physical activity and improving glycaemic control in adults with type 2 diabetes. Failure to deliver intervention components as planned can hinder overall effectiveness, which is a particular challenge during the time-constrained context of routine primary care. Aims: To assess whether the Movement as Medicine for Type 2 Diabetes multi-faceted behavioural intervention can be faithfully delivered by healthcare professionals during routine primary care. Methods: 56 consultations within a 12-month follow-up period were video recorded to capture intervention delivery by five trained healthcare professionals from two primary care practices. Video recordings were coded independently by two researchers using a fidelity checklist to code presence or absence of intervention content, i.e. 14 behaviour change techniques targeting physical activity behaviour. Inter-rater coding reliability was assessed using Cohen’s Kappa. Results: 11/14 behaviour change techniques were delivered consistently during consultations (e.g., review physical activity behaviour, self-monitoring, feedback on performance); 2/14 were frequently omitted (i.e. relapse prevention and generalisation of physical activity behaviour); and 1/14 (time management) was not delivered. Inter-rater coding reliability was moderate to good 0.55 to 0.67. Conclusions: The majority of behaviour change techniques were delivered faithfully by healthcare professionals, suggesting they can be feasibly delivered within the time constraints of primary care. Quality of delivery emerged as an issue, specifically regarding behaviour change techniques that targeted volition and maintenance of physical activity behaviour. The number of techniques delivered also reduced over time indicating a need for ongoing feedback / training for healthcare professionals to prevent skill drift and prompt delivery

Publication metadata

Author(s): Avery L, Mostafaee B, Charman S, Taylor R, Sniehotta F, Trenell M

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Diabetes UK Professional Conference 2016

Year of Conference: 2016

Pages: 133-134

Print publication date: 01/03/2016

Acceptance date: 01/03/2016

ISSN: 1464-5491

Publisher: Wiley


DOI: 10.1111/dme.30_13048