The effect of motivational interviewing-based intervention using self-determination theory on promotion of physical activity among women in reproductive age
A randomized clinical trial
Keywords:
Motivational interviewing, Physical activity, WomenAbstract
Background: Physical activity (PA) prevents chronic diseases. Self-determination theory (SDT) provides a useful framework to understand the nature of motivational interviewing (MI).
Objective: This study aimed to determine the effect of MI-based intervention using SDT on the promotion of PA among women in reproductive age.
Methods: Seventy women in reproductive age were selected by clustering sampling method for this randomized controlled trial. The questionnaire included the variables of physical fitness test, SDT, and global physical activity questionnaire (GPAQ). The validity of the questionnaires was approved using content validity ratio (CVR) and index (CVI). The reliability and internal consistency of the questionnaires and measures was approved using test-retest method and Cronbach's alpha test, respectively. The intervention group (n=35) received four MI sessions through theory and one standard education session about PA. The control group (n=35) received a standard education session about PA.
Results: Four months after the intervention, an increase in the mean scores of total PA (p<0.001, ES=4.77), physical fitness tests including flexibility (p<0.001, ES=1.59), muscular endurance (p<0.001, ES=2.0), cardiorespiratory endurance (p<0.001, ES=0.51), and a decrease in mean scores of agility test (p<0.001, ES= - 0.51) and sedentary behavior (p<0.01, ES=- 0.74) was observed in the intervention group compared to the control group. The intervention group reported an increase in the scores of intrinsic motivation (p<0.001, ES=3.34), identified regulation (p<0.001, ES= 1.28), perceptions of competence (p<0.001, ES=0.81) and autonomy (p<0.001, ES=2.01), enjoyment (p<0.001, ES=0.98) and health motives (p<0.01, ES=0.19), health care climate (p<0.001, ES=4.6), and a decreased score of external regulation (p<0.01, ES=-0.55) and amotivation (p<0.01, ES= -0.56) over time, compared to the control group.
Conclusion: MI-based intervention using SDT was effective on the promotion of PA.
Trial registration: The Trial was registered at the Iranian Registry of Clinical Trial (http://www.irct.ir) with the Irct ID: IRCT2015101924592N1.
References
Gagne M, Ryan RM, Bargmann K. Autonomy support and need satisfaction in the motivation and well- being of gymnasts. Journal of Applied Sport Psychology. 2003; 15(4): 372-90. doi:
1080/10413200390238031.
Najmabadi KM. Exercise prescription for Iranian midlife women. International journal of general medicine.
; 3: 365-9. doi: 10.2147/IJGM.S10807. PMID: 21189832, PMCID: PMC3008288.
Esteghamati A, Khalilzadeh O, Rashidi A, Kamgar M, Meysamie A, Abbasi M. Physical activity in Iran:
results of the third national surveillance of risk factors of non-communicable diseases (SuRFNCD-2007). J
Phys Act Health. 2011; 8(1): 27-35. doi: 10.1123/jpah.8.1.27. PMID: 21297182.
Momenan A, Delshad M, Mirmiran P, Ghanbarian A, Safarkhani M, Azizi F. Physical inactivity and
related factors in an adult Tehranian population (Tehran Lipid and Glucose Study). Iranian Journal of
Endocrinology and Metabolism. 2012; 13(5): 493-503.
Maddah M, Akbarian Z, Shoyooie S, Rostamnejad M, Soleimani M. Prevalence of regular exercise among
Iranian adults: a study in northern iran. J Phys Act Health. 2014; 11(4): 810-3. doi: 10.1123/jpah.2012- 0202. PMID: 23575214.
Motefaker M, Sadrbafghi SM, Rafiee M, Bahadorzadeh L, Namayandeh SM, Karimi M, et al.
Epidemiology of physical activity; a population based study in yazd city. Tehran University Medical
Journal. 2007; 65(4): 77-81.
Verloop J, Rookus MA, Van Der Kooy K, Van Leeuwen FE. Physical activity and breast cancer risk in
women aged 20-54 years. J Natl Cancer Inst. 2000; 92: 128-35. doi: 10.1093/jnci/92.2.128. PMID:
Friedenreich CM. Physical Activity and Cancer: lessons learned from nutritional epidemiology. Nutr Rev.
; 59(11): 349-57. doi: 10.1111/j.1753-4887.2001.tb06962.x. PMID: 11720340.
Kull M. The relationships between physical activity, health status and psychological well‐being of
fertility ‐ aged women. Scand J Med Sci Sports. 2002; 12(4): 241-7. doi: 10.1034/j.1600- 0838.2002.00341.x. PMID: 12199874.
Housley E, Leng GC, Donnan PT, Fowkes FG. Physical activity and risk of peripheral arterial disease in
the general population: Edinburgh Artery Study. J Epidemiol Community Health. 1993; 47(6): 475-80. doi:
1136/jech.47.6.475. PMID: 8120503, PMCID: PMC1059862.
Khandwala SS. Primary care of the perimenopausal woman. Primary care update for OB/GYNS. 1998;
(1): 43-9. doi: 10.1016/S1068-607X(97)00123-6.
Miller WR, Rollnick S. Ten things that motivational interviewing is not. Behav Cogn Psychother. 2009;
(2): 129-40. doi: 10.1017/S1352465809005128. PMID: 19364414.
Miller W, Rollnick S. Motivational interviewing: Preparing people for change behavior. 2nd The Guilford
Press: New York; 2002.
Miller WR. Motivational interviewing with problem drinkers. Behavioural psychotherapy. 1983; 11: 147- 72. doi: 10.1017/S0141347300006583.
Rollnick S, Miller WR, Butler CC, Aloia MS. Motivational interviewing in health care: helping patients
change behavior. Journal of Chronic Obstructive Pulmonary Disease. 2008; 5(3): 203. doi:
1080/15412550802093108.
Deci EL, Ryan RM. Handbook of self-determination research. Rochester, NY: University of Rochester
Press; 2002.
Ng J, Ntoumanis N, Thogersen-Ntoumani C, Deci EL, Ryan RM, Duda JL, et al. Self-determination theory
applied to health contexts: A meta-analysis. Perspectives on Psychological Science. 2012; 7: 325–40. doi:
1177/1745691612447309.
Vlachopoulos SP. The basic psychological needs in exercise scale: measurement invariance over gender.
Structural Equation Modeling. 2008; 15(1): 114-35. doi: 10.1080/10705510701758398.
Ryan RM, Deci EL. An overview of self-determination theory: an organismic-dialectical perspective. In
Deci EL, Ryan RM (Eds.). Handbook of self-determination research. Rochester, NY: University of
Rochester Press; 2002; 3–33.
Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social
development, and well-being. Am Psychol. 2000; 55(1): 68-78. doi: 10.1037/0003-066X.55.1.68. PMID:
Markland D. Internally informational versus internally controlling exercise motives and exercise
enjoyment: The mediating role of self-determination. In. Parisi P, Pigozzi F, Prinzi G (Eds), Sport Science
’99 in Europe: Proceedings of the 4th annual congress of the European College of Sport Science (p. 214).
Rome: University Institute of Motor Sciences.
Foote J, Deluca A, Magura S, Warner A, Grand A, Rosenblum A, et al. A group motivational treatment for
chemical dependency. J Subst Abuse Treat. 1999; 17: 181-92. doi: 10.1016/S0740-5472(99)00003-3.
PMID: 10531624.
Ginsburg JI, Mann RE, Rotgers F, Weekes JR. Motivational interviewing with criminal justice populations.
Motivational interviewing: Preparing people for change. Guilford Press; 2002: 333-46.
Ryan RM, Edward LD. A Motivational Approach to Self: Integration in Personality. Perspectives on
motivation. 1991; 38: 237.
Markland D, Ryan RM, Tobin VJ, Rollnick S. Motivational interviewing and self–determination theory.
Journal of social and clinical psychology. 2005; 24(6): 811-31. doi: 10.1521/jscp.2005.24.6.811.
Markland D, Tobin V. A modification to the behavioural regulation in exercise questionnaire to include an
assessment of amotivation. Journal of Sport and Exercise Psychology. 2004; 26: 191-6. doi:
1123/jsep.26.2.191.
Farmanbar R, Niknami S, Hidarnia A, Lubans DR. Psychometric Properties of the Iranian Version of the
Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2). Health Promot Perspect. 2011; 1(2): 95-104.
doi: 10.5681/hpp.2011.010. PMID: 24688905, PMCID: PMC3963623.
Verloigne M, De Bourdeaudhuij I, Tanghe A, D'hondt E, Theuwis L, Vansteenkiste M, et al. Self- determined motivation towards physical activity in adolescents treated for obesity: an observational study.
Int J Behav Nutr Phys Act. 2011; 8: 79. doi: 10.1186/1479-5868-8-97. PMID: 21923955, PMCID:
PMC3189862.
Wilson PM, Rogers WT, Rodgers WM, Wild TC. The psychological need satisfaction in exercise scale.
Journal of Sport and Exercise Psychology. 2006; 28(3): 231-51. doi: 10.1123/jsep.28.3.231.
Frederick CM, Ryan RM. Differences in motivation for sport and exercise and their relations with
participation and mental health. Journal of sport behavior. 1993; 16(3): 124.
Ryan RM, Frederick CM, Lepes D, Noel R, Sheldon KM. Intrinsic motivation and exercise adherence. Int J
Sport Psychol. 1997; 28: 335-54.
Williams GC, Grow VM, Freedman ZR, Ryan RM, Deci EL. Motivational predictors of weight loss and
weight-loss maintenance. J Pers Soc Psychol. 1996; 70(1): 115-26. doi: 10.1037/0022-3514.70.1.115.
PMID: 8558405.
Armstrong T, Bull F. Development of the World Health Organization global physical activity questionnaire
(GPAQ). Journal of Public Health. 2006; 14(2): 66–70. doi: 10.1007/s10389-006-0024-x.
WHO. Global physical activity questionnaire (GPAQ) analysis guide. Geneva: World Health Organization;
Hagströmer M, Bergman P, Bauman A, Sjöström M. The International Prevalence Study (Ips): Health- Enhancing Physical Activity In Sweden. Journal of Public Health. 2006; 14(5): 301-8. doi:
1007/s10389-006-0032-x.
Carpenter CL, Yan E, Chen S, Hong K, Arechiga A, Kim WS, et al. Body fat and body-mass index among
a multiethnic sample of college-age men and women. Journal of obesity. 2013. doi: 10.1155/2013/790654.
Gaeini AA, Rajabi H. Physical Fitness. Tehran: Samt Press; 2007.
Jones D, Robertson L, Figoni S. A strength-endurance index for power grip. J Occup Rehabil. 2009; 19(1):
-63. doi: 10.1007/s10926-009-9163-6. PMID: 19214717.
Hadavi F. Measurement and Evaluation in Physical Education. Tehran: Teacher Training University Press;
Chatterjee S, Chatterjee P, Bandyopadhyay A. Validity of Queen's College Step Test for estimation of
maximum oxygen uptake in female students. Indian J Med Res. 2005; 121: 32-5. PMID: 15713976.
McArdle WD, Katch FI, Pechar GS, Jacobson L, Ruck S. Reliability and interrelationships between
maximal oxygen intake, physical work capacity and step-test scores in college women. Med Sci Sports.
; 4(4): 182-6. doi: 10.1249/00005768-197200440-00019. PMID: 4648576.
Bandyopadhyay A. Queen's college step test as an alternative of Harvard step test in young Indian women.
International Journal of Sport and Health Science. 2008; 6: 15-20. doi: 10.5432/ijdhs.6.15.
Poursharifi H. Effectiveness of motivational interviewing on improving health behaviors in adults with
Type II diabetes. [dissertation]. [Iran]: Tehran University; 2007.
Friederichs SA, Oenema A, Bolman C, Guyaux J, Van Keulen HM, Lechner L. I Move: systematic
development of a web-based computer tailored physical activity intervention, based on motivational
interviewing and self-determination theory. BMC public health. 2014; 14: 212. doi: 10.1186/1471-2458-14- 212. PMID: 24580802, PMCID: PMC3944675.
Silva MN, Vieira PN, Coutinho SR, Minderico CS, Matos MG, Sardinha LB, et al. Using self- determination theory to promote physical activity and weight control: a randomized controlled trial in
women. J Behav Med. 2010; 33(2): 110-22. doi: 10.1007/s10865-009-9239-y. PMID: 20012179.
Gourlan M, Sarrazin P, Trouilloud D. Motivational interviewing as a way to promote physical activity in
obese adolescents: A randomised-controlled trial using self-determination theory as an explanatory
framework. Psychol Health. 2013; 28(11): 1265-86. doi: 10.1080/08870446.2013.800518. PMID:
Farmanbar RA, Niknami SA, Heydarnia AR. Effect of an Integrated Transtheoretical Model and Self- Determination Theory on the Promotion and Maintenance of Exercise Behavior. Journal of Guilan
University of Medical Sciences. 2012; 21(82): 46-56.
Hamrik Z, Sigmundová D, Kalman M, Pavelka J, Sigmund E. Physical activity and sedentary behavior in
Czech adults: Results from the GPAQ study. Eur J Sport Sci. 2014; 14(2): 193-8. doi:
1080/17461391.2013.822565. PMID: 23889330, PMCID: PMC3935222.
Sweet SN, Fortier MS, Blanchard CM. Investigating motivational regulations and physical activity over 25
weeks. J Phys Act Health. 2013; 11(5): 1052-6. doi: 10.1123/jpah.2012-0057. PMID: 23799262.
Wilson PM, Rodgers WM. The relationship between perceived autonomy support, exercise regulations and
behavioral intentions in women. Psychology of Sport and Exercise, 2004; 5: 229-42. doi: 10.1016/S1469- 0292(03)00003-7.
Wininger SR. Self-determination theory and exercise behavior: An examination of the psychometric
properties of the exercise motivation scale. Journal of Applied Sport Psychology. 2007; 19; 471-86. doi:
1080/10413200701601466.
Fortier MS, Sweet SN, O’sullivan TL, Williams GC. A self-determination process model of physical
activity adoption in the context of a randomized controlled trial. Psychology of Sport and Exercise. 2007;
: 741-57. doi: 10.1016/j.psychsport.2006.10.006.
Edmunds J, Ntoumanis N, Duda JL. Testing a self ‐ determination theory ‐ based teaching style
intervention in the exercise domain. European Journal of Social Psychology. 2007; 38 (2): 375-88. doi:
1002/ejsp.463.
Vlachopoulos SP. Psychological Needs In Exercise Scale. In Community Exercise Programs: A Cross- Validation Approach. Hellenic Journal of Psychology. 2007; 4: 52-74.
Levy SS, Cardinal BJ. Effects of a self-determination theory-based mail-mediated intervention on adults'
exercise behavior. Am J Health Promot. 2004; 18(5): 345-9. doi: 10.4278/0890-1171-18.5.345. PMID:
Fathi K, Ghorbani F, Heidarimoghadam R, Mojtahedi H. The effect of six- week aerobic step training on
cardiovascular fitness, body composition, flexibility, anaerobic power and quality of life of female students
of Isfahan University. Journal of Ergonomics. 2014; 2(2): 29-37.
Anbari S, Moghadasi M, Torkfar A, Rahimezadeh E, Khademi Y. The Effects of the Recommended Eight- weeks sports-for-all Program on Physical Fitness and General Health of Male Employees. Armaghane
danesh. 2012; 17(1): 40-9.
Fakourian A, Azarbaijani MA, Peeri M. Effect a period of selective military training on physical fitness,
body mass index, mental health and mood in officer students. J Army Univ Med Sci. 2012; 10(1): 17-27.
Published
Issue
Section
License
Copyright (c) 2020 KNOWLEDGE KINGDOM PUBLISHING
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
