THE EFFECT OF TRANS-THEORETICAL MODEL BASED-MOTIVATIONAL INTERVIEWING ON PROMOTING EXERCISE BEHAVIOR IN HEALTHY OLDER ADULTS: STUDY PROTOCOL OF A RANDOMIZED-CONTROLLED TRIA

Year 2021, Volume: 5 Issue: 1, 47 - 54, 15.02.2021

Ebru Sönmez , Yeter Kitiş

https://doi.org/10.26900/jsp.5.1.01

Abstract

Individualized health promotion activities are needed to bring the disadvantaged groups into healthy lifestyle behaviors. The older adult is both the most inactive and the most affected by physical inactivity in the community. Primary care nurses can help 65+ adults to gain exercise behavior by using their educator and guidance roles. The Trans-Theoretical Model (TTM) is an individualized counselling model that evaluates the behavior change as a process. TTM with motivational interviews (MI) is used to promote various health behaviors. This randomized-controlled trial will be conducted to investigate the effect of TTM based-MI on promoting exercise behavior in healthy older adults. The population is constituted of voluntary seniors who meet the inclusion criteria (n=117) from 65-74 aged adults (N=1630) who registered to a family health center. A power analysis was performed to sample size estimation with .30 effect size and .80 power. The projected sample size was found 90. The participants are divided into stratums, blocking according to the age, gender and exercise behavior stages of change. The seniors from the created stratums is allocated into intervention and control groups randomly. The data will be gathered via a questionnaire, TTM scales, KATZ Activities of Daily Living Scale (KATZ-ADL) and Physical Activity Scale for Elderly (PASE). Waist circumferences will be measured and average weekly step counts will be calculated via a pedometer. The data will be collected via an independent researcher, blinded to the study groups. TTM-based MI for gaining exercise behavior program is planned to apply to the intervention group overall six times (face-to-face for four times biweekly and twice via telephone by four weeks). Intervention period is planned as six months. The results obtained are expected to guide the community health nurses in terms of gaining exercise behavior of the older adults. This study is registered to clinicaltrials.gov, NCT04128553.

Keywords

Older Adult, Community Health Nursing, Exercise, Motivational Interviewing, Transtheoretical Mode

References

• ADAMS-FRYATT, A. (2010). Facilitating successful aging: encouraging older adults to be physically active.J. Nurse Pract., 6(3), 187-192.
• KİTİŞ, Y. (2017). Yaşlı Bireylerde Sağlığın Korunması ve Geliştirilmesi, In: Yaşlılık ve Yaşlı Sağlığı Yaşlı Bakımı Alanında Hizmet Veren Profesyoneller İçin, N. BİLGİLİ & Y. KİTİŞ (eds), Vize Basın Yayın, Ankara, 978-605-9278-21-8.
• CANGÖL, E. & ŞAHİN, N. H. (2017). Emzirmenin Desteklenmesinde Bir Model: Pender’in Sağlığı Geliştirme Modeline Dayalı Motivasyonel Görüşmeler. HEAD, 14(1), 98-103.
• CDC. (2020). Making Physical Activity a Part of an Older Adult's Life [online], Geneva, https://www.cdc.gov/physicalactivity/basics/adding-pa/activities-olderadults.htm, [ Date Accessed: 14 June 2020].
• COHEN-MANSFIELD, J., MARX, M. S., & GURALNIK, J. M. (2003). Motivators and barriers to exercise in an older community-dwelling population. JAPA, 11(2), 242-253.
• CORNACCHIONE J. & SMITH S.W. (2012). The effects of message framing within the stages of change on smoking cessation intentions and behaviors. Health Commun., 27(6), 612-22.
• EMMONS, K.M. & ROLLNICK, S. (2001). Motivational interviewing in health care settings: opportunities and limitations. Am. J. Prev. Med., 20(1), 68-74.
• FAHRENWALD N.L., ATWOOD J.R. & JOHNSON D.R. (2005). Mediator analysis of moms on the move. West. J. Nurs. Res., 27(3), 271-91.
• KIM, C.J. & KANG, S. (2013). Development and a pilot test of an internet-based cardiovascular risk reduction program for Korean male workers with metabolic syndrome. Comput. Inform. Nu., 31(4), 157-66.
• LILIENTHAL, K.R., PIGNOL, A.E., HOLM, J.E. & VOGELTANZ-HOLM, N. (2014). Telephone-based motivational interviewing to promote physical activity and stage of change progression in older adults. JAPA, 22(4), 527-535.
• LIN, C.H., CHIANG, S.L., HEITKEMPER, M.M., HUNG, Y.J., LEE, M.S., TZENG, W.C. & CHIANG, L.C. (2016). Effects of telephone-based motivational interviewing in lifestyle modification program on reducing metabolic risks in middle-aged and older women with metabolic syndrome: A randomized controlled trial. Int. J. Nurs, 60, 12-23.
• MCKENZIE, K. J., PIERCE, D. & GUNN, J. M. (2015). A systematic review of motivational interviewing in healthcare: the potential of motivational interviewing to address the lifestyle factors relevant to multimorbidity. JOC, 5(1), 162-174.
• NIED, R.J. & FRANKLIN, B.A. (2002). Promoting and prescribing exercise in the elderly. Am. Fam. Physıcıan, 65(3), 419.
• NIES, M.A. & MCEWEN, M. (2019). Community/Public Health Nursing: Promoting the Health of Populations. (Seventh edition), Elsevier, USA, 978-0-323-52894-8.
• PATERSON, D.H., JONES, G.R. & RICE, C.L. (2007). Ageing and physical activity: evidence to develop exercise recommendations for older adults. Appl. Physıol. Nutr. Me., 32(S2E), 69-108.
• ROLLNICK, S., HEATHER, N. & BELL, A. (1992). Negotiating behaviour change in medical, settings: the development of brief motivational interviewing. J. Ment. Health, 1(1), 25-37.
• RUBAK, S., SANDBÆK, A., LAURITZEN, T. & CHRISTENSEN, B. (2005). Motivational interviewing: a systematic review and meta-analysis. Br. J. Gen. Pract., 55(513), 305-312.
• SPENCER, L., ADAMS, T.B., MALONE, S., ROY, L. & YOST, E. (2006). Applying the transtheoretical model to exercise: a systematic and comprehensive review of the literatüre. Health Promot. Pract., 7(4), 428-443.
• TSE, M.M., VONG, S.K. & TANG, S.K. (2013). Motivational interviewing and exercise programme for community‐dwelling older persons with chronic pain: a randomised controlled study. J. Clin. Nurs., 22(13-14), 1843-1856.
• VAN DER BIJ, A.K., LAURANT, M.G. & WENSING, M. (2002). Effectiveness of physical activity interventions for older adults: a review. Am. J. Prev. Med., 22(2), 120-133.
• VELICER, W.F., PROCHASKA, J.O., FAVA, J.L., NORMAN, G.J. & REDDING, C.A. (1998). Detailed overview of the transtheoretical model. Homeostasis, 38, 216-33.
• WHO. (2010). Global recommendations on physical activity for health [online], Geneva, https://www.who.int/dietphysicalactivity/publications/9789241599979/en/, [Date Accessed: 14/06/2020].
• WHO. (2018). Global action plan on physical activity 2018–2030: more active people for a healthier World [online], Geneva, https://www.who.int/ncds/prevention/physical-activity/global-action-plan-2018-2030/en/, [Date Accessed: 14/06/2020].