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. 2018 Aug;25(4):438-447.
doi: 10.1007/s12529-018-9716-1.

Physiotherapists' Adoption of a Theory-Based Skills Training Program in Guiding People with Rheumatoid Arthritis to Health-Enhancing Physical Activity

Thomas Nessen  1 , Christina H Opava  1   2 , Ingrid Demmelmaier  3
Affiliations

Physiotherapists' Adoption of a Theory-Based Skills Training Program in Guiding People with Rheumatoid Arthritis to Health-Enhancing Physical Activity

Thomas Nessen et al. Int J Behav Med. 2018 Aug.

Abstract

Purpose: To describe physiotherapists' (PTs') adoption of a theory-based skills training program preparing them to guide people with rheumatoid arthritis (RA) to health-enhancing physical activity (HEPA) within a 1-year intervention trial.

Method: This was a longitudinal case study. Ten female PTs (age 25-59), delivering the HEPA intervention, participated. Data were collected on five occasions over a 19-month period: once before the training course, once after 4 course days, twice during the HEPA intervention and once after the HEPA intervention. Knowledge on about physical activity (score 0-6) and behavior change techniques (BCTs) (score 0-18), fear-avoidance beliefs (score 8-48) and self-efficacy to guide behavior change (score 9-54) were assessed with a questionnaire. Structured logbooks were used to register PTs' self-reported guiding behavior. Criteria for PTs' adherence to the protocol were pre-set.

Results: PTs' knowledge on about BCTs and their self-efficacy increased significantly (p < 0.05) from median 9 to 13 and from median 38 to 46.5, respectively. Knowledge on about physical activity was high and fear-avoidance beliefs were low before the education (median 6 and 13.5, respectively) and did not change over time. Two out of ten PTs fulfilled the pre-set criteria for adherence throughout the intervention.

Conclusion: The results suggest that a theory-based skills training program improves PTs' knowledge on about behavior change techniques and their self-efficacy to guide people with RA to HEPA. PTs' adherence to the protocol was not complete but the clinical relevance of the adherence criteria need to be validated against observed PT behavior and patient outcomes.

Keywords: Adherence; Behavior change techniques; Education; Fear-avoidance beliefs; Intervention; Physical activity; Physical therapist; Self-efficacy.

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Conflict of interest statement

The authors declare they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart for data collection (by questionnaire and logbook), the skills training program and the support group sessions during the HEPA intervention
Fig. 2
Fig. 2
Average proportions (0–1.0) of correct answers on PTs’ knowledge about physical activity and behavior change techniques. Average median scores for fear-avoidance beliefs and self-efficacy transferred to 0–1 scores (n = 10)
Fig. 3
Fig. 3
Percentage of maximum score for PTs’ self-reports of “Follow-up on previous week’s goal setting” and “Guidance in SMART goal setting” during support group sessions 1–20
See this image and copyright information in PMC

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