Telephonic Motivational Interviewing-based Health Coaching To Supplement Older Adult Walk With Ease Participation

Abstract

PURPOSE: Motivational interviewing (MI) is a commonly used method of promoting healthy lifestyles in clinical research. It is typically delivered in face-to-face interactions and is less commonly used with older adults. Thus, the purpose of this pilot study was to assess acceptability of telephonic delivery of MI with an older adult population. The study specifically tested the utility of pairing MI with an existing evidence-based program (Walk with Ease; WWE) to promote autonomy and intrinsic motivation for behavior change. METHOD: A subsample of participants enrolling in self-directed WWE (n = 10) were paired with student health coaches trained in MI for the six-week program. Coaches supported individual motivation and problem-solving but were explicitly not coaching to WWE activities. Motivation and autonomy were evaluated prior to the first coaching session and after program completion using the BREQ-3 motivation sub-scales and relative autonomy index. Changes in both indicators were evaluated using effect sizes with post WWE satisfaction ratings providing context. RESULTS: Participants attended 5.4 ± 1.4 sessions, lasting 15.7 ± 4.8 minutes and were overwhelmingly accepting of telephonic MI. Evaluations of behavioral correlates showed that WWE coupled with MI had a positive effect on intrinsic motivation (d = 0.47) and individual autonomy (d = 0.59). Participants reported that coaches positively impacted the program experience, and that telephonic delivery was convenient and presented minimal technical barriers. Common themes from the open-ended items revealed themes of developing connections with coaches who acted as a source of accountability, and provided support in developing a healthy relationship with PA. CONCLUSION: Participants were accepting of telephonic MI and viewed at as a positive enhancement to their program experience with WWE. Coaches provided an additional source of accountability and encouragement, and potential barriers due to delivery or coach training did not dissuade participants. When coupled with MI-based health coaching, WWE participants increased intrinsic motivation and autonomy, potentially increasing the likelihood of long-term behavior maintenance. Telephonic delivery may allow for greater access to health coaching and larger trials are warranted.