Theory-informed interventions to promote physical activity and reduce sedentary behaviour in rheumatoid arthritis: a critical review of the literature.

Jet J C S Veldhuijzen Van Zanten,Sally A M Fenton,Joan L Duda,George D Kitas,George S Metsios

doi:10.31138/mjr.31.1.19

Abstract

Moderate-intensity physical activity (PA) is recommended for the management of Rheumatoid Arthritis (RA). Recent evidence suggests that reducing sedentary behaviour (promoting ‘sedentary breaks’ and light intensity PA) may also offer potential for improving RA outcomes, independently of the benefits of moderate-intensity PA. Unfortunately, people living with RA engage in very little moderate-intensity PA, and the spend the majority of the day sedentary. Interventions to support PA and sedentary behaviour change in this population are therefore required. Psychological theory can provide a basis for the development and implementation of intervention strategies, and specify the cognitive processes or mechanisms assumed to result in behavioural change. Application of psychological theory to intervention development and evaluation, therefore, permits evaluation of “how things work”, helping to identify optimal intervention strategies, and eliminate ineffective components. In this review, we provide an overview of existing PA and sedentary behaviour change interventions in RA, illustrating the extent to which current interventions have been informed by psychological theories of behaviour change. Recommendations are provided for future interventional research in this domain, serving as a reference point to encourage proper application of behavioural theories into intervention design, implementation and appraisal.

Highlights

Experimental evidence consistently documents the health benefits of engagement in moderate-intensity physical activity (PA) for people living with Rheumatoid Arthritis (RA)
Where interventions are implied to be underpinned by psychological theory, the descriptions provided regarding the behavioural aspects of interventions are generally focussed on basic reporting of intervention strategies/methods of change, without making clear connections to psychological constructs/determinants and the underlying theory
There is rarely enough information provided to describe how psychological theory has been used to inform the selection and delivery of intervention components/methods of change, and evaluations seldom considered the psychological “mechanisms of action”. Such limited application of psychological theory restricts the degree to which interventions can be deconstructed to confirm effective methods of change/Behaviour Change Techniques’ (BCTs), which have successfully impacted on hypothesised theory-based psychological constructs

Summary

F RHEUMATO

©Fenton SAM, Duda JL, Veldhuijzen van Zanten JJCS, Metsios GS, Kitas GD. A.M. Fenton[1,2], Joan L. Duda[1], Jet J.C.S. Veldhuijzen van Zanten[1,2], George S. Metsios[2,3], George D. Kitas[1,2]

INTRODUCTION

Findings

Not reported