This article is more than 5 years old. Information may no longer be current.
Motivational interviewing fails to raise walking distance in black adults with PAD
Click Here to Manage Email Alerts
Motivational interviewing was not effective in improving walking distance for black adults with peripheral artery disease in either 6- or 12-month intervals, according to findings published in JAMA Network Open.
Tracie C. Collins, MD, MPH, MHCDS, of the department of preventive medicine and public health at the University of Kansas Medical Center, and colleagues determined whether motivational interviewing was more efficacious than patient-centered assessment and counseling for exercise (PACE) or control to improve walking distance in black adults with PAD.
“Reduced physical activity is associated with an increased risk of mobility loss and a higher risk of functional decline, with a subsequent inability to perform activities of daily living,” Collins and colleagues wrote. “Because of low levels of physical activity, African-American patients with PAD may benefit from motivational strategies to promote community-based walking therapy.”
The researchers studied data from 174 black patients with PAD (mean age, 64 years; 74% women) from May 2012 to November 2016 from churches, health care centers and health fairs in Kansas and Missouri.
At 6 months, the mean change in walking distance was lower in the motivational interviewing group (–3.42 m) compared with the PACE (2.74 m) and control (–0.18 m) groups.
After 12 months, motivational interviewing did not improve walking distance (–7.75 m) compared with the PACE (13.75 m) and control (–1.08 m) strategies.
Collins and colleagues identified no significant increases in walking distance at 6 months in motivational interviewing (change = –2.1 m; 95% CI, –16.54 to 12.35) or PACE (change = 2.31 m; 95% CI, –11.36 to 15.97) groups compared with the control group.
At 12 months, there was no significant change in walking distance in the motivational interviewing (change = –5.56 m; 95% CI, –21.18 to 10.06) or PACE (change = 14.24 m; 95% CI, –1.85 to 30.34) groups compared with the control group.
PACE resulted in a statistically significant increase in walking distance during a 12-month span compared with motivational interviewing (difference, 19.8 m; 95% CI, 3.33-36.28), the researchers wrote.
“Although our results did not demonstrate the efficacy of (motivational interviewing), the use of this counseling approach by primary care physicians could potentially add additional time to a visit, for which the length of such a visit may already be challenged by the needs of a patient with a complex condition,” Collins and colleagues wrote. “Future studies that assess the efficacy of [motivational interviewing] should assess the added time to a given clinic visit and the cost of obtaining training to deliver [motivational interviewing].” – by Earl Holland Jr.
Disclosures: Collins reports she received grants from the NIH during the study and personal fees from VIROMED. Please see the study for all other authors’ relevant financial disclosures.
Click Here to Manage Email Alerts