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Volitional processes in changing physical activity: A randomized controlled trial with individuals with knee
Noemi Lorbeer1, Ralf Schwarzer1, Jan Keller1
1Department of Education and Psychology, Freie Universitat Berlin.
Summary
This study found that a Health Action Process Approach (HAPA) intervention improved psychological factors for knee osteoarthritis patients but did not increase moderate-to-vigorous physical activity (MVPA). Further research may explore blended-care approaches for sustained MVPA support.
Area of Science:
- Health Psychology
- Rehabilitation Science
- Behavioral Medicine
Background:
- Osteoarthritis of the knee (OAK) significantly impacts physical activity levels.
- The Health Action Process Approach (HAPA) provides a framework for understanding and promoting health behaviors.
- There is a need for effective interventions to support physical activity in individuals with OAK.
Purpose of the Study:
- To examine the long-term effects of a HAPA-based intervention on HAPA determinants and moderate-to-vigorous physical activity (MVPA) in individuals with OAK.
- To explore the mediating role of HAPA determinants in changes in MVPA.
- To assess the efficacy of a psychological adherence program for physical activity in OAK patients.
Main Methods:
- A 12-month randomized controlled trial involving 241 individuals with OAK.
- Participants were assigned to either an intervention condition (IC) or an active control condition (CC).
- HAPA determinants and MVPA were assessed at multiple time points up to 24 months using self-report and accelerometry; multilevel and path models were used for analysis.
Main Results:
- The intervention group (IC) showed higher action planning compared to the control group (CC) at 6, 12, and 24 months.
- Maintenance and recovery self-efficacy remained stable in the IC but declined in the CC.
- Moderate-to-vigorous physical activity (MVPA) decreased in both groups, and no significant indirect effects of HAPA determinants on MVPA were found.
Conclusions:
- The HAPA-based intervention partially stabilized or enhanced psychological determinants of physical activity but did not lead to increased MVPA in this sample.
- Future interventions could benefit from blended-care models incorporating mobile applications for continuous support of MVPA in OAK patients.
- The findings suggest that while psychological factors can be influenced, sustained increases in physical activity require additional strategies for individuals with OAK.
