Trajectories of behavior change motivation among general hospital patients following proactive automatized...

Little is known about trajectories of the motivation to change health risk behavior following multi-behavior change interventions in health care patients. The aim was to explore trajectories of the motivation to stop smoking, reduce alcohol use, eat sufficient vegetable and fruit or be physical active after proactive automatized multibehavior change interventions that started during hospitalization irrespective of reason for admission.

Among general hospital in-patients, 175 were proactively recruited and participated in a pre-post intervention study including three intervention timepoints (baseline, 1-, 3-month) and a 6-month follow-up. Characteristics and trajectories of motivation to change according the transtheoretical model of behavior change (stages of change, processes of change, self-efficacy) were analyzed using latent growth curve models for vegetable/fruit intake and physical activity and exploratory descriptive data for smoking cessation and alcohol use.

The proportions of participants not yet ready to change respective behaviors at baseline ranged from 60.6% (at-risk alcohol use) to 81.7% (tobacco smoking) and at follow-up from 37.1% (physical inactivity) to 50.5% (vegetable/fruit intake). Models revealed motivational changes over time: Self-efficacy for vegetable/fruit intake increased (slope = 0.25, p < 0.001), also indicated by exploratory observations for alcohol use reduction. Behavioral process use increased for vegetable/fruit intake (slope = 0.04, p = 0.02). Cognitive-affective process use decreased for vegetable/fruit intake (slope = -0.14, p = 0.008); by trend for physical activity (slope = -0.1, p = 0.05).

Data revealed positive trajectories in behavior change motivation following hospitalization and multi-behavior change intervention. The findings suggest potential intervention efficacy and speak in favor of in-patient hospital stays as a learnable moment.