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Abstract Number: 631

A Self-Determination Theory Based Intervention to Promote Autonomous Motivation for, and Engagement in Physical Activity in Rheumatoid Arthritis: Theoretical Process Evaluation of a Randomised Controlled Trial

Sally A.M. Fenton1,2, Jet J.C.S. Veldhuijzen van Zanten1,2, George S. Metsios2,3, Peter C. Rouse4, Nikos Ntoumanis5, Chen-An Yu6, George D. Kitas1,2,7 and Joan L. Duda1, 1School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom, 2Department of Rheumatology, Russells Hall Hospital, Dudley Group of Hospitals NHS Foundation Trust, Dudley, United Kingdom, 3Faculty of Education Health & Wellbeing, University of Wolverhampton, Walsall, United Kingdom, 4Department for Health, University of Bath, Bath, United Kingdom, 5Faculty of Health Sciences, School of Psychology, Curtin University, Perth, Australia, 6Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom, 7Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester, United Kingdom

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Behavioral strategies, Intervention, physical activity, rheumatoid arthritis (RA) and well-being

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Session Information

Date: Sunday, October 21, 2018

Session Title: Rheumatoid Arthritis – Treatments Poster I – ARHP

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Moderate-to-vigorous physical activity (MVPA) is recommended for the treatment and management of physical and psychological health in Rheumatoid Arthritis (RA). However, most people living with RA are insufficiently active to accrue health benefits. Interventions are therefore required to support physical activity (PA) behaviour change in this population.

Using theory to develop interventions, can inform what may be the strategies undergirding behavioural change, and provide a framework for testing the efficacy of the theory post-intervention in terms of hypothesised mechanisms. Self-determination theory (SDT) suggests that social environments which foster autonomous motivation toward a behaviour (i.e., intrinsic and personally identified reasons), will promote better uptake and maintenance of the behaviour. This study reports the theoretical process evaluation of an SDT-based exercise intervention for people with RA, which aimed to increase MVPA engagement and optimise psychological well-being.

Methods: Patients with RA (n = 115) were randomised to an SDT-based psychological intervention + RA exercise programme (experimental group, n=59), or a RA exercise programme only (control group, n = 56), delivered over 3-months. The SDT-based psychological intervention involved one-on-one consultations with a PA advisor, trained in strategies to promote autonomous motivation for PA (Table 1). Validated questionnaires assessed autonomous and controlled motivation for PA (Behavioural Regulation in Exercise Questionnaire-2), psychological well-being (Subjective Vitality Scale), and daily MVPA (International Physical Activity Questionnaire). Assessments were conducted at baseline (T1) and the end of the exercise programme (T2). Path analyses examined the hypothesised theoretical process model (Figure 1).

Results: Participants were excluded from analyses due to missing baseline data (n = 36), or as extreme outliers (n = 6). The hypothesised model (n = 73), demonstrated an excellent fit to the data [X2 (26) = 34.10, p =.13, CFI = .96, RMSEA = .07]. The intervention promoted higher autonomous motivation and lower controlled motivation for PA at T2. In turn, changes in autonomous motivation from T1 to T2, significantly positively predicted changes from T1 to T2 in MVPA and subjective vitality. Controlled motivation did not significantly predict either outcome.

Conclusion: An SDT-based psychological intervention providing support for PA, may promote MVPA and more optimal psychological functioning in RA patients who are engaged in a tailored exercise programme.

Table 1_ACR

ACR_Figure 1


Disclosure: S. A. M. Fenton, None; J. J. C. S. Veldhuijzen van Zanten, None; G. S. Metsios, None; P. C. Rouse, None; N. Ntoumanis, None; C. A. Yu, None; G. D. Kitas, None; J. L. Duda, None.

To cite this abstract in AMA style:

Fenton SAM, Veldhuijzen van Zanten JJCS, Metsios GS, Rouse PC, Ntoumanis N, Yu CA, Kitas GD, Duda JL. A Self-Determination Theory Based Intervention to Promote Autonomous Motivation for, and Engagement in Physical Activity in Rheumatoid Arthritis: Theoretical Process Evaluation of a Randomised Controlled Trial [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/a-self-determination-theory-based-intervention-to-promote-autonomous-motivation-for-and-engagement-in-physical-activity-in-rheumatoid-arthritis-theoretical-process-evaluation-of-a-randomised-control/. Accessed April 17, 2021.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-self-determination-theory-based-intervention-to-promote-autonomous-motivation-for-and-engagement-in-physical-activity-in-rheumatoid-arthritis-theoretical-process-evaluation-of-a-randomised-control/

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