Self-efficacy in the initiation of physical activity in clinical samples: a systematic review with meta-analysis

Abstract

Background: Effective behaviour change techniques (BCTs) for changing self-efficacy and physical activity in healthy, obese, and older adults have been identified, but not in samples defined by clinical condition (e.g. people with cancer). This review aimed to identify which BCTs within interventions are the most effective for initiating self-efficacy and physical activity changes in clinical samples compared with non-clinical samples. Methods: A systematic review of 162 randomised trials (non-clinical=101; clinical=61) identified 185 comparisons (non-clinical=120; clinical=65) which reported changes in self-efficacy. Intervention content was coded using the BCT Taxonomy v1 (BCTTv1). Meta-analyses and moderator analyses examined whether the presence and absence of individual BCTs in interventions were associated with effect size changes for self-efficacy and physical activity. Findings: For self-efficacy, larger intervention effects were found for clinical (d=.359;CI:.26-.46) than for non-clinical (d=.191;CI:.13-.26) groups. Information about emotional consequences was significantly associated with positive changes in self-efficacy for clinical samples only. Similarly, larger intervention effects were found for clinical (d=.296;CI=.21-.39) than for non-clinical (d=.185;CI:.12-.25) groups for physical activity. Although goal setting (behaviour) was associated with positive changes in physical activity for both groups, in general, different BCTs were associated with positive changes in physical activity for non-clinical and clinical groups (e.g. goal setting (outcome) was only associated with positive changes in clinical samples). Discussion: The BCTTv1 allowed for the comparison of technique effectiveness across populations. Different BCTs are needed for changing self-efficacy and physical activity in clinical and non-clinical groups. Greater consideration of the intended intervention population is needed in health psychology theories.