Barrier-belief lifestyle counseling in primary care: a randomized controlled trial of efficacy

Abstract

Background:Theory-based behavior change strategies were newly developed to intervene on barrier-beliefs to handle potential causes of relapse and inhibit the role of beliefs as mediating factors in lifestyle behavior. The aim was to analyze the effects of a barrier-belief counseling intervention (BBCI). Methods:A multicenter randomized controlled trial, with balanced randomization, was conducted in a primary care setting in two 6-month intervention groups: BBCI (n=123) and SLI (n=122) and a non-treated hanging control group (n=36) in inactive adults (aged 18-70). Outcomes on physical activity (accelerometer and SQUASH questionnaire), diet (self-report), body composition (BMI, body fat, waist), and quality of life (EORTC QLQ-C30, LASA, Cantril’s Ladder) were measured with follow-ups at 6, 12 and 18 months and analyzed using a multiple regression analysis. Missing data was imputed with the predictive mean matching method combined with the last carried-forward method. Results:A barrier-belief counseling intervention was significantly (p<.01) more effective on physical activity in the short and the long term compared with the standard lifestyle group intervention and control group, and improved physical activity in the short term significantly (p<.05) with small effect sizes, diet in the short and the long term with small and moderate effect sizes respectively, body composition in the short and the long term with small effect sizes and quality of life in the short and the long term with a moderate effect size. Conclusions:The barrier-belief approach can be seen as an effective lifestyle counseling intervention on the long term and seems promising for implementation in healthcare practice.