107 Using Brief Motivational Interviewing to Increase Healthy Lifestyle Habits in Overweight and Obese Adults in a Rural Family Practice Setting

Abstract

Obesity is a rapidly growing epidemic in the United States of America resulting in a multitude of comorbid conditions. Individuals living in rural areas have a higher prevalence of obesity than in urban settings. Effective treatment of obesity is needed to decrease the morbidity and mortality of this chronic disease. Using motivational interviewing (MI) techniques to address unhealthy lifestyle habits has previously proven to be effective in aiding individuals to achieve a healthier lifestyle.

Objectives

The main objective is to determine the effectiveness of brief MI used during regular office visits and with phone follow-ups on body mass index (BMI) at the initiation of the project, as well as at the 3-month follow-up. Secondary objectives are to determine the effect brief MI has on the amount of weekly physical activity, advancing the individual to the next stage on the Transtheoretical Model of Change (TTM) continuum and determining common barriers to leading a healthy lifestyle in a rural adult population.

Method

Participants (n=15) were recruited using a convenience sampling method from the primary care practice. Using a pretest/posttest design, individuals were asked to complete a survey regarding their amount of weekly exercise, their perceived stage of change and their barriers to healthy lifestyle choices. A pre- and post-intervention BMI was collected. One in-office brief MI session and two monthly phone sessions were conducted, each lasting not longer than ten minutes.

Results

A total of 14 participants, mostly female (67%), aged 36 to 45 years old (33%), Caucasian (73.3%), and had some college education (40%), completed the study. It was hypothesized that brief MI would result in decreased BMI, increased exercise and advancement along the TTM continuum. No significant difference in the pre-and post -intervention BMI ([M=37.88, SD=9.15] vs [M=37.01, SD=9.37]); t (27)=0.25, p=0.801 was found. Many participants (n=10), however, had a decrease in BMI. The difference in weekly activity (M=644.2 min vs M=268.57 min) was not found to be statistically significant; t (27)=1.40, p=0.17. An increase in readiness to change was noted, but, was not significant (p =0.52). Of 34 responses, chronic pain or health conditions (n=10) and scheduling conflicts (n=7) were the two top cited reasons for not practicing a healthylifestyle.

Conclusions

This QI project did not demonstrate statistically significant improvement in BMI, weekly exercise or readiness to change after three months of brief MI. It is important to note, however, that many individuals did experience an overall decrease in BMI. It is also promising to note that more individuals were participating in healthylifestyle activities more frequently post-intervention when analyzed on the TTM continuum. Further studies are needed to analyze the most effective strategies to assist individuals in rural settings to make healthier lifestyle choices.

Funding Acknowledgements

No funding.