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Motivational Counseling Improves Sedentary Behaviors and Quality of Life in Women With Metabolic Syndrome
Study Questions:
Is motivational counseling effective at improving sedentary behavior, depressive symptoms, and health-related quality of life in women with metabolic syndrome?
Methods:
A randomized controlled trial of 115 middle-aged and older northern Taiwanese women with metabolic syndrome was conducted in an urban community health center using motivational counseling to improve physical activity. Exclusion criteria were end-stage renal disease, history of cancer, and an inability to walk without assistance. Participants were randomly assigned to one of three groups:
- The experimental group
- The comparison group
- The usual care group
In addition to usual care, the experimental group received 12 weeks of individualized motivational counseling by phone with a focus on decreasing sedentary behaviors. They also received an educational brochure about lifestyle modification and coping with stress. The comparison group received the same brochure but no counseling. The usual care group received neither. Sedentary behavior, defined as weekly sitting time in the previous 7 days, was measured pre- and post-intervention using The International Physical Activity Questionnaire-Short Form. Depression and health-related quality of life were also measured pre- and post-intervention using the Beck Depression Inventory and the Medical Outcomes Study Questionnaire Short Form 36 Health Survey, respectively.
Results:
Women who received 12 weeks of motivational counseling in addition to usual care had improved sedentary behaviors, as evidenced by a reduction in sitting time by 374 minutes (12.2%) compared with the usual care group (p < 0.001). They also had improvements in depressive symptoms (p < 0.05) and health-related quality of life (p < 0.001). The comparison group, which received only a brochure and no counseling, also saw an improvement in depressive symptoms (p < 0.037) and some subscales of health-related quality of life but no significant change in sedentary behavior.
Conclusions:
In Taiwanese women with metabolic syndrome, motivational counseling reduced sedentary behavior, improved depressive symptoms, and improved overall health-related quality of life compared with usual care. Patients who received printed educational material also had some improvement in depression symptoms and health-related quality of life but on a limited scale.
Perspective:
This study has implications for clinicians, public health educators, and patients. Similar to a previous study on the positive effects of motivational counseling on increasing physical activity and improving metabolic risks, the authors have demonstrated potential for this intervention across the spectrum of preventive care and chronic-disease management. Supporting and engendering behavioral change is challenging for clinicians, and adherence rates to these recommendations have been found to be low. A novel approach to patient engagement that attempts to enhance self-efficacy by focusing on patient strengths and previous successes, the motivational counseling model may help engage patients in their own self-care and encourage adoption of healthier lifestyles. Certainly, increasing physical activity and decreasing sedentary behavior in women with metabolic syndrome could have a broader impact on decreasing the burden of cardiovascular disease in this population.
Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Prevention, Exercise
Keywords: Metabolic Syndrome, Female, Counseling, Depression, Sedentary Behavior, Quality of Life, Exercise, Self Care, Self Efficacy, Pamphlets, Community Health Centers
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