title: Motivational interviewing to increase physical activity in people with chronic health conditions: a systematic review and meta-analysis.
abstract: OBJECTIVE
  A systematic review and meta-analysis of randomized controlled trials to determine if motivational interviewing leads to increased physical activity, cardiorespiratory fitness or functional exercise capacity in people with chronic health conditions.
  
  
  METHODS
  Seven electronic databases (MEDLINE, PsychINFO, EMBASE, AMED, CINHAL, SPORTDiscus and the Cochrane Central Register of Controlled trials) were searched from inception until January 2014.
  Two reviewers independently examined publications for inclusion. Trials were included if participants were adults (>18 years), had a chronic health condition, used motivational interviewing as the intervention and examined physical activity, cardiorespiratory fitness or functional exercise capacity.
  
  
  METHODS
  Two reviewers independently extracted data. Risk of bias within trials was assessed using the Physiotherapy Evidence Database Scale.
  
  
  RESULTS
  Meta-analyses were conducted with standardized mean differences and 95% confidence intervals (CIs) were calculated. The Grades of Recommendation, Assessment, Development and Evaluation approach was used to evaluate the quality of the evidence.
  
  
  RESULTS
  Eleven publications (of ten trials) were included. There was moderate level evidence that motivational interviewing had a small effect in increasing physical activity levels in people with chronic health conditions relative to comparison groups (standardized mean differences = 0.19, 95% CI 0.06 to 0.32, p = 0.004). Sensitivity analysis based on trials that confirmed treatment fidelity produced a larger effect. No conclusive evidence was observed for cardiorespiratory fitness or functional exercise capacity.
  
  
  CONCLUSIONS
  The addition of motivational interviewing to usual care may lead to modest improvements in physical activity for people with chronic health conditions.
authors.affiliation: Faculty of Health Sciences, La Trobe University, Australia p.ohalloran@latrobe.edu.au.
authors.forename: Paul D
authors.initials: PD
authors.lastname: O'Halloran
authors.affiliation: Faculty of Health Sciences, La Trobe University, Australia.
authors.forename: Felicity
authors.initials: F
authors.lastname: Blackstock
authors.affiliation: Faculty of Health Sciences, La Trobe University, Australia Northern Health, Australia.
authors.forename: Nora
authors.initials: N
authors.lastname: Shields
authors.affiliation: Faculty of Health Sciences, La Trobe University, Australia Department of Physiotherapy, Alfred Health, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Holland
authors.affiliation: Department of Physiotherapy, Monash University, Australia.
authors.forename: Ross
authors.initials: R
authors.lastname: Iles
authors.affiliation: Faculty of Health Sciences, La Trobe University, Australia.
authors.forename: Mike
authors.initials: M
authors.lastname: Kingsley
authors.affiliation: Faculty of Health Sciences, La Trobe University, Australia Florey Institute of Neuroscience and Mental Health, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Bernhardt
authors.affiliation: Faculty of Health Sciences, La Trobe University, Australia Department of Occupational Therapy, Alfred Health, Australia.
authors.forename: Natasha
authors.initials: N
authors.lastname: Lannin
authors.affiliation: Faculty of Health Sciences, La Trobe University, Australia.
authors.forename: Meg E
authors.initials: ME
authors.lastname: Morris
authors.affiliation: Northern Health, Australia Eastern Health, Australia.
authors.forename: Nicholas F
authors.initials: NF
authors.lastname: Taylor
mesh_terms: D000328:Adult; D002320:Cardiovascular Physiological Phenomena; D002908:Chronic Disease / Q000534:rehabilitation*; D016206:Databases, Bibliographic; D017079:Exercise Tolerance / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D062405:Motivational Interviewing / Q000379:methods*; D009043:Motor Activity / Q000502:physiology*; D010809:Physical Fitness / Q000502:physiology*; D016032:Randomized Controlled Trials as Topic
keywords: Cardiorespiratory fitness; motivational interviewing; physical activity; systematic review