title: A formative evaluation of customized pamphlets to promote physical activity and symptom self-management in women with multiple sclerosis.
abstract: Inactivity is a prevalent problem in the population affected with multiple sclerosis (MS). Thus, there is a need to develop and test physical activity (PA) interventions that can be widely disseminated. We conducted a formative evaluation as part of a randomized controlled trial of a pamphlet-based PA intervention among 30 women with MS. Pamphlets were customized to sub-sets of participants who shared similar symptoms and barriers to PA. Mixed methods were used to examine the intervention's influence on self-efficacy, social support, processes of change and stages of change placement, as well as explore participants' perceived barriers, motivators and strategies for engaging in a PA program. Results indicated that the intervention group significantly improved stages of change placement (F = 16.64, P < 0.01) and social support (F = 4.08, P = 0.05) in comparison to the control group. Fatigue, pain and lack of time were the commonly cited barriers to engage in the PA program; whereas the pamphlets, phone calls and action planning were cited as motivators. Participants used fatigue management strategies, enlisted social support and modified their environment to routinely engage in the PA program. Strategies were identified to improve the PA intervention in future research.
authors.affiliation: Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, USA, Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, ND-20, Cleveland, OH 44195, USA and Department of Family and Preventive Medicine, University of California, San Diego, CA 92093-0628, USA. map208@case.edu.
authors.forename: Matthew
authors.initials: M
authors.lastname: Plow
authors.affiliation: Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, USA, Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, ND-20, Cleveland, OH 44195, USA and Department of Family and Preventive Medicine, University of California, San Diego, CA 92093-0628, USA.
authors.forename: Francois
authors.initials: F
authors.lastname: Bethoux
authors.affiliation: Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, USA, Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, ND-20, Cleveland, OH 44195, USA and Department of Family and Preventive Medicine, University of California, San Diego, CA 92093-0628, USA.
authors.forename: Kimloan
authors.initials: K
authors.lastname: Mai
authors.affiliation: Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, USA, Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, ND-20, Cleveland, OH 44195, USA and Department of Family and Preventive Medicine, University of California, San Diego, CA 92093-0628, USA.
authors.forename: Bess
authors.initials: B
authors.lastname: Marcus
mesh_terms: D000328:Adult; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000628:therapy*; D010174:Pamphlets; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D012944:Social Support