Effects of telephone-based motivational interviewing in lifestyle modification program on reducing metabolic risks in middle-aged and older women with metabolic syndrome: A randomized controlled trial.
BACKGROUND
Lifestyle modification is often difficult for middle-aged and older women living in the community who are at high risk of physical inactivity and metabolic syndrome.


OBJECTIVE
To examine the effects of telephone-based motivational interviewing in a 12-week lifestyle modification program on physical activity, MetS, metabolic risks (fasting plasma glucose, blood pressure, triglyceride, high-density lipoprotein, and central obesity), and the number of metabolic risks in community-living middle-aged and older women diagnosed with metabolic syndrome.


METHODS
A randomized controlled trial was conducted. Recruited were 328 middle-aged and older women from a community health center in Taiwan. Eligible women medically diagnosed with metabolic syndrome (n=115) were randomly assigned to one of three groups: The experimental group received an individualized telephone delivered lifestyle modification program that included motivational interviewing delivered by an experienced nurse. The brief group received a single brief lifestyle modification counseling session with a brochure. The usual care group received standard care. Physical activity was assessed with the International Physical Activity Questionnaire and metabolic risks were determined by serum markers and anthropometric measures at pre- and post-intervention. One hundred women completed the study and an intention-to-treat analysis was performed. Generalized estimating equations were used to examine the intervention effects.


RESULTS
Women in the experimental group increased physical activity from 1609 to 1892 MET-min/week (β=846, p=.01), reduced the percentage of diagnosed with metabolic syndrome to 81.6% (β=-0.17, p=.003), and decreased the number of metabolic risks from 4.0 to 3.6 (β=-0.50, p<.001), compared to the usual care group (4.4-4.6). There was not a reduction in the percentage of diagnosed with metabolic syndrome in the brief group, but they had fewer metabolic risks after 12 weeks (mean=4.0 vs. 4.6, β=-0.2, p=.02) compared to the usual care group.


CONCLUSIONS
Motivational interviewing as a component of an individualized physical activity and lifestyle modification program has positive benefit in reducing metabolic risks in middle-aged and older women.
Department of Nursing at Tri-Service General Hospital, School of Nursing, National Defense Medical Center, Taipei, Taiwan, ROC.
Chia-Huei
CH
Lin
Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC.
Shang-Lin
SL
Chiang
Department of Biobehavioral Nursing and Health Systems, Division of Gastroenterology, School of Medicine, University of Washington, USA.
Margaret McLean
MM
Heitkemper
Division of Endocrinology & Metabolism, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC.
Yi-Jen
YJ
Hung
School of Public Health & Graduated Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan, ROC.
Meei-Shyuan
MS
Lee
School of Nursing, National Defense Medical Center, Taipei, Taiwan, ROC.
Wen-Chii
WC
Tzeng
School of Nursing & Graduated Institute of Medical Sciences, National Defense Medical Center & China Medical University, Taipei & Taichung, Taiwan, ROC. Electronic address: lichichiang@gmail.com.
Li-Chi
LC
Chiang
D000368:Aged; D015444:Exercise; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D024821:Metabolic Syndrome / Q000378:metabolism* / Q000523:psychology; D008875:Middle Aged; D009042:Motivation; D013624:Taiwan; D013689:Telephone
Lifestyle modification; Metabolic syndrome; Motivational interviewing; Physical activity; Randomized controlled trial; Telephone; Women