Physical activity and osteoarthritis; Fostering autonomous motivation and self-efficacy via a digital intervention

Berry, Alice Elizabeth

Abstract

Abstract
Osteoarthritis (OA) is a chronic musculoskeletal disease affecting approximately 8.75 million people in the UK alone. Symptoms include pain, joint stiffness, and muscle weakness, as well as psychological and emotional limitations such as depression and anxiety. Physical activity (PA) is recommended as a core treatment irrespective of disease severity, pain and function, yet nearly half of people with OA report doing no PA at all. Low-cost, accessible, and user-friendly interventions are needed to motivate people with OA to become and stay active over the long-term. Digital behaviour change interventions (DBCIs) might offer an opportunity to support people with OA to self-manage, and monitor their own levels of PA.
A pragmatic, sequential explanatory mixed methods design was adopted to develop and test a DBCI to motivate people with OA to become and stay active. Four phases of research were undertaken: A systematic literature review assessed the effectiveness of existing digital interventions; a survey and secondary data analysis explored beliefs and motives for PA in this population; a design and production phase adopted the intervention mapping approach to develop a prototype website; and a testing phase utilised interviews and a think-aloud approach to explore acceptability and usability with potential users.
The systematic literature review revealed that existing DBCIs provided small, positive outcomes for increasing PA in this population. The survey and secondary data analysis showed that higher levels of both self-efficacy and more autonomous forms of motivation were associated with higher levels of PA. Use of the intervention mapping approach enabled the development of a prototype website to be illustrated in a clear and transparent way, showing a clear link between the practical materials adopted within the website and the theoretical constructs they were attempting to change. Interviews and think-aloud sessions explored attitudes, values, and the perceived effectiveness of the website, and potential users highlighted the importance of clear, easy to understand information, focusing on enjoyment, and the importance of social connectedness.
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These findings highlight the potential that DBCIs have to engage people with OA to become and stay active. A greater utilisation of such interventions would take pressure off scarce NHS resources. It illustrates the value of identifying motivational factors associated with engagement in PA and describes how these findings can be used to build the theoretical foundations of a DBCI. Future development of similar interventions should be based on theory, adequately described, and thoroughly tested with potential users to further understand how they might integrate the use of a digital intervention into their everyday lives.

• Thesis Type: Thesis
• Publicly Available Date: Jul 16, 2019
• Public URL: https://uwe-repository.worktribe.com/output/1491029
• Award Date: Jan 4, 2019