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. 2019 Dec;23(69):1–144. doi: 10.3310/hta23690

Enhanced motivational interviewing for reducing weight and increasing physical activity in adults with high cardiovascular risk: the MOVE IT three-arm RCT.

Khalida Ismail, Daniel Stahl, Adam Bayley, Katherine Twist, Kurtis Stewart, Katie Ridge, Emma Britneff, Mark Ashworth, Nicole de Zoysa, Jennifer Rundle, Derek Cook, Peter Whincup, Janet Treasure, Paul McCrone, Anne Greenough, Kirsty Winkley
PMCID: PMC6943381  PMID: 31858966

Abstract

BACKGROUND

Motivational interviewing (MI) enhanced with behaviour change techniques (BCTs) and deployed by health trainers targeting multiple risk factors for cardiovascular disease (CVD) may be more effective than interventions targeting a single risk factor.

OBJECTIVES

The clinical effectiveness and cost-effectiveness of an enhanced lifestyle motivational interviewing intervention for patients at high risk of CVD in group settings versus individual settings and usual care (UC) in reducing weight and increasing physical activity (PA) were tested.

DESIGN

This was a three-arm, single-blind, parallel randomised controlled trial.

SETTING

A total of 135 general practices across all 12 South London Clinical Commissioning Groups were recruited.

PARTICIPANTS

A total of 1742 participants aged 40-74 years with a ≥ 20.0% risk of a CVD event in the following 10 years were randomised.

INTERVENTIONS

The intervention was designed to integrate MI and cognitive-behavioural therapy (CBT), delivered by trained healthy lifestyle facilitators in 10 sessions over 1 year, in group or individual format. The control group received UC.

RANDOMISATION

Simple randomisation was used with computer-generated randomisation blocks. In each block, 10 participants were randomised to the group, individual or UC arm in a 4 : 3 : 3 ratio. Researchers were blind to the allocation.

MAIN OUTCOME MEASURES

The primary outcomes are change in weight (kg) from baseline and change in PA (average number of steps per day over 1 week) from baseline at the 24-month follow-up, with an interim follow-up at 12 months. An economic evaluation estimates the relative cost-effectiveness of each intervention. Secondary outcomes include changes in low-density lipoprotein cholesterol and CVD risk score.

RESULTS

The mean age of participants was 69.75 years (standard deviation 4.11 years), 85.5% were male and 89.4% were white. At the 24-month follow-up, the group and individual intervention arms were not more effective than UC in increasing PA [mean 70.05 steps, 95% confidence interval (CI) -288 to 147.9 steps, and mean 7.24 steps, 95% CI -224.01 to 238.5 steps, respectively] or in reducing weight (mean -0.03 kg, 95% CI -0.49 to 0.44 kg, and mean -0.42 kg, 95% CI -0.93 to 0.09 kg, respectively). At the 12-month follow-up, the group and individual intervention arms were not more effective than UC in increasing PA (mean 131.1 steps, 95% CI -85.28 to 347.48 steps, and mean 210.22 steps, 95% CI -19.46 to 439.91 steps, respectively), but there were reductions in weight for the group and individual intervention arms compared with UC (mean -0.52 kg, 95% CI -0.90 to -0.13 kg, and mean -0.55 kg, 95% CI -0.95 to -0.14 kg, respectively). The group intervention arm was not more effective than the individual intervention arm in improving outcomes at either follow-up point. The group and individual interventions were not cost-effective.

CONCLUSIONS

Enhanced MI, in group or individual formats, targeted at members of the general population with high CVD risk is not effective in reducing weight or increasing PA compared with UC. Future work should focus on ensuring objective evidence of high competency in BCTs, identifying those with modifiable factors for CVD risk and improving engagement of patients and primary care.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN84864870.

FUNDING

This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 69. See the NIHR Journals Library website for further project information. This research was part-funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London.

Plain language summary

People who have a high risk of heart disease can reduce this risk by changing their lifestyles, such as by improving their diets and increasing their physical activity levels. However, there is no good evidence on how best to support people to change and then maintain healthier lifestyles. It is thought that support from others might be helpful. An intervention based on two talking therapies, called motivational interviewing and cognitive–behavioural therapy, to help people make a commitment to living healthier lives was developed. People from the local community with a health-related background were recruited and trained in these skills. Then general practitioners invited patients on their register who were at high risk of heart disease to participate. Those patients who replied and met the study criteria were randomly allocated to one of three arms. Participants received either group- or individual-based intensive lifestyle sessions or usual care. Those who were randomised to the lifestyle course were offered 10 sessions of therapy over 12 months by lifestyle trainers. Two years later, it was found that there were no differences in weight or physical activity levels between the three arms. The lifestyle interventions were not cost-effective compared with usual care. When the possible explanations were studied, it was found that those who could have benefited the most from the therapy (such as those who were most overweight, those from poorer backgrounds and those who were of African Caribbean ethnicity) were less likely to participate. Whether or not the skills of the therapists made a difference could not be properly assessed. Sometimes, patients and their doctors were not sure why they were invited. Future research should focus on people who have lifestyles that can be changed (e.g. more overweight individuals with unhealthy diets), on finding ways of improving the quality of the intervention and on ensuring that patients have more information.


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References

  1. World Health Organization. Global Status Report on Noncommunicable Diseases 2010. Geneva: World Health Organization; 2011.
  2. Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 2009;373:1083–96. https://doi.org/10.1016/S0140-6736(09)60318-4 doi: 10.1016/S0140-6736(09)60318-4. [DOI] [PMC free article] [PubMed]
  3. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903–13. https://doi.org/10.1016/S0140-6736(02)11911-8 doi: 10.1016/S0140-6736(02)11911-8. [DOI] [PubMed]
  4. Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, Halsey J, et al. Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet 2007;370:1829–39. https://doi.org/10.1016/S0140-6736(07)61778-4 doi: 10.1016/S0140-6736(07)61778-4. [DOI] [PubMed]
  5. Kvaavik E, Batty GD, Ursin G, Huxley R, Gale CR. Influence of individual and combined health behaviors on total and cause-specific mortality in men and women: the United Kingdom health and lifestyle survey. Arch Intern Med 2010;170:711–18. https://doi.org/10.1001/archinternmed.2010.76 doi: 10.1001/archinternmed.2010.76. [DOI] [PubMed]
  6. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004;364:937–52. https://doi.org/10.1016/S0140-6736(04)17018-9 doi: 10.1016/S0140-6736(04)17018-9. [DOI] [PubMed]
  7. Backholer K, Peters SAE, Bots SH, Peeters A, Huxley RR, Woodward M. Sex differences in the relationship between socioeconomic status and cardiovascular disease: a systematic review and meta-analysis. J Epidemiol Community Health 2017;71:550–7. https://doi.org/10.1136/jech-2016-207890 doi: 10.1136/jech-2016-207890. [DOI] [PubMed]
  8. Wild SH, Fischbacher C, Brock A, Griffiths C, Bhopal R. Mortality from all causes and circulatory disease by country of birth in England and Wales 2001-2003. J Public Health 2007;29:191–8. https://doi.org/10.1093/pubmed/fdm010 doi: 10.1093/pubmed/fdm010. [DOI] [PubMed]
  9. Unal B, Critchley JA, Capewell S. Explaining the decline in coronary heart disease mortality in England and Wales between 1981 and 2000. Circulation 2004;109:1101–7. https://doi.org/10.1161/01.CIR.0000118498.35499.B2 doi: 10.1161/01.CIR.0000118498.35499.B2. [DOI] [PubMed]
  10. Hardoon SL, Whincup PH, Lennon LT, Wannamethee SG, Capewell S, Morris RW. How much of the recent decline in the incidence of myocardial infarction in British men can be explained by changes in cardiovascular risk factors? Evidence from a prospective population-based study. Circulation 2008;117:598–604. https://doi.org/10.1161/CIRCULATIONAHA.107.705947 doi: 10.1161/CIRCULATIONAHA.107.705947. [DOI] [PMC free article] [PubMed]
  11. Department of Health and Social Care (DHSC). Vascular Checks: Risk Assessment and Management. London: DHSC; 2008.
  12. Robson J, Dostal I, Sheikh A, Eldridge S, Madurasinghe V, Griffiths C, et al. The NHS Health Check in England: an evaluation of the first 4 years. BMJ Open 2016;6:e008840. https://doi.org/10.1136/bmjopen-2015-008840 doi: 10.1136/bmjopen-2015-008840. [DOI] [PMC free article] [PubMed]
  13. Usher-Smith JA, Mant J, Martin A, Harte E, MacLure C, Meads C, et al. NHS Health Check Programme Rapid Evidence Synthesis. 2017. URL: www.rand.org/content/dam/rand/pubs/external_publications/EP60000/EP67129/RAND_EP67129.pdf (accessed 1 November 2017).
  14. Cochrane T, Davey R, Iqbal Z, Gidlow C, Kumar J, Chambers R, Mawby Y. NHS health checks through general practice: randomised trial of population cardiovascular risk reduction. BMC Public Health 2012;12:944. https://doi.org/10.1186/1471-2458-12-944 doi: 10.1186/1471-2458-12-944. [DOI] [PMC free article] [PubMed]
  15. Krogsbøll LT, Jørgensen KJ, Grønhøj Larsen C, Gøtzsche PC. General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis. BMJ 2012;345:e7191. https://doi.org/10.1136/bmj.e7191 doi: 10.1136/bmj.e7191. [DOI] [PMC free article] [PubMed]
  16. Dalton AR, Bottle A, Okoro C, Majeed A, Millett C. Uptake of the NHS Health Checks programme in a deprived, culturally diverse setting: cross-sectional study. J Public Health 2011;33:422–9. https://doi.org/10.1093/pubmed/fdr034 doi: 10.1093/pubmed/fdr034. [DOI] [PubMed]
  17. Anderson KM, Odell PM, Wilson PW, Kannel WB. Cardiovascular disease risk profiles. Am Heart J 1991;121:293–8. https://doi.org/10.1016/0002-8703(91)90861-B doi: 10.1016/0002-8703(91)90861-B. [DOI] [PubMed]
  18. Woodward M, Brindle P, Tunstall-Pedoe H, SIGN group on risk estimation. Adding social deprivation and family history to cardiovascular risk assessment: the ASSIGN score from the Scottish Heart Health Extended Cohort (SHHEC). Heart 2007;93:172–6. https://doi.org/10.1136/hrt.2006.108167 doi: 10.1136/hrt.2006.108167. [DOI] [PMC free article] [PubMed]
  19. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, May M, Brindle P. Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: prospective open cohort study. BMJ 2007;335:136. https://doi.org/10.1136/bmj.39261.471806.55 doi: 10.1136/bmj.39261.471806.55. [DOI] [PMC free article] [PubMed]
  20. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A, Brindle P. Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ 2008;336:1475–82. https://doi.org/10.1136/bmj.39609.449676.25 doi: 10.1136/bmj.39609.449676.25. [DOI] [PMC free article] [PubMed]
  21. National Institute for Health and Care Excellence (NICE). Cardiovascular Disease: Risk Assessment and Reduction, Including Lipid Modification. London: NICE; 2016. [PubMed]
  22. Wahid A, Manek N, Nichols M, Kelly P, Foster C, Webster P, et al. Quantifying the association between physical activity and cardiovascular disease and diabetes: a systematic review and meta-analysis. J Am Heart Assoc 2016;5:e002495. https://doi.org/10.1161/JAHA.115.002495 doi: 10.1161/JAHA.115.002495. [DOI] [PMC free article] [PubMed]
  23. Department of Health and Social Care (DHSC). UK Physical Activity Guidelines. London: DHSC; 2011.
  24. Hamer M, Chida Y. Walking and primary prevention: a meta-analysis of prospective cohort studies. Br J Sports Med 2008;42:238–43. https://doi.org/10.1136/bjsm.2007.039974 doi: 10.1136/bjsm.2007.039974. [DOI] [PubMed]
  25. Morris JN, Hardman AE. Walking to health. Sports Med 1997;23:306–32. https://doi.org/10.2165/00007256-199723050-00004 doi: 10.2165/00007256-199723050-00004. [DOI] [PubMed]
  26. Ogilvie D, Foster CE, Rothnie H, Cavill N, Hamilton V, Fitzsimons CF, et al. Interventions to promote walking: systematic review. BMJ 2007;334:1204. https://doi.org/10.1136/bmj.39198.722720.BE doi: 10.1136/bmj.39198.722720.BE. [DOI] [PMC free article] [PubMed]
  27. Craig R, Mindell J, Hirani V. Health Survey for England 2008. Volume 1: Physical Activity and Fitness. 2009. URL: https://files.digital.nhs.uk/publicationimport/pub00xxx/pub00430/heal-surv-phys-acti-fitn-eng-2008-rep-v1.pdf (accessed 1 November 2017).
  28. Conn VS, Hafdahl AR, Mehr DR. Interventions to increase physical activity among healthy adults: meta-analysis of outcomes. Am J Public Health 2011;101:751–8. https://doi.org/10.2105/AJPH.2010.194381 doi: 10.2105/AJPH.2010.194381. [DOI] [PMC free article] [PubMed]
  29. Foster C, Hillsdon M, Thorogood M, Kaur A, Wedatilake T. Interventions for promoting physical activity. Cochrane Database Syst Rev 2005;1:CD003180. https://doi.org/10.1002/14651858.CD003180.pub2 doi: 10.1002/14651858.CD003180.pub2. [DOI] [PMC free article] [PubMed]
  30. Lamming L, Pears S, Mason D, Morton K, Bijker M, Sutton S, et al. What do we know about brief interventions for physical activity that could be delivered in primary care consultations? A systematic review of reviews. Prev Med 2017;99:152–63. https://doi.org/10.1016/j.ypmed.2017.02.017 doi: 10.1016/j.ypmed.2017.02.017. [DOI] [PubMed]
  31. GC V, Wilson EC, Suhrcke M, Hardeman W, Sutton S, VBI Programme Team. Are brief interventions to increase physical activity cost-effective? A systematic review. Br J Sports Med 2016;50:408–17. https://doi.org/10.1136/bjsports-2015-094655 doi: 10.1136/bjsports-2015-094655. [DOI] [PMC free article] [PubMed]
  32. Murtagh EM, Nichols L, Mohammed MA, Holder R, Nevill AM, Murphy MH. The effect of walking on risk factors for cardiovascular disease: an updated systematic review and meta-analysis of randomised control trials. Prev Med 2015;72:34–43. https://doi.org/10.1016/j.ypmed.2014.12.041 doi: 10.1016/j.ypmed.2014.12.041. [DOI] [PubMed]
  33. Cress ME, Buchner DM, Prohaska T, Rimmer J, Brown M, Macera C, et al. Best practices for physical activity programs and behavior counseling in older adult populations. J Aging Phys Act 2005;13:61–74. https://doi.org/10.1123/japa.13.1.61 doi: 10.1123/japa.13.1.61. [DOI] [PubMed]
  34. Bravata DM, Smith-Spangler C, Sundaram V, Gienger AL, Lin N, Lewis R, et al. Using pedometers to increase physical activity and improve health: a systematic review. JAMA 2007;298:2296–304. https://doi.org/10.1001/jama.298.19.2296 doi: 10.1001/jama.298.19.2296. [DOI] [PubMed]
  35. Harris T, Kerry SM, Limb ES, Victor CR, Iliffe S, Ussher M, et al. Effect of a primary care walking intervention with and without nurse support on physical activity levels in 45- to 75-year-olds: the Pedometer And Consultation Evaluation (PACE-UP) cluster randomised clinical trial. PLOS Med 2017;14:e1002210. https://doi.org/10.1371/journal.pmed.1002210 doi: 10.1371/journal.pmed.1002210. [DOI] [PMC free article] [PubMed]
  36. Michie S, Ashford S, Sniehotta FF, Dombrowski SU, Bishop A, French DP. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health 2011;26:1479–98. https://doi.org/10.1080/08870446.2010.540664 doi: 10.1080/08870446.2010.540664. [DOI] [PubMed]
  37. Bhattarai N, Prevost AT, Wright AJ, Charlton J, Rudisill C, Gulliford MC. Effectiveness of interventions to promote healthy diet in primary care: systematic review and meta-analysis of randomised controlled trials. BMC Public Health 2013;13:1203. https://doi.org/10.1186/1471-2458-13-1203 doi: 10.1186/1471-2458-13-1203. [DOI] [PMC free article] [PubMed]
  38. Gulliford MC, Bhattarai N, Charlton J, Rudisill C. Cost-effectiveness of a universal strategy of brief dietary intervention for primary prevention in primary care: population-based cohort study and Markov model. Cost Eff Resour Alloc 2014;12:4. https://doi.org/10.1186/1478-7547-12-4 doi: 10.1186/1478-7547-12-4. [DOI] [PMC free article] [PubMed]
  39. Rees K, Dyakova M, Ward K, Thorogood M, Brunner E. Dietary advice for reducing cardiovascular risk. Cochrane Database Syst Rev 2013;3:CD002128. https://doi.org/10.1002/14651858.CD002128.pub4 doi: 10.1002/14651858.CD002128.pub4. [DOI] [PMC free article] [PubMed]
  40. Dansinger ML, Tatsioni A, Wong JB, Chung M, Balk EM. Meta-analysis: the effect of dietary counseling for weight loss. Ann Intern Med 2007;147:41–50. https://doi.org/10.7326/0003-4819-147-1-200707030-00007 doi: 10.7326/0003-4819-147-1-200707030-00007. [DOI] [PubMed]
  41. Miller W, Rollnick S. Motivational Interviewing: Preparing People to Change Addictive Behavior. 2nd edn. New York, NY: Guilford Press; 2002.
  42. Miller WR, Rollnick S. Motivational Interviewing: Helping People Change. 3rd edn. New York, NY: Guilford Press; 2012.
  43. Lundahl B, Moleni T, Burke BL, Butters R, Tollefson D, Butler C, Rollnick S. Motivational interviewing in medical care settings: a systematic review and meta-analysis of randomized controlled trials. Patient Educ Couns 2013;93:157–68. https://doi.org/10.1016/j.pec.2013.07.012 doi: 10.1016/j.pec.2013.07.012. [DOI] [PubMed]
  44. Burke BL, Arkowitz H, Menchola M. The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. J Consult Clin Psychol 2003;71:843–61. https://doi.org/10.1037/0022-006X.71.5.843 doi: 10.1037/0022-006X.71.5.843. [DOI] [PubMed]
  45. Rubak S, Sandbaek A, Lauritzen T, Christensen B. Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract 2005;55:305–12. [PMC free article] [PubMed]
  46. VanBuskirk KA, Wetherell JL. Motivational interviewing with primary care populations: a systematic review and meta-analysis. J Behav Med 2014;37:768–80. https://doi.org/10.1007/s10865-013-9527-4 doi: 10.1007/s10865-013-9527-4. [DOI] [PMC free article] [PubMed]
  47. Lee WW, Choi KC, Yum RW, Yu DS, Chair SY. Effectiveness of motivational interviewing on lifestyle modification and health outcomes of clients at risk or diagnosed with cardiovascular diseases: a systematic review. Int J Nurs Stud 2016;53:331–41. https://doi.org/10.1016/j.ijnurstu.2015.09.010 doi: 10.1016/j.ijnurstu.2015.09.010. [DOI] [PubMed]
  48. Jansink R, Braspenning J, Keizer E, van der Weijden T, Elwyn G, Grol R. No identifiable Hb1Ac or lifestyle change after a comprehensive diabetes programme including motivational interviewing: a cluster randomised trial. Scand J Prim Health Care 2013;31:119–27. https://doi.org/10.3109/02813432.2013.797178 doi: 10.3109/02813432.2013.797178. [DOI] [PMC free article] [PubMed]
  49. Hardcastle SJ, Taylor AH, Bailey MP, Harley RA, Hagger MS. Effectiveness of a motivational interviewing intervention on weight loss, physical activity and cardiovascular disease risk factors: a randomised controlled trial with a 12-month post-intervention follow-up. Int J Behav Nutr Phys Act 2013;10:40. https://doi.org/10.1186/1479-5868-10-40 doi: 10.1186/1479-5868-10-40. [DOI] [PMC free article] [PubMed]
  50. Baker MK, Simpson K, Lloyd B, Bauman AE, Singh MA. Behavioral strategies in diabetes prevention programs: a systematic review of randomized controlled trials. Diabetes Res Clin Pract 2011;91:1–12. https://doi.org/10.1016/j.diabres.2010.06.030 doi: 10.1016/j.diabres.2010.06.030. [DOI] [PubMed]
  51. Ebrahim S, Taylor F, Ward K, Beswick A, Burke M, Davey Smith G. Multiple risk factor interventions for primary prevention of coronary heart disease. Cochrane Database Syst Rev 2011;1:CD001561. https://doi.org/10.1002/14651858.CD001561.pub3 doi: 10.1002/14651858.CD001561.pub3. [DOI] [PubMed]
  52. Greaves CJ, Sheppard KE, Abraham C, Hardeman W, Roden M, Evans PH, et al. Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health 2011;11:119. https://doi.org/10.1186/1471-2458-11-119 doi: 10.1186/1471-2458-11-119. [DOI] [PMC free article] [PubMed]
  53. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process 1991;50:179–211. https://doi.org/10.1016/0749-5978(91)90020-T doi: 10.1016/0749-5978(91)90020-T. [DOI]
  54. Abraham C, Michie S. A taxonomy of behavior change techniques used in interventions. Health Psychol 2008;27:379–87. https://doi.org/10.1037/0278-6133.27.3.379 doi: 10.1037/0278-6133.27.3.379. [DOI] [PubMed]
  55. Greaves C, Gillison F, Stathi A, Bennett P, Reddy P, Dunbar J, et al. Waste the waist: a pilot randomised controlled trial of a primary care based intervention to support lifestyle change in people with high cardiovascular risk. Int J Behav Nutr Phys Act 2015;12:1. https://doi.org/10.1186/s12966-014-0159-z doi: 10.1186/s12966-014-0159-z. [DOI] [PMC free article] [PubMed]
  56. Renjilian DA, Perri MG, Nezu AM, McKelvey WF, Shermer RL, Anton SD. Individual versus group therapy for obesity: effects of matching participants to their treatment preferences. J Consult Clin Psychol 2001;69:717–21. https://doi.org/10.1037/0022-006X.69.4.717 doi: 10.1037/0022-006X.69.4.717. [DOI] [PubMed]
  57. Kozica SL, Lombard CB, Ilic D, Ng S, Harrison CL, Teede HJ. Acceptability of delivery modes for lifestyle advice in a large scale randomised controlled obesity prevention trial. BMC Public Health 2015;15:699. https://doi.org/10.1186/s12889-015-1995-8 doi: 10.1186/s12889-015-1995-8. [DOI] [PMC free article] [PubMed]
  58. Després JP, Poirier P. Diabetes: Looking back at Look AHEAD – giving lifestyle a chance. Nat Rev Cardiol 2013;10:184–6. https://doi.org/10.1038/nrcardio.2013.16 doi: 10.1038/nrcardio.2013.16. [DOI] [PubMed]
  59. Ismail K, Lawrence-Smith G, Cheah Y, Winkley K, Yadav R, Thomas S, et al. Motivational enhancement therapy with and without cognitive-behavioural therapy to treat type 1 diabetes: the long-term outcomes of a randomised controlled trial. Diabetologia 2009;52:S14-S.
  60. Ridge K, Bartlett J, Cheah Y, Thomas S, Lawrence-Smith G, Winkley K, Ismail K. Do the effects of psychological treatments on improving glycemic control in type 1 diabetes persist over time? A long-term follow-up of a randomized controlled trial. Psychosom Med 2012;74:319–23. https://doi.org/10.1097/PSY.0b013e31824c181b doi: 10.1097/PSY.0b013e31824c181b. [DOI] [PubMed]
  61. Ismail K, Maissi E, Thomas S, Chalder T, Schmidt U, Bartlett J, et al. A randomised controlled trial of cognitive–behavioural therapy and motivational interviewing for people with Type 1 diabetes mellitus with persistent sub-optimal glycaemic control: a Diabetes and Psychological Therapies (ADaPT) study. Health Technol Assess 2010;14(22). https://doi.org/10.3310/hta14220 doi: 10.3310/hta14220. [DOI] [PubMed]
  62. Anton RF, O’Malley SS, Ciraulo DA, Cisler RA, Couper D, Donovan DM, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA 2006;295:2003–17. https://doi.org/10.1001/jama.295.17.2003 doi: 10.1001/jama.295.17.2003. [DOI] [PubMed]
  63. Department of Health and Social Care (DHSC). Choosing Health: Making Healthy Choices Easier. London: DHSC; 2004.
  64. South J, Woodward J, Lowcock D. New beginnings: stakeholder perspectives on the role of health trainers. J R Soc Promot Health 2007;127:224–30. https://doi.org/10.1177/1466424007081791 doi: 10.1177/1466424007081791. [DOI] [PubMed]
  65. Lhussier M, Carr SM. Health-related lifestyle advice: critical insights. Crit Public Health 2008;18:299–309. https://doi.org/10.1080/09581590802225738 doi: 10.1080/09581590802225738. [DOI]
  66. Visram S, Carr SM, Geddes L. Can lay health trainers increase uptake of NHS Health Checks in hard-to-reach populations? A mixed-method pilot evaluation. J Public Health 2015;37:226–33. https://doi.org/10.1093/pubmed/fdu041 doi: 10.1093/pubmed/fdu041. [DOI] [PMC free article] [PubMed]
  67. Carr SM, Lhussier M, Forster N, Geddes L, Deane K, Pennington M, et al. An evidence synthesis of qualitative and quantitative research on component intervention techniques, effectiveness, cost-effectiveness, equity and acceptability of different versions of health-related lifestyle advisor role in improving health. Health Technol Assess 2011;15(9). https://doi.org/10.3310/hta15090 doi: 10.3310/hta15090. [DOI] [PMC free article] [PubMed]
  68. Attree P, Clayton S, Karunanithi S, Nayak S, Popay J, Read D. NHS health trainers: a review of emerging evaluation evidence. Crit Public Health 2012;22:25–38. https://doi.org/10.1080/09581596.2010.549207 doi: 10.1080/09581596.2010.549207. [DOI]
  69. Gidlow CJ, Cochrane T, Davey R, Beloe M, Chambers R, Kumar J, et al. One-year cardiovascular risk and quality of life changes in participants of a health trainer service. Perspect Public Health 2014;134:135–44. https://doi.org/10.1177/1757913913484419 doi: 10.1177/1757913913484419. [DOI] [PubMed]
  70. Bayley A, de Zoysa N, Cook DG, Whincup PH, Stahl D, Twist K, et al. Comparing the effectiveness of an enhanced MOtiVational intErviewing InTervention (MOVE IT) with usual care for reducing cardiovascular risk in high risk subjects: study protocol for a randomised controlled trial. Trials 2015;16:112. https://doi.org/10.1186/s13063-015-0593-5 doi: 10.1186/s13063-015-0593-5. [DOI] [PMC free article] [PubMed]
  71. Office for National Statistics (ONS). Census 2011. Newport ONS; 2011. URL: www.ons.gov.uk/census/2011censuspages/1b.asp (accessed 5 May 2017).
  72. Collins GS, Altman DG. Predicting the 10 year risk of cardiovascular disease in the United Kingdom: independent and external validation of an updated version of QRISK2. BMJ 2012;344:e4181. https://doi.org/10.1136/bmj.e4181 doi: 10.1136/bmj.e4181. [DOI] [PMC free article] [PubMed]
  73. Morgan PJ, Lubans DR, Collins CE, Warren JM, Callister R. The SHED-IT randomized controlled trial: evaluation of an internet-based weight-loss program for men. Obesity 2009;17:2025–32. https://doi.org/10.1038/oby.2009.85 doi: 10.1038/oby.2009.85. [DOI] [PubMed]
  74. Rose G. Sick individuals and sick populations. Int J Epidemiol 2001;30:427–32. https://doi.org/10.1093/ije/30.3.427 doi: 10.1093/ije/30.3.427. [DOI] [PubMed]
  75. Batistatou E, Roberts C, Roberts S. Sample size and power calculations for trials and quasi-experimental studies with clustering. Stata J 2014;14:159–75. https://doi.org/10.1177/1536867X1401400111 doi: 10.1177/1536867X1401400111. [DOI]
  76. Ministry of Housing, Communities and Local Government. English Indices of Deprivation 2010. GOV.UK; 2011. URL: www.gov.uk/government/statistics/english-indices-of-deprivation-2010 (accessed 1 November 2017).
  77. Noble M, Wright G, Smith G, Dibben C. Measuring multiple deprivation at the small-area level. Environ Plann A 2006;38:169–85. https://doi.org/10.1068/a37168 doi: 10.1068/a37168. [DOI]
  78. Davis TC, Crouch MA, Long SW, Jackson RH, Bates P, George RB, Bairnsfather LE. Rapid assessment of literacy levels of adult primary care patients. Fam Med 1991;23:433–5. [PubMed]
  79. Plasqui G, Westerterp KR. Physical activity assessment with accelerometers: an evaluation against doubly labeled water. Obesity 2007;15:2371–9. https://doi.org/10.1038/oby.2007.281 doi: 10.1038/oby.2007.281. [DOI] [PubMed]
  80. Mâsse LC, Fuemmeler BF, Anderson CB, Matthews CE, Trost SG, Catellier DJ, Treuth M. Accelerometer data reduction: a comparison of four reduction algorithms on select outcome variables. Med Sci Sports Exerc 2005;37(Suppl. 11):544–54. https://doi.org/10.1249/01.mss.0000185674.09066.8a doi: 10.1249/01.mss.0000185674.09066.8a. [DOI] [PubMed]
  81. Armstrong T, Bull F. Development of the world health organization global physical activity questionnaire (GPAQ). J Public Health-UK 2006;14:66–70. https://doi.org/10.1007/s10389-006-0024-x doi: 10.1007/s10389-006-0024-x. [DOI]
  82. Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption – II. Addiction 1993;88:791–804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x doi: 10.1111/j.1360-0443.1993.tb02093.x. [DOI] [PubMed]
  83. Nelson M, Haraldsdóttir J. Food photographs: practical guidelines I. Design and analysis of studies to validate portion size estimates. Public Health Nutr 1998;1:219–30. https://doi.org/10.1079/PHN19980038 doi: 10.1079/PHN19980038. [DOI] [PubMed]
  84. Welch AA, Luben R, Khaw KT, Bingham SA. The CAFE computer program for nutritional analysis of the EPIC-Norfolk food frequency questionnaire and identification of extreme nutrient values. J Hum Nutr Diet 2005;18:99–116. https://doi.org/10.1111/j.1365-277X.2005.00593.x doi: 10.1111/j.1365-277X.2005.00593.x. [DOI] [PubMed]
  85. Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA 1999;282:1737–44. https://doi.org/10.1001/jama.282.18.1737 doi: 10.1001/jama.282.18.1737. [DOI] [PubMed]
  86. Frasure-Smith N, Lespérance F, Talajic M. Depression following myocardial infarction. Impact on 6-month survival. JAMA 1993;270:1819–25. https://doi.org/10.1001/jama.1993.03510150053029 doi: 10.1001/jama.1993.03510150053029. [DOI] [PubMed]
  87. Broadbent E, Petrie KJ, Main J, Weinman J. The Brief Illness Perception Questionnaire. J Psychosom Res 2006;60:631–7. https://doi.org/10.1016/j.jpsychores.2005.10.020 doi: 10.1016/j.jpsychores.2005.10.020. [DOI] [PubMed]
  88. Resnick B, Jenkins LS. Testing the reliability and validity of the Self-Efficacy for Exercise scale. Nurs Res 2000;49:154–9. https://doi.org/10.1097/00006199-200005000-00007 doi: 10.1097/00006199-200005000-00007. [DOI] [PubMed]
  89. Rabin R, Gudex C, Selai C, Herdman M. From translation to version management: a history and review of methods for the cultural adaptation of the EuroQol five-dimensional questionnaire. Value Health 2014;17:70–6. https://doi.org/10.1016/j.jval.2013.10.006 doi: 10.1016/j.jval.2013.10.006. [DOI] [PubMed]
  90. Chisholm D, Knapp MRJ, Knudsen HC, Amaddeo F, Gaite L, Van Wijngaarden B. Client Socio-Demographic and Service Receipt Inventory-European Version: development of an instrument for international research. Br J Psychiatry 2000;177:s28–33. https://doi.org/10.1192/bjp.177.39.s28 doi: 10.1192/bjp.177.39.s28. [DOI] [PubMed]
  91. Hobbis ICA, Sutton S. Are techniques used in cognitive–behavioural therapy applicable to behaviour change interventions based on the theory of planned behaviour? J Health Psychol 2005;10:7–18. https://doi.org/10.1177/1359105305048549 doi: 10.1177/1359105305048549. [DOI] [PubMed]
  92. Bandura A. Social Foundation of Thought and Action: A Social Cognitive Theory. Prentice-Hall, Inc: Englewood Cliffs, NJ; 1986.
  93. Varley R, Webb TL, Sheeran P. Making self-help more helpful: a randomized controlled trial of the impact of augmenting self-help materials with implementation intentions on promoting the effective self-management of anxiety symptoms. J Consult Clin Psychol 2011;79:123–8. https://doi.org/10.1037/a0021889 doi: 10.1037/a0021889. [DOI] [PubMed]
  94. Miller WR, Moyers TB, Arciniega L, Ernst D, Forcehimes A. Training, supervision and quality monitoring of the COMBINE Study behavioral interventions. J Stud Alcohol Suppl 2005;15:188–95. https://doi.org/10.15288/jsas.2005.s15.188 doi: 10.15288/jsas.2005.s15.188. [DOI] [PubMed]
  95. Michie S, Churchill S, West R. Indentifying evidence-based competencies required to deliver behavioural support for smoking cessation. Ann Behav Med 2011;41:59–70. https://doi.org/10.1007/s12160-010-9235-z doi: 10.1007/s12160-010-9235-z. [DOI] [PubMed]
  96. Dixon D, Johnston M. Health Behaviour Change Competency Framework: Competences to Deliver Interventions to Change Lifestyle Behaviours that Affect Health. NHS Health Scotland; 2010. URL: www.healthscotland.com/uploads/documents/14543-HBCC_framework1.pdf (accessed 21 July 2017).
  97. Moyers TB, Martin T, Manuel JK, Miller W, Ernst D. Revised Global Scales: Motivational Interviewing Treatment Integrity 3.1.1 (MITI 3.1.1). 2010. URL: https://casaa.unm.edu/download/miti3_1.pdf (accessed 1 November 2017).
  98. Williams A. The Role of the EuroQol Instrument in QALY Calculations. York: University of York Centre for Health Economics; 1995.
  99. Beecham J, Knapp M. Costing Psychiatric Interventions: London: Gaskell; 2001.
  100. Curtis L. Unit Costs of Health and Social Care. Canterbury: Personal Social Services Research Unit, University of Kent; 2012.
  101. Campbell MK, Elbourne DR, Altman DG, CONSORT group. CONSORT statement: extension to cluster randomised trials. BMJ 2004;328:702–8. https://doi.org/10.1136/bmj.328.7441.702 doi: 10.1136/bmj.328.7441.702. [DOI] [PMC free article] [PubMed]
  102. Bauer DJ, Sterba SK, Hallfors DD. Evaluating group-based interventions when control participants are ungrouped. Multivariate Behav Res 2008;43:210–36. https://doi.org/10.1080/00273170802034810 doi: 10.1080/00273170802034810. [DOI] [PMC free article] [PubMed]
  103. Schafer JL. Analysis of Incomplete Multivariate Data. CRC Press: Boca Raton, FL; 1997. https://doi.org/10.1201/9781439821862 doi: 10.1201/9781439821862. [DOI]
  104. Gaughran F, Stahl D, Ismail K, Greenwood K, Atakan Z, Gardner-Sood P, et al. Randomised control trial of the effectiveness of an integrated psychosocial health promotion intervention aimed at improving health and reducing substance use in established psychosis (IMPaCT). BMC Psychiatry 2017;17:413. https://doi.org/10.1186/s12888-017-1571-0 doi: 10.1186/s12888-017-1571-0. [DOI] [PMC free article] [PubMed]
  105. Ismail K, Winkley K, De Zoysa N, Patel A, Heslin M, Graves H, et al. Nurse-led psychological intervention for type 2 diabetes: a cluster randomised controlled trial (Diabetes-6 study) in primary care. Br J Gen Pract 2018;68:e531–e540. https://doi.org/10.3399/bjgp18X696185 doi: 10.3399/bjgp18X696185. [DOI] [PMC free article] [PubMed]
  106. Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, et al. Weight loss, exercise, or both and physical function in obese older adults. Obstet Gynecol Surv 2011;66:488–9. https://doi.org/10.1097/OGX.0b013e3182352181 doi: 10.1097/OGX.0b013e3182352181. [DOI] [PMC free article] [PubMed]
  107. Herbert A, Wijlaars L, Zylbersztejn A, Cromwell D, Hardelid P. Data resource profile: Hospital Episode Statistics Admitted Patient Care (HES APC). Int J Epidemiol 2017;46:1093–1093i. https://doi.org/10.1093/ije/dyx015 doi: 10.1093/ije/dyx015. [DOI] [PMC free article] [PubMed]
  108. Public Health England. National General Practice Profiles. London: Public Health England; 2016. URL: https://fingertips.phe.org.uk/profile/general-practice (accessed 21 July 2017).
  109. Stuart-Buttle C, Read J, Sanderson H, Sutton Y. A language of health in action: Read codes, classifications and groupings. Proc AMIA Annu Fall Symp 1996:75–9. [PMC free article] [PubMed]
  110. Ismail K, Bayley A, Twist K, Stewart K, Ridge K, Britneff E, et al. Reducing weight and increasing physical activity in people at high risk of cardiovascular disease: a randomised controlled trial comparing the effectiveness of enhanced motivational interviewing intervention with usual care [published online ahead of print December 12 2019]. Heart 2019. https://doi.org/10.1136/heartjnl-2019-315656 doi: 10.1136/heartjnl-2019-315656. [DOI] [PMC free article] [PubMed]
  111. Ministry of Housing, Communities and Local Government. English Indices of Deprivation 2015. GOV.UK; 2015. URL: www.gov.uk/government/statistics/english-indices-of-deprivation-2015 (accessed 1 November 2017).
  112. Rogers A, Harris T, Victor C, Woodcock A, Limb E, Kerry S, et al. Which older people decline participation in a primary care trial of physical activity and why: insights from a mixed methods approach. BMC Geriatr 2014;14:46. https://doi.org/10.1186/1471-2318-14-46 doi: 10.1186/1471-2318-14-46. [DOI] [PMC free article] [PubMed]
  113. Tully MA, Cupples ME, Chan WS, McGlade K, Young IS. Brisk walking, fitness, and cardiovascular risk: a randomized controlled trial in primary care. Prev Med 2005;41:622–8. https://doi.org/10.1016/j.ypmed.2004.11.030 doi: 10.1016/j.ypmed.2004.11.030. [DOI] [PubMed]
  114. Foster CE, Brennan G, Matthews A, McAdam C, Fitzsimons C, Mutrie N. Recruiting participants to walking intervention studies: a systematic review. Int J Behav Nutr Phys Act 2011;8:137. https://doi.org/10.1186/1479-5868-8-137 doi: 10.1186/1479-5868-8-137. [DOI] [PMC free article] [PubMed]
  115. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Executive summary: heart disease and stroke statistics – 2014 update: a report from the American Heart Association. Circulation 2014;129:399–410. https://doi.org/10.1161/01.cir.0000442015.53336.12 doi: 10.1161/01.cir.0000442015.53336.12. [DOI] [PubMed]
  116. Ives DG, Traven ND, Kuller LH, Schulz R. Selection bias and nonresponse to health promotion in older adults. Epidemiology 1994;5:456–61. https://doi.org/10.1097/00001648-199407000-00013 doi: 10.1097/00001648-199407000-00013. [DOI] [PubMed]
  117. Harris TJ, Victor CR, Carey IM, Adams R, Cook DG. Less healthy, but more active: opposing selection biases when recruiting older people to a physical activity study through primary care. BMC Public Health 2008;8:182. https://doi.org/10.1186/1471-2458-8-182 doi: 10.1186/1471-2458-8-182. [DOI] [PMC free article] [PubMed]
  118. Groeneveld IF, Proper KI, van der Beek AJ, Hildebrandt VH, van Mechelen W. Factors associated with non-participation and drop-out in a lifestyle intervention for workers with an elevated risk of cardiovascular disease. Int J Behav Nutr Phys Act 2009;6:80. https://doi.org/10.1186/1479-5868-6-80 doi: 10.1186/1479-5868-6-80. [DOI] [PMC free article] [PubMed]
  119. van Heuvelen MJ, Hochstenbach JB, Brouwer WH, de Greef MH, Zijlstra GA, van Jaarsveld E, et al. Differences between participants and non-participants in an RCT on physical activity and psychological interventions for older persons. Aging Clin Exp Res 2005;17:236–45. https://doi.org/10.1007/BF03324603 doi: 10.1007/BF03324603. [DOI] [PubMed]
  120. Golomb BA, Chan VT, Evans MA, Koperski S, White HL, Criqui MH. The older the better: are elderly study participants more non-representative? A cross-sectional analysis of clinical trial and observational study samples. BMJ Open 2012;2:e000833. https://doi.org/10.1136/bmjopen-2012-000833 doi: 10.1136/bmjopen-2012-000833. [DOI] [PMC free article] [PubMed]
  121. Forsberg L, Berman AH, Kallmén H, Hermansson U, Helgason AR. A test of the validity of the Motivational Interviewing Treatment Integrity code. Cogn Behav Ther 2008;37:183–91. https://doi.org/10.1080/16506070802091171 doi: 10.1080/16506070802091171. [DOI] [PubMed]
  122. Martin T, Christopher PJ, Houck JM, Moyers TB. The structure of client language and drinking outcomes in project match. Psychol Addict Behav 2011;25:439–45. https://doi.org/10.1037/a0023129 doi: 10.1037/a0023129. [DOI] [PMC free article] [PubMed]
  123. Moyers TB, Martin T, Manuel JK, Hendrickson SM, Miller WR. Assessing competence in the use of motivational interviewing. J Subst Abuse Treat 2005;28:19–26. https://doi.org/10.1016/j.jsat.2004.11.001 doi: 10.1016/j.jsat.2004.11.001. [DOI] [PubMed]
  124. Cicchetti DV, Sparrow SA. Developing criteria for establishing interrater reliability of specific items: applications to assessment of adaptive behavior. Am J Ment Defic 1981;86:127–37. [PubMed]
  125. Oakley A, Strange V, Bonell C, Allen E, Stephenson J, RIPPLE Study Team. Process evaluation in randomised controlled trials of complex interventions. BMJ 2006;332:413–16. https://doi.org/10.1136/bmj.332.7538.413 doi: 10.1136/bmj.332.7538.413. [DOI] [PMC free article] [PubMed]
  126. Lewin S, Glenton C, Oxman AD. Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. BMJ 2009;339:b3496. https://doi.org/10.1136/bmj.b3496 doi: 10.1136/bmj.b3496. [DOI] [PMC free article] [PubMed]
  127. Hotham ED, Atkinson ER, Gilbert AL. Focus groups with pregnant smokers: barriers to cessation, attitudes to nicotine patch use and perceptions of cessation counselling by care providers. Drug Alcohol Rev 2002;21:163–8. https://doi.org/10.1080/09595230220139064 doi: 10.1080/09595230220139064. [DOI] [PubMed]
  128. Paterson C, Zheng Z, Xue C, Wang Y. ‘Playing their parts’: the experiences of participants in a randomized sham-controlled acupuncture trial. J Altern Complement Med 2008;14:199–208. https://doi.org/10.1089/acm.2007.0682 doi: 10.1089/acm.2007.0682. [DOI] [PubMed]
  129. Tonnon SC, Proper KI, van der Ploeg HP, Westerman MJ, Sijbesma E, van der Beek AJ. A qualitative study of the anticipated barriers and facilitators to the implementation of a lifestyle intervention in the Dutch construction industry. BMC Public Health 2014;14:1317. https://doi.org/10.1186/1471-2458-14-1317 doi: 10.1186/1471-2458-14-1317. [DOI] [PMC free article] [PubMed]
  130. Zhang X, Devlin HM, Smith B, Imperatore G, Thomas W, Lobelo F, et al. Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: a systematic review and meta-analysis. PLOS ONE 2017;12:e0176436. https://doi.org/10.1371/journal.pone.0176436 doi: 10.1371/journal.pone.0176436. [DOI] [PMC free article] [PubMed]
  131. Britt E, Hudson SM, Blampied NM. Motivational interviewing in health settings: a review. Patient Educ Couns 2004;53:147–55. https://doi.org/10.1016/S0738-3991(03)00141-1 doi: 10.1016/S0738-3991(03)00141-1. [DOI] [PubMed]
  132. Burke BL, Dunn CW, Atkins DC, Phelps JS. The emerging evidence base for motivational interviewing: a meta-analytic and qualitative inquiry. J Cogn Psychother 2004;18:309–22. https://doi.org/10.1891/jcop.18.4.309.64002 doi: 10.1891/jcop.18.4.309.64002. [DOI]
  133. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3:77–101. https://doi.org/10.1191/1478088706qp063oa doi: 10.1191/1478088706qp063oa. [DOI]
  134. Miller WR, Moyers TB. Eight stages in learning motivational interviewing. J Teaching Addict 2006;5:3–17. https://doi.org/10.1300/J188v05n01_02 doi: 10.1300/J188v05n01_02. [DOI]
  135. Madson MB, Loignon AC, Lane C. Training in motivational interviewing: a systematic review. J Subst Abuse Treat 2009;36:101–9. https://doi.org/10.1016/j.jsat.2008.05.005 doi: 10.1016/j.jsat.2008.05.005. [DOI] [PubMed]
  136. Brobeck E, Bergh H, Odencrants S, Hildingh C. Primary healthcare nurses’ experiences with motivational interviewing in health promotion practice. J Clin Nurs 2011;20:3322–30. https://doi.org/10.1111/j.1365-2702.2011.03874.x doi: 10.1111/j.1365-2702.2011.03874.x. [DOI] [PubMed]
  137. Östlund AS, Wadensten B, Kristofferzon ML, Häggström E. Motivational interviewing: experiences of primary care nurses trained in the method. Nurse Educ Pract 2015;15:111–18. https://doi.org/10.1016/j.nepr.2014.11.005 doi: 10.1016/j.nepr.2014.11.005. [DOI] [PubMed]
  138. van Eijk-Hustings YJ, Daemen L, Schaper NC, Vrijhoef HJ. Implementation of Motivational Interviewing in a diabetes care management initiative in the Netherlands. Patient Educ Couns 2011;84:10–15. https://doi.org/10.1016/j.pec.2010.06.016 doi: 10.1016/j.pec.2010.06.016. [DOI] [PubMed]
  139. Hirdle J, Vaughan T. Exploring the impact of motivational interviewing training for qualified health visitors. Community Pract 2016;89:38–42. [PubMed]
  140. Maissi E, Ridge K, Treasure J, Chalder T, Roche S, Bartlett J, et al. Nurse-led psychological interventions to improve diabetes control: assessing competencies. Patient Educ Couns 2011;84:e37–43. https://doi.org/10.1016/j.pec.2010.07.036 doi: 10.1016/j.pec.2010.07.036. [DOI] [PubMed]
  141. Graves H, Garrett C, Amiel SA, Ismail K, Winkley K. Psychological skills training to support diabetes self-management: qualitative assessment of nurses’ experiences. Prim Care Diabetes 2016;10:376–82. https://doi.org/10.1016/j.pcd.2016.03.001 doi: 10.1016/j.pcd.2016.03.001. [DOI] [PubMed]
  142. Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ 2015;350:h1258. https://doi.org/10.1136/bmj.h1258 doi: 10.1136/bmj.h1258. [DOI] [PMC free article] [PubMed]
  143. Schrack JA, Cooper R, Koster A, Shiroma EJ, Murabito JM, Rejeski WJ, et al. Assessing daily physical activity in older adults: unraveling the complexity of monitors, measures, and methods. J Gerontol A Biol Sci Med Sci 2016;71:1039–48. https://doi.org/10.1093/gerona/glw026 doi: 10.1093/gerona/glw026. [DOI] [PMC free article] [PubMed]
  144. Roth MA, Mindell JS. Who provides accelerometry data? Correlates of adherence to wearing an accelerometry motion sensor: the 2008 Health Survey for England. J Phys Act Health 2013;10:70–8. https://doi.org/10.1123/jpah.10.1.70 doi: 10.1123/jpah.10.1.70. [DOI] [PubMed]
  145. Hart TL, Swartz AM, Cashin SE, Strath SJ. How many days of monitoring predict physical activity and sedentary behaviour in older adults? Int J Behav Nutr Phys Act 2011;8:62. https://doi.org/10.1186/1479-5868-8-62 doi: 10.1186/1479-5868-8-62. [DOI] [PMC free article] [PubMed]
  146. British Heart Foundation. CVD Statistics – BHF UK Factsheet. 2018. URL: www.bhf.org.uk/what-we-do/our-research/heart-statistics (accessed 1 November 2017).
  147. Goldberg RW, Seybolt DC, Lehman A. Reliable self-report of health service use by individuals with serious mental illness. Psychiatr Serv 2002;53:879–81. https://doi.org/10.1176/appi.ps.53.7.879 doi: 10.1176/appi.ps.53.7.879. [DOI] [PubMed]
  148. Calsyn RJ, Allen G, Morse GA, Smith R, Tempelhoff B. Can you trust self-report data provided by homeless mentally ill individuals? Eval Rev 1993;17:353–66. https://doi.org/10.1177/0193841X9301700306 doi: 10.1177/0193841X9301700306. [DOI]
  149. van Staa TP, Gulliford M, Ng ES, Goldacre B, Smeeth L. Prediction of cardiovascular risk using Framingham, ASSIGN and QRISK2: how well do they predict individual rather than population risk? PLOS ONE 2014;9:e106455. https://doi.org/10.1371/journal.pone.0106455 doi: 10.1371/journal.pone.0106455. [DOI] [PMC free article] [PubMed]
  150. Tudor-Locke C, Bassett DR. How many steps/day are enough? Sports Med 2004;34:1–8. https://doi.org/10.2165/00007256-200434010-00001 doi: 10.2165/00007256-200434010-00001. [DOI] [PubMed]
  151. Hobbs N, Godfrey A, Lara J, Errington L, Meyer TD, Rochester L, et al. Are behavioral interventions effective in increasing physical activity at 12 to 36 months in adults aged 55 to 70 years? A systematic review and meta-analysis. BMC Med 2013;11:75. https://doi.org/10.1186/1741-7015-11-75 doi: 10.1186/1741-7015-11-75. [DOI] [PMC free article] [PubMed]
  152. Bakrania K, Yates T, Edwardson CL, Bodicoat DH, Esliger DW, Gill JM, et al. Associations of moderate-to-vigorous-intensity physical activity and body mass index with glycated haemoglobin within the general population: a cross-sectional analysis of the 2008 Health Survey for England. BMJ Open 2017;7:e014456. https://doi.org/10.1136/bmjopen-2016-014456 doi: 10.1136/bmjopen-2016-014456. [DOI] [PMC free article] [PubMed]
  153. Pedišić Ž, Bauman A. Accelerometer-based measures in physical activity surveillance: current practices and issues. Br J Sports Med 2015;49:219–23. https://doi.org/10.1136/bjsports-2013-093407 doi: 10.1136/bjsports-2013-093407. [DOI] [PubMed]
  154. Hankonen N, Sutton S, Prevost AT, Simmons RK, Griffin SJ, Kinmonth AL, Hardeman W. Which behavior change techniques are associated with changes in physical activity, diet and body mass index in people with recently diagnosed diabetes? Ann Behav Med 2015;49:7–17. https://doi.org/10.1007/s12160-014-9624-9 doi: 10.1007/s12160-014-9624-9. [DOI] [PMC free article] [PubMed]
  155. Bauman A, Pedišić Ž, Bragg K. Objective Measurement in Physical Activity Surveillance: Present Role and Future Potential. In Shephard RJ, Tudor-Locke C, editors. The Objective Monitoring of Physical Activity: Contributions of Accelerometry to Epidemiology, Exercise Science and Rehabilitation. Berlin: Springer; 2016. pp. 347–67. https://doi.org/10.1007/978-3-319-29577-0_13 doi: 10.1007/978-3-319-29577-0_13. [DOI]
  156. Paul L, Brewster S, Wyke S, McFadyen AK, Sattar N, Gill JM, et al. Increasing physical activity in older adults using STARFISH, an interactive smartphone application (app); a pilot study. J Rehabil Assist Technol Eng 2017;4:2055668317696236. https://doi.org/10.1177/2055668317696236 doi: 10.1177/2055668317696236. [DOI] [PMC free article] [PubMed]
  157. Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 1997;20:537–44. https://doi.org/10.2337/diacare.20.4.537 doi: 10.2337/diacare.20.4.537. [DOI] [PubMed]
  158. Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344:1343–50. https://doi.org/10.1056/NEJM200105033441801 doi: 10.1056/NEJM200105033441801. [DOI] [PubMed]
  159. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393403. doi: 10.1056/NEJMoa012512. [DOI] [PMC free article] [PubMed]
  160. Ahern AL, Wheeler GM, Aveyard P, Boyland EJ, Halford JCG, Mander AP, et al. Extended and standard duration weight-loss programme referrals for adults in primary care (WRAP): a randomised controlled trial. Lancet 2017;389:2214–25. https://doi.org/10.1016/S0140-6736(17)30647-5 doi: 10.1016/S0140-6736(17)30647-5. [DOI] [PMC free article] [PubMed]
  161. Lean ME, Leslie WS, Barnes AC, Brosnahan N, Thom G, McCombie L, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet 2018;391:541–51. https://doi.org/10.1016/S0140-6736(17)33102-1 doi: 10.1016/S0140-6736(17)33102-1. [DOI] [PubMed]
  162. Welch G, Zagarins SE, Feinberg RG, Garb JL. Motivational interviewing delivered by diabetes educators: does it improve blood glucose control among poorly controlled type 2 diabetes patients? Diabetes Res Clin Pr 2011;91:54–60. https://doi.org/10.1016/j.diabres.2010.09.036 doi: 10.1016/j.diabres.2010.09.036. [DOI] [PMC free article] [PubMed]
  163. Waker CL. The Effects of Motivational Interviewing on Diabetes Self-Management Behaviors and Glycemic Control in Type 2 Diabetes: A Translational Study. Cincinnati, OH: University of Cincinnati; 2012.
  164. Harris T, Kerry SM, Limb ES, Furness C, Wahlich C, Victor CR, et al. Physical activity levels in adults and older adults 3-4 years after pedometer-based walking interventions: long-term follow-up of participants from two randomised controlled trials in UK primary care. PLOS Med 2018;15:e1002526. https://doi.org/10.1371/journal.pmed.1002526 doi: 10.1371/journal.pmed.1002526. [DOI] [PMC free article] [PubMed]
  165. Ingersoll K. Rating the fidelity of MI groups sessions: the AMIGOS coding system, bridging the gap between MI practice, evaluation and research. Fourth International Conference on Motivational Interviewing, Amsterdam, 16–18 June 2014, abstract no. 167.

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