Qualitative analysis of intrinsic motivational indicators of high and low responders with disabilities to a tailored weight management program

Intrinsic motivational indicators are critical in predicting successful health behavior change. The purpose of this randomized controlled trial was to develop a 12-month telephone-based exercise and nutrition coaching intervention using motivational interviewing. Sixty-six overweight/obese adults (M age =47 yrs. + 13.6) with mobility disabilities (multiple sclerosis, spinal cord injury, spina bifida, cerebral palsy) were enrolled. Participants were primarily female (80%) and were randomized into one of three groups: (a) control group; (b) physical activity group (PEP); (c) physical activity plus nutrition group (PEP Plus). Based on level of engagement in goal setting and readiness to lose weight, participants were classified as high and low responders. High responders wore their pedometer at least 70% of the contact weeks and responded to at least 90% of telephone calls from their wellness coach. Low responders wore their pedometer less than 70% of the contact weeks and missed more than 10% of telephone calls from their wellness coach. Results indicated that 100% of high responders in the PEP group lost weight, with an average loss of 6.2%. 63% of low responders gained weight, with an average gain of 2.3%. In the PEP Plus group, 91% of high responders lost weight with an average loss of 6%. 75% of low responders gained weight, with an average gain of 1.1%. These results indicate the importance of evaluating predictors for behavior change and analyzing how modifications in knowledge, self-perception, attitude, and self-efficacy can alter value-based motivation and behavioral outcomes. Grant #R01/DD000134, Centers for Disease Control and Prevention