Changes in determinants of physical activity during interventions for adults with chronic diseases: systematic review and meta-analysis of randomised controlled trials

A better understanding of how interventions can increase the determinants of physical activity in adults with chronic diseases is needed to improve their efficacy. The present meta-analysis aims to assess the efficacy of behaviour change interventions in impacting determinants of physical activity in adults with chronic respiratory, metabolic, and/or cardiovascular disease. In addition, this review seeks to identify clinical and intervention characteristics associated to efficacy, including disease, mode of delivery, nature of operational constructs and behaviour change techniques (BCTs). The electronic bibliographic databases consulted were PubMed, PsycINFO, Web of Science and Open Grey. Studies involving adults (≥ 18 years) with chronic cardiovascular and/or respiratory and/or metabolic diseases were included. Only randomised control trials (RCT), explicitly targeting a change in determinants of behaviour and assessing one or several operational constructs pre- and post-intervention were included. The meta-analysis was conducted on 43 studies (202 effect sizes; N=15 361); the analyses revealed a medium effect of interventions on factors associated with motivation at the end of the intervention (d=0.5; 95% CI [0.283;0.716]; p < .001; k=43; 200 effect sizes) and 3 months or more after (d=0.69 (95% CI [0.038, 1.347]; p < .001; k=8; 30 effect sizes). The presence of the technique Framing/reframing led to a higher effect on determinants of physical activity (d=1.586; 95% CI [1.055;2.117]; p < .001; k=5; 16 effect sizes). Physical activity interventions are effective to change the determinants of physical activity and the presence of framing/reframing in the intervention content leads to higher effects.