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Effectiveness of small-group interactive education versus lecture-based information-only programs on motivation to change and lifestyle behaviours. A prospective controlled trial of rehabilitation inpatients [with consumer summary]
Reusch A, Strobl V, Ellgring H, Faller H
Patient Education and Counseling 2011 Feb;82(2):186-192
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: Although patient education may promote motivation to change health behaviours, the most effective method has not yet been determined. METHODS: This prospective, controlled trial compared an interactive, patient-oriented group program with lectures providing only information. We evaluated motivational stages of change and self-reported behaviours in three domains (sports, diet, relaxation) at four times up to one year (60% complete data) among 753 German rehabilitation inpatients (mean age 50 years, 52% male) with orthopaedic (59%) or cardiologic disorders (10%) or diabetes mellitus (31%). RESULTS: We found improvements between baseline and follow up regarding each outcome (p < 0.001) in both groups. At the end of rehabilitation, participants of the interactive group, as compared to the lectures, showed more advanced motivation regarding diet (p < 0.10) and sports (p = 0.006). Interactive group patients reported healthier diets both after 3 months (p = 0.013) and 12 months (p = 0.047), more relaxation behaviours (p = 0.029) after 3 months and higher motivation for sports after 12 months (p = 0.08). CONCLUSIONS: The superior effectiveness of the interactive group was only partly confirmed. PRACTICE IMPLICATIONS: This short, 5-session interactive program may not be superior to lectures to induce major sustainable changes in motivation.
With permission from Excerpta Medica Inc.

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