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S. Wong1, L. Hassett1,2, S. O'Rourke1, C. Kirkham1, E. Ramsay1, C. Morris3, C. West1, A. Lewis4, C. Longden4, M. van de Berg3, A. Tiedemann1, C. Greaves5, C. Sherrington1
1Institute for Musculoskeletal Health, Sydney School of Public Health, The University of Sydney, Sydney, Australia, 2Discipline of Physiotherapy, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia, 3Clinical Rehabilitation, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia, 4Eastern Health, Melbourne, Australia, 5Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
Background: ComeBACK (Coaching and Exercise for Better Walking) is a three-arm pragmatic randomised controlled trial (n=600) evaluating the effectiveness of two interventions to enhance physical activity in people with self-reported walking difficulties. The interventions, conducted over 6 months, are a health coaching intervention delivered by a physiotherapist fortnightly over the telephone, with an initial physiotherapy assessment and access to technologies such as Fitbit activity monitors; and a texting intervention, where participants receive a single telephone-delivered health coaching session by a physiotherapist followed by unidirectional text messages 2-7 times per week with some personalisation and tailoring. A waitlist control group receives the texting intervention after a 6-month delay. All interventions include a personalised physical activity plan, shared with the participants’ General Practitioner, and access to paper-based and online resources.
Purpose: To explore participant impressions of the Coaching to ComeBACK and Texting to ComeBACK interventions to date.
Methods: A trial-specific questionnaire was used to explore participants’ impressions of the intervention as a whole, the separate intervention components, and barriers to participation in the program. The questionnaire was completed by the Coaching and Texting to ComeBACK groups at the end of the intervention period (6 months).
Results: To date, 182 trial participants have been randomised, with 62 into Coaching to ComeBACK, 59 into Texting to ComeBACK and 61 into Texting to ComeBACK Later groups. The average age is 69 years (SD9) and majority female (71%). Sixty-eight participants; 36 from Coaching to ComeBACK and 32 from Texting to ComeBACK, completed the impressions questionnaire and are included in this analysis.
A large percentage from both groups (86% from Coaching to ComeBACK and 66% from Texting to ComeBACK) would recommend the program they received, however the average rating was higher for Coaching to ComeBACK (8.3/10; range 4-10) compared to Texting to ComeBACK (6.6/10; range 0-10). The components of Coaching to ComeBACK that participants valued highly included the physiotherapy assessment (mean:8.3/10), physical activity plan (mean:8.4/10) and fortnightly health coaching calls (mean:9/10). For the Texting to ComeBACK package, the initial one-off phone call of tailored advice (mean:7.9/10), physical activity plan (mean:7.9/10) and text messages (mean:6.8/10) were the most highly rated. The website resources were rated lowest across both groups.
Barriers to participation were more commonly reported in the Texting to ComeBACK group (47% vs 29%) and included deterioration in health, increase in carer responsibilities, isolation and COVID-19, and an asynchrony between physical capacity and text message content. The Coaching to ComeBACK group also raised pain as a barrier to program participation. More participants in the Texting to ComeBACK group reported discussions with their General Practitioner about physical activity (44% vs 31%).
A large percentage from both groups (86% from Coaching to ComeBACK and 66% from Texting to ComeBACK) would recommend the program they received, however the average rating was higher for Coaching to ComeBACK (8.3/10; range 4-10) compared to Texting to ComeBACK (6.6/10; range 0-10). The components of Coaching to ComeBACK that participants valued highly included the physiotherapy assessment (mean:8.3/10), physical activity plan (mean:8.4/10) and fortnightly health coaching calls (mean:9/10). For the Texting to ComeBACK package, the initial one-off phone call of tailored advice (mean:7.9/10), physical activity plan (mean:7.9/10) and text messages (mean:6.8/10) were the most highly rated. The website resources were rated lowest across both groups.
Barriers to participation were more commonly reported in the Texting to ComeBACK group (47% vs 29%) and included deterioration in health, increase in carer responsibilities, isolation and COVID-19, and an asynchrony between physical capacity and text message content. The Coaching to ComeBACK group also raised pain as a barrier to program participation. More participants in the Texting to ComeBACK group reported discussions with their General Practitioner about physical activity (44% vs 31%).
Conclusion(s): These preliminary results from the ongoing ComeBACK trial suggest a coaching or a texting intervention to increase physical activity in adults with walking difficulties would be recommended. The benefit of the online platform warrants further evaluation.
Implications: Interventions involving health coaching and text messages to increase physical activity in adults with walking difficulties living in the community are well received by the majority of people.
Funding, acknowledgements: Siobhan Wong is an Institute for Musculoskeletal Health scholarship recipient. The project funded from the Australian NHMRC (APP 1145739).
Keywords: physical activity, health coaching, text messaging
Topic: Health promotion & wellbeing/healthy ageing/physical activity
Did this work require ethics approval? Yes
Institution: Sydney Local Health District
Committee: SLHD Ethics Committee
Ethics number: HREC/18/RPAH/315
All authors, affiliations and abstracts have been published as submitted.
