FRI0625-HPR Learning To Guide People with Rheumatoid Arthritis To Health-Enhancing Physical Activity Behavior: Physiotherapists' Knowledge, Beliefs and Behavior

BackgroundPhysiotherapists (PTs) are raised in a biomedical tradition. They promote health-enhancing physical activity (HEPA) in persons with RA mainly by providing information, instructions and follow-up of prescribed exercises. To facilitate maintained HEPA behavior, PTs in rheumatology need to integrate their knowledge on RA and exercise physiology with use of evidence-based behavior change techniques (BCTs). Detailed, theory-based studies of how PTs can integrate these competencies are scarce. To gain more knowledge on PTs learning in this aspect, we performed the present study as a substudy in a HEPA intervention in the Physical Activity in RA (PARA 2010) program.ObjectivesTo describe changes in PTs' knowledge, beliefs and behaviours assessed before, during and after a theory-based skills training course preparing them to guide persons with RA to HEPA within a one-year intervention trial.MethodsThis was a longitudinal case study performed within a one-year HEPA intervention for persons with RA, including circuit training at public gyms twice a week and 30 minutes daily free-living physical activity of moderate intensity, framed by 20 bi-weekly support group sessions led by a PT. Our participants were ten registered PTs leading 10 support groups with 5–10 persons each. To prepare the PTs for their task we gave a course based on Social Cognitive Theory (SCT) principles and structured use of BCTs, see Figure 1. Data were collected by questionnaire at five occasions; at baseline, three times during the course and once after the course, assessing knowledge on physical activity in RA (score 0–6), knowledge on BCTs (score 0–18), fear-avoidance beliefs about physical activity in RA (score 8–48), and self-efficacy to guide in behaviour change (score 9–54). The questionnaire had good face validity and good test-retest reliability with ICC 0.88–0.98 for the four variables. Data were also collected by a log book for self-reported use of BCTs during group sessions, dichotomised as adherence to the support group session protocol or not.ResultsPTs' knowledge on BCTs and their self-efficacy to guide in behaviour change increased significantly (Friedman's test, p