Holsworth Research Initiative

Our research focusses on exercise, physical activity and rehabilitation.


Behaviour Change Interventions in Hospital Clinics

Insufficient physical activity is a widespread public health problem that is associated with a range of chronic diseases. Hospitals are increasingly being encouraged to broaden their perspective from curative care to incorporate integrated health promotion. Steve Barrett from Bendigo Health is working with A/Prof Steven Begg from the Holsworth Research Initiative at the La Trobe Rural Health School to investigate the effectiveness of integrated motivational interviewing and cognitive behaviour therapy  in changing physical activity behaviour.

How to stage successful physical activity interventions

At the March 2021 La Trobe Rural Health School research seminar, Steve Barrett presented on his work  developing an intervention that integrated motivational interviewing with cognitive behaviour therapy to help patients attending Bendigo Health orthopedic and general clinics improve their levels of physical activity. The intervention resulted in significant and cost-effective changes in physical activity in patients who self-selected into a randomised control trial for the research program.

As recruiting individuals via self-selection was unlikely to engage with ambivalent and disinterested individuals, Steve then liaised with consulting surgeons to instigate behaviour change contemplation in their patients. First he  identified factors influencing surgeons’ decision-making in undertaking health promotion activities. He used this research to inform a pathway to encourage surgeons to refer insufficiently physically active patients to a behaviour change intervention.  He found that the surgeon’s referral resulted in significant and maintained increases in physical activity in their patients.

Physical activity and behaviour change

Engaging people attending hospital clinics in behaviour change interventions results in maintained improvements in physical activity and other health-related outcomes. Steve found that:

  • engagement with practicing clinicians is essential in facilitating integrating preventive health interventions in routine care, and
  • understanding the clinicians’ perspectives and the co-design of simple referral pathways facilitates the integration of effective preventive health practice into standard care.

Steve will continue to research recommendations for clinicians and researchers to inform effective behaviour change interventions aimed at promoting health in ambulatory secondary care.

Steve’s research supports the Holsworth Research Initiative’s aim to:

address the global challenges of inactivity and chronic disease

Do you want to find out more?

Read the journal articles resulting from this study:

The effect of behaviour change interventions on changes in physical activity and anthropometrics in ambulatory hospital settings: a systematic review and meta-analysis. (2021).

A physical activity coaching intervention can improve and maintain physical activity and health-related outcomes in adult ambulatory hospital patients: the Healthy4U-2 randomised controlled trial. (2021)

Cost-effectiveness of telephone coaching for physically inactive ambulatory care hospital patients: economic evaluation alongside the Healthy4U randomised controlled trial (2019)

Surgeons and preventive health: a mixed methods study of current practice, beliefs and attitudes influencing health promotion activities amongst public hospital surgeons (2019).

Integrated motivational interviewing and cognitive behaviour therapy can increase physical activity and improve health of adult ambulatory care patients in a regional hospital: the Healthy4U randomised controlled trial. (2018)

Integrated motivational interviewing and cognitive behaviour therapy for lifestyle mediators of overweight and obesity in community-dwelling adults: a systematic review and meta-analyses (2018)