Barrier-belief lifestyle counseling in primary care: A randomized controlled trial of efficacy

Objective: Intervening on barrier beliefs (BBs) may inhibit the role of barriers as mediating factors in lifestyle behavior. The aim of this study was to analyze the effects of a barrier-belief counseling intervention (BBCI) on physical activity (PA) and healthy food intake. Methods: An RCT was conducted in a primary care setting among adults (aged 18-70), with two interventions: a BBCI (n=123) and a standardized lifestyle group intervention (SLI) (n=122). A nontreated hanging control group (n=36) received no intervention. Outcomes on PA (accelerometer and SQUASH) and fruit and vegetable intake (self-report) were measured with follow-ups at 6,12 and 18 months, and analyzed using multiple regression. Results: The BBCI was more effective on PA compared with the SLI (p <.01): in the short term all PA outcomes improved (p < .05), in the long term moderate-to-vigorous PA outcomes improved (p < .05), all with small effect sizes. No differences between interventions were found on fruit and vegetable intake. None of the outcomes in the control group changed over time. Conclusions: BBCI in primary care improves PA compared with SLI. Practice implications: The customized BB approach seems promising for implementation in healthcare practice to stimulate PA. Practice implications: The customized BB approach seems promising for implementation in healthcare practice to stimulate PA. (C) 2018 Elsevier B.V. All rights reserved.