Objective To evaluate the effectiveness of behavioural interventions that include motivational interviewing on physical activity outcomes in adults. Design Systematic review and meta-analysis. Study selection A search of seven databases for randomised controlled trials published from inception to 1 March 2023 comparing a behavioural intervention including motivational interviewing with a comparator without motivational interviewing on physical activity outcomes in adults. Outcomes of interest were differences in change in quantitative measures of total physical activity, moderate to vigorous physical activity (MVPA), and sedentary time. Data extraction and synthesis Two reviewers extracted data and assessed risk of bias. Population characteristics, intervention components, comparison groups, and outcomes of studies were summarised. For overall main effects, random effects meta-analyses were used to report standardised mean differences (SMDs) and 95% confidence intervals (CIs). Differential effects based on duration of follow-up, comparator type, intervention duration, and disease or health condition of participants were also examined. Results 129 papers reporting 97 randomised controlled trials totalling 27 811 participants and 105 comparisons were included. Interventions including motivational interviewing were superior to comparators for increases in total physical activity (SMD 0.45, 95% CI 0.33 to 0.65, equivalent to 1323 extra steps/day; low certainty evidence) and MVPA (0.45, 0.19 to 0.71, equivalent to 95 extra min/week; very low certainty evidence) and for reductions in sedentary time (−0.58, −1.03 to −0.14, equivalent to −51 min/day; very low certainty evidence). Evidence for a difference in any outcome compared with comparators of similar intensity was lacking. The magnitude of effect diminished over time, and evidence of an effect of motivational interviewing beyond one year was lacking. Most interventions involved patients with a specific health condition, and evidence of an effect of motivational interviewing to increase MVPA or decrease sedentary time was lacking in general population samples. Conclusions Certainty of the evidence using motivational interviewing as part of complex behavioural interventions for promoting total physical activity in adults was low, and for MVPA and sedentary time was very low. The totality of evidence suggests that although interventions with motivational interviewing increase physical activity and decrease sedentary behaviour, no difference was found in studies where the effect of motivational interviewing could be isolated. Effectiveness waned over time, with no evidence of a benefit of motivational interviewing to increase physical activity beyond one year. Systematic review registration PROSPERO CRD42020219881. The statistical code used in the analysis is available from .

中文翻译：

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动机访谈行为干预对成人身体活动结果的有效性：系统评价和荟萃分析


目的 评估行为干预措施的有效性，包括对成人身体活动结果的动机访谈。设计系统回顾和荟萃分析。研究选择 检索从开始到 2023 年 3 月 1 日发表的随机对照试验的七个数据库，比较行为干预措施，包括与比较者进行动机访谈，而不对成人的身体活动结果进行动机访谈。感兴趣的结果是总身体活动、中度至剧烈身体活动（MVPA）和久坐时间的定量测量变化的差异。数据提取和合成 两名评审员提取数据并评估偏倚风险。总结了人群特征、干预措施、对照组和研究结果。对于总体主效应，随机效应荟萃分析用于报告标准化平均差 (SMD) 和 95% 置信区间 (CI)。还检查了基于随访持续时间、比较器类型、干预持续时间以及参与者的疾病或健康状况的差异效应。结果 纳入了 129 篇论文，报告了 97 项随机对照试验，总计 27 811 名参与者和 105 项比较。包括动机访谈在内的干预措施在总体力活动增加（SMD 0.45，95% CI 0.33 至 0.65，相当于每天额外 1323 步；低确定性证据）和 MVPA（0.45，0.19 至 0.71，相当于额外 95 步）方面优于对照组。分钟/周；非常低确定性证据）和减少久坐时间（-0.58，-1.03 至 -0.14，相当于 -51 分钟/天；非常低确定性证据）。与相似强度的比较者相比，缺乏任何结果差异的证据。 随着时间的推移，效果的程度逐渐减弱，并且缺乏一年后动机性访谈效果的证据。大多数干预措施涉及具有特定健康状况的患者，并且在一般人群样本中缺乏动机访谈对增加 MVPA 或减少久坐时间的效果的证据。结论 使用动机访谈作为促进成人总体身体活动的复杂行为干预措施的一部分，其证据的确定性较低，并且 MVPA 和久坐时间也非常低。全部证据表明，尽管动机访谈的干预措施增加了体力活动并减少了久坐行为，但在可以孤立动机访谈效果的研究中没有发现差异。随着时间的推移，效果逐渐减弱，没有证据表明动机性访谈对增加身体活动超过一年有好处。系统审评注册PROSPERO CRD42020219881。分析中使用的统计代码可从.