June 1, 2015 by Nicholas Spence
As separate entities, community based programming and motivational interviewing are far from new in addressing a variety of health outcomes. How about combining the two? This approach is an integral part of the initiative based out of Australia (City of Cockburn) called, “Your Move: Get Active Your Way.”
Basically, it is a community based behavior change intervention that incorporates sustainable transport and physical activity objectives. Specific targets include increases in physical activity, such as walking and cycling, as well as use of public transportation.
The entire process can be broken down into 5 distinct parts.
Sign Up: After signing up, the participant receives a call to gather information on the specific needs of a household to get active and connected.
Welcome Pack: Using the information provided during the sign up process, an adapted welcome pack is delivered right to the participant’s household, with a variety tools to facilitate program goals, such as maps of footpaths, bike ways and bus routes in the local neighbourhood, fridge planners to track progress, and information on sport and recreation activities in the community.
Ongoing Support: Ongoing support is provided as determined by the participant in a tailored manner using a variety of forms of communication, including text messaging, telephone, and email. Whether it is calls to check in on progress or helpful SMS and email reminders of goals, a skilled team of health coaches is always available to provide support to community members.
Extra Help: Partners and supporters of the initiative provide the contextual support to optimize the efforts of community members, such as improving physical infrastructure to promote physical activity and sustainable transport and health education for a variety of lifestyle behaviours.
Your Hub: Upon signing up, the participant is able to use the My Hub dashboard, which is a useful instrument to support goals. Features of My Hub include tracking progress, connecting with fellow community members, apps, prizes, and weekly challenges.
A unique aspect of the program is that motivational interviewing is an essential part of the initiative. Health coaches and managers receive a 14 hour training program on behavior change and motivational interviewing over a nine week period. As well, another 16 hours of pre-study work are provided (e.g., case studies, role playing, presentations). The training is developed specifically for this community based physical activity project by INTERVENT.
This type of initiative requires a lot of co-ordination, partnerships, and supporters; indeed, the list is a long one: The Departments of Transport and Sport and Recreation, Heart Foundation, Nature Play, Diabetes WA, South Metropolitan Public Health Unit, RAC, Public Transport Authority, HBF, North Metropolitan Health Service, City of Cockburn, and City of Wanneroo.
The use of motivational interviewing in an initiative of this magnitude, outside of a clinical setting, is not without its potential shortcomings. Furthermore, issues surrounding motivational interviewing and a number of aspects surrounding the implementation of the program, such as fidelity and mode of communication (telephone) are no doubt important.
While I do not have any evaluation data to share with you from Your Move in the City of Cockburn, the potential impact is huge given that out of 30 000 households contacted for participation, 10 000 were recruited into the program, with ongoing coaching for 8000 via telephone.
It is a unique and exciting program and I applaud the multi-level intervention strategy (contextual and individual factors)! I encourage you to watch an informative video of the program called, “Your Move: Cockburn’s Story.”
Finally, the success of Your Move in the City of Cockburn has been the driving force for expanding the program in 2015 to the City of Wanneroo.