A novel health behaviour intervention to promote adherence in kidney failure.

Christopher M Celano, Juliana Zambrano, Lauren Harnedy, Daniel Arroyo-Ariza, Alba Carrillo, Wei-Jean Chung, Christina N Massey, Abraham Cohen-Bucay, Jeff C Huffman

Journal: Journal of renal care 2023;49(1):24-34

PMID: 35638610

Abstract

BACKGROUND

Health behaviour adherence is associated with improved survival in kidney failure (KF); however, most patients with KF do not adhere to one or more health behaviours. Existing health behaviour interventions have significant limitations and do not focus on psychological factors that are associated with adherence and health.

OBJECTIVES

To examine the feasibility, acceptability, and preliminary efficacy of a 12-week, phone-delivered, positive psychology-motivational interviewing (MI) intervention to promote psychological well-being and adherence in KF.

DESIGN

Single-arm, proof-of-concept trial (N = 10).

PARTICIPANTS

Participants were adults with KF undergoing haemodialysis and reporting suboptimal adherence to physical activity, diet, and/or medications. Participants attended weekly phone sessions with a study trainer, completed weekly positive psychology exercises (focused on gratitude, strengths, and meaning), and worked towards physical activity, diet, and/or medication goals.

MEASUREMENTS

Feasibility was measured by the percentage of sessions completed, while acceptability was assessed through participant ratings of positive psychology and MI session ease and utility (0-10 Likert scales). We explored the intervention's impact on psychological outcomes and health behaviour adherence using validated scales and accelerometers.

RESULTS

Participants completed 78% of sessions and rated the program's components as easy to complete (positive psychology: 8.7 ± 1.5; MI: 8.3 ± 2.0) and subjectively helpful (positive psychology: 8.8 ± 1.2; MI: 8.8 ± 1.6). The intervention led to promising but nonsignificant improvements in psychological and adherence measures.

CONCLUSIONS

This 12-week, phone-delivered program was feasible, well-accepted, and associated with nonsignificant improvements health behaviour adherence, highlighting the need for a larger efficacy trial.

© 2022 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Address: Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.; Department of Personality, Assessment and Psychological Treatments, University of Valencia, Valencia, Spain.; Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.; Renal Division and Transplant Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
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