Increasing physical activity (PA) among inactive middle-older aged adults in rural communities is challenging. This study investigates the efficacy of a PA intervention supporting inactive adults in rural/semirural communities. Inactive participants enrolled on either a single signposting session (n =427) or a multisession pathway combining signposting with motivational interviewing (MI; n = 478). Pre-post outcomes data assessed activity levels (International Physical Activity Questionnaire–Short Form; Single Item Sport England Measure), self-efficacy (New General Self-Efficacy scale [NGSE]) and well-being (five-item World Health Organization Well-Being Index [WHO-5]). Measures were repeated at longitudinal time points (26, 52 weeks) for the MI pathway. Outcomes were contrasted with results from an unmatched comparison group receiving treatment as usual (TAU). Cost-utility (quality-adjusted life years [QALY]-incremental cost-effectiveness ratio) and return on investment (NHS-ROI; QALY-ROI) were estimated for short (5 years), medium (10 years) and long (25 years) time horizons. Both pathways significantly increased participants’ PA. The MI pathway resulted in significantly greater increases in PA than signposting-only and TAU. Improvements in psychological outcomes (NGSE; WHO-5) were significantly greater in the MI pathway than TAU. Longitudinal results indicated MI pathway participants sustained increases in light-intensity PA at 52 weeks (p < 0.001;  = 0.16). Regression analyses found baseline self-efficacy predicted increased PA at 52 weeks, while baseline well-being did not. The relationship between self-efficacy and PA increased successively across time points. However, magnitude of participants’ increased self-efficacy did not predict PA at any time point. Both pathways were cost-effective and cost -saving for participants aged ≥61 years from the short time horizon, with the MI pathway having greater ROI estimates. Overall, MI increased efficacy of a signposting PA intervention and was cost-saving for older adults.

中文翻译：

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动机性访谈和自我效能对不活跃中老年人社区运动干预的结果和成本效益的作用

增加农村社区不活跃的中老年人的体力活动 (PA) 具有挑战性。本研究调查了支持农村/半农村社区不活跃成年人的 PA 干预措施的效果。不活跃的参与者参加了单次路标会议 ( n  = 427) 或将路标与动机性访谈相结合的多会话途径 (MI; n = 478）。事前结果数据评估了活动水平（国际体育活动问卷 - 简表；单项体育英格兰测量）、自我效能（新通用自我效能量表 [NGSE]）和幸福感（世界卫生组织健康状况五项- 存在指数 [WHO-5])。在 MI 通路的纵向时间点（26、52 周）重复测量。结果与接受照常治疗（TAU）的无与伦比的对照组的结果形成对比。对短期（5 年）、中期（10 年）和长期（25年）时间范围。两种途径都显着提高了参与者的 PA。与仅路标和 TAU 相比，MI 途径导致 PA 显着增加。MI途径中心理结果（NGSE；WHO-5）的改善明显大于TAU。纵向结果表明 MI 通路参与者在 52 周时光强度 PA 持续增加（p  < 0.001； = 0.16)。回归分析发现基线自我效能预测在 52 周时 PA 增加，而基线幸福感则没有。自我效能感与PA之间的关系在不同时间点连续增加。然而，参与者自我效能增加的幅度并不能预测任何时间点的 PA。对于短期内年龄≥61 岁的参与者来说，这两种途径都具有成本效益和成本节约，MI 途径具有更高的 ROI 估计值。总体而言，MI 提高了标志性 PA 干预的功效，并且为老年人节省了成本。