This primary analysis evaluated the "PREVenting the impairment of primary Osteoarthritis by high-impact long-term Physical exercise regimen-Psychological Adherence Program" (PrevOP-PAP), designed to support patients with osteoarthritis of the knee (OAK) to engage in regular moderate-to-vigorous physical activity (MVPA) to reduce OAK symptoms (WOMAC scores). Theory-based on the health action process approach (HAPA), the intervention targeted volitional precursors of MVPA change: action and coping planning, maintenance and recovery self-efficacy, action control, and social network formation. We hypothesized that compared to an active control condition, increases in MVPA at the end of the 12-month intervention would translate into lower WOMAC scores at 24 months in the intervention condition.Participants with radiographically verified moderate OAK (N = 241; 62.66% female; M(SD) = 65.60(7.61) years) were randomly assigned to the intervention (51%) or the active control condition. WOMAC scores (24 months) were the primary -, accelerometer-assessed MVPA (12 months) the key secondary outcomes. The PrevOP-PAP was a 12-month intervention with computer-assisted face-to-face and phone-based sessions designed to increase HAPA-proposed volitional precursors of MVPA change (up to 24 months; secondary outcomes). Intent-to-treat analyses included multiple regression and manifest path models.MVPA (12 months) did not mediate effects of the PrevOP-PAP on WOMAC scores (24 months). Compared to the active control condition, WOMAC scores (24 months) were lower in the intervention condition, but this effect did not remain stable in sensitivity analyses (b(SE) = -8.41(4.66), 95%-CI [-17.53; 0.71]). However, exploratory analyses revealed significantly stronger reductions in WOMAC-pain (24 months) in the intervention condition (b(SE) = -2.99(1.18), 95%-CI [-5.36; -0.63]). Groups did not differ in MVPA at 12 months (b(SE) = -3.78(3.42), 95%-CI [-10.80; 2.58]). Of the proposed precursors of MVPA change, action planning was higher in the intervention than in the control condition (24 months; b(SE) = 0.64(0.26), 95%-CI [0.14; 1.15]).Compared to an active control condition, the PrevOP-PAP did not produce reliable effects on WOMAC scores and none on preceding MVPA. Of the HAPA-proposed volitional precursors, only action planning was sustainably increased. Future interventions should use m-health applications to digitally support long-term changes in proposed volitional precursors of MVPA change.German Clinical Trials Register; https://drks.de/search/de/trial/DRKS00009677 ; also available at http://apps.who.int/trialsearch/ ; registration number: DRKS00009677; date of registration: 26/01/2016. 

https://bmcmusculoskeletdisord.biomedcentral.com/counter/pdf/10.1186/s12891-023-06661-x

Enhancing physical activity and reducing symptoms of patients with osteoarthritis of the knee: a randomized controlled trial of the PrevOP-Psychological Adherence Program

Behavioral Counseling for students is currently being implemented as an alternative solution to the problem of difficulties in learning Arabic. Students learning difficulties are caused by high anxiety due to poor learning management. The process of overcoming Arabic learning difficulties through participatory Behavioral Counseling is described implicitly in this study. The goal of this study is to examine (1) the process of overcoming difficulties in learning Arabic using Behavioral Counseling, (2) the level of academic anxiety and learning attitudes of students before and after the implementation of Behavioral Counseling, and (3) whether Behavioral Counseling implementation can improve students' Arabic language skills. This study was designed employing a Mixed Method Research approach. The questionnaire respondents were 250 students from IAIN Metro and UIN RIL (Raden Intan Lampung) Indonesia. According to the questionnaire distribution results, 46 students of UIN RIL and 45 students of IAIN Metro Indonesia required counseling. Data were gathered through observation, questionnaires, interviews, and tests. The research findings are that behavioral counseling was given to two groups of students who had difficulty learning Arabic. The first step in providing Behavioral Counseling to both groups of students with learning disabilities was conducting an assessment. The primary objective of this assessment was to discover what behaviors respondents engaged in when learning Arabic. The observed behavior was a unique behavior related to the respondent's problems. The assessment results revealed some poor learning behaviors, such as being too lazy to study, lacking enthusiasm, and being confused, anxious, and depressed about learning tasks that were not understood. Thus, students needed to be more motivated to learn Arabic because they perceived it to be difficult. The second research finding shows that in both groups of respondents, the level of academic anxiety is in the low range. Following Behavioral Counseling, there was a significant change in learning attitudes and academic anxiety—respondents whose learning attitude was poor due to various factors improved after receiving Behavioral Counseling. Similarly, academic anxiety, which was initially high, decreased after behavioral counseling. The study's findings reveal that respondents' Arabic ability improves after receiving Behavioral Counseling. Respondents at UIN RIL have an average value of 64.57, while respondents at IAIN Metro have an average value of 62.71.

pdf/overcoming-the-difficulties-of-learning-the-arabic-language-30jufdh6mc.pdf

Overcoming The Difficulties Of Learning The Arabic Language Through Behavioral Counseling For University Students

Additional file 1: Additional Information 1. Inclusion and Exclusion Criteria. Additional Figure 1. Conditions of the PrevOP-Main Medical Trial (PrevOP-MMT) nested in the PrevOP-Psychological Adherence Program (PrevOP-PAP) conditions. Additional Table 1. Manifest Regression Analyses Predicting Central Variables. Additional Table 2. Manifest Path Models Predicting Participants‘ Functional Limitations Associated with Osteoarthritis of the Knee. Additional Table 3. Manifest Path Models Predicting Participants‘ Pain Associated with Osteoarthritis of the Knee. Additional Table 4. Manifest Path Models Predicting Participants‘ Stiffness Associated with Osteoarthritis of the Knee. 

Additional file 1 of Enhancing physical activity and reducing symptoms of patients with osteoarthritis of the knee: a randomized controlled trial of the PrevOP-Psychological Adherence Program

Purpose: To explore participant experiences for people on an arthroplasty waitlist, randomised to an exercise and behaviour-change counselling program (ENHANCE). The ENHANCE program for arthroplasty patients was led by an accredited exercise physiologist who delivered an individually tailored and structured exercise program. Included in the exercise program were up to five in-person counselling sessions, based on the Health Action Process Approach (HAPA) applied specifically to people with osteoarthritis. Nine adults (mean 69.4 years) who were on the waiting list for a total hip or knee arthroplasty and who had completed a 12-week program (ENHANCE) as part of a randomised controlled trial were recruited for this study. Methods: Two focus groups were conducted to explore participant experiences of ENHANCE. Data were analysed using inductive thematic analysis with constructs of the HAPA (motivational and volitional factors) as a framework. Results: We identified three themes (1) ‘The structured program addressed inactivity and improved feelings of wellness and preparation for the operation’. The benefits were not only physical, but psychological and were contextualised in terms of preparation for the upcoming surgery. (2) ‘People as enablers of participation’: Participants identified that the attitude, and skill of the experienced instructor were supportive and motivating, especially in tailoring the intervention. Within the program, the support of the group was considered a positive attribute (3) ‘Improved awareness changed attitudes to self-efficacy and perceived self-control’. Participants described an increased awareness of their condition and a better understanding of health expectations. They felt more control and ownership over their health journey. Conclusion: Goal setting and social support were identified factors in a behaviour-change counselling program, delivered in conjunction with structured exercise that led to a positive experience. Improved psychological and physical health were described. Participants were better prepared for their upcoming surgery, with increased self efficacy and mastery to support long-term physical-activity engagement.

Adding Behaviour-Change Counselling to an Exercise Program for Adults Preparing for Hip and Knee Arthroplasty Improves Psychological and Physical Wellness: Focus Group Reflections

This study aimed to determine if a novel intervention that combined individualised exercise training with behaviour change counselling based on Health Action Process Approach (HAPA) constructs could elicit long-term increase in physical activity (PA) and reduce comorbidity development among people requiring hip or knee arthroplasty. A pre-registered two arm, parallel group, randomised controlled trial comparing the effect of a 12-week individualised exercise program combined with behavioural counselling delivered by accredited exercise physiologists, versus usual care to Osteoarthritis (OA) patients on public surgery waitlists. Participants were followed up at 6 months after baseline (pre-surgery) and again at 6 months post-surgery. Within and between group differences in post-surgery PA (as measured by ActivPal accelerometer), pain, function, quality of life, HAPA-based behavioural and psychological constructs, and health risk factors were analysed. 63 participants (34 Female; Mean age ​= ​66.4 ​± ​7.2 ​yrs) consented to participate in this study. At 6 months post baseline and 6 months post-surgery there were significant improvements in PA, pain, function, and quality of life, however there were no significant differences in the between group responses. Significant between group changes were observed in several psychological constructs related to volition at 6 months post baseline; however, these had disappeared by 6 months post-surgery. An exercise program and HAPA guided counselling intervention can improve psychological constructs related to exercise behaviour; however, these did not result in significant between group changes in PA at the timepoints measured. Further research with larger sample size is required. Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN 12617000357358) Date of registration: 08/03/2017. 

/pdf/effect-of-combined-exercise-training-and-behaviour-change-r4umbp2h.pdf

Effect of combined exercise training and behaviour change counselling versus usual care on physical activity in patients awaiting hip and knee arthroplasty: A randomised controlled trial

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Effect of combined exercise training and behaviour change counselling versus usual care on physical activity in patients awaiting hip and knee arthroplasty: A randomised controlled trial