Active Choices: effectiveness and feasibility of a ‘stepped down’ program on self-managed physical activity and social connectedness in Australian war veterans and their dependents

Active Choices is a 12-week ‘stepped down’ program that supports Department of Veterans’ Affairs (DVA) clients (i.e., Australian war veterans, war widows and their dependents), who are currently receiving DVA-funded treatment from an allied health professional, to self-manage their physical activity (PA) regimes and form new social connections. The program is based in Michie and colleagues’ (2011) COM-B Framework. Program development was informed by a systematic review conducted by our team (Gilson et al., 2019), which examined the effectiveness of ‘stepped down’ PA programs for veterans and their dependents, and the key effective strategies used in these programs to promote self-managed PA. The behaviour change strategies identified as most effective in this review are incorporated within the Active Choices program, and are education, goal setting, goal review, self-monitoring, social support, action planning, barrier identification and problem-solving. (1) Consultations The Active Choices program consists of 4 consultations, which clients complete individually with a member of the Active Choices team, during Weeks 1, 4, 8 and 12. The consultations in Week 1 and 12 are conducted face-to-face at the UQ PA Laboratory or a location of convenience for the client (e.g., at the allied health practice they attend) and run for 1-hour. The consultations in Week 4 and 8 are conducted via telephone and run for 30-minutes. During the Week 1 Consultation, clients receive education about PA and are supported in developing their individualised Active Choices program for weeks 1 to 4. This involves identifying the client’s PA preferences and linking these to local opportunities for those activities in their community, setting PA goals, developing a PA plan, identifying barriers to PA and problem-solving solutions to overcome these. During the Week 4 Consultation, clients review their progress during weeks 1 to 4, and are supported in developing their individualised Active Choices program for weeks 5 to 8 using the same strategies and processes as in the Week 1 Consultation. During the Week 8 Consultation, clients review their progress during weeks 5 to 8, and are supported in developing their individualised Active Choices program for weeks 9 to 12 using the same strategies and processes as in the Week 1 Consultation. During the Week 12 Consultation, clients review their progress during weeks 9 to 12, and are supported in developing their plan for continuing to self-manage their PA beyond the program using the same strategies and processes as in the Week 1 Consultation. (2) Resource Booklet Consultations are guided by the Active Choices resource booklet, which contains educational and behavioural support materials that map onto the behaviour change strategies incorporated within the program. This resource booklet is also used by clients throughout the 12-week program to self-monitor their PA and as an educational resource. The resource booklet was designed specifically for the Active Choices program. (3) SMS Reminders SMS reminders are sent to clients the day before their PA choices in Week 2, 5 and 9. (4) Financial Support The Active Choices program provides financial support (of up to $20/week) for clients to access their PA choices. (5) Social Meet-Ups Monthly meet-and-greet sessions are held to provide clients the opportunity to meet others engaged in the program and form new social connections. Intervention adherence will be assessed by PA log data recorded in the resource booklet, and through interviews conducted at end-intervention. *Michie, S., van Stralen, M., & West, R. (2011). The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implementation Science, 6 (42). *Gilson, N., Papinczak, Z., Mielke, G., Haslam, C., McKenna, J., & Brown, W. (2019). Intervention Strategies to Promote Self-Managed Physical Activity in Service Veterans and their Dependents – A Rapid Evidence Assessment (Technical Report).