(PS2-D94) Movement-oriented Behavioral Activation (MOBA): Results of a Novel Pilot Intervention to Reduce Stationary Behavior and Improve Well-being Among Older Food Service Workers

Physical inactivity, defined as excessive sitting and/or standing without ambulation, is associated with multiple health co-morbidities acquired by adults through the lifespan that lead to loss of mobility and diminished functional independence. This highlights a critical need for interventions that are specific to encouraging regular movement-oriented behaviors as an alternative to physical inactivity. We present methods and preliminary outcomes of an NIH Stage I pilot intervention study of Movement-Oriented Behavioral Activation (MOBA).

MOBA is a novel group-based intervention that adapts core principles of behavioral activation to the contexts of individual actions in workplace and home settings. The overall therapeutic objective is to reduce the avoidance that perpetuates physical inactivity by systematically engaging individuals in personally valued and rewarding movement-oriented alternatives. This intervention occurred in an occupational setting with food service workers, which is a population reporting excessive physical inactivity, high rates of medical conditions associated with low physical activity, and disparities in access to preventative healthcare.

Based on a waitlist-control design, 22 participants (90% African American; 90% > age 50) were randomized to a 10-week MOBA group (n =11) or an initial waitlist (n = 11). The aims of the pilot project were to (1) determine feasibility and acceptability after MOBA compared to waitlist control, and (2) assess activity and mobility changes after MOBA compared to waitlist control.

Results showed that MOBA demonstrated both feasibility and acceptability based on focus groups and metrics of participation; for instance, 86% completed MOBA, and noncompletion was due to work-issues unrelated to MOBA. Findings identified changes in the direction of improved physical performance and increased self-reported activity, though statistical significance was not achieved due to insufficient power.

In qualitative analysis of focus groups, participants reported high levels of satisfaction with MOBA, valued improvements in personal medical conditions, higher co-worker co-participation in physical activity, lower perceived barriers to engaging in physical activity, and intention to continue physical activity; the trend of continued activity was confirmed in focus groups at 6-month follow-up, with walking emerging at the most sustained activity. We discuss how acceptability and feasibility findings from this pilot study will inform a larger MOBA efficacy study in this and other populations in which low physical activity is a driver of health co-morbidities.