How the Plants for Joints multidisciplinary lifestyle intervention achieved its effects: a mixed methods process evaluation
- PMID: 38615001
- PMCID: PMC11016213
- DOI: 10.1186/s12889-024-18554-2
How the Plants for Joints multidisciplinary lifestyle intervention achieved its effects: a mixed methods process evaluation
Abstract
Background: Plants for Joints (PFJ) is a multidisciplinary intervention centered around a whole-food plant-based diet, physical activity, and sleep and stress management. The PFJ intervention successfully improved disease activity and symptoms in people with rheumatoid arthritis (RA) or osteoarthritis (OA), respectively, and metabolic health. To investigate how these effects were achieved a mixed methods process evaluation was conducted to understand the context, implementation, and mechanism of impact of the PFJ intervention. Also, the relationship between degree of implementation and lifestyle changes was explored.
Methods: Quantitative and qualitative data were collected across the evaluation domains context (i.e. reach), implementation (i.e. recruitment and delivery), and mechanism of impact (i.e. responsiveness) of both the participants and coaches (incl. dietitians, sport coaches) according to the UK MRC guidelines for process evaluations. Data was collected from the participants via focus groups and questionnaires after the intervention, and interviews with coaches. Qualitative data were analyzed thematically, and quantitative data were assessed with descriptive statistics and linear regression analyses. Degree of implementation was quantified using a theory-driven implementation index score composed of different process evaluation constructs.
Results: Of the 155 participants who participated in the PFJ intervention, 106 (68%) took part in the questionnaire and 34 (22%) attended a focus group. Participants felt the intervention was complete, coherent, and would recommend the intervention to others (mean score 9.2 (SD 1.4) out of 10). Participants felt heard and empowered to take control of their lifestyle and health outcomes. Components perceived as most useful were self-monitoring, social support, practical and theoretical information, and (individual) guidance by the multidisciplinary team. Participants perceived the intervention as feasible, and many indicated it effectively improved their health outcomes. In an explorative analysis there was no significant difference in healthy lifestyle changes across implementation index score groups.
Conclusion: This process evaluation offers important insights into why the PFJ intervention works and how the intervention can be optimized for future implementation. Results indicating the intervention's high satisfaction, feasibility, and perceived effectiveness, further support the use of plant-based lifestyle interventions as an additional treatment option for patients with RA, OA, or other chronic diseases.
Trial registration: International Clinical Trial Registry Platform numbers: NL7800, NL7801, and NL7802, all registered 17-06-2019.
Keywords: Lifestyle intervention; Osteoarthritis; Process evaluation; Rheumatoid arthritis.
© 2024. The Author(s).
Conflict of interest statement
The authors declare no competing interests.
Similar articles
-
Long-term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis: 1-year follow-up of the 'Plants for Joints' randomised clinical trial.RMD Open. 2024 Feb 27;10(1):e004025. doi: 10.1136/rmdopen-2023-004025. RMD Open. 2024. PMID: 38413171 Free PMC article.
-
A multidisciplinary lifestyle program for rheumatoid arthritis: the 'Plants for Joints' randomized controlled trial.Rheumatology (Oxford). 2023 Aug 1;62(8):2683-2691. doi: 10.1093/rheumatology/keac693. Rheumatology (Oxford). 2023. PMID: 36617162 Free PMC article. Clinical Trial.
-
The effect of a multidisciplinary lifestyle program for patients with rheumatoid arthritis, an increased risk for rheumatoid arthritis or with metabolic syndrome-associated osteoarthritis: the "Plants for Joints" randomized controlled trial protocol.Trials. 2021 Oct 18;22(1):715. doi: 10.1186/s13063-021-05682-y. Trials. 2021. PMID: 34663431 Free PMC article.
-
Digital interventions for hypertension and asthma to support patient self-management in primary care: the DIPSS research programme including two RCTs [Internet].Southampton (UK): National Institute for Health and Care Research; 2022 Dec. Southampton (UK): National Institute for Health and Care Research; 2022 Dec. PMID: 36538606 Free Books & Documents. Review.
-
Better post-operative prediction and management of chronic pain in adults after total knee replacement: the multidisciplinary STAR research programme including RCT.Southampton (UK): National Institute for Health and Care Research; 2023 Jun. Southampton (UK): National Institute for Health and Care Research; 2023 Jun. PMID: 37494508 Free Books & Documents. Review.
References
-
- World Health Organization. Noncommunicable diseases. 2023; Available at: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-disease.... Accessed 20 Sept 2023.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical