MTM-Based Intervention and Physical Activity among African American Women
The results of the study provide strong support for Hayes et al.’s (2019) conclusion that the MTM-based intervention was effective in encouraging physical activity among African American women. The intervention demonstrated significant improvements in physical activity levels, waist circumference, and MTM constructs, indicating that the approach meaningfully influenced health behavior. These results align with the purpose of health behavior theories, such as MTM, which aim to address multiple determinants of behavior through structured constructs like participatory dialogue and alterations to the social and physical surroundings (Sharma & Romas, 2021).
MTM appears to have been adequately operationalized in this study. Each of the following constructs was put into practice through interactive, experience-based sessions: behavioral confidence, emotional transformation, practice for change, environmental support, and participatory discussion. This aligns with Sharma and Romas’ definition of theory-based interventions that integrate cognitive and behavioral components to promote health behavior change (Sharma & Romas, 2021). However, one potential enhancement could have been the inclusion of a longer follow-up period (for instance, three or six months) to examine the sustainability of behavior change beyond the initial weeks.
The three-week duration of the educational intervention is a reasonable starting point, particularly for initiating change. According to Sharma and Romas (2021), the intensity and frequency of exposure to health education are key factors in its effectiveness. While three weeks may suffice for initiating behavior change, sustaining it typically requires ongoing reinforcement. Therefore, a booster session or digital follow-up might have improved long-term adherence and outcome retention.
In summary, the MTM-based intervention is a promising model for promoting physical activity in underserved populations like African American women. The study’s design effectively captured MTM constructs, and while the short duration yielded measurable outcomes, longer engagement would likely support more sustained behavior change. This case illustrates how integrating theory into intervention design yields measurable and meaningful health improvements.
References
Hayes, T., Sharma, M., Shahbazi, M., Sung, J. H., Bennett, R., & Reese-Smith, J. (2019). The evaluation of a fourth-generation multi-theory model (MTM) based intervention to initiate and sustain physical activity. Health Promotion Perspectives, 9(1), 13–23. https://doi.org/10.15171/hpp.2019.02
Sharma, M., & Ramos, J. A. (2021). Theoretical foundations of health education and health promotion. Jones & Bartlett Learning.
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Question 
MTM-Based Intervention and Physical Activity among African American Women
Physical inactivity is the fourth leading cause of mortality around the world, yet many people are not being physically active. One such high-risk group for physical inactivity consists of African American women. Several approaches and interventions have been tried to promote physical activity in African American women. This case study describes an intervention developed by Hayes and colleagues (2019) based on the multi-theory model (MTM) of health behavior change for initiating and sustaining physical activity among African American women and its evaluation when compared to a traditional knowledge-based intervention.
MTM-Based Intervention and Physical Activity among African American Women
The MTM-based precision experimental intervention consisted of three 60-minute sessions over a 3-week period. It utilized interactive, bi-directional conversations about the advantages and disadvantages of PA (participatory dialogue), participating in demonstrations of moderate-impact exercises and movements and 10 to 15 minutes workout sessions (behavioral confidence), membership to gym and instruction on gym equipment (changes in the physical environment), affective learning activities (emotional transformation), participation with regard to self-monitoring of the behavior (practice for change) and mobilization of social support (changes in the social environment).
For evaluation, a randomized controlled trial (RCT) was used and data were collected at baseline, post-intervention and at six weeks follow-up. The MTM-based intervention when compared to the knowledge-based intervention over time was significantly efficacious in increasing the minutes of physical activity from pre-test mean of 37 minutes to 172 minutes at follow-up, reducing waist circumference from pretest mean of 39 inches to 38 inches at follow-up and improving the MTM construct of changes in physical environment from a mean of 7 units at pre-test to 9 units at follow-up.
There were directional improvements in the mean scores for most of the study variables over time in the MTM-based intervention. The researchers concluded that the MTM-based approach was efficacious in promoting physical activity among African American women and must be extended for effectiveness trials.
Discussion Questions:
1. Do you agree with the conclusion of the researchers? Why or why not?
2. Do you think MTM was adequately operationalized in this case study? Why or why not? What else could have been done?
3. Do you think three weeks is sufficient for an educational intervention? Why or why not?