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Purpose: This article outlines the development and validation of the Need-Relevant Instructor Behaviors Scale (NIBS). Drawing from self-determination theory, the NIBS is the first observation tool designed to code the frequency and the intensity of autonomy-, competence-, and relatedness-relevant behaviors of exercise instructors. The scale also captures the frequency of need-indifferent behaviors., Methods: The behaviors of 27 exercise instructors were coded by trained raters on two occasions, before and after they received training in adaptive motivational communication., Results: Findings supported the structural validity and reliability of the scale. The scale's sensitivity to detect changes in frequency and intensity of need-relevant behaviors was also evidenced., Conclusions: The NIBS is a new tool that offers a unique, tripartite assessment of need-relevant behaviors of leaders in the physical activity domain.

Diabetic foot ulcers (DFUs) impact a substantial proportion of patients with diabetes, with high recurrence rates, severe complications, and significant financial burden to health care systems. Adherence to treatment advice (e.g., limiting weight-bearing activity) is low with patients reporting dissatisfaction with the way in which advice is communicated. This study aimed to address this problem via the systematic development of a motivation communication training program. The program was designed to support diabetes-specialist podiatrists in empowering patients to actively engage with treatment. The development process followed an intervention mapping approach. Needs assessment involved observations of 24 patient–practitioner consultations within a diabetes-specialist foot clinic. This informed specification of a theory of change (self-determination theory) and relevant evidence-based communication strategies (drawing from motivational interviewing). The training program was developed iteratively with changes made following feedback from five diabetic foot health care professionals. The resulting training program, consisting of six one-hour face-to-face sessions over an 8-week period, was delivered to a further six diabetes specialist podiatrists, with five participating in postprogram telephone interviews to assess acceptability. Deductive thematic analysis of interview data revealed positive aspects of the training (e.g., valuable and relevant content), ideas for improvement (e.g., online resources and context-specific video examples), the acceptability of motivation strategies, and challenges putting the strategies into practice (such as time constraints and breaking old communication habits). This study contributes to our understanding of integrating motivation principles into routine consultations and holds potential for enhancing adherence to treatment recommendations in patients living with diabetic foot ulcers. [ABSTRACT FROM AUTHOR]

Patients with diabetic foot ulcers are advised to limit weight‐bearing activity for ulcers to heal. Patients often disregard this advice although the reasons are not yet fully understood. This study explored (1) patients' experiences of receiving the advice and (2) factors influencing adherence to the advice. Semi‐structured interviews were conducted with 14 patients with diabetic foot ulcers. Interviews were transcribed and analysed using inductive thematic analysis. Advice regarding limiting weight‐bearing activity was described by patients as directive, generic and conflicting with other priorities. Rapport, empathy and rationale supported receptivity to the advice. Barriers and facilitators to limiting weight‐bearing activity included demands of daily living, enjoyment of exercise, sick/disabled identity and burden, depression, neuropathy/pain, health benefits, fear of negative consequences, positive feedback, practical support, weather and active/passive role in recovery. It is important that healthcare professionals pay attention to how limiting weight‐bearing activity advice is communicated. We propose a more person‐centred approach in which advice is tailored to individuals' specific needs with discussion around patient priorities and constraints. [ABSTRACT FROM AUTHOR]

This study examined the feasibility of a 10-week self-determination theory - based training programme delivered to 24 group exercise instructors. Feasibility of implementing the programme was explored in terms of 1) recruitment, 2) rates of adherence and retention, and 3) acceptability. Results revealed modest uptake (31%) and excellent workshop attendance (either in-person or online) and retention rates (96%). Coding of the interview data revealed 9 main themes with regard to the acceptability of the training programme: satisfaction with content, challenging current motivational practices, perceived relevance of the motivational strategies, social support, mix of theory and practice, usefulness of learning resources, need-supportive delivery, multi-stage structure, and value for professional development. The findings can inform the development, design, and implementation of future research with the target population. [ABSTRACT FROM AUTHOR]