Effectiveness of a BCW theory-based exercise adherence intervention protocol in Chinese maintenance hemodialysis patients

A randomized controlled trial

Bibliographic Data

ID22079685
AuthorsQianqian Wei (0000-0002-8317-959X, Lianyungang Oriental Hospital), Hailin Zhang (0000-0002-8545-1032, Lianyungang Oriental Hospital, corresponding author), Fei Chen (0000-0002-4500-2590, The First People’s Hospital of Lianyungang), Yanan Ban (Lianyungang Oriental Hospital), Xiaoyan Wen (Xuzhou Medical College), Lixia Yin (Lianyungang Oriental Hospital)
Year2025
Volume13
Pages1700057-1700057
Publication date2025-12-12
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1700057
PMID41458410
OpenAlexW4417263411
LanguageEN
References cited68

Objective To develop and implement a theory-based exercise adherence intervention grounded in the behavior change wheel (BCW) framework, with the goal of improving exercise adherence among maintenance hemodialysis (MHD) patients, enhancing clinical outcomes, and maximizing the benefits of physical activity. Methods This study included two phases. In Phase I (Development), we used the BCW framework to develop the intervention. This process involved semi-structured patient interviews and evidence synthesis, followed by refinement with an expert panel. In Phase II (Evaluation), we performed an assessor-blinded randomized controlled trial (RCT). We randomly assigned 80 MHD patients (1:1) to either the intervention or control group. A computer-generated sequence determined allocation, which was concealed with opaque, sealed envelopes. The intervention group received the BCW-based exercise protocol via mobile health (mHealth) technology, and the control group received standard nursing care. Throughout the trial, outcome assessors and data analysts remained blinded to group assignment. Results Following the 12-week intervention, the intervention group demonstrated significantly greater exercise adherence scores compared to controls ( p 0.05). Conclusion The study findings demonstrate the efficacy of a BCW-based exercise adherence intervention program in enhancing exercise adherence, physical functioning, dialysis adequacy, nutritional status, and glucose-lipid metabolism among MHD patients. Clinical trial registration https://www.chictr.org.cn ; identifier (ChiCTR2400091015)

Hemodialysis · MEDLINE · Psychological intervention · Randomized controlled trial · Cardiovascular and exercise physiology · Dialysis and Renal Disease Management · Physical Activity and Health

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