The Moderating Effects of Race and Ethnicity on a Motivational Interviewing Intervention for Improving Physical Health Among Patients With Peripheral Artery Disease: Secondary Analysis of a Pilot Randomized Trial.

In 30 seconds

This secondary analysis of a pilot randomized trial examined whether social determinants of health modified motivational interviewing (MI) effects on walking distance and weight among community-dwelling adults with peripheral artery disease. Participants were assigned to MI (n=16) or a smartphone app (n=13). The only significant between-group difference in change across social strata was for 6-minute walk distance: improvement was greater among participants of “other” race and ethnicity than among non-Hispanic White participants (DiD=44.0 m, 95% CI 19.2-164.2; P=.004). No significant differences by social determinant strata were found for weight loss.

Key findings

• The 6-minute walk distance change differed by race and ethnicity, with a DiD of 44.0 m (95% CI 19.2-164.2; P=.004) for “other” versus non-Hispanic White participants.
• No significant difference-in-differences for weight loss was observed across any social determinant of health strata.
• Walking distance increased significantly in strata including participants with college or higher education, unmarried participants, and those living with or frequently seeing family or friends.

Why it matters

The analysis raises the possibility that social context, including race and ethnicity, may shape functional response to MI among people with PAD. Identifying such variation could help future studies examine whether intervention design or support needs differ across groups. The findings also underscore the importance of evaluating outcomes across social strata rather than relying only on overall average effects.

What to keep in mind

This was a small pilot-trial secondary analysis, with only 29 participants, and the authors describe the findings as exploratory and hypothesis-generating.