MedWalk trial interviews: how older participants and clinicians experienced diet and walking support
In interviews nested in the MedWalk randomised trial, 19 intervention participants and 5 clinicians described how behaviour-change support was communicated. Participants valued autonomy-supportive, credible guidance but wanted clearer progress indicators; clinicians relied on reflective dialogue. Group walking aided connection and accountability. [1]
Automatic summary · not editorially reviewed
The key findings
Nineteen intervention-arm participants and five clinicians were interviewed in a nested qualitative study within the MedWalk randomised controlled trial. [1]
Clinicians emphasised reflective dialogue to evoke self-recognition, while participants sought clearer indicators of progress. [1]
The authors suggest that reflective, autonomy-supportive communication alone may not meet participants' feedback expectations. [1]
The source at a glance
- Study type / format
- Nested qualitative study (semi-structured interviews, reflexive thematic analysis) within a randomised controlled trial; abstract only.
- Population / context
- Nineteen purposively sampled participants from the intervention arm of the MedWalk randomised controlled trial and five clinicians who delivered the dietary, walking and behaviour-change components.
- Summary based on
- Study abstract
- Original publication
- October 11, 2026
Nested interviews within the MedWalk randomised trial
This was a nested qualitative study inside the MedWalk randomised controlled trial, which combined a Mediterranean diet and a walking programme. Nineteen participants from the intervention arm were purposively sampled to capture variation in how people responded behaviourally, and five clinicians who delivered the dietary, walking and behaviour-change components took part. Semi-structured interviews were conducted and analysed with reflexive thematic analysis. Participant and clinician transcripts were first coded separately, then themes were integrated across both datasets. The aim was to explore experiences, focusing on how behaviour-change support, communication and feedback processes influenced engagement.
Supporting source [1]
Four themes: autonomy, feedback gap, group power
Four themes were identified: learning to live well; supported, not directed; tracking progress and seeking feedback; and the power of the group. Participants valued autonomy-supportive communication and credible guidance. Clinicians described intentionally using motivational-interviewing-consistent relational strategies, including reflective listening, to support engagement. A key divergence concerned feedback expectations: clinicians emphasised reflective dialogue to evoke self-recognition, whereas participants sought clearer indicators of progress. Group-based walking enhanced social connection and accountability but required facilitation to keep the behavioural focus.
Supporting source [1]
Authors' conclusion on communication and feedback
The authors concluded that engagement was shaped not only by intervention content but also by how behaviour-change support was communicated and enacted. They suggest that relying on reflective, autonomy-supportive communication alone may not meet participants' expectations for feedback, and that adding explicit, interpretable indicators of progress may strengthen engagement in lifestyle interventions for older adults. As practice implications, they recommend prioritising relational communication skills and structured feedback with clear, personalised, interpretable progress indicators, and intentionally designing and facilitating group components to support social connection, shared problem-solving and peer accountability.
Supporting source [1]
How to interpret this
Abstract only; the full text was not reviewed. This is a qualitative interview study of 19 intervention participants and 5 clinicians in one trial, so findings describe experiences and are not causal or generalisable to other populations.
Based on the study abstract; the full paper, tables and supplementary data were not reviewed.
Source & supporting passages
Barrett S, Reddan JM, Breckon JD, Pipingas A, Barrett G, Davis C, Murphy K, Segal L, Kennedy G, Itsiopoulos C, Macpherson H, Minihane AM, Meyer D, Scholey A, Kingsley M. · europepmc.org · October 11, 2026