Title: Pulmonary Rehabilitation Intervention to Maintain Exercise Behavior (PRIMEb) ? a motivational analysis.

Introduction: Behavior change regarding physical activity in people with Chronic Respiratory Diseases (CRD) and its maintenance over time is of utmost importance to assure patients' functionality and quality of life along time. However, little is known about effectiveness and how to implement it in clinical practice.

Aim: To analyze the effectiveness of behavior change techniques and maintenance component in a pulmonary rehabilitation (PR) program.

Methods: A quasi-experimental study, called PRIMEb, is being carried out with people with CRD recruited from an outpatient PR program, conducted by rehabilitation nurses in Portugal. The study design consists of an 8 to 12 weeks PR program after which a maintenance component is added for 9 months with telephone contacts. Throughout the program (outpatient and maintenance), a set of tools and techniques for behavior change, based on motivational interviewing and self-determination theory principles, is made available and reinforced with telephone contacts. The BREQ-3 questionnaire is used for understanding patient motivation regulations.

Findings: The support of the basic psychological needs (autonomy, relatedness and competence) of patients included seems to enhance their autonomous motivation through providing exercise options in home setting, support of their initiatives and encouraging them to find activities that they enjoy and feel pleasure.

Conclusions: The agents (rehabilitation nurses), the behavior and messages that are delivery, modulate patients? satisfaction and motivation which is relevant for sustain behavior change.