MOTIVATE

With funding from the Medical Research Council and the Canadian Institutes of Health Research, and in collaboration with the University of British Columbia (Canada), we conducted a feasibility randomised controlled trial of the MOTIVATE-T2D intervention.

The study demonstrated that delivering the intervention to people with recently diagnosed type 2 diabetes is feasible and showed encouraging levels of exercise adherence in this population.

With funding from the Alder Hey Children’s Charity, we conducted a programme of work to develop an exercise and physical activity intervention for young people attending Complications from Excess Weight (CEW) services.

An initial feasibility study suggested the MOTIVATE concept was promising in this population but required further optimisation.

Building on these findings, and following Medical Research Council guidance for developing complex interventions, we used an intervention mapping approach and co-development with key stakeholders to refine the MOTIVATE-CEW intervention.

A second feasibility study demonstrated that MOTIVATE-CEW2 is feasible and acceptable for young people receiving care from CEW services and shows promising effects on the uptake and maintenance of physical activity.

With funding from Heart Research UK and in collaboration with the University of Warwick, we conducted a programme of work to explore the MOTIVATE concept in cardiac rehabilitation.

Initial feasibility trials aimed to provide proof of concept that the intervention could support uptake, adherence and maintenance of exercise-based cardiac rehabilitation within the UK. The trials are now complete and the research team is currently analysing the outcomes.

In collaboration with the University of Birmingham, we investigated the feasibility of using MOTIVATE to support physical activity in people living with rheumatoid arthritis and lupus.

The trials are now complete and the research team is currently analysing the outcomes.

In collaboration with The Clatterbridge Cancer Centre and Liverpool University Hospitals NHS Foundation Trust, we are exploring how the MOTIVATE intervention can be used to support prehabilitation and rehabilitation in people living with liver cancer.

Hesketh, K., Low, J., Andrews, R., Blitz, S., Buckley, B., Falkenhain, K., Job, J., Jones, C.A., Jones, H., Jung, M.E. and Little, J., 2025. Mobile Health Biometrics to Enhance Exercise and Physical Activity Adherence in Type 2 Diabetes (MOTIVATE-T2D): a decentralised feasibility randomised controlled trial delivered across the UK and Canada. BMJ open, 15(3), p.e092260. DOI: doi.org/10.1136/bmjopen-2024-092260 

Hesketh, K., Low, J., Andrews, R., Jones, C.A., Jones, H., Jung, M.E., Little, J., Mateus, C., Pulsford, R., Singer, J. and Sprung, V.S., 2021. Mobile Health Biometrics to Enhance Exercise and Physical Activity Adherence in Type 2 Diabetes (MOTIVATE-T2D): protocol for a feasibility randomised controlled trial. BMJ open, 11(11), p.e052563. DOI: doi.org/10.1136/bmjopen-2021-052563 

Low, J.L., Hesketh, K., Falkenhain, K., Jung, M.E., Singer, J., Jones, C.A., Russon, C., Andrews, R., Cocks, M., McManus, A.M. and Little, J.P., 2025. Improved glycemic regulation on exercise compared to non‐exercise days in a real‐world setting in individuals recently diagnosed with type 2 diabetes: A secondary analysis of the MOTIVATE T2D randomised controlled trial. Diabetes, Obesity & Metabolism, 27(10), p.6044. DOI: 10.1111/dom.16623 

Low, J.L., Hesketh, K., Falkenhain, K., Jung, M.E., Singer, J., Jones, C.A., Russon, C., Cocks, M., McManus, A. and Little, J.P., 2025. Improved Glycemic Control in Adults with Type 2 Diabetes is More Strongly Associated with Exercise Duration Than with Volume, Frequency, or Consistency. Medicine & Science in Sports & Exercise. DOI: 10.1249/MSS.0000000000003922 

Davies, A.P., Hesketh, K.L., Apperley, L.J., Clarke, E., Crozier, A., Russon, C., Sprung, V.S., Jones, H., Kinnafick, F., Senniappan, S. and Cocks, M., 2026. Integrating an exercise specialist supported by mHealth technology to increase exercise and physical activity adherence in a paediatric Complications from Excess Weight Service (MOTIVATE-CEW): a feasibility study. Archives of Disease in Childhood. DOI: doi.org/10.1136/archdischild-2025-329092 

Crozier, A., Cocks, M., Hesketh, K., Miller, G., Mcgregor, G., Thomas, L. and Jones, H., 2024. Mobile health biometrics to prescribe immediate remote physical activity for enhancing uptake to cardiac rehabilitation (MOTIVATE-CR+): protocol for a randomised controlled feasibility trial. BMJ open, 14(2), p.e076734. DOI: doi.org/10.1136/bmjopen-2023-076734 

Denton, F., Waddell, A., Kite, C., Hesketh, K., Atkinson, L., Cocks, M., Jones, H., Randeva, H., Davenport, N., Powell, R. and Clark, C., 2023. Remote maintenance cardiac rehabilitation (MAINTAIN): a protocol for a randomised feasibility study. Digital health, 9, p.20552076231152176. DOI: doi.org/10.1177/2055207623115217 

Quickfall, M., Green, S., Hesketh, K., Van Zanten, J.V., Cocks, M., Reynolds, J. and Wadley, A.J., 2025. EXamining the feasibility of exerCisE to manage symptoms of Lupus (EXCEL): a protocol for a randomised controlled pilot study. Lupus science & medicine, 12(1). DOI: 10.1136/lupus-2024-001382