Feasibility of a Physical Activity Pathway for Irish Primary Care Physiotherapy Services (original) (raw)
Related papers
BMC Public Health, 2011
The 'Physical Activity Care Pathway' (a Pilot for the 'Let's Get Moving' policy) is a systematic approach to integrating physical activity promotion into the primary care setting. It combines several methods reported to support behavioural change, including brief interventions, motivational interviewing, goal setting, providing written resources, and follow-up support. This paper compares costs falling on the UK National Health Service (NHS) of implementing the care pathway using two different recruitment strategies and provides initial insights into the cost of changing physical activity behaviour. Methods: A combination of a time driven variant of activity based costing, audit data through EMIS and a survey of practice managers provided patient-level cost data for 411 screened individuals. Self reported physical activity data of 70 people completing the care pathway at three month was compared with baseline using a regression based 'difference in differences' approach. Deterministic and probabilistic sensitivity analyses in combination with hypothesis testing were used to judge how robust findings are to key assumptions and to assess the uncertainty around estimates of the cost of changing physical activity behaviour. Results: It cost £53 (SD 7.8) per patient completing the PACP in opportunistic centres and £191 (SD 39) at disease register sites. The completer rate was higher in disease register centres (27.3% vs. 16.2%) and the difference in differences in time spent on physical activity was 81.32 (SE 17.16) minutes/week in patients completing the PACP; so that the incremental cost of converting one sedentary adult to an 'active state' of 150 minutes of moderate intensity physical activity per week amounts to £ 886.50 in disease register practices, compared to opportunistic screening. Conclusions: Disease register screening is more costly than opportunistic patient recruitment. However, additional costs come with a higher completion rate and better outcomes in terms of behavioural change in patients completing the care pathway. Further research is needed to rigorously evaluate intervention efficiency and to assess the link between behavioural change and changes in quality adjusted life years (QALYs).
Integrating Physical Activity in Primary Care Practice
The American journal of medicine, 2016
Based on a collaborative symposium in 2014 hosted by the Society of Behavioral Medicine (SBM) and the American College of Sports Medicine (ACSM), this paper presents a model for physical activity counseling for primary care physicians (PCPs). Most United States adults do not meet national recommendations for physical activity levels. Socioecological factors drive differences in physical activity levels by geography, gender, age, and racial/ethnic group. The recent Patient Protection and Affordable Care Act (ACA) incentivizes PCPs to offer patients physical activity counseling. However, PCPs have reported socioecological barriers to physical activity counseling and also patient barriers to physical activity, spanning from the individual to the environmental (e.g., lack of safe spaces for physical activity), policy (e.g., reimbursement policies), and organizational (e.g., electronic medical record protocols, worksite norms/policies) levels. The aims of this paper are to: (1) discuss b...
Feasibility and acceptability of a physical activity promotion programme in general practice
Family Practice, 2004
Background. Physical activity promotion in general practice is advocated though not incorporated into daily practice. Several barriers must be overcome to develop a feasible and acceptable programme. Objective. The aim of this study was to conduct a process evaluation of a physical activity promotion programme in general practice (PACE), in which patients visited their provider (GP or practice nurse) twice. Methods. Process evaluation was conducted by means of telephone-administered, semistructured interviews with providers and practice assistants. The main topics of the interviews were overall impression of PACE, PACE training, content and usability of the intervention materials, counselling, implementation of the intervention, and opportunities for future use. Results. In the 15 participating general practices, a total of 17 providers and 12 practice assistants were interviewed. The overall impression of the PACE programme was positive. Most providers experienced the provided material and training as helpful. Some problems concerning the number of forms used and patients having difficulties completing the forms were mentioned. Most providers (70.6%) spend 10 min or more discussing PACE during the first consultation. The second consultation mostly was completed within 10 min. Patients overestimating their level of physical activity was mentioned as the main barrier in providing the counselling. PACE was evaluated as suitable for implementation in Dutch general practice, and 60% of the providers actually intended using PACE in the future. Conclusion. The PACE programme was evaluated as being both acceptable and feasible in a selection of Dutch general practices. Positive adaptations will be made in order to implement PACE successfully in general practice at a wider scale.
Physical activity promotion in primary careBridging the gap between research and practice
American Journal of Preventive Medicine, 2004
Background: While a growing literature supports the effectiveness of physical activity interventions delivered in the primary care setting, few studies have evaluated efforts to increase physician counseling on physical activity during routine practice (i.e., outside the context of controlled research). This paper reports the results of a dissemination trial of a primary care-based physical activity counseling intervention conducted within the context of a larger, multi-strategy, Australian community-based, physical activity intervention, the 10,000 Steps Rockhampton Project.
International Journal of Environmental Research and Public Health
Physical activity counselling has demonstrated effectiveness at increasing physical activity when delivered in healthcare, but is not routinely practised. This study aimed to determine (1) current use of physical activity counselling by physiotherapists working within publicly funded hospitals; and (2) influences on this behaviour. A cross-sectional survey of physiotherapists was conducted across five hospitals within a local health district in Sydney, Australia. The survey investigated physiotherapists’ frequency of incorporating 15 different elements of physical activity counselling into their usual healthcare interactions, and 53 potential influences on their behaviour framed by the COM-B (Capability, Opportunity, Motivation-Behaviour) model. The sample comprised 84 physiotherapists (79% female, 48% <5 years of experience). Physiotherapists reported using on average five (SD:3) elements of physical activity counselling with at least 50% of their patients who could be more acti...
Health education journal, 2015
Referring clinicians' experiences of exercise referral schemes (ERS) can provide valuable insights into their uptake. However, most qualitative studies focus on patient views only. This paper explores health professionals' perceptions of their role in promoting physical activity and experiences of a National Exercise Referral Scheme (NERS) in Wales. Qualitative semi-structured group interviews. General practice premises. Nine semi-structured group interviews involving 46 health professionals were conducted on general practice premises in six local health board areas. Purposive sampling taking into account area deprivation, practice size and referral rates was employed. Interviews were transcribed verbatim and analysed using the Framework method of thematic analysis. Health professionals described physical activity promotion as important, although many thought it was outside of their expertise and remit, and less important than other health promotion activities such as smokin...
Scandinavian Journal of Medicine & Science in Sports, 2009
Physical activity referral (PAR) schemes or concepts occur in varying forms. Because few physical activity intervention studies have been carried out in routine health care settings, it is difficult to translate research findings into daily practice. The aim of this study was to analyze the effectiveness of a PAR scheme implemented in routine primary health care. The study did not include a control group and was based on the ordinary staff's work efforts and follow-up measures. During a 2-year period, 6300 PARs were issued. Effectiveness was measured by an increase in self-reported physical activity. Half of the patients reached reported increased physical activity both at 3 months (49%) and at 12 months (52%). The proportion of inactive patients decreased from 33% at baseline to 17% at 3 months and 20% at 12 months. The proportion of patients who were physically active on a regular basis increased from 22% at baseline to 33% at 3 months and 32% at 12 months. Neither the patient's age nor the profession of the prescriber was associated with differences in effectiveness. The patient's activity level at baseline, the type of physical activity as well as the reason for the prescription were associated with increased physical activity.