Preventing Chronic Disease | Clinician-Targeted Intervention and Patient-Reported Counseling on Physical Activity - CDC
Clinician-Targeted Intervention and Patient-Reported Counseling on Physical Activity
Jennifer K. Carroll, MD, MPH; Paul C. Winters, MS; Mechelle R. Sanders; Francesca Decker, MD, MPH; Thanh Ngo; Christopher N. Sciamanna, MD, MPH
Suggested citation for this article:
Carroll JK, Winters PC, Sanders MR, Decker F, Ngo T, Sciamanna CN. Clinician-Targeted Intervention and Patient-Reported Counseling on Physical Activity. Prev Chronic Dis 2014;11:130302. DOI:http://dx.doi.org/10.5888/pcd11.130302
Limited time and lack of knowledge are barriers to physical activity counseling in primary care. The objective of this study was to examine the effectiveness of a clinician-targeted intervention that used the 5As (Ask, Advise, Agree, Assist, Arrange) approach to physical activity counseling in a medically underserved patient population.
Family medicine clinicians at 2 community health centers were randomized to Group 1 or Group 2 intervention. Both clinician groups participated in 4 training sessions on the 5As for physical activity counseling; Group 2 training took place 8 months after Group 1 training. Both groups were trained to refer patients to a community exercise program. We used a pre–post analysis to evaluate the effectiveness of the intervention on clinician use of 5As. Eligible patients (n = 319) rated their clinicians’ counseling skills by using a modified Physical Activity Exit Interview (PAEI) survey. Clinicians (n = 10) self-assessed their use of the 5As through a survey and interviews.
Both patient and clinician groups had similar sociodemographic characteristics. The PAEI score for both groups combined increased from 6.9 to 8.6 (on a scale of 0–15) from baseline to immediately postintervention (P = .01) and was 8.2 (P = .09) at 6-month follow-up; most of the improvement in PAEI score was due to increased use of 5As skills by Group 2 clinicians. Group 1 reported difficulty with problem solving, whereas Group 2 reported ease of referral to the community exercise program.
A clinician training intervention showed mixed results for 5As physical activity counseling.
Corresponding Author: Jennifer K. Carroll, MD, MPH, University of Rochester Medical Center, Department of Family Medicine, Family Medicine Research Programs, 1381 South Ave, Rochester, NY 14620. Telephone: 585-506-9484 x219. E-mail: Jennifer_carroll@urmc.rochester.edu
Author Affiliations: Paul C. Winters, Mechelle R. Sanders, Francesca Decker, Thanh Ngo, University of Rochester, Rochester, New York; Christopher N. Sciamanna, Penn State College of Medicine, Hershey, Pennsylvania.
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