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Karvinen KH, Reed T. The Effectiveness of an Online Learning Strategy on Changing Physical Activity Counseling Practice in Nurses. Can J Nurs Res 2023; 55:100-109. [PMID: 35088613 DOI: 10.1177/08445621221075157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Nurses may be well poised for providing physical activity guidance and support to patients. PURPOSE The purposes of this study were to examine the effectiveness of a concise, evidence based online learning modules strategy (OLMS) for improving nurses' physical activity counselling. METHODS 68 nurses were randomly assigned to either an OLMS group or control group. The OLMS group completed a series of six online learning modules aimed at improving physical activity counselling practice. RESULTS The OLMS group, compared to the control group, showed a trend for improvement in Physical Activity Counselling Practice (p = .063) after controlling for baseline values, and significant improvement in (a) Self-efficacy for Physical Activity Counselling (p = .001), (b) Knowledge of Physical Activity Guidelines, (p = .031), and (c) Perceived Benefits of Physical Activity Counselling (p = .014) over the course of the intervention. No significant change was found for Barriers for Providing Physical Activity Counselling (p > .05). CONCLUSIONS The OLMS tested may be an effective means for improving self-efficacy, knowledge, and perceived benefits of physical activity counselling, suggesting the utility of online learning strategies for improving nurses' physical activity counselling practice. Given barriers to providing physical activity counselling were not affected by the intervention, future interventions and policy change could target these barriers specifically in order to give nurses more tools and time for reaching patients and addressing physical activity counselling in practice.
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Affiliation(s)
| | - Treva Reed
- School of Nursing, 6057Nipissing University
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2
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Niela-Vilen H, Azimi I, Suorsa K, Sarhaddi F, Stenholm S, Liljeberg P, Rahmani AM, Axelin A. Comparison of Oura Smart Ring Against ActiGraph Accelerometer for Measurement of Physical Activity and Sedentary Time in a Free-Living Context. Comput Inform Nurs 2022; 40:856-862. [PMID: 35234703 DOI: 10.1097/cin.0000000000000885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Smart rings, such as the Oura ring, might have potential in health monitoring. To be able to identify optimal devices for healthcare settings, validity studies are needed. The aim of this study was to compare the Oura smart ring estimates of steps and sedentary time with data from the ActiGraph accelerometer in a free-living context. A cross-sectional observational study design was used. A convenience sample of healthy adults (n = 42) participated in the study and wore an Oura smart ring and an ActiGraph accelerometer on the non-dominant hand continuously for 1 week. The participants completed a background questionnaire and filled out a daily log about their sleeping times and times when they did not wear the devices. The median age of the participants (n = 42) was 32 years (range, 18-46 years). In total, 191 (61% of the potential) days were compared. The Oura ring overestimated the step counts compared with the ActiGraph. The mean difference was 1416 steps (95% confidence interval, 739-2093 steps). Daily sedentary time was also overestimated by the ring; the mean difference was 17 minutes (95% confidence interval, -2 to 37 minutes). The use of the ring in nursing interventions needs to be considered.
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Affiliation(s)
- Hannakaisa Niela-Vilen
- Author Affiliations: Departments of Nursing Science (Dr Niela-Vilen) and Computing (Drs Azimi and Liljeberg, and Ms Sarhaddi), University of Turku; and Department of Public Health and Centre for Population Health Research (Drs Suorsa and Stenholm), University of Turku and Turku University Hospital, Finland; Department of Electrical Engineering and Computer Science and School of Nursing (Dr Rahmani), University of California, Irvine; and Departments of Nursing Science and of Obstetrics and Gynaecology, University of Turku and Turku University Hospital (Dr Axelin), Finland
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3
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A scoping review of interventions to improve strength training participation. PLoS One 2022; 17:e0263218. [PMID: 35113954 PMCID: PMC8812857 DOI: 10.1371/journal.pone.0263218] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/17/2022] [Indexed: 11/27/2022] Open
Abstract
Background Low participation rates (1–31%) and unique barriers to strength training (e.g., specialized knowledge, equipment, perceived complexity) suggest effective strength training interventions may differ from effective aerobic or general physical activity interventions. The purpose of this scoping review was to examine interventions used to improve strength training participation through mapping theory, intervention characteristics, prescription parameters, and behaviour change techniques. Methods Recommendations by Levac et al. (2010) and PRISMA-ScR were followed in the conduct and reporting of this review, respectively. Patients and exercise professionals participated in developing the research question and data extraction form, interpreting the findings, and drafting the manuscript. Medline, Embase, PsycINFO, CINAHL, SPORTDiscus, and PubMed databases (inception–December 2020) were searched. The inclusion criteria were (a) original peer-reviewed articles and grey literature, (b) intervention study design, and (c) behavioural interventions targeted towards improving strength training participation. Two reviewers performed data screening, extraction, and coding. The interventions were coded using the Behaviour Change Technique Taxonomy version 1. Data were synthesized using descriptive and frequency reporting. Results Twenty-seven unique interventions met the inclusion criteria. Social cognitive theory (n = 9), the transtheoretical model (n = 4), and self-determination theory (n = 2) were the only behaviour change theories used. Almost all the interventions were delivered face-to-face (n = 25), with the majority delivered by an exercise specialist (n = 23) in community or home settings (n = 24), with high variability in exercise prescription parameters. Instructions on how to perform the behaviour, behavioural practice, graded tasks, goal setting, adding objects to the environment (e.g., providing equipment), and using a credible source (e.g., exercise specialist delivery) comprised the most common behaviour change techniques. Conclusions Our results highlight gaps in theory, intervention delivery, exercise prescription parameters, and behaviour change techniques for future interventions to examine and improve our understanding of how to most effectively influence strength training participation.
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4
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Kettle VE, Madigan CD, Coombe A, Graham H, Thomas JJC, Chalkley AE, Daley AJ. Effectiveness of physical activity interventions delivered or prompted by health professionals in primary care settings: systematic review and meta-analysis of randomised controlled trials. BMJ 2022; 376:e068465. [PMID: 35197242 PMCID: PMC8864760 DOI: 10.1136/bmj-2021-068465] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To examine the effectiveness of physical activity interventions delivered or prompted by primary care health professionals for increasing moderate to vigorous intensity physical activity (MVPA) in adult patients. DESIGN Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES Databases (Medline and Medline in progress, Embase, PsycINFO, CINAHL, SPORTDiscus, Sports Medicine and Education Index, ASSIA, PEDro, Bibliomap, Science Citation Index, Conference Proceedings Citation Index), trial registries (Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, TRoPHI), and grey literature (OpenGrey) sources were searched (from inception to September 2020). ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials of aerobic based physical activity interventions delivered or prompted by health professionals in primary care with a usual care control group or another control group that did not involve physical activity. STUDY SELECTION AND ANALYSIS Two independent reviewers screened the search results, extracted data from eligible trials and assessed the risk of bias using the Cochrane risk of bias tool (version 2). Inverse variance meta-analyses using random effects models examined the primary outcome of difference between the groups in MVPA (min/week) from baseline to final follow-up. The odds of meeting the guidelines for MVPA at follow-up were also analysed. RESULTS 14 566 unique reports were identified and 46 randomised controlled trials with a range of follow-ups (3-60 months) were included in the meta-analysis (n=16 198 participants). Physical activity interventions delivered or prompted by health professionals in primary care increased MVPA by 14 min/week (95% confidence interval 4.2 to 24.6, P=0.006). Heterogeneity was substantial (I2=91%, P<0.001). Limiting analyses to trials that used a device to measure physical activity showed no significant group difference in MVPA (mean difference 4.1 min/week, 95% confidence interval -1.7 to 9.9, P=0.17; I2=56%, P=0.008). Trials that used self-report measures showed that intervention participants achieved 24 min/week more MVPA than controls (95% confidence interval 6.3 to 41.8, P=0.008; I2=72%, P<0.001). Additionally, interventions increased the odds of patients meeting guidelines for MVPA by 33% (95% confidence interval 1.17 to 1.50, P<0.001; I2=25%, P=0.11) versus controls. 14 of 46 studies were at high risk of bias but sensitivity analyses excluding these studies did not alter the results. CONCLUSIONS Physical activity interventions delivered or prompted by health professionals in primary care appear effective at increasing participation in self-reported MVPA. Such interventions should be considered for routine implementation to increase levels of physical activity and improve health outcomes in the population. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021209484.
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Affiliation(s)
- Victoria E Kettle
- The Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Claire D Madigan
- The Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - April Coombe
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Henrietta Graham
- The Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Jonah J C Thomas
- The Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Anna E Chalkley
- The Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Amanda J Daley
- The Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Ma JK, Floegel TA, Li LC, Leese J, De Vera MA, Beauchamp MR, Taunton J, Liu-Ambrose T, Allen KD. Tailored physical activity behavior change interventions: challenges and opportunities. Transl Behav Med 2021; 11:2174-2181. [PMID: 34424344 DOI: 10.1093/tbm/ibab106] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
A physically active lifestyle provides innumerable benefits; yet, few individuals are physically active enough to reap those benefits. Tailored physical activity interventions may address low rates of physical activity by offering individualized strategies that consider a person's characteristics, needs, preferences, and/or context, rather than the traditional one-size-fits-all approach. However, the tailoring methodology is in its nascency, and an understanding of how best to develop such interventions is needed. In this commentary, we identify future directions to enhance the impact of tailored interventions designed to increase physical activity participation. A multi-country collaborative was established to review the literature and discuss an agenda for future research. Two overarching research opportunities are suggested for improving the development of tailored, behavioral physical activity interventions: (a) optimize the engagement of diverse knowledge users in intervention co-design and (b) examine ethical considerations that may impact the use of technology to support tailored physical activity delivery. Specifically, there is a need for better reporting and evaluation of knowledge user involvement alongside targeting diversity in the inclusion of knowledge users. Furthermore, while technology boasts many opportunities to increase the scale and precision of interventions, examinations of how it impacts recipients' experiences of and participation in tailored interventions are needed to ensure the benefits of technology use outweigh the risks. A better understanding of these research areas will help ensure that the diverse needs of individuals are met, technology is appropriately used to support tailoring, and ultimately it improves the effectiveness of tailored physical activity interventions.
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Affiliation(s)
- Jasmin K Ma
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada.,Arthritis Research Canada, Vancouver, Canada
| | | | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada.,Arthritis Research Canada, Vancouver, Canada
| | - Jenny Leese
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada.,Arthritis Research Canada, Vancouver, Canada
| | - Mary A De Vera
- Arthritis Research Canada, Vancouver, Canada.,Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Mark R Beauchamp
- School of Kinesiology, University of British Columbia, Vancouver, Canada
| | - Jack Taunton
- Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
| | - Kelli D Allen
- Department of Medicine and Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Durham, NC, USA.,Center of Innovation to Accelerate Discovery and Practice Transformation, Department of Veterans Affairs Healthcare System, Durham, NC, USA
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6
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Gucuk S, Tokur Kesgin M, Turken Gel K, Yorgun S. Determining The Relationship Between Smoking Habits and Healthy Lifestyle Behaviors of Health Workers: Smoke-Free Hospital, Healthy Life. EURASIAN JOURNAL OF FAMILY MEDICINE 2020. [DOI: 10.33880/ejfm.2020090402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: Using tobacco and tobacco products is an important public health issue. This study aims to determine the smoking status of hospital staff and to examine the relationship between their smoking habits and healthy lifestyle behaviors.
Methods: This cross-sectional study was carried out between March and September 2018 with 387 health workers in Izzet Baysal Training and Research Hospital affiliated to Bolu Abant Izzet Baysal University. Data were collected using the Healthy Lifestyle Behaviors Scale II and the Fagerstrom Test for Nicotine Dependence, which were applied via face-to-face interview technique to health workers who accepted to participate in the study.
Results: The study sample consisted of 387 health workers. Of them, 58.7% of the participants were exposed to smoking in the workplace, and 75.9% of the nonsmokers were exposed to smoking environment, which was statistically significantly high. A statistically significant difference was found between the health workers’ Healthy Lifestyle Behaviors Scale mean scores with respect to gender, smoking status, being in a smoking environment, and duration of smoking.
Conclusion: Determining the relationship between smoking habits and healthy lifestyle behaviors of health workers, identifying their negative or incomplete behaviors in this regard, and developing training and support programs for their relevant needs are considered to positively affect the images of health workers in society, and thus to increase healthcare quality and satisfaction.
Keywords: health personnel, smoking cessation, healthy lifestyle
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Affiliation(s)
| | | | | | - Songul Yorgun
- Bolu Abant Izzet Baysal University Training and Research Hospital
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Weitzer J, Gonzalez-Viana A, Pérez-Hoyos S, Coma E, Mendez L, Violan M, Rubinat M, Cabezas C. Evaluation of the Catalan Physical Activity, Sports and Health Plan: a nested case-control study. Eur J Public Health 2020; 30:1084-1090. [PMID: 32594111 DOI: 10.1093/eurpub/ckaa090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Physical inactivity is one of the most important risk factors in modern society. Primary Health Care (PHC) interventions have been shown to be effective to increase physical activity (PA). This work evaluates the Catalan Physical Activity, Sport and Health Plan (PAFES). METHODS Nested case-control design with risk-set matching based on a retrospective cohort of 22 450 physically inactive people registered between 2010 and 2018 in the Catalan electronic medical record (EMR). Confounder adjusted conditional logistic regression was used to estimate the probability that participants who had received PA advice became active between 2010 and 2018 compared to those who did not receive it. RESULTS A lower probability to become active [odds ratio (OR) = 0.11, 95% confidence interval (CI) 0.10-0.13] was found for those people who had received PA advice only once. However, the probability to become active increased for people who had received advice two or more times (two times: OR = 1.43, 95% CI 1.32-1.55). A dose-response relationship was observed. CONCLUSIONS This is the first study evaluating a PA promotion real-life intervention in PHC using a large cohort based on data from an EMR with more than 2 years of follow-up.
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Affiliation(s)
- Jakob Weitzer
- Department of Epidemiology, Medical University of Vienna, Vienna, Austria
| | - Angelina Gonzalez-Viana
- Department of Health, Public Health Agency of Catalonia, Government of Catalonia, Barcelona, Spain
| | | | - Ermengol Coma
- Department of Health, Sistema d'Informació dels Serveis d'Atenció Primària, Institut Català de la Salut, Barcelona, Spain
| | - Leonardo Mendez
- Department of Health, Sistema d'Informació dels Serveis d'Atenció Primària, Institut Català de la Salut, Barcelona, Spain
| | - Mariona Violan
- Department of Presidency, General Secretary of Sport and Physical Activity, Government of Catalonia, Barcelona, Spain
| | - Maica Rubinat
- Department of Presidency, General Secretary of Sport and Physical Activity, Government of Catalonia, Barcelona, Spain
| | - Carmen Cabezas
- Department of Health, Public Health Agency of Catalonia, Government of Catalonia, Barcelona, Spain
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Forster AK, Richards EA, Foli KJ, McGowan B, Hass Z, Becker M, Miller A. Influence of Affect on Physical Activity: An Integrative Review. Clin Nurs Res 2020; 30:934-949. [PMID: 33111569 DOI: 10.1177/1054773820968039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Affective states, such as feelings of anger and excitement, are linked to health outcomes and behaviors. The benefits of physical activity for individual affect is known; however, how affect influences physical activity participation is less understood. Using Whittemore and Knafl's framework, this integrative review examines the influence of affect on adult physical activity. using six databases, 19 articles published between 1997 and 2019. Themes found include support for the influence of positive affect on increased physical activity, a temporal aspect of affect, a variety of measurement tools, and varying uses of theoretical frameworks across studies. Advanced practice nurses and registered nurses may improve patient health behaviors, such as physical activity, by incorporating affect-focused assessments. Review findings support consideration of affect in physical activity counseling. Further research using theory-driven methods and consistent affect assessments is needed to test the complex relationship between affect and physical activity.
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Affiliation(s)
- Anna K Forster
- Purdue University School of Nursing, West Lafayette, IN, USA.,Center on Aging and the Life Course, West Lafayette, IN, USA
| | - Elizabeth A Richards
- Purdue University School of Nursing, West Lafayette, IN, USA.,Center on Aging and the Life Course, West Lafayette, IN, USA
| | - Karen J Foli
- Purdue University School of Nursing, West Lafayette, IN, USA
| | - Bethany McGowan
- Purdue University Libraries and School of Information Studies, West Lafayette, IN, USA
| | - Zachary Hass
- Purdue University School of Nursing, West Lafayette, IN, USA.,Purdue School of Industrial Engineering, West Lafayette, IN, USA.,Regenstrief Center for Healthcare Engineering, West Lafayette, IN, USA
| | - Margaret Becker
- Purdue University Psychological Sciences, West Lafayette, IN, USA
| | - Ann Miller
- Purdue University School of Nursing, West Lafayette, IN, USA
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9
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Nurse Counseling as Part of a Multicomponent Tobacco Treatment Intervention: An Integrative Review. J Addict Nurs 2020; 31:161-179. [PMID: 32868609 DOI: 10.1097/jan.0000000000000347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Although tobacco use is widely recognized as a major cause of preventable morbidity and mortality, tobacco treatment remains challenging. PURPOSE The purpose of this integrative review is to synthesize the research findings regarding multicomponent tobacco treatment interventions combining nurse counseling and nicotine replacement therapy (NRT). METHODS Published literature from 1990 through April 2019 was searched using the databases PubMed, CINAHL, PsycINFO, and Scopus. We extracted data into a literature matrix to facilitate comparison across primary sources and make conclusions about this body of literature as a whole. FINDINGS This integrative review includes 21 publications that investigated the effects of tobacco treatment interventions incorporating both nurse counseling and NRT. Articles were reviewed for quality indicators. RESULTS The evidence from this set of studies indicates that nurse counseling is an effective intervention when combined with NRT. The most successful interventions included long-term face-to-face counseling with a nurse. In addition, interventions in which longer courses of NRT were offered for free or at subsidized rates were most successful at engendering smoking cessation. Moreover, interventions that maximized social support for participants attempting to quit smoking resulted in favorable outcomes. DISCUSSION The findings can provide useful guidance regarding the designing and implementation of effective tobacco treatment interventions that incorporate various components. CONCLUSION Nurse counseling augmented by additional effective tobacco treatment therapies including NRT leads to beneficial outcomes in smoking cessation. Future researchers should capitalize on this apparent synergistic relationship between multiple tobacco treatment components.
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Freene N, Cools S, Hills D, Bissett B, Pumpa K, Cooper G. A wake-up call for physical activity promotion in Australia: results from a survey of Australian nursing and allied health professionals. AUST HEALTH REV 2019; 43:165-170. [PMID: 29224589 DOI: 10.1071/ah16240] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 10/09/2017] [Indexed: 11/23/2022]
Abstract
Objective Nursing and allied health professionals (AHPs) are in an ideal position to promote physical activity (PA) as part of their health care provision. The aim of this study was to investigate current promotion and knowledge of PA among people in these disciplines. Methods A cross-sectional online survey of practicing Australian physiotherapists, nurses, exercise physiologists, occupational therapists, dietitians and pharmacists was conducted in 2016. Results A total of 433 nurses and AHPs completed the survey. All disciplines agreed that providing PA advice was part of their role, although nurses were less likely to agree. All disciplines felt they had the skills to promote PA but nurses were more likely to report a lack of time as a barrier. Physiotherapists and exercise physiologists were more confident giving PA advice to patients. Most health professionals (68%) were aware of the PA guidelines, although only 16% were accurately able to describe all relevant components. In logistic regression modelling, women and those working in public hospitals were less likely to encourage PA. Awareness of the PA guidelines doubled the odds of encouraging PA in patients (odds ratio 2.01, 95% confidence interval 1.18-3.43). Conclusions Australian nurses and AHPs perceive that PA promotion is part of their role, however few have specific knowledge of the PA guidelines. To increase PA promotion by nurses and AHPs awareness of the PA guidelines appears to be essential. What is known about the topic? Nurses and AHPs are in an ideal position to promote PA, although there is limited evidence of their PA promotion and knowledge. What does the paper add? Australian nurses and AHPs are confident and think it is feasible to promote PA to patients in several healthcare settings but many lack sufficient PA knowledge, limiting their PA promotion. What are the implications for practitioners? Increasing PA knowledge of nurses and AHPs could generate increased levels of PA in the Australian population and improve national health and wellbeing.
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Affiliation(s)
- Nicole Freene
- Physiotherapy, Faculty of Health, University of Canberra, ACT 2601, Australia.
| | - Sophie Cools
- Physiotherapy, Faculty of Health, University of Canberra, ACT 2601, Australia.
| | - Danny Hills
- Nursing and Midwifery, Monash University, Clayton, Vic. 3800, Australia. Email
| | - Bernie Bissett
- Physiotherapy, Faculty of Health, University of Canberra, ACT 2601, Australia.
| | - Kate Pumpa
- Sport and Exercise Science, Faculty of Health, University of Canberra, ACT 2601, Australia. Email
| | - Gabrielle Cooper
- Pharmacy, Faculty of Health, University of Canberra, ACT 2601, Australia. Email
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Lion A, Vuillemin A, Thornton JS, Theisen D, Stranges S, Ward M. Physical activity promotion in primary care: a Utopian quest? Health Promot Int 2019; 34:877-886. [PMID: 29893846 PMCID: PMC6735934 DOI: 10.1093/heapro/day038] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The health benefits of physical activity (PA) are acknowledged and promoted by the scientific community, especially within primary care. However, there is little evidence that such promotion is provided in any consistent or comprehensive format. Brief interventions (i.e. discussion, negotiation or encouragement) and exercise referral schemes (i.e. patients being formally referred to a PA professional) are the two dominant approaches within primary care. These cost-effective interventions can generate positive changes in health outcomes and PA levels in inactive patients who are at increased risk for non-communicable diseases. Their success relies on the acceptability and efficiency of primary care professionals to deliver PA counselling. To this end, appropriate training and financial support are crucial. Similarly, human resourcing and synergy between the different stakeholders must be addressed. To obtain maximum adherence, specific populations should be targeted and interventions adapted to their needs. Key enablers include motivational interviewing, social support and multi-disciplinary approaches. Leadership and lines of accountability must be clearly delineated to ensure the success of the initiatives promoting PA in primary care. The synergic and multisectoral action of several stakeholders, especially healthcare professionals, will help overcome physical inactivity in a sustainable way.
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Affiliation(s)
- Alexis Lion
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, L-1460 Luxembourg, Luxembourg
- Fédération Luxembourgeoise des Associations de Sport de Santé, L-8009 Strassen, Luxembourg
| | | | - Jane S Thornton
- Western Centre for Public Health and Family Medicine, University of Western Ontario, London, Ontario, Canada
| | - Daniel Theisen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, L-1460 Luxembourg, Luxembourg
| | - Saverio Stranges
- Department of Population Health, Luxembourg Institute of Health, L-1445 Strassen, Luxembourg
- Department of Epidemiology & Biostatistics, University of Western Ontario, London, Ontario, Canada
- Department of Family Medicine, University of Western Ontario, London, Ontario, Canada
| | - Malcolm Ward
- Policy, Research & International Development, Public Health Wales, Cardiff, Wales, UK
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Vetrovsky T, Vetrovska K, Bunc V. A qualitative exploration of the experiences of primary care patients engaged in email counseling meant to increase physical activity. ACTA GYMNICA 2019. [DOI: 10.5507/ag.2019.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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13
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da Silva Costa L, de Lima Lopes J, Takáo Lopes C, Batista Santos V, Lúcia Bottura Leite de Barros A. Prevalence and Associations Between Related Factors and Defining Characteristics of the Nursing Diagnosis Sedentary Lifestyle in Patients with Acute Coronary Syndrome. Int J Nurs Knowl 2018; 30:234-238. [DOI: 10.1111/2047-3095.12234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Tai Chi exercise is more effective than brisk walking in reducing cardiovascular disease risk factors among adults with hypertension: A randomised controlled trial. Int J Nurs Stud 2018; 88:44-52. [DOI: 10.1016/j.ijnurstu.2018.08.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/25/2018] [Accepted: 08/23/2018] [Indexed: 12/21/2022]
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15
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Gonzalez-Viana A, Violan Fors M, Castell Abat C, Rubinat Masot M, Oliveras L, Garcia-Gil J, Plasencia A, Cabezas Peña C. Promoting physical activity through primary health care: the case of Catalonia. BMC Public Health 2018; 18:968. [PMID: 30075720 PMCID: PMC6090750 DOI: 10.1186/s12889-018-5773-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 06/28/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In adults, as little as 10 minutes of moderate physical activity (PA) three times a day can help prevent non-communicable diseases and prolong life expectancy. The aim of the study was to evaluate the process and impact of scaling up a complex intervention (PAFES) implemented in Catalonia, aimed to increase the proportion of adults complying with PA recommendations (especially those with cardiovascular risk factors). METHODS The intervention, piloted in 2005, had three elements: 1) establishing clinical guidelines for PA; 2) identifying local PA resources; 3) PA screening and advice in primary health care (PHC) settings, based on stage of change. Central and local level implementation activities included training, support to municipalities, dissemination through a web page, and promotion of World Physical Activity Day (WPAD). Evaluation followed the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance), identifying 3-6 variables for annual evaluation of each dimension. These included coverage of PA screening and advice and individuals with access to a healthy exercise route (Reach), increased PA level between 2006 and 2010-15 (Effectiveness), PAFES adoption by PHC centres and municipalities (Adoption), process evaluation data (Implementation), and cost (Maintenance). RESULTS PHC screening coverage increased from 14.4% (2008) to 69.6% (2015) and advice coverage from 8.3% (2012) to 35.6% (2015). In 2015, 82.5% patients had access to a "healthy route" (Reach). The proportion of patients with at least one cardiovascular risk factor who were "sufficiently active" increased from 2006 to 2010-2013 (Effectiveness). By 2015, PAFES was applied by all PHC teams, 8.3% municipalities and 22.7% PHC centres had organized WPAD events (Adoption). The Plan showed good penetration in all health regions by 2013, with relatively low use of resources and estimated cost (Implementation). By 2013 the Plan was embedded within the health system (Maintenance). CONCLUSIONS In the first application of the RE-AIM framework to evaluate the scaling-up of a PA plan, PAFES showed good results for most RE-AIM indicators. Changes in priority and investment in health promotion programs affect reach, adoption, and effectiveness. It is important to maintain support until programs are strongly embedded into the health system.
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Affiliation(s)
| | | | - Conxa Castell Abat
- Public Health Agency of Catalonia, Government of Catalonia, Barcelona, Spain
| | | | - Laura Oliveras
- Department of Preventive Medicine and Epidemiology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Juanjo Garcia-Gil
- Blanquerna Health Sciences School, Ramon Llull University, Barcelona, Spain
| | - Antoni Plasencia
- Institute of Global Health Barcelona - IS Global, Barcelona, Spain
| | - Carmen Cabezas Peña
- Public Health Agency of Catalonia, Government of Catalonia, Barcelona, Spain
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Vetrovsky T, Cupka J, Dudek M, Kuthanova B, Vetrovska K, Capek V, Bunc V. A pedometer-based walking intervention with and without email counseling in general practice: a pilot randomized controlled trial. BMC Public Health 2018; 18:635. [PMID: 29769107 PMCID: PMC5956962 DOI: 10.1186/s12889-018-5520-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 04/26/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND General practitioners play a fundamental role in combatting the current epidemic of physical inactivity, and pedometer-based walking interventions are able to increase physical activity levels of their patients. Supplementing these interventions with email counseling driven by feedback from the pedometer has the potential to further improve their effectiveness but it has to be yet confirmed in clinical trials. Therefore, the aim of our pilot randomized controlled trial is to evaluate the feasibility and potential efficacy of future trials designed to assess the additional benefit of email counseling added to a pedometer-based intervention in a primary care setting. METHODS Physically inactive patients were opportunistically recruited from four general practices and randomized to a 12-week pedometer-based intervention with or without email counseling. To explore the feasibility of future trials, we assessed the speed and efficiency of recruitment, adherence to wearing the pedometer, and engagement with email counseling. To evaluate the potential efficacy, daily step-count was the primary outcome and blood pressure, waist and hip circumference, and body mass were the secondary outcomes. Additionally, we conducted a qualitative analysis of structured interviews with the participating general practitioners. RESULTS The opportunistic recruitment has been shown to be feasible and acceptable, but relatively slow and inefficient; moreover, general practitioners selectively recruited overweight and obese patients. Patients manifested high adherence, wearing the pedometer on 83% (± 20) of days. All patients from the counseling group actively participated in email communication and responded to 46% (± 22) of the emails they received. Both groups significantly increased their daily step-count (pedometer-plus-email, + 2119, p = 0.002; pedometer-alone, + 1336, p = 0.03), but the difference between groups was not significant (p = 0.18). When analyzing both groups combined, there was a significant decrease in body mass (- 0.68 kg, p = 0.04), waist circumference (- 1.73 cm, p = 0.03), and systolic blood pressure (- 3.48 mmHg, p = 0.045). CONCLUSIONS This study demonstrates that adding email counseling to a pedometer-based intervention in a primary care setting is feasible and might have the potential to increase the efficacy of such an intervention in increasing physical activity levels. TRIAL REGISTRATION The trial was retrospectively registered at ClinicalTrials.gov (ID: NCT03135561 , date: April 26, 2017).
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Affiliation(s)
- Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Jose Martiho 31, 162 52, Prague 6, Czech Republic.
| | - Jozef Cupka
- Mediciman s.r.o, Maxovska 1019/6, 155 00, Prague 5, Czech Republic
| | - Martin Dudek
- Laureus s.r.o, Palackeho 541, 252 29, Dobrichovice, Czech Republic
| | - Blanka Kuthanova
- Praktici Praha 6, s.r.o, Vitezne namesti 817/9, 160 00, Prague 6, Czech Republic
| | | | - Vaclav Capek
- Second Faculty of Medicine, Charles University, V Uvalu 84, 150 06, Prague 5, Czech Republic
| | - Vaclav Bunc
- Faculty of Physical Education and Sport, Charles University, Jose Martiho 31, 162 52, Prague 6, Czech Republic
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Olsen JM, Horning ML, Thorson D, Monsen KA. Relationships between public health nurse-delivered physical activity interventions and client physical activity behavior. Appl Nurs Res 2018; 40:13-19. [DOI: 10.1016/j.apnr.2017.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 11/22/2017] [Accepted: 12/14/2017] [Indexed: 11/30/2022]
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Wald A, Garber CE. A Review of Current Literature on Vital Sign Assessment of Physical Activity in Primary Care. J Nurs Scholarsh 2017; 50:65-73. [PMID: 29068556 DOI: 10.1111/jnu.12351] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2017] [Indexed: 12/15/2022]
Abstract
PURPOSE To conduct an integrated review of the performance and implementation of two physical activity (PA) assessment tools, the exercise vital sign (EVS) and the physical activity vital sign (PAVS), in U.S. primary care practice. DESIGN An integrative review following Whittemore and Knafl's methodology. METHODS Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched. Search terms were "exercise vital sign" OR "physical activity vital sign" AND "primary care". Additional inclusion criteria were studies conducted in the United States, published in English, in primary care, between 2010 and 2016. RESULTS Nine studies met inclusion criteria. Five studies reported validity data of the EVS tool, while four studies reported data from the PAVS tool. Compared with the accelerometer, the EVS tool overestimated moderate-vigorous PA, while the PAVS tool demonstrated moderate agreement in identifying those not meeting national PA guidelines. The EVS tool was successfully implemented in large, integrated practices utilizing electronic health record systems. PA documentation increased compared to non-EVS practices. The predictive ability of the PAVS tool for clinical outcomes was shown. Studies of PA assessment tool use in children were not found. CONCLUSIONS Preliminary evidence on the validity of both the EVS and PAVS tools support cautious use of each as a screening tool in primary care. There were no data on reliability, with limited data on tool use in diverse populations or settings. Data in children, older adults, and diverse population subgroups were lacking. CLINICAL RELEVANCE Two brief exercise vital signs tools have each shown some initial validity for use by primary care clinicians as measures to identify patients not meeting PA guidelines.
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Affiliation(s)
- Adrienne Wald
- Assistant Professor, Nursing, School of Nursing and Healthcare Professions, The College of New Rochelle, New Rochelle, NY, USA
| | - Carol Ewing Garber
- Professor and Chair, Department of Behavioral Sciences, Teachers College, Columbia University, New York, NY, USA
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Won MH, Son YJ. Perceived Social Support and Physical Activity Among Patients With Coronary Artery Disease. West J Nurs Res 2016; 39:1606-1623. [PMID: 27881811 DOI: 10.1177/0193945916678374] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Adherence to recommended physical activity after a cardiac event is important to prevent cardiac recurrence. Social support from peers and family is known to improve self-care in chronic illnesses, including cardiovascular disease. However, the relationship between social support from health care providers and physical activity among patients with coronary artery disease remains unclear. This cross-sectional study aimed to identify the relationship between perceived social support from health care providers and physical activity among patients with stable coronary artery disease. The study included 237 patients with stable coronary artery disease attending an outpatient clinic. Hierarchical linear regression found that perceived social support explained 12% of variance in physical activity, F(14, 222) = 7.37, p < .001. In addition, self-efficacy partially mediated the relationships between perceived social support and physical activity. Abundant support from health care providers plays a key role in promoting physical activity among patients with stable coronary artery disease.
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Affiliation(s)
- Mi Hwa Won
- 1 Dankook University, Cheonan, South Korea
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Richards EA, Ogata N, Cheng CW. Randomized Controlled Theory-Based, E-Mail-Mediated Walking Intervention. Clin Nurs Res 2016; 26:47-67. [PMID: 27369044 DOI: 10.1177/1054773816657799] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to evaluate the ability of two concurrent randomized controlled interventions based on social cognitive theory to increase walking. A second purpose was to compare the efficacy of the intervention between two distinct groups: dog owners and non-dog owners. Adult dog owners ( n = 40) and non-dog owners ( n = 65) were randomized into control or intervention groups. Intervention groups received bi-weekly emails for first 4 weeks and then weekly email for the next 8 weeks targeting self-efficacy, social support, goal setting, and benefits/barriers to walking. Dog owner messages focused on dog walking while non-dog owners received general walking messages. Control groups received a 1-time email reviewing current physical activity guidelines. At 6 months, both intervention groups reported greater increases in walking and maintained these increases at 12 months. The greatest increases were seen in the dog owner intervention group. In conclusion, dog owners accumulated more walking, which may be attributed to the dog-owner relationship.
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Richards EA. Walk the Talk: The Nurses' Role in Increasing Physical Activity. West J Nurs Res 2015; 38:391-3. [PMID: 26486653 DOI: 10.1177/0193945915611053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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