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Laberge S, Gosselin V, Lestage K, Chagnon M, Guimond C. Promotion of Physical Activity by Québec Primary Care Physicians: What Has Changed in the Last Decade? J Phys Act Health 2024; 21:508-518. [PMID: 38490193 DOI: 10.1123/jpah.2023-0379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVE This study aimed to assess the changes in the frequency of physical activity (PA) counseling and in the predictors of primary care PA promotion in Québec primary care physicians (PCPs) between 2010 and 2020. METHODS In 2010, we conducted a survey among Québec PCPs. Questions included: frequency of promoting PA to patients, perceived barriers, needs to improve PA promotion practice, frequency of PCPs' PA practice, and sociodemographic information. In 2020, we took over the 2010 questionnaire to document the evolution of the PA promotion practice. RESULTS The proportion of PCPs discussing PA with their patients significantly increased (P < .05) in 2020 for the following health conditions: depression, low back pain, chronic obstructive pulmonary disease, and cancer; it declined (P < .05) for overweight patients, those with metabolic syndrome, and in primary prevention. Collaboration with PA professionals was the major need identified, and it increased in 2020. PCPs' own practice of PA was a predictor of PA promotion in 2010 (odds ratio = 6.679; P < .001) and in 2020 (odds ratio = 6.679; P < .001). In both 2010 and in 2020, older or more experienced PCPs were more likely to discuss PA with their patients without diagnosed diseases than younger ones or those with less experience. CONCLUSIONS Over the last 10 years, there has been a significant increase in PCPs promoting PA in Québec; however, it has been mainly oriented toward secondary prevention. It is concerning that PA counseling in primary prevention has declined, notably among younger PCPs. The stronger claim for closer collaboration with kinesiologists suggests that PCPs are in favor of an interprofessional strategy, namely collaboration with PA specialists.
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Affiliation(s)
- Suzanne Laberge
- School of Kinesiology and Physical Activity, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Véronique Gosselin
- School of Kinesiology and Physical Activity, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Kim Lestage
- Public Health Program | RLS Pierre-Boucher, Integrated Health and Social Services Center-Montérégie-Est, Longueuil, QC, Canada
| | - Miguel Chagnon
- Department of Mathematics and Statistics, Université de Montréal, Montréal, QC, Canada
| | - Claude Guimond
- Fédération des médecins omnipraticiens du Québec, Westmount, QC, Canada
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Mincarone P, Bodini A, Tumolo MR, Sabina S, Colella R, Mannini L, Sabato E, Leo CG. Association Between Physical Activity and the Risk of Burnout in Health Care Workers: Systematic Review. JMIR Public Health Surveill 2024; 10:e49772. [PMID: 38498040 PMCID: PMC10985610 DOI: 10.2196/49772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/18/2023] [Accepted: 12/12/2023] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Burnout is a multidimensional psychological syndrome that arises from chronic workplace stress. Health care workers (HCWs), who operate in physically and emotionally exhausting work contexts, constitute a vulnerable group. This, coupled with its subsequent impact on patients and public economic resources, makes burnout a significant public health concern. Various self-care practices have been suggested to have a positive effect on burnout among HCWs. Of these, physical activity stands out for its ability to combine psychological, physiological, and biochemical mechanisms. In fact, it promotes psychological detachment from work and increases self-efficacy by inhibiting neurotransmitters and neuromodulators, increasing endorphin levels, enhancing mitochondrial function, and attenuating the hypothalamic pituitary-adrenal axis response to stress. OBJECTIVE Our objective was to conduct a systematic review of the evidence on the association between physical activity and burnout among HCWs. METHODS We considered HCWs, physical activity, and burnout, framing them as population, exposure, and outcome, respectively. We searched APA PsycArticles, MEDLINE, and Scopus until July 2022. We extracted relevant data on study design, methods to measure exposure and outcome, and statistical approaches. RESULTS Our analysis encompassed 21 independent studies. Although 10% (2/21) of the studies explicitly focused on physical activity, the remaining investigations were exploratory in nature and examined various predictors, including physical activity. The most commonly used questionnaire was the Maslach Burnout Inventory. Owing to the heterogeneity in definitions and cutoffs used, the reported prevalence of burnout varied widely, ranging from 7% to 83%. Heterogeneity was also observed in the measurement tools used to assess physical activity, with objective measures rarely used. In total, 14% (3/21) of the studies used structured questionnaires to assess different types of exercise, whereas most studies (18/21, 86%) only recorded the attainment of a benchmark or reported the frequency, intensity, or duration of exercise. The reported prevalence of physically active HCWs ranged from 44% to 87%. The analyses, through a variety of inferential approaches, indicated that physical activity is often associated with a reduced risk of burnout, particularly in the domains of emotional exhaustion and depersonalization. Furthermore, we compiled and classified a list of factors associated with burnout. CONCLUSIONS Our comprehensive overview of studies investigating the association between physical activity and burnout in HCWs revealed significant heterogeneity in definitions, measurements, and analyses adopted in the literature. To address this issue, it is crucial to adopt a clear definition of physical activity and make thoughtful choices regarding measurement tools and methodologies for data analysis. Our considerations regarding the measurement of burnout and the comprehensive list of associated factors have the potential to improve future studies aimed at informing decision-makers, thus laying the foundation for more effective management measures to address burnout.
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Affiliation(s)
- Pierpaolo Mincarone
- Research Unit of Brindisi, Institute for Research on Population and Social Policies, National Research Council, Brindisi, Italy
- MOVE-Mentis s.r.l, Cesena, Italy
| | - Antonella Bodini
- Institute for Applied Mathematics and Information Technologies "Enrico Magenes", National Research Council, Milan, Italy
| | - Maria Rosaria Tumolo
- Biological and Environmental Sciences and Technology Department, University of Salento, Lecce, Italy
| | - Saverio Sabina
- MOVE-Mentis s.r.l, Cesena, Italy
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
| | - Riccardo Colella
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
- Innovation Engineering Department, University of Salento, Lecce, Italy
| | - Linda Mannini
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
| | - Eugenio Sabato
- Research Unit of Brindisi, Institute for Research on Population and Social Policies, National Research Council, Brindisi, Italy
- Respiratory Diseases Unit, "Antonio Perrino" P.O., Local Health Unit "ASL Brindisi", Brindisi, Italy
| | - Carlo Giacomo Leo
- MOVE-Mentis s.r.l, Cesena, Italy
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
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Paez DC, Cortés-Corrales S, Jimenez-Mora MA, Gutiérrez A, Arango-Paternina CM, Duperly J. Health-related fitness in medical students: a curricular intervention in Bogota, Colombia. BMC Public Health 2024; 24:320. [PMID: 38287350 PMCID: PMC10826255 DOI: 10.1186/s12889-024-17748-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/11/2024] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE To evaluate the impact of a curricular intervention to promote health-related fitness (HRF) among medical students in Bogota, Colombia. METHOD The study was conducted between May 2014 and December 2015 as part of the medical physiology course, in which 208 medical students were enrolled.The curricular intervention included two lectures on physical activity (PA) and student-led group presentations on the physiological effects of exercise on human physiology. An academic incentive (10% of final grade) was given to students who reported and documented regular PA practice during the semester. This study assessed students' HRF variables, perceptions of the curriculum intervention, and PA practices using quantitative and qualitative approaches. RESULTS 55% of the students were female, with a mean age of 19.5 years. Body fat, estimated maximum oxygen consumption (VO2max), handgrip, and sit-up strength showed statistically significant improvements at the end of the intervention. Students reported that PA practice was positively influenced by the curriculum intervention, particularly the academic incentive and the HRF tests. Students reported a wide variety of PA practices, which were mainly done with friends, classmates, or family members. Lack of time was the main reported barrier to PA practice. CONCLUSION The curricular intervention was effective in improving HRF and promoting PA. It remains to be investigated whether these gains are sustained over time.
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Affiliation(s)
- Diana C Paez
- School of Medicine, Universidad de los Andes, Bogotá, Colombia.
| | | | | | - Agustín Gutiérrez
- Department of Social Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Carlos M Arango-Paternina
- Instituto Universitario de Educación Física y Deportes, Universidad de Antioquia, Medellín, Colombia
| | - John Duperly
- School of Medicine, Universidad de los Andes, Bogotá, Colombia
- Institute of Exercise Medicine and Rehabilitation, Fundación Santa Fe de Bogotá, Bogotá, Colombia
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Chen S, Wu Y, Bushey EL, Pescatello LS. Evaluation of Exercise Mobile Applications for Adults with Cardiovascular Disease Risk Factors. J Cardiovasc Dev Dis 2023; 10:477. [PMID: 38132645 PMCID: PMC10743387 DOI: 10.3390/jcdd10120477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To conduct a systematic review to determine if there are exercise mobile applications (apps) that can produce evidence-based, individualized exercise plans. MATERIALS AND METHODS We searched the Apple Store and Google Play for exercise apps with terms related to exercise and health. Exercise apps were eligible if they: (1) had a ≥4 out of 5 overall rating with ≥1000 reviews; (2) were free to download; and (3) were not gender specific. Exercise apps were evaluated via the evidence-based exercise prescription (ExRx) standards of the American College of Sports Medicine (ACSM) and American Heart Association. For the exercise app evaluation criteria, an app was included if it (1) was evidence-based; (2) contained a preparticipation health screening protocol; (3) built a cardiovascular disease (CVD) risk factor profile; (4) prioritized one chronic disease or health condition to focus on; (5) framed the exercise plan by the frequency, intensity, time, and type principle (FITT) of ExRx; and (6) specified special considerations. RESULTS Of the 531 potentially qualifying apps, 219 qualified. The qualifying apps were rarely evidenced-based (0.5%) or had a preparticipation screening protocol (3.7%). Only 27.7% built CVD risk factor profiles. Most apps (64.8%) focused on body image and/or athletic performance. Only 4.3% focused on chronic diseases or health conditions, while the remainder (34.5%) did not disclose a focus. No app framed the exercise plans by the FITT of ExRx. Only 1.4% of the apps specified special considerations. CONCLUSION There are no commercially available exercise apps that generate an evidence-based, individualized exercise plan for adults with CVD risk factors.
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Affiliation(s)
- Shiqi Chen
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
| | - Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
- Institute for Collaboration on Health Intervention and Policy, University of Connecticut, Storrs, CT 06269, USA
- Department of Research, Hartford Hospital, Hartford, CT 06102, USA
| | - Erica L. Bushey
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
| | - Linda S. Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
- Institute for Collaboration on Health Intervention and Policy, University of Connecticut, Storrs, CT 06269, USA
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Raghavan A, Vishnubala D, Iqbal A, Hunter R, Marino K, Eastwood D, Nykjaer C, Pringle A. UK Nurses Delivering Physical Activity Advice: What Are the Challenges and Possible Solutions? A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7113. [PMID: 38063543 PMCID: PMC10706598 DOI: 10.3390/ijerph20237113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023]
Abstract
There are a multitude of health benefits gained from regular physical activity (PA). Currently, PA advice implementation from NHS nurses is inadequate despite their ever-increasing role in lifestyle and preventive medicine. By assessing their knowledge of current PA guidance, this study proposed to investigate the issues with regular PA advice being given and expand upon nurses' proposed barriers and solutions. A qualitative approach using semi structured interviews was undertaken between March and August 2023 involving 13 NHS nurses. Thematic analysis was undertaken using Braun and Clarke's six step approach. Four themes and fifteen subthemes emerged as barriers and solutions in delivering PA advice. Intrinsic barriers included a lack of nurse knowledge on the topic and PA being seen as an afterthought. Extrinsic barriers included time pressures and a lack of staff engagement. Solutions involved increasing staff awareness of guidelines through teaching, policy, encouraging staff to be active and optimising PA advice delivery through a piecemeal approach and utilising online and visual resources. This study displayed an insight into nurses' thoughts on their consultations with patients regarding PA, and proposed several barriers and solutions. Further work is needed to improve nurses' PA knowledge and to assess the proposed strategies to improve its delivery.
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Affiliation(s)
| | - Dane Vishnubala
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK; (D.V.); (D.E.); (C.N.)
- School of Public Health, Imperial College London, London SW7 2BX, UK
| | - Adil Iqbal
- Calderdale and Huddersfield NHS Foundation Trust, Huddersfield HD3 3EA, UK;
| | - Ruth Hunter
- York and Scarborough Teaching Hospitals NHS Foundation Trust, York YO31 8HE, UK;
| | | | - David Eastwood
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK; (D.V.); (D.E.); (C.N.)
- Musculoskeletal Department, Locala Health and Wellbeing, Huddersfield HD1 4EW, UK
| | - Camilla Nykjaer
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK; (D.V.); (D.E.); (C.N.)
| | - Andy Pringle
- Clinical Exercise and Rehabilitation Research Centre, School of Sport and Exercise Science, University of Derby, Derby DE22 1GB, UK;
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Tangjitgamol S, Bunsiricomchai P, Kaewwanna W, Ativanichayapong N, Manusirivithaya S. Exercise and associated features with low-level exercise among doctors. Clinics (Sao Paulo) 2023; 78:100282. [PMID: 37797347 PMCID: PMC10622831 DOI: 10.1016/j.clinsp.2023.100282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Physical activity had been reported among doctors-in-training, with very few focusing on attending doctors. This study aimed to evaluate the physical activity, particularly exercise, of Thai doctors and features associated with low-level exercise. MATERIALS AND METHODS Thai doctors who participated in the hospital's CSR service, which was conducted between Feb 14, 2022, to Oct 31, 2022, were verbally informed along with an information sheet about this parallel study. The doctors who consented to participate provided their personal data on diets, work hours, illnesses, health surveillance, stress, state of well-being, and exercise. To investigate the association with clinical features, the exercise level was categorized as low-level (≤ 2 days/week) or high-level (≥ 3 days/week). RESULTS The median age of 1187 doctors was 45.0 years. Slightly over half were female (55.4%) or worked ≤ 40 hours/week (55.3%). The presence of illnesses was found in 55.9%, irregular health surveillance in 29.0%, no/low fiber diet in 19.2%, overweight/obesity in 28.0%, and moderate/severe stress in 25.9%. Among the doctors who provided exercise data, 29.8% had a high-level of exercise and 49.0% had a low-level. Independent features associated with low-level exercise were no/low fiber diet (aOR = 3.01), irregular health surveillance (aOR = 2.41), age ≤ 60 years (aOR = 1.82), female gender (aOR = 1.79), and work > 40 hours/week (aOR = 1.76). CONCLUSIONS Only 30% of Thai doctors had a high level of exercise. The significant independent factors for low-level exercise were younger age, female, working load, irregular health surveillance, and no/ low fiber diet.
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Petrie MA, Johnson KA, Dubey O, Shields RK. Exercise Prescription Principles among Physicians and Physical Therapists for Patients with Impaired Glucose Control: A Cross-Sectional Study. J Funct Morphol Kinesiol 2023; 8:112. [PMID: 37606407 PMCID: PMC10443365 DOI: 10.3390/jfmk8030112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/19/2023] [Accepted: 08/03/2023] [Indexed: 08/23/2023] Open
Abstract
Exercise confers a multitude of benefits with limited adverse side effects, making it a powerful "medication" for a plethora of diseases. In people living with uncontrolled glucose levels, exercise can be an effective "medication" to assist in the management of hyperglycemia. We sought to survey healthcare providers (physicians and physical therapists) to determine the current state of exercise recommendation for people with glucose control issues. Healthcare providers were surveyed from six academic medical centers in the Midwest to determine the recommended exercise parameters (type, frequency, duration, intensity, and timing) for patients with glucose control issues. Data from 209 practitioners who completed the survey were used for analysis. Chi-square tests were used to determine differences in exercise recommendations between physical therapists (PTs) and physicians (MD/DOs). PTs and MD/DOs recommended similar exercise parameters. Of all respondents, 78.9% recommended exercise to patients with glucose control issues. Respondents who considered themselves to be active exercisers were more likely to recommend exercise than those who were not exercisers. Only 6.1% of all respondents recommended post-meal exercise. Healthcare providers overwhelmingly recommended exercise for people with glucose control issues, but the "timing" is not congruent with best practice recommendations.
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Affiliation(s)
| | | | | | - Richard K. Shields
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, The University of Iowa, Iowa City, IA 52242, USA; (M.A.P.); (K.A.J.); (O.D.)
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Yenit MK, Kolbe-Alexander TL, Gelaye KA, Gezie LD, Tesema GA, Abebe SM, Azale T, Shitu K, Gyawali P. An Evaluation of Community Health Workers' Knowledge, Attitude and Personal Lifestyle Behaviour in Non-Communicable Disease Health Promotion and Their Association with Self-Efficacy and NCD-Risk Perception. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095642. [PMID: 37174162 PMCID: PMC10178727 DOI: 10.3390/ijerph20095642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/05/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023]
Abstract
Community health workers, also known as health extension workers (HEWs), play an important role in health promotion. This study evaluates HEWs' knowledge, attitude, and self-efficacy for non-communicable diseases (NCD) health promotion. HEWs (n = 203) completed a structured questionnaire on knowledge, attitude, behaviour, self-efficacy and NCD risk perception. Regression analysis was used to determine the association between self-efficacy and NCD risk perception with knowledge (high, medium, low), attitude (favourable/unfavourable) and physical activity (sufficient/insufficient). HEWs with higher self-efficacy were more likely to have high NCD knowledge (AOR: 2.21; 95% CI: 1.21. 4.07), favourable attitude towards NCD health promotion (AOR: 6.27; 95% CI: 3.11. 12.61) and were more physically active (AOR: 2.27; 95% CI: 1.08. 4.74) than those with lower self-efficacy. HEWs with higher NCD susceptibility (AOR: 1.89; 95% CI: 1.04. 3.47) and perceived severity (AOR: 2.69; 95% CI: 1.46, 4.93) had higher odds of NCD knowledge than their counterparts. Moreover, sufficient physical activity was influenced by HEWs' perceived NCD susceptibility and perceived benefits of lifestyle change. Therefore, HEWs need to adopt healthy lifestyle choices to become effective role models for the community. Our findings highlight the need to include a healthy lifestyle when training HEWs, which might increase self-efficacy for NCD health promotion.
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Affiliation(s)
- Melaku Kindie Yenit
- School of Health and Medical Sciences, Centre for Health Research, University of Southern Queensland, Ipswich, QLD 4305, Australia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Tracy L Kolbe-Alexander
- School of Health and Medical Sciences, Centre for Health Research, University of Southern Queensland, Ipswich, QLD 4305, Australia
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Lemma Derseh Gezie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Solomon Mekonnen Abebe
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Telake Azale
- Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Kegnie Shitu
- Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Prajwal Gyawali
- Centre for Health Research, School of Health and Medical Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia
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Morgan M. Matt Morgan: We all contain multitudes. BMJ 2022; 379:o2483. [PMID: 36257673 DOI: 10.1136/bmj.o2483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Vishnubala D, Iqbal A, Marino K, Whatmough S, Barker R, Salman D, Bazira P, Finn G, Pringle A, Nykjaer C. UK Doctors Delivering Physical Activity Advice: What Are the Challenges and Possible Solutions? A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912030. [PMID: 36231332 PMCID: PMC9566007 DOI: 10.3390/ijerph191912030] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 05/15/2023]
Abstract
Despite strategies to enable Health Care Professionals (HCPs) to give physical activity (PA) advice to patients, this appears to be rarely done in consultations. The aims of the present study were to gain an understanding of doctors' awareness of current PA guidelines and to explore their opinions on barriers and solutions. A qualitative approach using semi-structured interviews was adopted. This study included 15 doctors currently working in the UK's National Health Service (NHS). A thematic analysis approach was used to analyse the transcripts. Four themes and twelve sub-themes were deciphered. Intrinsic factors limiting the delivery of PA advice included a lack of knowledge of PA guidelines and PA being an afterthought. Barriers to delivering PA guidance included a lack of PA education, time pressures, and patient engagement. Solutions included staff training, incorporating PA into undergraduate training, and encouraging staff to be physically active. Methods to optimise PA guidance included individualised PA advice, local exercise services and schemes, utilising online and visual resources, and motivational interviewing. This study provides an updated insight into doctors' opinions on barriers and solutions to discussing PA with patients. It is clear that further work is needed to ensure greater awareness of PA guidelines amongst clinicians.
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Affiliation(s)
- Dane Vishnubala
- Health Professions Education Unit, Hull York Medical School, York YO10 5DD, UK
- Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
- School of Public Health, Imperial College London, London SW7 2BX, UK
- MSK Lab, Imperial College London, London SW7 2BX, UK
- Correspondence:
| | - Adil Iqbal
- Bradford Teaching Hospital Foundation Trust, Bradford BD9 6RJ, UK
| | | | | | - Ruth Barker
- Health Professions Education Unit, Hull York Medical School, York YO10 5DD, UK
| | - David Salman
- School of Public Health, Imperial College London, London SW7 2BX, UK
- MSK Lab, Imperial College London, London SW7 2BX, UK
| | - Peter Bazira
- Health Professions Education Unit, Hull York Medical School, York YO10 5DD, UK
| | - Gabrielle Finn
- Health Professions Education Unit, Hull York Medical School, York YO10 5DD, UK
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Andy Pringle
- Sport Outdoor and Exercise Science, School of Human Sciences, Human Science Research Centre University of Derby, Derby DE22 1GB, UK
| | - Camilla Nykjaer
- Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
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Silva CS, Mendes R, Godinho C, Monteiro-Pereira A, Pimenta-Ribeiro J, Martins HS, Brito J, Themudo-Barata JL, Fontes-Ribeiro C, Teixeira PJ, Freitas G, Silva MN. Predictors of physical activity promotion in clinical practice: a cross-sectional study among medical doctors. BMC MEDICAL EDUCATION 2022; 22:624. [PMID: 35978358 PMCID: PMC9386999 DOI: 10.1186/s12909-022-03686-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Physical activity is a major determinant of physical and mental health. International recommendations identify health professionals as pivotal agents to tackle physical inactivity. This study sought to characterize medical doctors' clinical practices concerning the promotion of patients' physical activity, while also exploring potential predictors of the frequency and content of these practices, including doctors' physical activity level and sedentary behaviours. METHODS A cross-sectional study assessed physical activity promotion in clinical practice with a self-report questionnaire delivered through the national medical prescription software (naturalistic survey). Physical activity and sedentary behaviours were estimated using the International Physical Activity Questionnaire (short form). Indicators of medical doctors' attitudes, knowledge, confidence, barriers, and previous training concerning physical activity promotion targeting their patients were also assessed. Multiple regression analysis was performed to identify predictors of physical activity promotion frequency by medical doctors, including sociodemographic, attitudes and knowledge-related variables, and physical activity behaviours as independent variables. RESULTS A total of 961 medical doctors working in the Portuguese National Health System participated (59% women, mean age 44 ± 13 years) in the study. The majority of the participants (84.6%) reported to frequently promote patients' physical activity. Five predictors of physical activity promotion frequency emerged from the multiple regression analysis, explaining 17.4% of the dependent variable (p < 0.001): working in primary healthcare settings (p = 0.037), having a medical specialty (p = 0.030), attributing a high degree of relevance to patients' physical activity promotion in healthcare settings (p < 0.001), being approached by patients to address physical activity (p < 0.001), and having higher levels of physical activity (p = 0.001). CONCLUSIONS The sample of medical doctors approached reported a high level of engagement with physical activity promotion. Physical activity promotion frequency seems to be influenced by the clinical practice setting, medical career position and specialty, attitudes towards physical activity, and perception of patients´ interest on the topic, as well as medical doctors' own physical activity levels.
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Affiliation(s)
- Catarina Santos Silva
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Programa Nacional para a Promoção da Atividade Física, Direção-Geral da Saúde, Lisbon, Portugal
| | - Romeu Mendes
- Programa Nacional para a Promoção da Atividade Física, Direção-Geral da Saúde, Lisbon, Portugal
- EPIUnit – Instituto de Saúde Pública, ITR, Universidade do Porto, Porto, Portugal
- Portugal Football School, Portuguese Football Federation, Cruz Quebrada, Portugal
- ACES Douro I - Marão e Douro Norte, Administração Regional de Saúde do Norte, Vila Real, Portugal
| | - Cristina Godinho
- Programa Nacional para a Promoção da Atividade Física, Direção-Geral da Saúde, Lisbon, Portugal
- Católica Research Centre for Psychological, Family and Social Wellbeing, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Ana Monteiro-Pereira
- Portugal Football School, Portuguese Football Federation, Cruz Quebrada, Portugal
- CIDESD, University Institute of Maia, Maia, Portugal
- ACES Loures-Odivelas, Administração Regional de Saúde de Lisboa e Vale do Tejo, Lisbon, Portugal
| | - Jaime Pimenta-Ribeiro
- ACES Douro I - Marão e Douro Norte, Administração Regional de Saúde do Norte, Vila Real, Portugal
| | | | - João Brito
- Portugal Football School, Portuguese Football Federation, Cruz Quebrada, Portugal
| | - José Luís Themudo-Barata
- Serviço de Nutrição e Atividade Física do Centro Hospitalar Universitário da Cova da Beira, Covilhã, Portugal
- Faculdade de Ciências da Saúde da Universidade da Beira Interior, Covilhã, Portugal
| | - Carlos Fontes-Ribeiro
- Instituto de Farmacologia e Terapêutica Experimental, Subunidade 1, Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
| | - Pedro J. Teixeira
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | | | - Marlene Nunes Silva
- Programa Nacional para a Promoção da Atividade Física, Direção-Geral da Saúde, Lisbon, Portugal
- CIDEFES, Faculdade de Educação Física e Desporto, Universidade Lusófona, Lisbon, Portugal
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