1
|
Van Oosterwijck S, Meeus M, van Der Wekken J, Dhondt E, Billens A, Van Oosterwijck J. Physical activity is predictive of conditioned pain modulation in healthy individuals: a cross-sectional study. THE JOURNAL OF PAIN 2024:104639. [PMID: 39029881 DOI: 10.1016/j.jpain.2024.104639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 07/04/2024] [Accepted: 07/14/2024] [Indexed: 07/21/2024]
Abstract
Even in healthy populations, conditioned pain modulation (CPM) magnitude varies. This may be accounted for by (non-)modifiable factors, including physical activity. Yet, little research has thoroughly examined physical activity and its relation with CPM magnitude in a representative sample. Therefore, the present study investigated the predictive effect of physical activity on CPM magnitude in 105 healthy adults. Physical activity was assessed during seven consecutive days by self-report using the International Physical Activity Questionnaire and by monitored-based accelerometry. CPM was examined using a heterotopic noxious conditioning stimulation protocol during which the effect of a hot water conditioning stimulus on pressure pain thresholds was evaluated. Comparative, correlation, and hierarchical linear regression analyses were performed. Report-based walking predicts 4.8% of variance in pain modulatory capacity, moderate physical activity predicts 10.2% of variance in pain modulatory capacity, and report-based time spent on total physical activity predicts 7.0% of variance in pain modulatory capacity. More MET-minutes/week spent on total physical activity, including walking and moderate physical activity is associated with greater pain modulatory capacity. The findings of this study add to the limited evidence on the predictive effect of physical activity on CPM. It urges to consider physical activity a confounding factor when examining CPM. The current study provides evidence that a physically active lifestyle benefits endogenous pain modulation in healthy adults. Given its potential, walking and moderate-intensity physical activity might be achievable treatment strategies for pain patients known to have impaired CPM. PERSPECTIVE: The results of this article show that a physically active lifestyle including larger amounts of walking and moderate activity predict greater pain modulatory capacity. TRIAL REGISTRATION: This study has not been preregistered.
Collapse
Affiliation(s)
- Sophie Van Oosterwijck
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Pain in Motion international research group, www.paininmotion.be; Research Foundation - Flanders (FWO), Brussels, Belgium
| | - Mira Meeus
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Pain in Motion international research group, www.paininmotion.be; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Jacob van Der Wekken
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Evy Dhondt
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Pain in Motion international research group, www.paininmotion.be
| | - Amber Billens
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Pain in Motion international research group, www.paininmotion.be
| | - Jessica Van Oosterwijck
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Pain in Motion international research group, www.paininmotion.be; Research Foundation - Flanders (FWO), Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| |
Collapse
|
2
|
Leese CJ, Mann RH, Al-Zubaidi H, Cockcroft EJ. A movement for movement: an exploratory study of primary healthcare professionals' perspectives on implementing the Royal College of General Practitioners' active practice charter initiative. BMC PRIMARY CARE 2024; 25:112. [PMID: 38622556 PMCID: PMC11017589 DOI: 10.1186/s12875-024-02345-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/18/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Regular physical activity (PA) results in extensive physical, psychological, and social benefits. Despite primary care being a key point of influence for PA behaviours in the UK, research indicates poor application of PA interventions in this context. To address this, the Royal College of General Practitioners' (RCGP) developed and implemented the Active Practice Charter (APC). The aim of the study was to evaluate the perceived impact and acceptability of the APC initiative from the perspective of primary healthcare professionals (PHPs). METHODS An online exploratory cross-sectional survey was designed to assess the perceived impact, experiences, and challenges of the APC initiative, from the perspective of PHPs. The survey was distributed by the RCGP via email to 184 registered APC practices across the UK. RESULTS Responses were reviewed from staff (n = 33) from 21 APC practices. Initiatives used by APC practices included: educational programmes, partnerships with PA providers, referral systems, and infrastructure investment. Perceived benefits included: increased awareness about PA, staff cohesion, and improved well-being. However, staff felt the APC had limited effect due to implementation barriers, including: a lack of engagement, time, resources, and funding. CONCLUSION This is the first evaluation of any nationwide UK-based initiative engaging GP practices in promoting PA. Acknowledging the limitations in response rate, although support exists for the RCGP APC, the evaluation highlights challenges to its implementation. Nonetheless, the wide reach of the RCGP, combined with the cited staff and patient benefits, demonstrates the significant potential of the APC initiative. Given the need to address physical inactivity nationally, further development the APC offers a possible solution, with further research required to overcome the challenges to implementation.
Collapse
Affiliation(s)
- Callum J Leese
- Department of Population Health and Genomics, Ninewells Hospital, University of Dundee, James Arnott Drive, Dundee, United Kingdom.
| | - Robert H Mann
- Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Hussain Al-Zubaidi
- Physical Activity and Lifestyle Champion, Royal College of General Practitioners, London, United Kingdom
| | - Emma J Cockcroft
- Department of Health and Community Sciences, Faculty of Health and Life Sciences, Royal College of General Practitioners, Exeter, United Kingdom
| |
Collapse
|
3
|
Wattanapisit A, Hemarachatanon P, Somrak K, Manunyanon S, Wattanapisit S, Amornsriwatanakul A, Katewongsa P, Sangkaew S, Vichitkunakorn P, Lee PY, Ramdzan SN, Salim H, Ng CJ, Stoutenberg M. Physical Activity with Sports Scientist (PASS) programme to promote physical activity among patients with non-communicable diseases: a pragmatic randomised controlled trial protocol. BMJ Open Sport Exerc Med 2024; 10:e001985. [PMID: 38601124 PMCID: PMC11002402 DOI: 10.1136/bmjsem-2024-001985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2024] [Indexed: 04/12/2024] Open
Abstract
Physical activity (PA) effectively prevents and treats non-communicable diseases in clinical settings. PA promotion needs to be more consistent, especially in busy primary care. Sports scientists have the potential to support PA promotion in primary care. The Physical Activity with Sports Scientist (PASS) programme is created to personalise PA promotion led by a sports scientist in a primary care clinic. A pragmatic randomised controlled trial with two parallel groups will be conducted at a family medicine clinic. Physically inactive participants aged 35-70 years who have type 2 diabetes mellitus, hypertension or dyslipidaemia will be invited. The control group (n=60) will receive usual care. The intervention group (n=60) will receive the PASS programme and usual care. The PASS programme will consist of a tailored PA prescription after the physician's consultation at the first visit and monthly phone follow-ups. The primary outcome is the proportion of participants who have achieved the PA goal defined as aerobic activity (≥150 min/week of moderate to vigorous-intensity PA), muscle-strengthening activity (≥2 days/week of moderate or greater intensity) and multicomponent PA (≥2 days/week of moderate or greater intensity). Secondary outcomes are body composition and physical fitness. The primary and secondary outcomes will be measured and compared between the control and intervention groups at visit 1 (month 0: baseline measurements), visit 2 (months 3-4: follow-up measurements), visit 3 (months 6-8: end-point measurements) and visit 4 (months 9-12: continuing measurements). The study protocol was registered with the Thai Clinical Trials Registry. Trial registration number: TCTR20240314001.
Collapse
Affiliation(s)
- Apichai Wattanapisit
- Department of Clinical Medicine, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
- Family Medicine Clinic, Walailak University Hospital, Nakhon Si Thammarat, Thailand
| | - Poramet Hemarachatanon
- Department of Sport and Exercise Science, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
| | - Kamlai Somrak
- Department of Community Nursing, School of Nursing, Walailak University, Nakhon Si Thammarat, Thailand
- Department of Health Promotion, Walailak University Hospital, Nakhon Si Thammarat, Thailand
| | - Saranrat Manunyanon
- Division of Student Support and Development, Walailak University, Nakhon Si Thammarat, Thailand
| | | | | | - Piyawat Katewongsa
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - Sorawat Sangkaew
- Department of Social Medicine, Hatyai Hospital, Songkhla, Thailand
| | - Polathep Vichitkunakorn
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Ping Yein Lee
- UMeHealth Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Siti Nurkamilla Ramdzan
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Hani Salim
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Research, SingHealth Polyclinics, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Mark Stoutenberg
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| |
Collapse
|
4
|
Leese C, Mann RH, Cockcroft EJ, Abraham K. GP specialty trainees' knowledge and values towards physical activity: a national survey of Scottish trainees. BJGP Open 2024; 8:BJGPO.2023.0051. [PMID: 37652716 PMCID: PMC11169968 DOI: 10.3399/bjgpo.2023.0051] [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: 03/23/2023] [Revised: 06/14/2023] [Accepted: 07/16/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Despite the known benefits of physical activity (PA), one-third of adults in the UK fail to meet recommended levels of PA. PA promotion in primary care has been shown to be effective at improving PA in patients but implementation of PA promotion by GPs remains poor. Research has shown a need to improve PA education in undergraduate medical education, but, to the authors' knowledge, no review of postgraduate medical education has been performed. AIM To assess the knowledge and values of general practice specialist trainees (GPSTs) towards PA promotion in Scotland. DESIGN & SETTING Cross-sectional survey distributed to GPSTs in Scotland. METHOD A mixed-methods cross-sectional survey, informed by previous research, was developed and distributed to all (n = 1205) GPSTs in Scotland in December 2022. Descriptive statistics were used to analyse quantitative data. A content analysis of free-text responses was also performed. RESULTS A total of 168 GPSTs responded, representing 13.9% of all GPSTs in Scotland. Of responders, 93.5% reported no previous experience in the subject of sports and exercise science and medicine. Overall, 38.9% of responders stated they were unaware of the current UK PA guidelines, with 33.9% unable to correctly identify the UK PA guidelines when presented with multiple choice options. In addition, 83.3% felt they had been inadequately trained to deliver PA advice during their medical training. CONCLUSION This study highlights a lack of knowledge, confidence, and education in PA promotion in GPSTs in Scotland. Given the importance of primary prevention, this urgently needs to be addressed.
Collapse
Affiliation(s)
- Callum Leese
- School of Medicine, University of Dundee, Dundee, UK
| | - Robert H Mann
- Department of Public Health and Sport Sciences, University of Exeter Medical School, Exeter, United Kingdom
| | - Emma J Cockcroft
- Department of Health and Community Sciences, University of Exeter Medical School, Exeter, UK
| | | |
Collapse
|
5
|
Wattanapisit A, Lapmanee S, Chaovalit S, Lektip C, Chotsiri P. Prevalence of physical activity counseling in primary care: A systematic review and meta-analysis. Health Promot Perspect 2023; 13:254-266. [PMID: 38235006 PMCID: PMC10790122 DOI: 10.34172/hpp.2023.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/20/2023] [Indexed: 01/19/2024] Open
Abstract
Background This systematic review aimed to summarize and evaluate the prevalence of physical activity (PA) counseling in primary care. Methods Five databases (CINAHL Complete, Embase, Medline, PsycInfo, and Web of Science) were searched. Primary epidemiological studies on PA counseling in primary care were included. The Joanna Briggs Institute critical appraisal checklist for studies reporting prevalence data was used to assess the quality of studies. The review protocol was registered with PROSPERO (CRD42021284570). Results After duplicate removal, 4990 articles were screened, and 120 full-text articles were then assessed. Forty studies were included, with quality assessment scores ranging from 5/9 to 9/9. The pooled prevalence of PA counseling based on 35 studies (199830 participants) was 37.9% (95% CI 31.2 to 44.6). The subgroup analyses showed that the prevalence of PA counseling was 33.1% (95% CI: 22.6 to 43.7) in females (10 studies), 32.1% (95% CI: 22.6 to 41.7) in males (10 studies), 65.5% (95% CI: 5.70 to 74.1) in people with diabetes mellitus (6 studies), 41.6% (95% CI: 34.9 to 48.3) in people with hypertension (5 studies), and 56.8% (95% CI: 31.7 to 82.0) in people with overweight or obesity (5 studies). All meta-analyses showed high levels of heterogeneity (I2=93% to 100%). Conclusion The overall prevalence of PA counseling in primary care was low. The high levels of heterogeneity suggest variability in the perspectives and practices of PA counseling in primary care. PA counseling should be standardized to ensure its optimum effectiveness in primary care.
Collapse
Affiliation(s)
- Apichai Wattanapisit
- Department of Clinical Medicine, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
- Family Medicine Clinic, Walailak University Hospital, Nakhon Si Thammarat, Thailand
| | - Sarawut Lapmanee
- Department of Basic Medical Sciences, Faculty of Medicine, Siam University, Bangkok, Thailand
| | - Sirawee Chaovalit
- Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Charupa Lektip
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Palang Chotsiri
- Department of Clinical Pharmacology, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| |
Collapse
|
6
|
Kim SY. Does Excessive Smartphone Use Reduce Physical Activity in Adolescents? Korean J Fam Med 2023; 44:247-248. [PMID: 37743789 PMCID: PMC10522468 DOI: 10.4082/kjfm.44.5e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Affiliation(s)
- Soo Young Kim
- Department of Family Medicine, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| |
Collapse
|
7
|
Morgan TL, Faught E, Ross-White A, Fortier MS, Duggan M, Jain R, Lane KN, Lorbergs A, Maclaren K, McFadden T, Tomasone JR. Tools to guide clinical discussions on physical activity, sedentary behaviour, and/or sleep for health promotion between primary care providers and adults accessing care: a scoping review. BMC PRIMARY CARE 2023; 24:140. [PMID: 37420229 PMCID: PMC10326959 DOI: 10.1186/s12875-023-02091-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 06/22/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Health care providers have reported low knowledge, skill, and confidence for discussing movement behaviours (i.e., physical activity, sedentary behaviour, and sleep), which may be improved with the use of tools to guide movement behaviour discussions in their practice. Past reviews have examined the psychometric properties, scoring, and behavioural outcomes of physical activity discussion tools. However, the features, perceptions, and effectiveness of discussion tools for physical activity, sedentary behaviour, and/or sleep have not yet been synthesized. The aim of this review was to report and appraise tools for movement behaviour discussions between health care providers and adults 18 + years in a primary care context within Canada or analogous countries. METHODS An integrated knowledge translation approach guided this review, whereby a working group of experts in medicine, knowledge translation, communications, kinesiology, and health promotion was engaged from research question formation to interpretation of findings. Three search approaches were used (i.e., peer-reviewed, grey literature, and forward searches) to identify studies reporting on perceptions and/or effectiveness of tools for physical activity, sedentary behaviour, and/or sleep. The quality of included studies was assessed using the Mixed Methods Appraisal Tool. RESULTS In total, 135 studies reporting on 61 tools (i.e., 51 on physical activity, one on sleep, and nine combining two movement behaviours) met inclusion criteria. Included tools served the purposes of assessment (n = 57), counselling (n = 50), prescription (n = 18), and/or referral (n = 12) of one or more movement behaviour. Most tools were used or intended for use by physicians, followed by nurses/nurse practitioners (n = 11), and adults accessing care (n = 10). Most tools were also used or intended to be used with adults without chronic conditions aged 18-64 years (n = 34), followed by adults with chronic conditions (n = 18). The quality of the 116 studies that evaluated tool effectiveness varied. CONCLUSIONS Many tools were positively perceived and were deemed effective at enhancing knowledge of, confidence for, ability in, and frequency of movement behaviour discussions. Future tools should guide discussions of all movement behaviours in an integrated manner in line with the 24-Hour Movement Guidelines. Practically, this review offers seven evidence-based recommendations that may guide future tool development and implementation.
Collapse
Affiliation(s)
- Tamara L Morgan
- School of Kinesiology and Health Studies, Queen's University, 28 Division Street, Kingston, ON, K7L 3N6, Canada.
| | - Emma Faught
- School of Medicine, Queen's University, Kingston, ON, Canada
| | - Amanda Ross-White
- Bracken Health Sciences Library, Queen's University, Kingston, ON, Canada
| | | | - Mary Duggan
- Canadian Society for Exercise Physiology, Ottawa, ON, Canada
| | - Rahul Jain
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kirstin N Lane
- Canadian Society for Exercise Physiology, Ottawa, ON, Canada
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | | | | | - Taylor McFadden
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Canadian Medical Association, Ottawa, ON, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queen's University, 28 Division Street, Kingston, ON, K7L 3N6, Canada
| |
Collapse
|
8
|
Wattanapisit A, Ng CJ, Angkurawaranon C, Wattanapisit S, Chaovalit S, Stoutenberg M. Summary and application of the WHO 2020 physical activity guidelines for patients with essential hypertension in primary care. Heliyon 2022; 8:e11259. [PMID: 36325139 PMCID: PMC9618974 DOI: 10.1016/j.heliyon.2022.e11259] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/15/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
The new World Health Organization (WHO) 2020 guidelines on physical activity (PA) and sedentary behavior include recommendations for adults with chronic conditions. The guidelines provide adaptable and general recommendations for people living with chronic medical conditions. This article summarizes the content and provides suggestions for the application of the guidelines for patients with essential hypertension in primary care. The WHO 2020 PA guidelines recommend broad advice for adults and older adults with chronic conditions. The key recommendations are consistent with other hypertension guidelines. A systemic approach to promote PA in primary care (i.e., PA assessment, safety considerations, PA prescription, behavioral counseling, and referral) along with applying the WHO guidelines is required. Health risk assessment and safety issues related to hypertension (e.g., current PA levels, level of blood pressure, treatment plans, comorbidities) should be concerned. The FITT Pro (frequency, intensity, time, type, and progression) can be adopted as a framework to break down the guidelines into specific PA prescription. The WHO 2020 PA guidelines address the importance of PA in clinical populations. The guidelines can be adapted for patients with hypertension in primary care settings.
Collapse
Affiliation(s)
- Apichai Wattanapisit
- Department of Clinical Medicine, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand,Family Medicine Clinic, Walailak University Hospital, Nakhon Si Thammarat, Thailand
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia,SingHealth Polyclinics, Singapore, Singapore,Duke-NUS Medical School, Singapore, Singapore
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand,Corresponding author.
| | | | - Sirawee Chaovalit
- Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Mark Stoutenberg
- Department of Kinesiology, College of Public Health, Temple University, Philadelphia, USA
| |
Collapse
|
9
|
Bytyci Katanolli A, Probst-Hensch N, Ann Obas K, Gerold J, Zahorka M, Jerliu N, Ramadani Q, Fota N, Merten S. Perceived barriers to physical activity behaviour among patients with diabetes and hypertension in Kosovo: a qualitative study. BMC PRIMARY CARE 2022; 23:257. [PMID: 36180857 PMCID: PMC9523175 DOI: 10.1186/s12875-022-01866-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/31/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
In a cohort of primary health care users across Kosovo (KOSCO cohort), high rates and poor control of diabetes and hypertension were observed. These conditions can be prevented and better controlled by adapting to a healthy lifestyle. Physical activity is an important target, as inactivity and related obesity were very prevalent in the KOSCO cohort. This qualitative study aims to identify individual and structural barriers to physical activity perceived by patients with diabetes and/or hypertension so as to inform health care providers and policy-makers in Kosovo on strategies for promoting physical activity.
Methods
Interviews were conducted from July to October 2020 with 26 public primary health care users from five municipalities of Kosovo (Mitrovica, Vushtrri, Fushe Kosova, Gjakova, and Malisheva). The qualitative study was nested into the KOSCO cohort. KOSCO was implemented in 2019 and recruited consecutive patients visiting the public primary health care centres in these municipalities. Participants of this qualitative sub-study were selected if they had a doctor’s diagnosis of diabetes and/or hypertension. The interview guide consisted of questions related to physical activity barriers these patients are facing, despite having received motivational counselling sessions in primary healthcare centres. Data were analysed using a framework methodology.
Results
Three main themes moderating physical activity behaviour were identified: 1) neighbourhood built environment, 2) health-related problems, and 3) social support. The barriers to physical activity related to the first theme were structural features of the neighbourhoods such as: crowded sidewalks, lack of green spaces, lack of proper lighting in public spaces, as well as dense traffic. In regards to the second theme, the main health reasons for study participants to delay physical activity were related to: physical discomfort as well as stress, worry, and lack of energy. An additional barrier to exercise was lack of social support specifically from friends.
Conclusion
The study identifies structural and individual targets for integrated and inter-sectoral physical activity promotion efforts.
Collapse
|
10
|
Bondaronek P, Dicken SJ, Singh Jennings S, Mallion V, Stefanidou C. Barriers to and Facilitators of the Use of Digital Tools in Primary Care to Deliver Physical Activity Advice: Semistructured Interviews and Thematic Analysis. JMIR Hum Factors 2022; 9:e35070. [PMID: 36040764 PMCID: PMC9472053 DOI: 10.2196/35070] [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: 11/22/2021] [Revised: 03/11/2022] [Accepted: 04/19/2022] [Indexed: 11/15/2022] Open
Abstract
Background Physical inactivity is a leading risk factor for many health conditions, including cardiovascular disease, diabetes, and cancer; therefore, increasing physical activity (PA) is a public health priority. Health care professionals (HCPs) in primary care are pivotal in addressing physical inactivity; however, few HCPs provide PA advice to patients. There can be obstacles to delivering PA advice, including lack of time, confidence, or knowledge. Digital technology has the potential to overcome obstacles and facilitate delivering PA advice. However, it is unknown if and how digital tools are used to deliver PA advice in primary care consultations and what factors influence their use. Objective We aimed to understand the use of digital tools to support primary care consultations and to identify the barriers to and facilitators of using these systems. Methods Overall, 25 semistructured interviews were conducted with primary care HCPs. Professionals were sampled based on profession (general practitioners, practice nurses, and health care assistants), prevalence of long-term conditions within their practice area, and rural-urban classification. The data were analyzed thematically to identify the influences on the use of digital tools. Themes were categorized using the COM-B (capability, opportunity, and motivation—behavior) model and the Theoretical Domains Framework to identify the barriers to and facilitators of using digital tools to support the delivery of PA advice in primary care consultations. Results The identified themes fell within 8 domains of the Theoretical Domains Framework. The most prominent influence (barrier or facilitator) within psychological capability was having the skills to use digital tools. Training in the use of digital tools was also mentioned several times. The most notable influences within physical opportunity were limited digital tools to prompt/support the provision of PA advice, time constraints, efficiency of digital tools, simplicity and ease of use of digital tools, and integration with existing systems. Other physical opportunity influences included lack of access to digital tools and technical support in the use of digital tools. Within social opportunity, a notable barrier was that digital tools reduce interpersonal communication with patients. Patient preference was also identified. Several important influences were within reflective motivation, including confidence to use digital tools, beliefs about the usefulness of digital tools, the belief that digital tools “are the way forward,” beliefs related to data privacy and security concerns, and perceptions about patient capabilities. About automatic motivation, influences included familiarity and availability regarding digital tools and the fact that digital tools prompt behavior. Conclusions A variety of influences were identified on the use of digital tools to support primary care consultations. These findings provide a foundation for designing a digital tool addressing barriers and leverages the facilitators to support PA advice provision within primary care to elicit patient behavior change and increase PA.
Collapse
Affiliation(s)
- Paulina Bondaronek
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, United Kingdom.,Research, Translation & Innovation, Public Health England, London, United Kingdom.,Institute of Health Informatics, University College London, London, United Kingdom
| | - Samuel J Dicken
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, United Kingdom.,Research, Translation & Innovation, Public Health England, London, United Kingdom.,Centre for Obesity Research, University College London, London, United Kingdom
| | - Seth Singh Jennings
- Research, Translation & Innovation, Public Health England, London, United Kingdom
| | - Verity Mallion
- Research, Translation & Innovation, Public Health England, London, United Kingdom
| | - Chryssa Stefanidou
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, United Kingdom.,Research, Translation & Innovation, Public Health England, London, United Kingdom
| |
Collapse
|
11
|
Seo YB, Oh YH, Yang YJ. Current Status of Physical Activity in South Korea. Korean J Fam Med 2022; 43:209-219. [PMID: 35903044 PMCID: PMC9334717 DOI: 10.4082/kjfm.22.0099] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/16/2022] [Accepted: 06/25/2022] [Indexed: 11/03/2022] Open
Abstract
The health benefits of physical activity have been well established. However, more than a quarter of the adult population in the world is insufficiently active (not performing at least 150 minutes of moderate-intensity physical activity per week, 75 minutes of vigorous-intensity physical activity per week, or any equivalent combination of the two), and there has been little improvement since 2001. In South Korea, the prevalence of insufficient physical activity was 54.4% in adults and 94.1% in adolescents in 2020. There was continuous decrease in the prevalence of sufficient aerobic physical activity, from 58.3% in 2014 to 45.6% in 2020. However, daily duration of sedentary behavior increased from 7.5 to 8.6 hours in the same period. Interventions to promote physical activity are necessary in various fields including clinical and policy approaches. As physical activity has decreased during the coronavirus disease 2019 pandemic, safer and more effective strategies to promote physical activity are required.
Collapse
Affiliation(s)
- Yoo Bin Seo
- Department of Family Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea
| | - Yun Hwan Oh
- Department of Family Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
| | - Yun Jun Yang
- Department of Family Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - on behalf of the Korea Interest Group of Physical Activity
- Department of Family Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea
- Department of Family Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
- Department of Family Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| |
Collapse
|
12
|
Wattanapisit A, Poomiphak Na Nongkhai M, Hemarachatanon P, Huntula S, Amornsriwatanakul A, Paratthakonkun C, Ng CJ. What Elements of Sport and Exercise Science Should Primary Care Physicians Learn? An Interdisciplinary Discussion. Front Med (Lausanne) 2021; 8:704403. [PMID: 34422861 PMCID: PMC8371467 DOI: 10.3389/fmed.2021.704403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/12/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Apichai Wattanapisit
- Department of Clinical Medicine, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand.,Family Medicine Clinic, Walailak University Hospital, Nakhon Si Thammarat, Thailand
| | - Marisa Poomiphak Na Nongkhai
- Department of Sport and Exercise Science, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
| | - Poramet Hemarachatanon
- Department of Sport and Exercise Science, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
| | - Soontaraporn Huntula
- Department of Sport and Exercise Science, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
| | - Areekul Amornsriwatanakul
- College of Sports Science and Technology, Mahidol University, Nakhon Pathom, Thailand.,School of Human Sciences (Sport Science, Exercise, and Health), University of Western Australia, Perth, WA, Australia
| | | | - Chirk Jenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
13
|
Wattanapisit A, Amaek W, Wattanapisit S, Tuangratananon T, Wongsiri S, Pengkaew P. Challenges of Implementing an mHealth Application for Personalized Physical Activity Counselling in Primary Health Care: A Qualitative Study. Int J Gen Med 2021; 14:3821-3831. [PMID: 34335048 PMCID: PMC8318008 DOI: 10.2147/ijgm.s317241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/09/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction A mobile health (mHealth) technology has the potential to facilitate personalized physical activity (PA) counselling. We aimed to explore the feasibility and challenges of implementing a newly developed mHealth application (PAC app) for personalized PA counselling. Material and Methods A qualitative design employed a descriptive phenomenology approach. Data were collected through focus group discussions (FGDs) with primary health care (PHC) providers and were analyzed using a deductive thematic approach. Results A total of 16 participants participated in four FGDs. Four major themes were found: application for personalized PA counselling, barriers to the use of the application by providers, patient involvement, and impact on PHC services. Discussion The results showed that the new mHealth application can potentially facilitate PA counselling. However, its use in PHC settings requires an understanding of the context of service delivery; the challenges faced by providers and patients and effects on services must be considered. Conclusion Future research should focus on the long-term use of PAC app and its impact on behavioral and health outcomes.
Collapse
Affiliation(s)
- Apichai Wattanapisit
- School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand.,Walailak University Hospital, Nakhon Si Thammarat, Thailand
| | - Waluka Amaek
- College of Graduate Studies, Walailak University, Nakhon Si Thammarat, Thailand
| | | | | | - Sunton Wongsiri
- Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Prasert Pengkaew
- School of Informatics, Walailak University, Nakhon Si Thammarat, Thailand
| |
Collapse
|
14
|
Jordan S, Starker A. Physical activity counselling by physicians - Results from the KomPaS study. JOURNAL OF HEALTH MONITORING 2021; 6:74-80. [PMID: 35146313 PMCID: PMC8734144 DOI: 10.25646/7148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/25/2020] [Indexed: 11/23/2022]
Abstract
Physical activity counselling aimed at promoting physical and sporting activity is easily accessible and has the potential to reach many people. Until now, very little has been known about the factors influencing physical activity counselling and their frequency. However, the study 'KomPaS: survey on communication and patient-safety', provides current data about this topic. The analyses published here are based on data from 4,561 people aged 18 or older who were interviewed by telephone between May and September 2017 and who stated that they had visited a physician's practice or outpatient clinic in the last twelve months. 28.6% of participants reported having received a physician's counselling about sporting activity during the past twelve months. Sex, age and socioeconomic status have an impact on how frequently participants reported a physical activity counselling by a physician as well as changes to physical activity. As such, differences associated with sex, age and socioeconomic status should be taken into account during physical activity counselling so as to provide various population groups with targeted support.
Collapse
Affiliation(s)
- Susanne Jordan
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | | |
Collapse
|
15
|
Wattanapisit A, Wattanapisit S, Tuangratananon T, Amaek W, Wongsiri S, Petchuay P. Primary Health Care Providers' Perspectives on Developing an eHealth Tool for Physical Activity Counselling: A Qualitative Study. J Multidiscip Healthc 2021; 14:321-333. [PMID: 33603391 PMCID: PMC7882433 DOI: 10.2147/jmdh.s298390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/22/2021] [Indexed: 02/06/2023] Open
Abstract
Purpose Physical inactivity is a global health concern. Physical activity (PA) counselling is an effective intervention for promoting PA in primary health care (PHC) settings. The use of electronic health (eHealth) technology has the potential to support PA counselling. This study aimed to explore PHC providers’ perspectives on the development of an eHealth tool to aid PA counselling in the resource-limited settings. Methods This qualitative study employed interpretive phenomenology. The study was conducted at hospital-based PHC clinics among physicians and registered nurses. Data collection involved in-depth interviews (IDIs) and focus group discussions (FGDs). An inductive thematic approach was used to analyze the data. Results Three physicians participated in three IDIs and 12 nurses participated in four FGDs at three hospitals. The median age of the participants was 43 years. Participants saw 15–100 patients/day (median 40) and spent 2–20 min with each patient (median 5). Three themes emerged. Theme 1: requirements for PA counselling: the participants reflected the needs and characteristics of eHealth tool that may support PA counselling. Theme 2: enabling an eHealth tool for PA counselling: the eHealth should be easy to use, provide PA prescription function, and support follow-up PA counselling. Theme 3: reducing barriers to PA counselling: the eHealth tool was expected to help reduce service and workforce barriers and patients’ limitations. Conclusion A well-designed and practical eHealth tool has the potential to improve PA counselling practice in PHC settings. The eHealth tool may affect an indirect mechanism to reduce barriers to PA counselling. Future research should focus on the usability and utility as well as the process evaluation of the PA counselling eHealth tool that will be implemented in resource-limited settings.
Collapse
Affiliation(s)
- Apichai Wattanapisit
- Department of Clinical Medicine, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand.,Family Medicine Clinic, Walailak University Hospital, Nakhon Si Thammarat, Thailand
| | | | | | - Waluka Amaek
- College of Graduate Studies, Walailak University, Nakhon Si Thammarat, Thailand
| | - Sunton Wongsiri
- Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Prachyapan Petchuay
- Department of Clinical Medicine, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
| |
Collapse
|
16
|
Wattanapisit A, Tuangratananon T, Wattanapisit S. Usability and utility of eHealth for physical activity counselling in primary health care: a scoping review. BMC FAMILY PRACTICE 2020; 21:229. [PMID: 33158430 PMCID: PMC7648312 DOI: 10.1186/s12875-020-01304-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/29/2020] [Indexed: 02/09/2023]
Abstract
Background Physical activity (PA) counselling is an effective approach to promote PA in primary health care (PHC). Barriers to PA counselling in PHC include time constraints, lack of knowledge and skills of providers, and systemic barriers. Using electronic health (eHealth) has the potential to promote PA. This scoping review aimed to identify usability and utility of eHealth for tailored PA counselling introduced in PHC settings. Methods A scoping review included primary research articles. The authors systematically searched six databases (Cochrane Library, CINAHL Complete, Embase, PubMed, Scopus and Web of Science) from the inception of the databases. The search terms consisted of three search components: intervention (PA counselling), platform (eHealth), and setting (PHC). Additional articles were included through reference lists. The inclusion criteria were research or original articles with any study designs in adult participants. Results Of 2501 articles after duplicate removal, 2471 articles were excluded based on the title and abstract screening and full text review. A total of 30 articles were included for synthesis. The eHealth tools had a wide range of counselling domains as a stand-alone PA domain and multiple health behaviours. The included articles presented mixed findings of usability and utility of eHealth for PA counselling among patients and providers in PHC settings. Technical problems and the complexity of the programmes were highlighted as barriers to usability. The majority of articles reported effective utility, however, several articles stated unfavourable outcomes. Conclusions eHealth has the potential to support PA counselling in PHC. Facilitators and barriers to eHealth usability should be considered and adapted to particular settings and contexts. The utility of eHealth for promoting PA among patients should be based on the pragmatic basis to optimise resources. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-020-01304-9.
Collapse
Affiliation(s)
- Apichai Wattanapisit
- School of Medicine, Walailak University, Thasala, Nakhon Si Thammarat, Thailand. .,Walailak University Hospital, Thasala, Nakhon Si Thammarat, Thailand.
| | | | | |
Collapse
|