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Screening While You Wait: An Intervention to Facilitate Exercise in Primary Care

Not Applicable
Completed
Conditions
Physical Activity
Interventions
Behavioral: Personalized exercise Rx and resources
Registration Number
NCT03181295
Lead Sponsor
Women's College Hospital
Brief Summary

Despite knowing that exercise improves health, primary care providers (PCPs) do not regularly assess physical activity (PA) levels or use proven techniques to help patients to increase their PA levels. Studies have shown that PCPs don't talk to patients about their PA levels because they don't feel they have adequate knowledge or resources to help their patients. Additionally they don't feel they have time to provide personalized advice regarding PA.

This study will use tablet computers and email to engage patients in contemplating their own PA levels and starting conversations with their PCPs. Electronic surveys delivered via tablets and email prior to periodic health reviews will be used to support customized, patient-centred health care. The patient's survey responses will be used to develop a printable 'toolkit' with individualized PA recommendations, a personalized exercise prescription (Rx), as well as patient-specific educational and community resources. The exercise Rx and resources can be edited by the PCP based on the resulting discussion between patient and PCP.

The overarching aim of this study is to determine how the use of technology in family doctors' offices can help patients to engage with their PCPs regarding PA and ultimately increase their PA levels.

Detailed Description

The study will take place at the academic Women's College Hospital (WCH) Family Practice (FP) in Toronto, Canada. The clinic provides over 50,000 patient visits per year and is split into four sub-teams for operational purposes. These teams have unique members with no crossover of PCPs. Patients typically see their own PCP for planned care visit (e.g., preventative care and chronic disease management) but access any PCP available when more acute issues arise.

The PA surveys are administered via Ocean by CognisantMD. Ocean connects patients, PCPs, and researchers using secure surveys on tablets in the FP waiting room and online patient surveys that integrate with WCH FP Electronic Medical Records.

This is a pilot step wedge trial, with graduated, random intervention roll-out across the clinical setting in four steps over five time intervals. Eligible patients presenting to the clinic during the study period will be allocated to intervention or control depending on whether the PCP they have booked to see has had the intervention 'turned-on'. The order determining when each PCP and his or her team change from control to intervention is randomly assigned. This design was chosen to avoid the risk of intervention contamination and to enable logistics of implementation. The teams will receive the control and intervention according to the following schedule:

Time Interval 1: Team A-D Control Time Interval 2: Team A Intervention, Team B-D Control Time Interval 3: Team A+B Intervention, Team C+D Control Time Interval 4: Team A-C Intervention, Team D Control Time Interval 5: Team A-D Intervention

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
537
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Usual care plus interventionPersonalized exercise Rx and resourcesStandard PHR appointment plus personalized exercise Rx and resources
Primary Outcome Measures
NameTimeMethod
Metabolic Equivalent of Task-minutes per week4 months post-intervention

The primary outcome will assess intervention effectiveness in terms of total PA; specifically, Metabolic Equivalent of Task (MET)-minutes per week will be calculated from the International Physical Activity Questionnaire (IPAQ).

Secondary Outcome Measures
NameTimeMethod
Measures of motivation (based on the Health Action Process Approach)4 months post-intervention

Assessed in both intervention and control patients

Proportion of eligible patients providing outcome data4 months post-intervention

Assessed in both intervention and control patients

Measures of self-efficacy (based on the Health Action Process Approach)4 months post-intervention

Assessed in both intervention and control patients

Proportion of eligible patients provided the exercise Rx0-2 weeks post-intervention

Intervention patients only

Satisfaction with PA advice0-2 weeks post-intervention

Intervention patients only

Estimated time spent on PA0-2 weeks post-intervention

Intervention patients only

Trial Locations

Locations (1)

Women's College Hospital Family Practice

🇨🇦

Toronto, Ontario, Canada

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