scholarly journals Mixed Methods Process Evaluation of a National Peer-Led Training Program to Increase Brief Advice on Physical Activity Given By Health Care Professionals

2021 ◽  
pp. 1-11
Author(s):  
Maxine E. Whelan ◽  
Liz Carlin ◽  
Hayley Musson ◽  
Emma J. Adams
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Training Program ◽  
Process Evaluation ◽  
Health Care Professionals ◽  
Administrative Support ◽  
Training Session ◽  
Population Level ◽  
Program Improvement ◽  
Geographical Regions

Introduction: Health care professionals are well-positioned to encourage physical activity. The Clinical Champions Physical Activity Training Program (CCTP) aimed to increase population-level physical activity across England. This study aimed to (1) evaluate CCTP uptake and utilization; (2) explore CCTP fidelity, barriers, facilitators, and satisfaction; and (3) provide recommendations for program improvement. Methods: Physical Activity Clinical Champions were recruited and trained to deliver training to other health care professionals about physical activity. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to conduct a process evaluation using data collected from CCTP training sessions delivered (often at hospitals and General Practitioner surgeries) between February and December 2018. Results: About 509 training sessions were delivered, with 89% of sessions delivered by doctor/physician and nurse Clinical Champions; 8917 health care professionals attended a training session. Sessions lasted on average 1 hour 28 minutes and core slide sets were used in 65% of sessions. Barriers related to arranging the sessions and time available to deliver sessions. Conclusion: The process evaluation demonstrated a national peer-led training program can reach all geographical regions of England; however, barriers need to be addressed. Recommendations include providing more administrative support to the Clinical Champions, improving communication and advertising to raise awareness of the CCTP, and standardizing training session duration and content.

scholarly journals Impact of a National Peer-Led Training Program to Increase Brief Physical Activity Advice Given to Patients by Health Care Professionals

2021 ◽  
pp. 1-8
Author(s):  
Liz Carlin ◽  
Maxine E. Whelan ◽  
Hayley Musson ◽  
Emma J. Adams
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Training Program ◽  
Health Care Professionals ◽  
Training Session ◽  
Baseline Survey ◽  
Physical Activity Guidelines ◽  
Physical Activity Advice ◽  
The Impact

Background: The benefits of physical activity for preventing and managing long-term health conditions are well established and health care professionals could promote physical activity to patients. The current study aims to evaluate the impact of the Clinical Champions Physical Activity Training Program. Methods: Health care professionals attend a one-off in-person training session delivered by a trained Clinical Champion. Attendees at the Clinical Champions Physical Activity Training Program were asked to complete a baseline survey prior to the training session and follow-up surveys 4 and 12 weeks posttraining. Results: A total of 5945 training attendees completed the baseline survey. A total of 1859 and 754 participants completed 4- and 12-week follow-up (31.3% and 12.7% response rate, respectively). Significant increases in confidence to deliver brief physical activity advice and knowledge of physical activity guidelines were reported at 12 weeks (P < .001). The perceived frequency of physical activity discussions with patients significantly increased (P < .001). Twelve weeks after training, fewer barriers in promoting physical activity were reported. Conclusions: The evaluation of the Clinical Champions Physical Activity Training Program demonstrated an increase in knowledge of physical activity guidelines, levels of confidence, and frequency of delivery of brief physical activity advice to patients. Further research is required to determine if this impact translates into changes to patients’ physical activity behavior.

scholarly journals Improving Physical Activity in Adults Admitted to a Hospital With Interventions Developed and Implemented Through Cocreation: Protocol for a Pre-Post Embedded Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Sven J G Geelen ◽  
Boukje M Giele ◽  
Frans Nollet ◽  
Raoul H H Engelbert ◽  
Marike van der Schaaf
Keyword(s):  
Internal Medicine ◽  
Physical Activity ◽  
Health Care ◽  
Process Evaluation ◽  
Health Care Professionals ◽  
Outcome Evaluation ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Barriers And Enablers ◽  
Hospital Wards

BACKGROUND Admission to a hospital is often related with hospital-associated disabilities. Improving physical activity during hospitalization is considered effective to counteract hospital-associated disabilities, whereas many studies report on very low physical activity levels. Gradually developing and implementing interventions in cocreation with patients and health care professionals rather than implementing predefined interventions may be more effective in creating sustainable changes in everyday clinical practice. However, no studies have reported on the use of cocreation in the development and implementation of interventions aimed at improving physical activity. OBJECTIVE This protocol presents a study that aims to investigate if interventions, which will be developed and implemented in cocreation, improve physical activity among patients in surgery, internal medicine, and cardiology hospital wards. The secondary aims are to investigate effectiveness in terms of the reduction in the time patients spend in bed, the length of hospital stay, and the proportion of patients going home after discharge. METHODS The Better By Moving study takes place for 12 months at the following five different wards of a university hospital: two gastrointestinal and oncology surgery wards, one internal medicine hematology ward, one internal medicine infectious diseases ward, and one cardiology ward. The step-by-step implementation model of Grol and Wensing is used, and all interventions are developed and implemented in cocreation with health care professionals and patients. Outcome evaluation is performed across the different hospital wards and for each hospital ward individually. The primary outcome is the amount of physical activity in minutes assessed with the Physical Activity Monitor AM400 accelerometer in two individual groups of patients (preimplementation [n=110], and 13 months after the start of the implementation [n=110]). The secondary outcomes are time spent in bed measured using behavioral mapping protocols, and length of stay and discharge destination assessed using organizational data. A process evaluation using semistructured interviews and surveys is adopted to evaluate the implementation, mechanisms of impact, context, and perceived barriers and enablers. RESULTS This study is ongoing. The first participant was enrolled in January 2018. The last outcome evaluation and process evaluation are planned for May and June 2020, respectively. Results are expected in April 2021. CONCLUSIONS This study will provide information about the effectiveness of developing and implementing interventions in cocreation with regard to improving physical activity in different subgroups of hospitalized patients in a university hospital. By following step-by-step implementation and by performing process evaluation, we will identify the barriers and enablers for implementation and describe the effect of new interventions on improving physical activity among hospitalized patients. CLINICALTRIAL Netherlands Trial Register NL8480; https://www.trialregister.nl/trial/8480 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/19000

scholarly journals Long Term Exercise Engagement of Adults Living With Type Two Diabetes Is Enhanced by a Person-Centred Care Approach Delivered by Knowledgeable, Well Trained Health Care Professionals

2021 ◽  
Vol 2 ◽  
Author(s):  
Leigh Hale ◽  
Christopher Higgs ◽  
Donna Keen ◽  
Catherine Smith
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Health Care Professionals ◽  
Administrative Support ◽  
Exercise Programme ◽  
Educational Programme ◽  
Time Of Day ◽  
The Self ◽  
Group Setting

Background: Regular engagement in exercise or physical activity is a key evidence-based recommendation in the self-management of type 2 diabetes (T2D). The Diabetes Community Exercise Programme (DCEP) is an exercise and educational programme aimed at supporting adults living with T2D to take control of their health and to live well with T2D. It was specifically developed to enhance the self-efficacy of people to engage in exercise for a long term and is underpinned by the spirit of motivational interviewing. This study explores what DCEP attendees and health care professionals (HCPs) who deliver the programme perceived DCEP to be and what motivated attendance. Such insights further the knowledge of how people with T2D can be supported to engage in exercise or physical activity programmes.Method: This qualitative study used open-ended interviews of 17 DCEP attendees and 12 HCPs delivering DCEP. Interviews occurred at the completion of the initial twice-a-week, 12-week duration part of the programme and prior to attendees starting with a twice-weekly maintenance exercise class, which forms the second part of the programme. Interviews were audio-recorded, transcribed verbatim and analysed with the General Inductive Approach.Results: The two themes constructed from the analysis were person-centred care and attention to logistics and administration. Person-centred care comprised four subthemes: monitoring, individualised exercise within a sociable group setting, flexible education and discussion, and HCP training, and these components appeared to support attendees to engage in exercise. The second theme spoke about the processes, that was either present or that should be included, that enabled DCEP delivery, such as appropriate venues, flexible approaches to time of day and the requirement of good administrative support.Conclusion: The Diabetes Community Exercise Programme did motivate people with T2D to engage in exercise. Important to this was the emphasis on a person-centred approach that focussed on the health status monitoring and educational and social aspects of the programme, which in turn facilitated exercise engagement. Knowledgeable HCPs who require training in the delivery of person-centred care to tailor the exercise and education to the individual is imperative. Equally important are optimal exercise environments and well-trained administrative support.

scholarly journals Improving Physical Activity in Adults Admitted to a Hospital With Interventions Developed and Implemented Through Cocreation: Protocol for a Pre-Post Embedded Mixed Methods Study

10.2196/19000 ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. e19000
Author(s):  
Sven J G Geelen ◽  
Boukje M Giele ◽  
Frans Nollet ◽  
Raoul H H Engelbert ◽  
Marike van der Schaaf
Keyword(s):  
Internal Medicine ◽  
Physical Activity ◽  
Health Care ◽  
Process Evaluation ◽  
Health Care Professionals ◽  
Outcome Evaluation ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Barriers And Enablers ◽  
Hospital Wards

Background Admission to a hospital is often related with hospital-associated disabilities. Improving physical activity during hospitalization is considered effective to counteract hospital-associated disabilities, whereas many studies report on very low physical activity levels. Gradually developing and implementing interventions in cocreation with patients and health care professionals rather than implementing predefined interventions may be more effective in creating sustainable changes in everyday clinical practice. However, no studies have reported on the use of cocreation in the development and implementation of interventions aimed at improving physical activity. Objective This protocol presents a study that aims to investigate if interventions, which will be developed and implemented in cocreation, improve physical activity among patients in surgery, internal medicine, and cardiology hospital wards. The secondary aims are to investigate effectiveness in terms of the reduction in the time patients spend in bed, the length of hospital stay, and the proportion of patients going home after discharge. Methods The Better By Moving study takes place for 12 months at the following five different wards of a university hospital: two gastrointestinal and oncology surgery wards, one internal medicine hematology ward, one internal medicine infectious diseases ward, and one cardiology ward. The step-by-step implementation model of Grol and Wensing is used, and all interventions are developed and implemented in cocreation with health care professionals and patients. Outcome evaluation is performed across the different hospital wards and for each hospital ward individually. The primary outcome is the amount of physical activity in minutes assessed with the Physical Activity Monitor AM400 accelerometer in two individual groups of patients (preimplementation [n=110], and 13 months after the start of the implementation [n=110]). The secondary outcomes are time spent in bed measured using behavioral mapping protocols, and length of stay and discharge destination assessed using organizational data. A process evaluation using semistructured interviews and surveys is adopted to evaluate the implementation, mechanisms of impact, context, and perceived barriers and enablers. Results This study is ongoing. The first participant was enrolled in January 2018. The last outcome evaluation and process evaluation are planned for May and June 2020, respectively. Results are expected in April 2021. Conclusions This study will provide information about the effectiveness of developing and implementing interventions in cocreation with regard to improving physical activity in different subgroups of hospitalized patients in a university hospital. By following step-by-step implementation and by performing process evaluation, we will identify the barriers and enablers for implementation and describe the effect of new interventions on improving physical activity among hospitalized patients. Trial Registration Netherlands Trial Register NL8480; https://www.trialregister.nl/trial/8480 International Registered Report Identifier (IRRID) DERR1-10.2196/19000

scholarly journals Development and Process Evaluation of a 5-Week Exercise Program to Prevent Falls in People after Stroke: The FALLS Program

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
H. J. R. van Duijnhoven ◽  
D. De Kam ◽  
W. Hellebrand ◽  
E. Smulders ◽  
A. C. H. Geurts ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Clinical Practice ◽  
Process Evaluation ◽  
Fall Prevention ◽  
Health Care Professionals ◽  
Exercise Program ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Common Complication

Falls are a common complication after stroke, with balance and gait deficits being the most important risk factors. Taking into account the specific needs and capacities of people with stroke, we developed the FALLS program (FALL prevention after Stroke), based on the “Nijmegen falls prevention program” (a proven-effective 5-week exercise program designed for community-dwelling elderly people). The program was tested in twelve community-dwelling persons with stroke, and a process evaluation was conducted with patients, trainers, health care professionals, and managers. The FALLS program was considered suitable and feasible by people with stroke in the study and relevant health care professionals, and recommendations for implementation in clinical practice have been suggested.

scholarly journals Flash Glucose Monitoring: A Review of the Literature with a Special Focus on Type 1 Diabetes

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 992 ◽  
Author(s):  
Giulia Mancini ◽  
Maria Berioli ◽  
Elisa Santi ◽  
Francesco Rogari ◽  
Giada Toni ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Health Care ◽  
Glycemic Control ◽  
Health Care Professionals ◽  
Glucose Monitoring ◽  
Special Focus ◽  
Flash Glucose Monitoring

In people with type 1 diabetes mellitus (T1DM), obtaining good glycemic control is essential to reduce the risk of acute and chronic complications. Frequent glucose monitoring allows the adjustment of insulin therapy to improve metabolic control with near-normal blood glucose concentrations. The recent development of innovative technological devices for the management of T1DM provides new opportunities for patients and health care professionals to improve glycemic control and quality of life. Currently, in addition to traditional self-monitoring of blood glucose (SMBG) through a glucometer, there are new strategies to measure glucose levels, including the detection of interstitial glucose through Continuous Glucose Monitoring (iCGM) or Flash Glucose Monitoring (FGM). In this review, we analyze current evidence on the efficacy and safety of FGM, with a special focus on T1DM. FGM is an effective tool with great potential for the management of T1DM both in the pediatric and adult population that can help patients to improve metabolic control and quality of life. Although FGM might not be included in the development of an artificial pancreas and some models of iCGM are more accurate than FGM and preferable in some specific situations, FGM represents a cheaper and valid alternative for selected patients. In fact, FGM provides significantly more data than the intermittent results obtained by SMBG, which may not capture intervals of extreme variability or nocturnal events. With the help of a log related to insulin doses, meal intake, physical activity and stress factors, people can achieve the full benefits of FGM and work together with health care professionals to act upon the information provided by the sensor. The graphs and trends available with FGM better allow an understanding of how different factors (e.g., physical activity, diet) impact glycemic control, consequently motivating patients to take charge of their health.

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