Impact of integrating a physical activity counsellor into the primary health care team: physical activity and health outcomes of the Physical Activity Counselling randomized controlled trial

The purpose of this paper was to report the physical activity and health outcomes results from the Physical Activity Counselling (PAC) trial. Patients (n = 120, mean age 47.3 ± 11.1 years, 69.2% female) who reported less than 150 min of physical activity per week were recruited from a large community-based Canadian primary care practice. After receiving brief physical activity counselling from their provider, they were randomized to receive 6 additional patient-centered counselling sessions over 3 months from a physical activity counsellor (intensive-counselling group; n = 61), or no further intervention (brief-counselling group; n = 59). Physical activity (self-reported and accelerometer) was measured every 6 weeks up to 25 weeks (12 weeks postintervention). Quality of life was also assessed, and physical and metabolic outcomes were evaluated in a randomly selected subset of patients (33%). In the intent-to-treat analyses of covariance, the intensive-counselling group self-reported significantly higher levels of physical activity at 6 weeks (p = 0.009) and 13 weeks (p = 0.01). There were no differences in self-reported physical activity between the groups after the intervention in the follow-up period, nor was there any increase in accelerometer-measured physical activity. Finally, the intensive-counselling patients showed greater decreases in percent body fat and total fat mass from 13 weeks to 25 weeks. Results for physical activity depended on the method used, with positive short-term results with self-report and no effects with the accelerometers. Between-group differences were found for body composition in that the intensive-counselling patients decreased more. A multisite randomized controlled trial with a longer intensive intervention and follow-up is warranted.

Download Full-text

The physical activity counselling (PAC) randomized controlled trial: rationale, methods, and interventions

Applied Physiology Nutrition and Metabolism ◽

10.1139/h07-075 ◽

2007 ◽

Vol 32 (6) ◽

pp. 1170-1185 ◽

Cited By ~ 32

Author(s):

Michelle S. Fortier ◽

William Hogg ◽

Tracey L. O’Sullivan ◽

Christopher Blanchard ◽

Robert D. Reid ◽

...

Keyword(s):

Physical Activity ◽

Primary Care ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Care Practice ◽

Randomized Controlled ◽

Physical Activity Counselling ◽

Metabolic Outcomes ◽

Motivation And Confidence ◽

The Impact

Primary care is a promising venue to build patient motivation and confidence to increase physical activity (PA). Physician PA counselling has demonstrated some success; however, maintenance of behaviour change appears to require more intensive interventions. In reality, most physicians do not have the necessary training nor the time for this type of counselling. The purpose of this paper is to outline the rationale, methods, and interventions for the ongoing physical activity counselling (PAC) randomized controlled trial (RCT), which aims to assess the impact of integrating a PA counsellor into a primary care practice. This RCT has 2 arms: (i) brief PA counselling (2–4 min) from a health care provider and (ii) brief PA counselling + intensive PA counselling from a PA counsellor (3 months). The impact of this intervention is being evaluated using the comprehensive RE-AIM framework. One hundred twenty insufficiently active adult patients, aged 18 to 69 y and recruited during regular primary care visits have been randomized. Dependent measures include psychological mediators, PA participation, quality of life, and physical and metabolic outcomes. The PAC project represents an innovative, theoretically-based approach to promoting PA in primary care, focusing on psychological mediators of change. We anticipate that key lessons from this study will be useful for shaping future public health interventions, theories, and research.

Download Full-text

Effectiveness of a psychological online training to promote physical activity among students: protocol of a randomized-controlled trial

Trials ◽

10.1186/s13063-021-05333-2 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Lena Violetta Krämer ◽

Nadine Eschrig ◽

Lena Keinhorst ◽

Luisa Schöchlin ◽

Lisa Stephan ◽

...

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Mixed Model ◽

Controlled Trial ◽

Control Group ◽

Web Based ◽

Intention To Treat ◽

Randomized Controlled ◽

Link Type

Abstract Background Many students in Germany do not meet recommended amounts of physical activity. In order to promote physical activity in students, web-based interventions are increasingly implemented. Yet, data on effectiveness of web-based interventions in university students is low. Our study aims at investigating a web-based intervention for students. The intervention is based on the Health Action Process Approach (HAPA), which discriminates between processes of intention formation (motivational processes) and processes of intention implementation (volitional processes). Primary outcome is change in physical activity; secondary outcomes are motivational and volitional variables as proposed by the HAPA as well as quality of life and depressive symptoms. Methods A two-armed randomized controlled trial (RCT) of parallel design is conducted. Participants are recruited via the internet platform StudiCare (www.studicare.com). After the baseline assessment (t1), participants are randomized to either intervention group (immediate access to web-based intervention) or control group (access only after follow-up assessment). Four weeks later, post-assessment (t2) is performed in both groups followed by a follow-up assessment (t3) 3 months later. Assessments take place online. Main outcome analyses will follow an intention-to-treat principle by including all randomized participants into the analyses. Outcomes will be analysed using a linear mixed model, assuming data are missing at random. The mixed model will include group, time, and the interaction of group and time as fixed effects and participant and university as random effect. Discussion This study is a high-quality RCT with three assessment points and intention-to-treat analysis meeting the state-of-the-art of effectiveness studies. Recruitment covers almost 20 universities in three countries, leading to high external validity. The results of this study will be of great relevance for student health campaigns, as they reflect the effectiveness of self-help interventions for young adults with regard to behaviour change as well as motivational and volitional determinants. From a lifespan perspective, it is important to help students find their way into regular physical activity. Trial registration The German clinical trials register (DRKS) DRKS00016889. Registered on 28 February 2019

Download Full-text

Efficacy of task-specific circuit training on physical activity levels and mobility of stroke patients: A randomized controlled trial

Neurorehabilitation ◽

10.3233/nre-203207 ◽

2020 ◽

Vol 47 (4) ◽

pp. 451-462

Author(s):

Júlia Caetano Martins ◽

Sylvie Nadeau ◽

Larissa Tavares Aguiar ◽

Aline Alvim Scianni ◽

Luci Fuscaldi Teixeira-Salmela ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Post Intervention ◽

Randomized Controlled ◽

Secondary Outcomes ◽

Experimental Group

BACKGROUND: Impaired mobility is related to low physical activity (PA) levels observed after stroke. Therapeutic approaches, such as task-specific circuit training (TSCT), used to improve mobility in individuals with stroke, could also improve PA levels. OBJECTIVE: To investigate the efficacy of TSCT, focused on both upper (UL) and lower (LL) limbs, in improving PA levels and mobility (primary outcomes), as well as muscle strength, exercise capacity, and quality of life (secondary outcomes) in subjects with stroke. METHODS: A randomized controlled trial with 36 subjects with chronic stroke was conducted. Experimental group: TSCT, involving both UL and LL. Control group: global stretching, memory exercises, and education sessions. Both groups received 60 minute sessions/week over 12 weeks. Outcomes were measured at baseline, post-intervention and 16 week follow-up. RESULTS: No changes were found for primary and secondary outcomes (0.11≤p≤0.99), except for quality of life, which improved in the experimental group post-intervention and 16 week follow-up (p = 0.02). CONCLUSION: TSCT focused on both UL and LL was not effective on PA levels and mobility of individuals with chronic stroke, however, improvements in quality of life were observed. Since this is the first study to investigate this combined training aimed at improving PA levels, future studies are necessary to better understand the impact of this type of intervention.

Download Full-text

Changes in physical activity during a weight loss intervention and follow‐up: a randomized controlled trial

Clinical Obesity ◽

10.1111/cob.12057 ◽

2014 ◽

Vol 4 (3) ◽

pp. 127-135 ◽

Cited By ~ 11

Author(s):

N. R. Fuller ◽

K. Williams ◽

R. Shrestha ◽

A. L. Ahern ◽

C. Holzapfel ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Weight Loss Intervention ◽

Randomized Controlled

Download Full-text

Effects of a School-Based Physical Activity Intervention for Obesity and Health-Related Physical Fitness in Adolescents With Intellectual Disability: Protocol for a Randomized Controlled Trial

JMIR Research Protocols ◽

10.2196/25838 ◽

2021 ◽

Vol 10 (3) ◽

pp. e25838

Author(s):

Aiwei Wang ◽

Yang Gao ◽

Jingjing Wang ◽

Tomas K Tong ◽

Yan Sun ◽

...

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Intellectual Disability ◽

Controlled Trial ◽

Special Schools ◽

Randomized Controlled ◽

School Based ◽

Health Related ◽

Children With Intellectual Disability

Background Childhood obesity accompanied by lower levels of health-related physical fitness (HRPF) is a major threat to public health both internationally and locally. Children with intellectual disability, especially adolescents, have a higher risk of being overweight/obese and having poor HRPF levels. Therefore, more interventions are needed to help this population attain their optimal health levels. However, there has been relatively limited research on this population compared with on their typically developing peers. Objective The proposed study aims to fill this knowledge gap by developing and examining the success of a physical activity (PA) intervention for the target population. Methods The proposed study will be a 12-week, school-based randomized controlled trial. The participants (N=48) will be recruited from special schools for students with mild intellectual disability and then randomly allocated to either the intervention group (IG) or the wait-list control group (CG). During the intervention period, the participants in the IG will receive a fun game–based moderate-to-vigorous PA (MVPA) training program (2 sessions/week, 60 minutes/session, for a total of 24 sessions). The intensity of the activities will increase in a progressive manner. Participants in the CG will receive no program during the study period, but the same PA program will be provided to them after the completion of the study. To observe and evaluate the sustaining effects of the intervention, follow-up testing will be scheduled for the participants 12 weeks after the intervention concludes. The study outcomes will include primary outcomes (obesity- and fitness-related outcomes) and a secondary outcome (blood pressure). All of the measurements will be taken at 3 time points. After the follow-up tests, the same PA training program will be provided to the participants in the CG. Results This study is ongoing. The participants were recruited from October 2020 to November 2020. The total duration of the study is 13 months. Study results are expected at the end of 2021. Conclusions The proposed study is expected to reduce obesity and improve HRPF levels in children with intellectual disability. If proven effective, the intervention will be made accessible to more special schools and mainstream schools with students with intellectual disability. Furthermore, the study can serve as an example for international researchers, policy makers, and members of the public who are seeking to tackle the problem of obesity and poor HRPF among children with intellectual disability. Trial Registration ClinicalTrials.gov NCT04554355; https://www.clinicaltrials.gov/ct2/show/NCT04554355 International Registered Report Identifier (IRRID) PRR1-10.2196/25838

Download Full-text

Game-Based Meditation Therapy to Improve Posttraumatic Stress and Neurobiological Stress Systems in Traumatized Adolescents: Protocol for a Randomized Controlled Trial (Preprint)

10.2196/preprints.19881 ◽

2020 ◽

Cited By ~ 1

Author(s):

Angela A T Schuurmans ◽

Karin S Nijhof ◽

Ron Scholte ◽

Arne Popma ◽

Roy Otten

Keyword(s):

Randomized Controlled Trial ◽

Posttraumatic Stress ◽

Controlled Trial ◽

Self Report ◽

Treatment As Usual ◽

Randomized Controlled ◽

Posttraumatic Symptoms ◽

Secondary Outcomes ◽

Anxiety Depression

BACKGROUND Many adolescents in residential care have been exposed to prolonged traumatic experiences such as violence, neglect, or abuse. Consequently, they suffer from posttraumatic stress. This not only negatively affects psychological and behavioral outcomes (eg, increased anxiety, depression, and aggression) but also has adverse effects on physiological outcomes, in particular on their neurobiological stress systems. Although current evidence-based treatment options are effective, they have their limitations. An alternative to traditional trauma treatment is meditation-based treatment that focuses on stress regulation and relaxation. Muse is a game-based meditation intervention that makes use of adolescents’ intrinsic motivation. The neurofeedback element reinforces relaxation abilities. OBJECTIVE This paper describes the protocol for a randomized controlled trial in which the goal is to examine the effectiveness of Muse (InteraXon Inc) in reducing posttraumatic stress and normalizing neurobiological stress systems in a sample of traumatized adolescents in residential care. METHODS This will be a multicenter, multi-informant, and multimethod randomized controlled trial. Participants will be adolescents (N=80), aged 10 to 18 years, with clinical levels of posttraumatic symptoms, who are randomized to receive either the Muse therapy sessions and treatment as usual (intervention) or treatment as usual alone (control). Data will be collected at 3 measurement instances: pretest (T1), posttest (T2), and at 2-month follow-up. Primary outcomes will be posttraumatic symptoms (self-report and mentor report) and stress (self-report) at posttest. Secondary outcomes will be neurobiological stress parameters under both resting and acute stress conditions, and anxiety, depression, and aggression at posttest. Secondary outcomes also include all measures at 2-month follow-up: posttraumatic symptoms, stress, anxiety, depression aggression, and neurobiological resting parameters. RESULTS The medical-ethical committee Arnhem-Nijmegen (NL58674.091.16) approved the trial on November 15, 2017. The study was registered on December 2, 2017. Participant enrollment started in January 2018, and the results of the study are expected to be published in spring or summer 2021. CONCLUSIONS Study results will demonstrate whether game-based meditation therapy improves posttraumatic stress and neurobiological stress systems, and whether it is more effective than treatment as usual alone for traumatized adolescents. CLINICALTRIAL Netherlands Trial Register NL6689 (NTR6859); https://www.trialregister.nl/trial/6689 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/19881

Download Full-text

Implementation of a School Physical Activity Policy Improves Student Physical Activity Levels: Outcomes of a Cluster-Randomized Controlled Trial

Journal of Physical Activity and Health ◽

10.1123/jpah.2019-0595 ◽

2020 ◽

Vol 17 (10) ◽

pp. 1009-1018

Author(s):

Nicole K. Nathan ◽

Rachel L. Sutherland ◽

Kirsty Hope ◽

Nicole J. McCarthy ◽

Matthew Pettett ◽

...

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Vigorous Physical Activity ◽

Cluster Randomized Controlled Trial ◽

Randomized Controlled ◽

School Day ◽

Cluster Randomized ◽

The Impact

Aim: To assess the impact of a multistrategy intervention designed to improve teachers’ implementation of a school physical activity (PA) policy on student PA levels. Methods: A cluster-randomized controlled trial was conducted in 12 elementary schools. Policy implementation required schools to deliver 150 minutes of organized PA for students each week via physical education, sport, or class-based activities such as energizers. Schools received implementation support designed using the theoretical domains framework to help them implement the current policy. Results: A total of 1,502 children in kindergarten to grade 6 participated. At follow-up compared with control, students attending intervention schools had, measured via accelerometer, significantly greater increases in school day counts per minute (97.5; 95% confidence interval [CI], 64.5 to 130.4; P < .001) and moderate to vigorous physical activity (MVPA) (3.0; 95% CI, 2.2–3.8, P < .001) and a greater decrease in sedentary time (−2.1; 95% CI, −3.9 to −0.4, P = .02) per school day. Teachers in intervention schools delivered significantly more minutes (36.6 min) of PA to their students at follow-up (95% CI, 2.7–70.5, P = .04). Conclusions: Supporting teachers to implement a PA policy improves student PA. Additional strategies may be needed to support teachers to implement activities that result in larger gains in student MVPA.

Download Full-text

Impact of a Knowledge Translation Intervention on Physical Activity and Mobility in Older Adults (the Move4Age Study): Randomized Controlled Trial (Preprint)

10.2196/preprints.15125 ◽

2019 ◽

Author(s):

Sarah Neil-Sztramko ◽

Jenna Smith-Turchyn ◽

Julie Richardson ◽

Maureen Dobbins

Keyword(s):

Physical Activity ◽

Older Adults ◽

Randomized Controlled Trial ◽

Knowledge Translation ◽

Controlled Trial ◽

Rapid Assessment ◽

Control Group ◽

Self Rated Health ◽

Randomized Controlled

BACKGROUND The McMaster Optimal Aging Portal (the Portal) was launched in 2014 as a knowledge translation (KT) tool to increase access to evidence-based health information. OBJECTIVE The purpose of this study was to understand if and how dissemination of mobility information through the Portal impacts physical activity (PA) in older adults. METHODS In this randomized controlled trial, participants (n=510) were assigned to a 12-week mobility-focused KT intervention or self-serve control group. The intervention included weekly email alerts and a study-specific social media hashtag linking to mobility-focused Portal materials. The control group was able to access the Portal on their own but did not receive targeted KT strategies. Participants completed questionnaires (including the Rapid Assessment of Physical Activity to quantify PA) at baseline, end of the study, and 3-month follow-up. RESULTS Participants were predominantly female (430/510, 84.3%), mean age 64.7 years, with no baseline differences between groups. Over half (277/510, 54.3%) of the participants were classified as “active” at baseline. There was no significant between-group difference in the PA category. Overall, both groups increased their PA with improvements maintained at 3-month follow-up (<i>P</i><.001). In planned subgroup analyses, the KT intervention had a significant effect for those with poor or fair baseline self-rated health (<i>P</i>=.03). CONCLUSIONS No differences were found between those who received the targeted intervention and a control group with self-serve access to the Portal, except in subgroups with low self-rated health. Both groups did report increases in PA that were sustained beyond participation in a research study. Findings suggest that different KT strategies may be needed for different types of users, with more intense interventions being most impactful for certain groups (ie, those with lower self-rated health). CLINICALTRIAL ClinicalTrials.gov NCT02947230; https://clinicaltrials.gov/ct2/show/NCT02947230

Download Full-text

Comparison of Brief Videos and Articles to Promote Coping Skills Among Student-Athletes

Journal of Clinical Sport Psychology ◽

10.1123/jcsp.2019-0027 ◽

2020 ◽

pp. 1-17

Author(s):

Tyler L. Malone ◽

Adam Kern ◽

Emily Klueh ◽

Daniel Eisenberg

Keyword(s):

Randomized Controlled Trial ◽

College Student ◽

Student Athletes ◽

Coping Skills ◽

Controlled Trial ◽

Self Report ◽

Deep Breathing ◽

Randomized Controlled ◽

College Student Athletes

This study sought to determine the efficacy of particular strategies for delivering information about coping skills for stress to college student-athletes. This study analyzed 166 undergraduate varsity student-athletes. Among these participants, 60.8% were female (n = 101). The authors used a randomized controlled trial to compare video-based and text-based interventions designed to deliver coping skills information. Five weeks after the intervention, the participants completed a follow-up survey containing simple self-report questions regarding the memorability, use, and helpfulness of the coping skills information. In general, both strategies led to the use of coping skills by a sizeable proportion of the sample. The participants in the video-based deep breathing intervention were more than twice as likely to use coping skills compared with participants in the text-based intervention (risk ratio = 2.20, 95% confidence interval [1.02, 4.71], p = .03). Overall, the results suggest that both video- and text-based interventions have the potential to promote coping skills.

Download Full-text