Development of an evidence-informed recommendation guide to facilitate physical activity counseling between oncology care providers and patients in Canada

Decision support aids help reduce decision conflict and are reported as acceptable by patients. Currently, an aid from the American College of Sports Medicine exists to help oncology care providers advise, assess, and refer patients to physical activity (PA). However, some limitations include the lack of specific resources and programs for referral, detailed PA, and physical function assessments and not being designed following an international gold standard (Appraisal of Guidelines for Research and Evaluation [AGREE] II). This study aimed to develop a recommendation guide to facilitate PA counseling by assessing the risk for PA-related adverse events and offering a referral to an appropriate recommendation. Recommendation guide development followed AGREE II, and an AGREE methodologist was consulted. Specifically, a stakeholder group of oncology care providers and cancer survivors were engaged to develop the assessment criteria for comorbidities, PA levels, and physical function. Assessment criteria were developed from published PA interventions, consultations with content experts, and targeted web-based searches for cancer-specific PA programs. Feedback on the recommendation guide was solicited from stakeholders and external reviewers with relevant knowledge and clinical experience. Independent AGREE methodologists appraised the development process. The recommendation guide is a five-page document, including a preamble, assessment criteria for absolute contraindications to PA, comorbidities, and PA/functional capacity with a list of appropriate resources. Independent AGREE methodologists rated the development process as strong and recommended the guide for use. The recommendation guide has the potential to facilitate PA counseling between oncology care providers and cancer survivors, thus, potentially impacting PA behavior.

Exercise and Physical Activity Counseling Needs among Cardiac Rehabilitation Patients

Cardiac rehabilitation (CR) has decreased in recurrent cardiac events. However, information related the needs of cardiac rehabilitation patients such as exercise and physical activities counseling are very limited. This study aims to identify the needs of cardiac rehabilitation patients such as exercise, physical activity counselling, and the relationship between them. It also applied a quantitative approach combined with a descriptive correlational method. 38 cardiac rehabilitation patients were recruited as samples and were selected using the convenience sampling technique. Data collection was performed using questionnaires filled out by the respondents (with a retrospective technique) at the end of the CR program, and the results were evaluated through descriptive correlational statistics. The results revealed that patients with CR required exercise (92.1%) and nurses' counseling for physical activities (86.9%). It also indicates that there is a statistically positive relationship between exercise and physical activities counseling among CR patients (r = 0.485, p < 0.01). Consequently, most CR patients desire nurses to take part in their exercise and physical activities. The needs of CR patients on exercise and physical activity counseling were correlated positively. Therefore, information regarding exercise and physical activity for CR patients should be provided simultaneously to complement each other.

Associated factors with physical activity counseling among Brazilian Family Health Strategy workers

This study aimed to determine the prevalence and associated factors with physical activity counseling among Brazilian Family Health Strategy workers. This is a cross-sectional study conducted with a random sample of 591 health workers who work in the Family Health Teams of João Pessoa-PB, Brazil. Counseling for physical activity was defined as any advising targeted for increasing patients’ physical activity levels conducted for at least six months. The following factors were considered: time working in health care units, amount of daily attendance, continuing education, perceived barriers, self-efficacy, attitude, self-rated health, physical activity level and nutritional status. Prevalence of counseling was 46.3%, being higher among physicians (74.5%; 95%CI: 59.6-85.2) and nurses (60.3%; 95%CI: 48.0-71.4) compared to community health workers (42.9%; 95%CI: 38.2-47.7) and nurses assistants (31.5%; 95%CI: 20.2-45.4). The results showed health professionals with positive self-rated health, without perception of barriers, having a positive attitude and high self-efficacy were more likely to perform physical activity counseling. Knowledge and actions on factors associated with physical activity counseling can help broaden the involvement of primary health care providers in health education.

Question of Participation

Background. Recent studies indicate that physical activity levels among Ontario university students are about 35% to 42%. Furthermore, there is a sparsity of evidence on effective interventions to support increased physical activity among university students. The current study uses the Comprehensive School Health (CSH) framework for the analysis of current physical activity interventions at York University and provides four observations of an effective program. Methods. 249 York University undergraduate students (n = 153 women, n = 96 men) ages 18 – 42 (M = 19.92 years, SD = 2.99 for men; M = 19.96 years, SD = 2.61 for women) were recruited from the school of Kinesiology and Health Sciences. Participants were measured for their physical activity status and physical activity factors pertaining to the CSH framework via an online survey. Results. 67.9% of the participants were considered physically active, and 80.3% declared they would not “travel to the university only to engage in physical activity”. Additionally, 74.7% of the participants reported that they believed that they had enough information regarding physical activity, with 44.2% having been exposed to signs and posters about physical activity on campus. 49.4% of participants reported engaging in the school’s mandatory practicums (PKINs) with a resulting 125 minutes of average weekly physical activity. 16.9% of participants reported having received physical activity counseling and 83.1% did not. Conclusions. Based on the results of this study, an effective intervention to support increased physical activity among university students, in the case of York University, was one that fit well with the students’ academic schedule, did not rely on signs or posters for physical activity promotion, integrated itself into the curriculum, and would benefit from incorporating partnerships with healthcare professionals.

Insights From an Usability Review of an Electronic Medical Record–Integrated Physical Activity Counseling Tool for Primary Care

This study assessed primary care providers’ (PCPs) perceptions of the usability of an electronic medical record tool to support physical activity counseling in primary care. Our analyses revealed that usability improved when the electronic medical record tool followed a PCP’s natural workflow and when the tool could assist in engaging in a discussion about physical activity. Poor usability was associated with the presence of large amounts of text on the screen and technological aspects that required additional learning. Overall, efficiency, workflow integration, and the inclusion of a care plan were vital in a physical activity counseling tool for a primary care setting.