Including Physical Activity Exercise in Diabetes Management: Diabetes Educators' Perceptions of Their Own Abilities the Abilities of Their Patients

Dillman, Carrie; Shields, Christopher; Fowles, Jonathon R.; Perry, Arlene; Murphy, René J.L.; Dunbar, Peggy

doi:10.1016/s1499-2671(10)43010-5

Cited by 21 publications

(24 citation statements)

References 22 publications

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“…AHPs (primarily nurses) and EPs both reported patients' interest in PAE as the most common and impactful barrier. These results are consistent with diabetes educators' low confidence in their patients to increase their PAE (Dillman et al 2010); however, this previous work also suggests that changing health care providers' perceptions of patients may influence their PAE practices. Providing workshop training increased diabetes educators' efficacy, perceived patient knowledge and improved diabetes educators' confidence in their patients to perform PAE (Shields et al 2013).…”

Section: Discussionsupporting

confidence: 84%

“…Sections of the questionnaire were based on previous work in the area; activity prescription questions were adapted from the national survey by Petrella et al (2007), confidence variables were incorporated because of the known impact on PAE counselling self-efficacy (Hébert et al 2012), and inclusion in other studies to evaluate physical activity prescription training (Dacey et al 2013). The questions regarding demographic information, current practice history, barriers, and postworkshop reflection were based on previous research in diabetes education (Dillman et al 2010;Shields et al 2013). …”

Section: Self-reflection Questionnairementioning

confidence: 99%

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Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees

O’Brien

Shields

et al. 2017

Appl. Physiol. Nutr. Metab.

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Abstract:The Exercise is Medicine Canada (EIMC) initiative promotes physical activity counselling and exercise prescription within health care. The purpose of this study was to evaluate perceptions and practices around physical activity counselling and exercise prescription in health care professionals before and after EIMC training. Prior to and directly following EIMC workshops, 209 participants (physicians (n = 113); allied health professionals (AHPs) (n = 54), including primarily nurses (n = 36) and others; and exercise professionals (EPs) (n = 23), including kinesiologists (n = 16), physiotherapists (n = 5), and personal trainers (n = 2)) from 7 provinces completed self-reflection questionnaires. Compared with AHPs, physicians saw more patients (78% > 15 patients/day vs 93% < 15 patients/day; p < 0.001) and reported lower frequencies of exercise counselling during routine client encounters (48% vs 72% in most sessions; p < 0.001). EPs had higher confidence providing physical activity information (92 ± 11%) compared with both physicians (52 ± 25%; p < 0.001) and AHPs (56 ± 24%; p < 0.001). Physicians indicated that they experienced greater difficulty including physical activity and exercise counselling into sessions (2.74 ± 0.71, out of 5) compared with AHPs (2.17 ± 0.94; p = 0.001) and EPs (1.43 ± 0.66; p < 0.001). Physicians rated the most impactful barriers to exercise prescription as lack of patient interest (2.77 ± 0.85 out of 4), resources (2.65 ± 0.82 out of 4), and time (2.62 ± 0.71 out of 4). The majority of physicians (85%) provided a written prescription for exercise in <10% of appointments. Following the workshop, 87% of physician attendees proposed at least one change to practice; 47% intended on changing their practice by prescribing exercise routinely, and 33% planned on increasing physical activity and exercise counselling, measured through open-ended responses.Key words: Exercise is Medicine, physical inactivity, exercise prescription, primary care.

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Section: Discussionsupporting

confidence: 84%

Section: Self-reflection Questionnairementioning

confidence: 99%

Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees

O’Brien

Shields

et al. 2017

Appl. Physiol. Nutr. Metab.

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“…Despite this, many people with type 2 diabetes do not follow recommended guidelines for PA or healthful eating (5e8). In addition, they often do not receive adequate support for lifestyle changes in community settings, including primary care (9,10). To address this challenge, effective behaviour-modification interventions have been developed (11,12).…”

Section: Introductionmentioning

confidence: 99%

Contextualizing the Proven Effectiveness of a Lifestyle Intervention for Type 2 Diabetes in Primary Care: A Qualitative Assessment Based on the RE-AIM Framework

Wozniak

Soprovich

Mundt

et al. 2015

Canadian Journal of Diabetes

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“…Self-reflection questionnaires included demographics, practice history (<10%, 11%-25%, 26%-50%, 51%-75%, 76%-100%), confidence (0%-100% using 10% intervals), barriers (1-4; 1 = not at all difficult, 4 = completely prevents me from counselling), and resource information and were consistent with previously used measures as described by O'Brien et al (2017). In brief, variables were based on previous work in the areas of exercise prescription (Petrella et al 2007, Dacey et al 2013, self-efficacy on PAE practices (Hébert et al 2012), and current healthcare providers' practices and barriers (Dillman et al 2010;Shields et al 2013) as they influence PAE practice. In addition to reassessing the measures given at baseline, the 3-month follow-up survey (survey link via email) asked participants about the usefulness of the EIMC resources, how they changed their practice as a result of attending the workshop, and resources they use in discussing PAE with their patients.…”

Section: Follow-up Reflection Questionnairementioning

confidence: 99%

Exercise is Medicine Canada physical activity counselling and exercise prescription training improves counselling, prescription, and referral practices among physicians across Canada

Fowles

O’Brien

Solmundson

et al. 2018

Appl. Physiol. Nutr. Metab.

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Exercise is Medicine Canada (EIMC) is an initiative that promotes physical activity (PA) counselling and exercise prescription within health care. The purpose of this study was to compare physicians' perceptions and practices around PA counselling and exercise prescription following EIMC training. Physicians (n = 46) from 7 different provinces completed questionnaires initially and 3 months following an EIMC workshop. Three months after intervention, physicians reported greater confidence compared with baseline for providing physical activity and exercise (PAE) information to patients (79% vs 55%; p < 0.001), assessing patients' PAE (69% vs 44%, p = 0.005), answering patients' PAE questions (78% vs 54%, p < 0.001), providing PAE advice (71% vs 43%, p < 0.001), and identifying which patients would benefit from referral to qualified exercise professionals (77% vs 52%, p = 0.002). At follow-up, physicians reported PA prescription barriers as less impactful (out of 4; all p < 0.05), including perceived patients' lack of interest (2.75 to 2.25), lack of available resources (2.59 to 2.00), and lack of time (2.41 to 2.14). The proportion of physicians providing written exercise prescriptions increased from 20% to 74%. This study suggests that the completion of a 1-day EIMC workshop increases physicians' confidence, knowledge, and counselling behaviours of physicians in prescribing PAE.

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Including Physical Activity Exercise in Diabetes Management: Diabetes Educators' Perceptions of Their Own Abilities the Abilities of Their Patients

Cited by 21 publications

References 22 publications

Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees

Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees

Contextualizing the Proven Effectiveness of a Lifestyle Intervention for Type 2 Diabetes in Primary Care: A Qualitative Assessment Based on the RE-AIM Framework

Exercise is Medicine Canada physical activity counselling and exercise prescription training improves counselling, prescription, and referral practices among physicians across Canada

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