Integrating Physical Activity in Primary Care Practice

AuYoung, Mona; Linke, Sarah E.; Pagoto, Sherry L.; Buman, Matthew P.; Craft, Lynette L.; Richardson, Caroline R.; Hutber, Adrian; Marcus, Bess H.; Estabrooks, Paul A.; Gorin, Sherri Sheinfeld

doi:10.1016/j.amjmed.2016.02.008

Cited by 99 publications

(94 citation statements)

References 57 publications

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“…However, holding these positive attitudes are not predictive of PA prescribing behavior and specific, practical solutions need to be developed, implemented, and tested in clinical practice. Other studies have proposed strategies to enhance general PA counseling in primary care . These strategies include organizational prioritization and support of PA counseling as an essential service, system‐wide structural supports such as use of electronic medical records to assist in integration of PA into patient visits, and inclusion of exercise prescription as an essential component in medical school curricula and continuing education.…”

Section: Introductionmentioning

confidence: 99%

Physical Activity Intervention in Primary Care and Rheumatology for the Management of Knee Osteoarthritis: A Review

Waugh

King

Gakhal

et al. 2019

Arthritis Care & Research

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Physical activity (PA) is recommended by osteoarthritis (OA) international organizations as an essential component of first-line management of knee OA. Primary care physicians (PCP) and rheumatologists can play a key role in promoting PA but the extent that PA recommendation is occurring in primary and rheumatology care is unclear. This review provides an overview of current practice of PCP- and rheumatology-delivered PA intervention in the United States, Canada and Europe for the management of knee OA and explores barriers to implementing PA intervention in primary and rheumatology care. A search of MEDLINE from 2000-April 2017 was conducted, 848 abstracts were identified from which 22 relevant articles were selected for this review. Overall, recommendation of PA is suboptimal - the majority of studies reported that < 50% of PCPs and rheumatologists make this recommendation to people with knee OA. Key barriers identified were time constraints, lack of patient motivation, PA-specific resources and financial reimbursement, concerns about inadequate training and knowledge for detailed exercise prescription and beliefs about the efficacy of exercise in the management of OA and their role in providing PA intervention. There is a sparsity of data about rheumatology practice and barriers to PA intervention among this group. In summary, this review suggests that there is a notable gap between what clinical guidelines recommend and what is happening in clinical practice. Addressing this practice gap through addressing key barriers provides an opportunity for improving OA care and ultimately, the health and quality of life of people with OA. This article is protected by copyright. All rights reserved.

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Section: Introductionmentioning

confidence: 99%

Physical Activity Intervention in Primary Care and Rheumatology for the Management of Knee Osteoarthritis: A Review

Waugh

King

Gakhal

et al. 2019

Arthritis Care & Research

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“…48 Moreover, there have been calls in leading medical journals (eg, JAMA) to incorporate physical activity counseling in primary care as a preventive medicine measure. 49,50 They suggest that, based on accumulating evidence, merely advising patients to engage in physical activity is not sufficient to facilitate behavior change. 21,34 The 5A framework (assess, advise, agree, assist, arrange) has been suggested as an effective way to encourage patients to adopt physical activity.…”

Section: Physical Activity Counseling In Primary Carementioning

confidence: 99%

Physical activity counseling in primary care: Insights from public health and behavioral economics

Shuval

Leonard

Drope

et al. 2017

CA A Cancer J Clinicians

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Physical inactivity has reached epidemic proportions in modern society. Abundant evidence points to a causal link between physical inactivity and increased risk for numerous noncommunicable diseases, such as some types of cancer and heart disease, as well as premature mortality. Yet, despite this overwhelming evidence, many individuals do not meet the recommended amount of physical activity required to achieve maximum health benefits. Because primary care physicians’ advice is highly regarded, clinicians have the unique opportunity to play an important role in enabling patients to modify their behavior at the point of care with the goal of guiding patients to adopt and maintain an active lifestyle. In the current study, the authors evaluate pertinent literature from the fields of medicine/public health and economics/psychology to suggest a comprehensive approach to physical activity counseling at the primary care level. They first examine the public health approach to physical activity counseling, and then proceed to offer insights from behavioral economics, an emerging field that combines principles from psychology and economics. The application of key behavioral economics tools (eg, precommitment contracts, framing) to physical activity counseling in primary care is elaborated. CA Cancer J Clin 2017;67:233–244. © 2017 American Cancer Society.

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“…Given the current state of evidence about physical activity and disease progression in ALS, we sought to determine the opinions of front-line ALS health professionals on this issue. Since health professionals play a vital role in motivating change in the physical activity of patients, their intentions are an important measure to compare with the increasing call for exercise counsel in the clinic [19,20]. The primary goal of the survey was to measure their intention to provide exercise counsel and the factors that contribute to that decision.…”

Section: Introductionmentioning

confidence: 99%

Intentions of Canadian health professionals towards recommending exercise for people living with ALS

et al. 2019

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Background: To provide a nationwide overview of the attitudes, social pressure, perceived ability and intentions of health professionals toward exercise prescription for people living with ALS (pALS). Methods: An online survey of physician and non-physician health professionals (HPs) working in academic ALS clinics across Canada. Results: The response rate was 48% (84/176) with 30% of respondents identifying as physicians, 63% as other HPs and the remainder as administrative or research personnel. Respondents were sharply divided in their intentions to provide exercise counsel: 24% unlikely and 45% likely. Respondents with low intentions were HPs that considered this activity outside their scope of practice. Measures of intention and attitude were more positive for flexibility compared to strength and aerobic exercise. Perceptions of social pressure and ability to provide exercise counsel were significantly correlated with intention across the three exercise modes in all respondents. Qualitative themes identified as barriers to exercise prescription were lack of confidence or competence (31% physicians, 32% HP), patient tolerance (30% HP), lack of evidence (22% physicians) and lack of infrastructure (22% physicians). Conclusions: While "lack of evidence" for the benefit of exercise was a deterrent for physicians, the larger issue for all respondents was building competence and confidence in exercise prescription for pALS.

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Integrating Physical Activity in Primary Care Practice

Cited by 99 publications

References 57 publications

Physical Activity Intervention in Primary Care and Rheumatology for the Management of Knee Osteoarthritis: A Review

Physical Activity Intervention in Primary Care and Rheumatology for the Management of Knee Osteoarthritis: A Review

Physical activity counseling in primary care: Insights from public health and behavioral economics

Intentions of Canadian health professionals towards recommending exercise for people living with ALS

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