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Marjo Rinne, D.Sc, 1

Erja Toropainen, M.Sc 1

Minna Aittasalo D.Sc 1,

Tommi Vasankari, D.Med.Sci 1,

Katriina Kukkonen-Harjula, D.Med.Sci 1,2

1The UKK Institute for Health Promotion Research Tampere2 University of Eastern Finland, KuopioFinland

[email protected]

Developing counselling practices in physical activity by tutoring multi-professional

teamwork in primary care

Marjo Rinne, Turku 24.-26.8.2011

Physical Activity Prescription Program (PAPP) 2001-2004

Physical Activity Prescription (PAP) has been proven feasible

and effective in routine health care practices.

(Aittasalo et al. 2006, Aittasalo et al. 2007)

However, local efforts are needed to facilitate its adoption

in primary health care services.

Introduction

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Assess and Advise-physical activity level

-physical abilities

-beliefs and knowledge

-Health risks, benefits of change

Agree and Assist

-Collaboratively developed personalized action plan

-Identify personal barriers and strategies

Arrange

- Plan for follow-up

5 A´s FRAMEWORK

Estabrooks et al. 2003


Ongoing actions in Finland

� continuous training

� integration of PAP to national patient record system

� updating of PAP material according to recent recommendations

� producing all material in various electronic formats

� linking PA and PAP to all relevant clinical guidelines

� development of dissemination protocol and supportive material for

health care units �

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Intervention to improve PA counseling practices, uptake of PAP and collaboration

Aims are

• to increase knowledge about PA, counselling and PAP,

• to improve counselling practices and adoption of PAP,

• to enhance counselling collaboration among health care and exercise professionals, and

• to develop electric documentation of PA counselling in patient records.


Implementation

� In four municipal health centres in Pirkanmaa region, Finland

� A multi-professional team selected in each health centre is responsible for carrying out the 6-month study.

� Teams select target groups and actions.

� The professionals in health care have received supportive PAP material (electronic Physical Activity Prescription, User´́́́s Guide for PAP, Rated Perceived Exertion (RPE) Scale, electronic follow-up description)

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Double-sided User’s Guide


Implementation

� The actions of the responsible teams are tutored for 6 month with 4 goal-oriented meetings.

� After tutoring process a conclusive meeting will be held.

� The study will last until February 2012.

� The preliminary experiences are positive.

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Evaluation at baseline and after the intervention:

1) Self-administered questionnaire to the professionals: • attitudes, knowledge, current counseling,

• use of written PAP,

• documentation of PA counseling,

• collaboration

2) Professionals’ 5-day logbooks after the patient visits: • bringing out the contents of counselling PA,

• implementing PA counseling,

• use of PAP during patient appointments,

• documentation of PA to the patient record system



3) Self-administered questionnaire to the patients: • discussion about PA,

• occurrence of PA counseling,

• delivery of PA prescription etc.

4) Telephone interview of municipal exercise service providers:

� to most important collaborators in exercise sector are used

to evaluate collaboration with health care.

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5) A sample of patient documentation from the patient record system:

• documentation of PA counseling

6) Process evaluation is based on• the meeting minutes of the responsible teams and

• tutor meetings to explain underlying factors promoting or

preventing the process of change.


Conclusion

� The intervention produces one approach to improve

volume and quality of counselling in primary health care.

� If the results are positive, they may be applied

to other similar kind of processes, e.g. nutrition.

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Physicians start to write physical activity prescriptions

Unfortunately we do not have these as pills, you have to do these exercises by yourself.

Health & Medicine

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