Computerized Physical Activity Promotion in Primary Care

说明(由申请人提供)：鼓励将有效的体力活动促进干预措施纳入常规护理，是降低心血管疾病发病率和死亡率的国家卫生优先事项。医生指出，咨询患者进行体力活动存在几个障碍，包括缺乏时间、专业知识和组织支持。使用计算机收集数据，帮助咨询患者，并提供针对患者的材料来促进体力活动，是提高当前计算机技术和行为模型利用率的一种方式。这项研究的具体目的是确定一种计算机程序的有效性，该程序为个人创建1)特定于患者的体力活动自助报告，以及2)创建特定于患者的报告以提示和指导医生建议。该研究的主要目的是通过随机对照试验设计，确定在6个月的干预和随后的6个月的随访后，患者和医生的体力活动计算机报告对体力活动的影响。医生的实践将是随机的单位。医生将收到的干预条件(IC 在IC受试者所有预定的非急性就诊时，接受一次体力活动咨询培训，并针对患者特定的计算机生成咨询提示。增强型日常护理(EUC)条件医生将接受关于一般预防指南的培训，但在患者就诊时不会有量身定制的咨询提示。IC受试者将在基线、1个月、3个月和6个月时收到量身定制的印刷信息，此外还将收到一套手册，旨在帮助他们准备成为身体活跃和以标准预防为导向的健康教育材料。EUC条件受试者将接受常规护理、身体活动建议和以标准预防为导向的健康教育材料。我们假设，在12个月末，与EUC受试者相比，IC受试者至少中等强度的体力活动分钟数显著增加(即6个月增加90分钟，12个月增加60分钟)。

DESCRIPTION (provided by applicant): Encouraging the incorporation of effective physical activity promotion interventions into routine care is a national health priority to decrease the morbidity and mortality from cardiovascular disease. Physicians note several barriers to counseling patients to be physically active, including a lack of time, expertise, and organizational support. Using computers for collecting data to assist in counseling patients and to provide patient-specific materials to promote physical activity is a way of improving the utilization of current computer technologies and behavioral models. The specific aim of this study is to determine the efficacy of a computer program that creates 1) patient-specific physical activity self-help reports for individuals and 2) patient-specific reports to prompt and guide physician advice. The major objective of the proposed study is to determine via a randomized controlled trial design, the effects of the patient and physician physical activity computer reports on physical activity after a 6-month intervention and subsequent 6 months of follow-up. Physician practices will be the unit of randomization. Intervention condition (IC) physicians will receive training on physical activity counseling once and patient-specific computer-generated counseling prompts at all scheduled, non-acute visits of IC subjects. Enhanced Usual Care (EUC) condition physicians will receive training on general prevention guidelines but no tailored counseling prompts at patient visits. IC subjects will receive tailored print messages at baseline, 1, 3, and 6 months, in addition to a set of manuals targeted to their readiness to become physically active and standard prevention-oriented health education materials. EUC condition subjects will receive usual care physical activity advice and standard prevention-oriented health education materials. We hypothesize that at the end of 12 months, IC subjects will have a significantly greater increase in minutes of physical activity of at least moderate intensity (namely a 90 minute increase at 6 months and a 60 minute increase at 12 months) compared to EUC subjects.