Computerized Physical Activity Promotion in Primary Care

描述（由申请人提供）：鼓励将有效的身体活动促进干预措施纳入常规护理是国家卫生优先事项，以降低心血管疾病的发病率和死亡率。医生指出，在指导患者进行身体活动方面存在一些障碍，包括缺乏时间、专业知识和组织支持。使用计算机收集数据，以帮助咨询患者，并提供患者特定的材料，以促进身体活动是提高当前计算机技术和行为模型的利用率的一种方式。本研究的具体目的是确定计算机程序的有效性，该程序创建1）针对个人的患者特定身体活动自助报告和2）针对患者的报告，以提示和指导医生建议。拟议研究的主要目的是通过随机对照试验设计，确定患者和医生身体活动计算机报告对6个月干预和随后6个月随访后身体活动的影响。医师实践将是随机化的单位。干预条件（IC）医生将收到 在IC受试者的所有计划的非急性访视时，进行一次关于身体活动咨询的培训和患者特定的计算机生成的咨询提示。增强型糖尿病护理（EUC）条件医生将接受一般预防指南的培训，但在患者就诊时没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，此外还有一套针对他们是否准备好进行身体活动的手册和标准预防导向的健康教育材料。EUC条件受试者将接受常规护理、体力活动建议和标准预防性健康教育材料。我们假设在12个月结束时，IC受试者至少中等强度的体力活动分钟数的增加（即6个月时增加90分钟，12个月时增加60分钟）显著大于EUC受试者。

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.