The development of an intervention to promote walking in primary care

在过去的十年里，英国的肥胖症增加了一倍多，这主要是因为人们在日常生活中不那么活跃，比如更多地开车和看更多的电视。政府目前的建议是，人们应该至少进行30分钟的运动？中等强度还是剧烈强度？每周至少锻炼五天，以获得健康保护益处。然而，在英格兰和威尔士，超过60%的男性和70%的女性不符合这些要求，活动随着年龄的增长而减少。由于缺乏运动而导致的健康问题，如糖尿病，预计在未来将急剧增加，并可能很快超过吸烟，成为导致最不健康和过早死亡的行为。这项研究旨在促进？快活？走路，即走路会导致轻微的上气不接下气。大多数人可以在不需要任何特殊设备的情况下步行，有时是适合他们的。我们已经开发出一种干预措施，可以在大约10-15分钟内送达。它要求参与者为增加步行设定现实的目标，通过要求参与者回忆他们实现这些目标的实例来增强信心，并通过制定具体的计划帮助人们将善意付诸行动。它帮助130名志愿者增加步行，通过计步器测量，从平均每天20分钟增加到32分钟。这项提案旨在调整这一干预措施，使其能够由实习护士和健康培训师在初级保健中提供，目标是那些增加体力活动是健康优先事项的患者。它将被制定为那些提供它的人可以接受的，很容易按照预期的方式提供，并且可以被参加初级保健的患者接受。有必要开展一项研究，研究如果更广泛地采用这种干预措施，会对步行产生多大影响，以及这种干预会持续多久。将制定和完善干预措施，包括材料和培训，以最大限度地提高干预措施的可接受性。将开发评估这种干预效果的方法，以招募和留住研究中的人，并对步行、实际步行和医疗费用的信念进行可接受的测量。它还将调查一些人增加步行而一些人不步行的原因。这将为更明确地研究干预的有效性奠定基础。

Obesity has more than doubled in the UK over the past decade, largely because people are less active in their daily lives, e.g. by driving more and watching more television. Current government recommendations are that people should engage in at least 30 minutes of ?moderate or vigorous? exercise, for at least five days each week, to gain health protective benefits. However, over 60% of men and 70% of women in England and Wales do not meet these requirements, with activity decreasing with age. Health problems due to physical inactivity, such as diabetes, are expected to increase dramatically in the future as a consequence, and may soon overtake smoking as the behaviour which causes most ill-health and premature death. This research aims to promote ?brisk? walking, i.e. walking that results in being slightly out of breath. Walking can be done by most people without any special equipment, at times that suit them. We have developed an intervention that can be delivered in about 10-15 minutes. It asks participants to set realistic goals for increasing their walking, boosts confidence by asking participants to recall instances when they have achieved these goals, and helps people put their good intentions into action, by making concrete plans. It helped 130 volunteers increase their walking, as measured by pedometers, from an average of 20 mins/day to 32 mins/day. These increases were maintained for at least six weeks.This proposal aims to adapt this intervention so that it can be delivered in primary care by practice nurses and health trainers, targeted at patients for whom increasing physical activity is a health priority. It will be developed to be acceptable to those delivering it, easy to deliver as intended and acceptable to patients attending primary care. There is a need to develop a study of how much this intervention would affect walking if it were adopted more widely, and for how long increases would last. The intervention, including materials and training, will be developed and refined to maximise the acceptability of the intervention. Methods of evaluating the efficacy of this intervention will be developed, to recruit and retain people into the study, with acceptable measures of beliefs about walking, actual walking, and healthcare costs. It will also investigate the reasons why some people increase their walking and some do not. This will lay the basis for a more definitive study of the effectiveness of the intervention.