The PAC Project: Integrating a Physical Activity Counsellor in the Primary Health Care Team (PAC)

April 27, 2007 updated by: University of Ottawa

The PAC Project: Integrating a Physical Activity Counsellor in the Primary Health Care Team: A Randomized Controlled Trial

The Physical Activity Counselling (PAC) randomized controlled trial had as overall goal the establishment of a collaborative interdisciplinary primary care team to encourage physical activity. The main intervention was to integrate a physical activity counsellor to the primary care team so that the most appropriate care was given by the most appropriate provider. Much research has shown and many experts agree that patients need significant help to make and especially maintain physical activity behavior changes. Maintenance of these changes is essential for optimal health benefits. It was predicted that patients receiving both brief (2-4 minute) physical activity counselling from their family physician and intensive (3 month) physical activity counselling from an integrated physical activity counsellor (intensive counselling group) would report greater improvements in task motivation and task self-efficacy to engage in physical activity at the end of the intervention than those receiving only brief counselling (brief counselling group). The same was expected for both self-reported and objective physical activity. This RCT involved testing a theory-based counselling intervention, determining why the intervention was effective or ineffective by measuring key psychological mediating variables, using an objective measure to track changes in physical activity, and assessing physical and metabolic outcomes. This project represents an innovative theoretically based multi-level multi-intervention approach to promoting physical activity in primary care and is of great public health importance.

Study Overview

Status

Completed

Conditions

Physical Inactivity

Intervention / Treatment

Behavioral: Intensive physical activity counselling by an integrated physical activity counsellor

Detailed Description

Family doctors and nurses (health care providers - HCP) recommend that their patients are physically active because this is one of the most important things that patients can do to benefit their health. The Physical Activity Counselling (PAC) randomized controlled trial examined what happens when a physical activity counsellor is added to the family health care team. For the project, HCPs did a brief, 2-4 minute counselling session with their patients who reported doing less than 150 minutes of physical activity a week. Half (59) of the patients in the PAC Project only received this brief counselling from their HCP (brief counselling group) while the other half (61) also received six sessions with the physical activity counsellor over a three month period (intensive counselling group). The purpose of the project was to compare these 2 groups. The HCPs and the PAC used the 7 As shared-care model for physical activity counselling in primary care (Fortier et al., 2006). The HCPs and the PAC tried to help the patients want to (be motivated to) and to feel able to (be confident that they can) increase their level of physical activity. A number of validated questionnaires as well as some interviews were used to look at the effects of the counselling on motivation, confidence and physical activity. As well patients wore wear a small gadget known as an accelerometer to measure their actual physical activity. Quality of life was measured in all patients. Some patients (one third) had physical and metabolic testing three times during the trial. The cost of adding a PAC to a family health care team was also assessed.

Study Type

Interventional

Enrollment (Actual)

120

Phase

Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Canada
- Ontario
  - Ottawa, Ontario, Canada, K1K 0T1
    - Montfort Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 69 years (Adult, Older Adult)

Accepts Healthy Volunteers

Genders Eligible for Study

All

Description

Inclusion Criteria:

aged 18 to 69 years
<150 minutes of physical activity/week
no uncontrolled medical conditions

Exclusion Criteria:

pregnancy (funder's request),
planned absence >3 weeks during the first 3 months of the study,
living with another patient in the study,
uncontrolled medical condition,
did not receive a physical activity prescription from their provider during the brief physical activity counselling,
received brief counselling more than once during the trial period and
uninterested in receiving intensive physical activity counselling

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Allocation: Randomized
Interventional Model: Parallel Assignment
Masking: None (Open Label)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
task motivation to engage in physical activity (0-100% motivated to engage in physical activity from 1-7 days a week in the next 6 weeks) Time Frame: baseline, 6 weeks, 13 weeks, 19 weeks, 25 weeks	baseline, 6 weeks, 13 weeks, 19 weeks, 25 weeks
task self-efficacy to engage in physical activity (0-100% confident to engage in physical activity from 1-7 days a week in the next 6 weeks), measured every 6 weeks up to 25 weeks for maintenance Time Frame: baseline, 6 weeks, 13 weeks, 19 weeks, 25 weeks	baseline, 6 weeks, 13 weeks, 19 weeks, 25 weeks

Secondary Outcome Measures

Outcome Measure	Time Frame
Physical activity (subjective: in units with the Godin Leisure-Time Exercise Questionnaire) Time Frame: baseline, 6 weeks, 13 weeks, 19 weeks, 25 weeks	baseline, 6 weeks, 13 weeks, 19 weeks, 25 weeks
physical activity (objective: in activity counts by the Actical accelerometer) Time Frame: baseline, 13 weeks, 25 weeks	baseline, 13 weeks, 25 weeks
Quality of life Time Frame: baseline, 13 weeks, 25 weeks	baseline, 13 weeks, 25 weeks
Physical and metabolic outcomes (33% sample) Time Frame: baseline, 13 weeks, 25 weeks	baseline, 13 weeks, 25 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Ottawa

Collaborators

Hopital Montfort

Investigators

Principal Investigator: Michelle Fortier, PhD, University of Ottawa, Faculty of Health Sciences
Principal Investigator: William Hogg, MD, Department of Family Medicine, University of Ottawa and the C.T. Lamont Primary Health Care Research Centre, Élisabeth Bruyère Research Institute

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

May 1, 2005

Study Completion (Actual)

June 1, 2006

Study Registration Dates

First Submitted

September 16, 2005

First Submitted That Met QC Criteria