Efficacy of GP referral of insufficiently active patients for expert physical activity counseling: protocol for a pragmatic randomized trial (The NewCOACH trial)

James, Erica L., Ewald, Ben, Johnson, Natalie, Brown, Wendy, Stacey, Fiona G., Mcelduff, Patrick, Booth, Angela, Yang, Fan, Hespe, Charlotte and Plotnikoff, Ronald C. (2014) Efficacy of GP referral of insufficiently active patients for expert physical activity counseling: protocol for a pragmatic randomized trial (The NewCOACH trial). BMC Family Practice, 15 1: . doi:10.1186/s12875-014-0218-1


Author James, Erica L.
Ewald, Ben
Johnson, Natalie
Brown, Wendy
Stacey, Fiona G.
Mcelduff, Patrick
Booth, Angela
Yang, Fan
Hespe, Charlotte
Plotnikoff, Ronald C.
Title Efficacy of GP referral of insufficiently active patients for expert physical activity counseling: protocol for a pragmatic randomized trial (The NewCOACH trial)
Journal name BMC Family Practice   Check publisher's open access policy
ISSN 1471-2296
Publication date 2014-12-29
Year available 2014
Sub-type Article (original research)
DOI 10.1186/s12875-014-0218-1
Open Access Status DOI
Volume 15
Issue 1
Total pages 10
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2015
Language eng
Formatted abstract
Background
Physical inactivity is fourth in the list of risk factors for global mortality. General practitioners are well placed to offer physical activity counseling but insufficient time is a barrier. Although referral to an exercise specialist is an alternative, in Australia, these allied health professionals are only publicly funded to provide face-to-face counseling to patients who have an existing chronic illness. Accordingly, this trial aims to determine the efficacy of GP referral of insufficiently active patients (regardless of their chronic disease status) for physical activity counseling (either face-to-face or predominately via telephone) by exercise specialists, based on patients’ objectively assessed physical activity levels, compared with usual care. If the trial is efficacious, the equivalence and cost-effectiveness of face-to-face counseling versus telephone counseling will be assessed.

Methods
This three arm pragmatic randomized trial will involve the recruitment of 261 patients from primary care clinics in metropolitan and regional areas of New South Wales, Australia. Insufficiently active (less than 7000 steps/day) consenting adult patients will be randomly assigned to: 1) five face-to-face counseling sessions, 2) one face-to-face counseling session followed by four telephone calls, or 3) a generic mailed physical activity brochure (usual care). The interventions will operationalize social cognitive theory via a behavior change counseling framework. Participants will complete a survey and seven days of pedometry at baseline, and at three and 12 months post-randomization. The primary analyses will be based on intention-to-treat principles and will compare: (i) mean change in average daily step counts between baseline and 12 months for the combined intervention group (Group 1: face-to-face, and Group 2: telephone) and usual care (Group 3); (ii) step counts at 3 months post-randomization. Secondary outcomes include: self-reported physical activity, sedentary behavior, quality of life, and depression.

Discussion
If referral of primary care patients to exercise specialists increases physical activity, this process offers the prospect of systematically and sustainably reaching a large proportion of insufficiently active adults. If shown to be efficacious this trial provides evidence to expand public funding beyond those with a chronic disease and for delivery via telephone as well as face-to-face consultations.
Keyword Physical activity
Primary care
Referral
Pedometry
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article no.: 15:218

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Human Movement and Nutrition Sciences Publications
 
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Created: Fri, 23 Jan 2015, 14:26:53 EST by Sandrine Ducrot on behalf of School of Human Movement and Nutrition Sciences