Physical Activity Clinical Trial
Official title:
Screening While You Wait: A Technology-based Intervention to Facilitate Actionable Exercise Prescriptions in Primary Care
Despite knowing that exercise improves health, primary care providers (PCPs) do not regularly
assess physical activity (PA) levels or use proven techniques to help patients to increase
their PA levels. Studies have shown that PCPs don't talk to patients about their PA levels
because they don't feel they have adequate knowledge or resources to help their patients.
Additionally they don't feel they have time to provide personalized advice regarding PA.
This study will use tablet computers and email to engage patients in contemplating their own
PA levels and starting conversations with their PCPs. Electronic surveys delivered via
tablets and email prior to periodic health reviews will be used to support customized,
patient-centred health care. The patient's survey responses will be used to develop a
printable 'toolkit' with individualized PA recommendations, a personalized exercise
prescription (Rx), as well as patient-specific educational and community resources. The
exercise Rx and resources can be edited by the PCP based on the resulting discussion between
patient and PCP.
The overarching aim of this study is to determine how the use of technology in family
doctors' offices can help patients to engage with their PCPs regarding PA and ultimately
increase their PA levels.
The study will take place at the academic Women's College Hospital (WCH) Family Practice (FP)
in Toronto, Canada. The clinic provides over 50,000 patient visits per year and is split into
four sub-teams for operational purposes. These teams have unique members with no crossover of
PCPs. Patients typically see their own PCP for planned care visit (e.g., preventative care
and chronic disease management) but access any PCP available when more acute issues arise.
The PA surveys are administered via Ocean by CognisantMD. Ocean connects patients, PCPs, and
researchers using secure surveys on tablets in the FP waiting room and online patient surveys
that integrate with WCH FP Electronic Medical Records.
This is a pilot step wedge trial, with graduated, random intervention roll-out across the
clinical setting in four steps over five time intervals. Eligible patients presenting to the
clinic during the study period will be allocated to intervention or control depending on
whether the PCP they have booked to see has had the intervention 'turned-on'. The order
determining when each PCP and his or her team change from control to intervention is randomly
assigned. This design was chosen to avoid the risk of intervention contamination and to
enable logistics of implementation. The teams will receive the control and intervention
according to the following schedule:
Time Interval 1: Team A-D Control Time Interval 2: Team A Intervention, Team B-D Control Time
Interval 3: Team A+B Intervention, Team C+D Control Time Interval 4: Team A-C Intervention,
Team D Control Time Interval 5: Team A-D Intervention
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