Abstract
Background Physical inactivity affects a third of the population and is the fourth leading risk factor for mortality globally.1 Increasing activity by just thirty minutes a week can extend life expectancy by four years.2 The number needed to treat for physical activity is 12,3 thus the role of clinicians in promoting physical activity is immensely valuable. The ‘Let’s Get Moving’ project was implemented in a large Wiltshire health centre to try and address physical inactivity amongst patients and staff. The aim was to reduce sedentary behaviour in patient waiting rooms; increase physical activity levels amongst both staff and patients; and improve awareness of physical activity guidelines amongst both staff and patients.
Methods A poster displaying four chair-based exercises with a QR-link to additional resources was created. A summary of physical activity recommendations was also included. The poster was displayed in all patient waiting rooms and a PDF format was sent via text to patients before face-to-face appointments. A visual display board of physical activity guidelines and recommendations for different population groups was created in the main waiting room and the poster was additionally featured on the practice website.
Educational sessions were provided to clinical staff as well as practice receptionists with content focussed on physical activity guidelines and the benefits of both increasing physical activity and reducing sedentary behaviour.
A survey was distributed to all staff, as well as randomly selected patients, pre-intervention and four months post-intervention.
Results Pre-intervention only 31.0% of staff and 39.5% of patients met the recommended 150 minutes of aerobic activity in the previous week.
The aerobic and strength components of the physical activity guidelines were correctly identified by 27.6% and 33.3% of staff respectively. Only 20.5% of patients correctly identified the guidance for 150 minutes of aerobic activity a week.
65.5% of staff and 71.8% of patients believed regular exercise could extend life expectancy by over five years. Importantly, 65% of patients reported they would be ‘likely’ or ‘very likely’ to engage in more physical activity if recommended by a clinician.
Post-intervention, activity levels amongst staff increased with 36.0% meeting recommended levels. Activity amongst the patient group dropped with only 32.1% achieving 150 minutes of aerobic activity in the preceding week. There was no improvement in staff or patient recognition of physical activity guidelines in either the aerobic or strength components.
Conclusion Despite the strong belief in the benefits of physical activity to health and longevity, there is a lack of understanding of the guidelines by both clinicians and the public. Educational sessions for staff did not result in improved and sustained knowledge of physical activity guidelines but did marginally improve activity levels within this group. Visual displays promoting physical activity across the practice did not result in increased activity levels or improved guideline knowledge in the patient group. Patients did, however, report they would respond positively to exercise recommendations from healthcare professionals. Efforts should therefore perhaps focus on promoting movement at a practice-wide level and providing brief personalised interventions during patient consults, with visual displays acting as an adjunct.
References
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Reimers CD, Knapp G, Reimers AK. Does physical activity increase life expectancy? A review of the literature. Journal of Aging Research 2012 Oct;2012.
Brooks J, Ahmad I, Easton G. Promoting physical activity: the general practice agenda. British Journal of General Practice 2016 Sep 1;66(650):454–5.