Ethical approval was received from Griffin Hospital’s (Derby, Connecticut, USA) Institutional Review Board and Yale University Human Investigations Committee.
Impact of an educational intervention on internal medicine residents’ physical activity counselling: the Pressure System Model
Article first published online: 6 MAR 2008
© 2008 The Authors
Journal of Evaluation in Clinical Practice
Volume 14, Issue 2, pages 294–299, April 2008
How to Cite
Katz, D. L., Shuval, K., Comerford, B. P., Faridi, Z. and Njike, V. Y. (2008), Impact of an educational intervention on internal medicine residents’ physical activity counselling: the Pressure System Model. Journal of Evaluation in Clinical Practice, 14: 294–299. doi: 10.1111/j.1365-2753.2007.00853.x
- Issue published online: 6 MAR 2008
- Article first published online: 6 MAR 2008
- Accepted for publication: 15 November 2006
- behavioural counselling;
- controlled educational trial;
- physical activity;
- Pressure System Model;
- primary care
Rationale, aims and objectives Systematic reviews point to inconclusive evidence that counselling patients in a primary care setting is effective in increasing adults’ physical activity (PA) levels. This study evaluates the impact of an innovative physician counselling programme on physicians’ PA counselling behaviour and their patients’ PA levels.
Methods A controlled educational study conducted at six Yale School of Medicine hospitals. Sixty-five internal medicine residents and 316 primary care patients were randomized to intervention or control groups. Intervention physicians participated in five interactive sessions outlining details of the Pressure System Model, while control physicians received usual residency training. Intervention and control patients’ PA levels and residents counselling behaviour were assessed using a validated questionnaire and compared pre- and post intervention. Data analysis was performed using paired t-tests and repeated measures anova.
Results At 6-month follow-up intervention, patients’ PA levels increased significantly from baseline (1.77 ± 0.84; P = 0.0376). A similar pattern was observed after 12 months (1.94 ± 0.98; P = 0.0486). Control patients’ PA did not change significantly from baseline at 6 or 12 months (0.35 ± 1.00; P = 0.7224 and 0.99 ± 1.52; P = 0.5160, respectively). At 12 months, intervention residents provided PA counselling 1.5 times more than they did at baseline (P < 0.05) compared with no significant changes in the control group.
Conclusions The present study has shown that providing residents with a practical tool, enabling them to deal with patients’ barriers and previous failure in behavioural change, is efficacious in increasing PA levels of adult patients.