ObjectivesThe study aimed to investigate the prevalence of physical activity (PA) and factors influencing PA behaviours among medical students in Southern Thailand.DesignThe study implemented a mixed methods approach. The sequential design consisted of 2 phases: a survey followed by in-depth interviews.SettingThe study was conducted in the 3 campuses of a medical school in Southern Thailand. The preclinical students (years 1–3) studied general and basic science subjects at Nakhon Si Thammarat campus. The clinical students (years 4–6) received clinical training and hospital attachments at Trang or Phuket campuses. Total number of students was 285, with 46–48 students in each class. The study was conducted from September 2015 to February 2016.ParticipantsParticipants were medical students, 18 years old and above, from 3 campuses without disabilities or medical conditions which limited their ability to perform PA.Outcome measuresThe prevalence of the recommended levels of PA was measured using Global Physical Activity Questionnaire (GPAQ). The association between the demographic data and the recommended PA levels were analysed by univariate and multivariate analysis. In-depth interviews and thematic analysis were completed to explore PA behaviours.ResultsA total of 279 (response rate 97.9%) medical students participated in the study. Approximately half (49.5%) of the participants were physically active. The median total energy use was 540 metabolic equivalent-min/week (range 0–5640). Male and preclinical students were more likely to be physically active (p<0.05). Twenty-four in-depth interviews were conducted. Supportive factors included social support from friends and families. Study-related activities and overtime shift work were barriers.ConclusionsMore than half of the medical students have insufficient PA because of study-related activities and overtime shift work. Future studies should focus on finding ways to improve PA in clinical and female students in Thailand.

Background Physical activity (PA) counselling is an intervention to promote PA among patients in primary care, yet it remains limited in this clinical setting. This study aimed to explore PA counselling practices among general practitioners (GPs), as well as barriers to and recommendations for improving PA counselling. Methods This qualitative study employed a descriptive approach. Data were collected by in-depth interviews and analysed by thematic analysis. The study was conducted in district hospitals in Nakhon Si Thammarat, Thailand, from February 2017 to February 2018. The study participants were GPs who worked at district hospitals. Results Seventeen GPs (6 males and 11 females, mean age 29.8 ± 3.4 years) from 6 district hospitals were interviewed. Their clinical experience ranged from 2 to 12 years (mean 4.7 ± 2.9). The GPs saw 30–80 outpatients/day (mean 56.2 ± 14.1) and spent 1–8 min (mean 3.8 ± 1.8) with each patient. They emphasised PA in patients with poorly controlled non-communicable diseases (NCDs) using the word ‘exercise’ in the Thai language as well as discussing time and frequency of exercise. PA was considered a non-pharmacological treatment in the management of NCDs, which improved patient health and quality of life. Barriers to PA counselling among GPs included time constraints, insufficient knowledge, and lack of opportunities to follow-up previously counselled patients. GPs suggested that training in PA counselling was required. Conclusions GPs concurred that PA counselling is essential in the treatment of NCDs. Physicians’ recommendations to improve the quality of PA counselling in primary care include 3 Ts: training in PA counselling, tools for prescribing PA, and teams of healthcare professionals. Implementing use of written PA prescriptions may encourage patients to increase PA. Multidisciplinary teams should be developed to support PA counselling in the clinical setting. Further studies should focus on appropriate techniques to implement PA counselling and overcome existing barriers.

Background: Mobile health applications (mHealth apps) are increasingly being used to perform tasks that are conventionally performed by general practitioners (GPs), such as those involved in promoting health, preventing disease, diagnosis, treatment, monitoring, and support for health services. This raises an important question: can mobile apps replace GPs? This study aimed to systematically search for and identify mobile apps that can perform GP tasks. Methods: A scoping review was carried out. The Google Play Store and Apple App Store were searched for mobile apps, using search terms derived from the UK Royal College of General Practitioners (RCGP) guideline on GPs' core capabilities and competencies. A manual search was also performed to identify additional apps. Results: The final analysis included 17 apps from the Google Play Store and Apple App Store, and 21 apps identified by the manual search. mHealth apps were found to have the potential to replace GPs for tasks such as recording medical history and making diagnoses; performing some physical examinations; supporting clinical decision making and management; assisting in urgent, long-term, and disease-specific care; and health promotion. In contrast, mHealth apps were unable to perform medical procedures, appropriately utilise other professionals, and coordinate a teambased approach. Conclusions: This scoping review highlights the functions of mHealth apps that can potentially replace GP tasks. Future research should focus on assessing the performance and quality of mHealth apps in comparison with that of real doctors.

BackgroundPhysical inactivity is a global public health challenge. Physical activity (PA) promotion in healthcare delivery systems is effective to reduce physical inactivity. A primary care setting provides an appropriate environment for PA counseling since it is a primary contact with primary care or family physicians encounter the majority of the population. Lack of knowledge and inadequate training in PA counseling is one of the most important barriers to PA promotion. The purpose of this systematic review was to evaluate PA counseling training in primary care residency programs.MethodsThe authors systematically searched PubMed, Web of Science, Scopus and The Cochrane Library for articles published in English from 2000 to 2017. Articles regarding PA counseling in primary care residency training were extracted and outcomes assessed for this systematic review.ResultsBased on the initial review, 378 articles were excluded (362 articles excluded based on titles and abstracts and 16 articles excluded based on full texts). Four articles were included in this review, addressed PA counseling curricula in primary care residency training. All studies included PA counseling training as part of obesity and healthy lifestyle training. The training improved knowledge among primary care residents, but may not necessarily result in better attitudes or self-efficacy, which could be improved by elective rotations that focus on improved attitudes, self-efficacy, and professional norms for PA counseling. Brief training in counseling did not improve quality nor increase the rate of counseling.ConclusionsThis systematic review demonstrates a lack of evidence due to a small number of included studies. The heterogeneous outcomes from the minimal programs are needed to carefully interpret. However, this review sheds light on the importance of training in PA counseling in primary care residency programs. The development of training in PA counseling should focus on an approach that improves attitudes and the self-efficacy of primary care residents. Elective rotations, where residents voluntarily choose their subject, may provide the appropriate training period for PA counseling. Policymakers and academics should play an active role in the implementation of PA counseling as an essential competency for primary care physicians.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1268-1) contains supplementary material, which is available to authorized users.

Physical inactivity is a global health burden. Promoting physical activity in primary care through physical activity counseling is an effective intervention. This article provides an overview of and perspectives on physical activity counseling in primary care. The identification of physical inactivity as a health problem may increase the awareness of physical inactivity among patients and primary care providers, which will lead to an action plan. The contents of physical activity counseling should be based on evidence-based recommendations. Safety issues should be evaluated appropriately to optimize the utilization of primary care services. Physical activity counseling methods should be "tailored" for an individual using appropriate counseling methods and setting-specific resources. Multilevel barriers to physical activity counseling in primary care (i.e., healthcare providers, patients, and systems) must be addressed. Setting-specific strategies to overcome these barriers should be implemented to maximize the effectiveness of physical activity counseling in primary care.