A Brief Intervention of Physical Activity Education and Counseling in Community Rehabilitation: A Feasibility Randomized Controlled Trial

Abstract

This study aimed to assess the feasibility of delivering a brief physical activity (PA) intervention to community rehabilitation clients. Participants were randomized to receive one session of stage-of-change-based PA education and counseling in addition to written educational material, or education material alone. Outcomes were measured at baseline and 3 months; the primary outcome was feasibility, measured by the percentage of those who were eligible, consented, randomized, and followed-up. A total of 123 individuals were both eligible and interested in participating, 32% of those screened on admission to the program. Forty participants consented, and 35 were randomized, with mean age 72 years (SD = 12.2). At baseline, 66% had recently commenced or intended to begin regular PA in the next 6 months. A total of 30 participants were followed-up. It is feasible to deliver education and counseling designed to support the long-term adoption of regular PA to community rehabilitation clients. Further refinement of the protocol is warranted (ACTRN12617000519358).

What is the effect of a brief intervention to promote physical activity when delivered in a health care setting? A systematic review

“…Thirteen studies examined a single session brief intervention, 24–27,29,30,35,36,42–44,46,47 with four using technology for delivery 26,27,30,47 (i‐pad, DVD, computer program). Nine studies included a single brief counselling session with follow up by either mail or phone call 23,28,31–34,37,38,41 .…”

“…Outcomes reported were self-reported PA minutes/day (n = 15 studies [24][25][26]28,[31][32][33]35,37,38,[41][42][43][44]46,47 ), self-reported MET (metabolic equivalent)/day of PA (n = 5 studies 23,27,28,30,34 ), pedometer steps/ day (n = 4 studies 28,39,40,45 ) and PA using activity monitors (n = 3 studies 28,35,36 ). Secondary review outcomes reported included: QoL (n = 6 studies 23,[34][35][36]39,40,45 ); self-efficacy for exercise (n = 7 studies 30,31,33,36,[42][43][44] ); and, stage of change in relation to exercise (n = 2 studies 30,36 ). Three studies reported adherence to prescribed walking interventions from patient-reported activity logs 23,28,46 with mean adherence ranging from 62%…”

“…Table 1 summarizes the characteristics of included studies. Studies were conducted in the United States (n = 8 [23][24][25][26][27][28][29][30] ), Australia (n = 6 [31][32][33][34][35][36] ), the UK (n = 4 [37][38][39][40] ), Germany (n = 4 [41][42][43][44] ), Canada, 45 Poland 46 and New Zealand. 47 In all included studies, the experimental group received a brief PA counselling session based on behaviour change principles, including some or all of the following elements: education; exercise prescription; goal setting; problem solving to overcome barriers to PA; behavioural reinforcement; and consideration of social supports.…”

“…39,40,45 The brief counselling sessions in the included studies ranged in duration from 5 minutes 35 up to 2 hours, 45 with the longer session also including nutrition education and counselling. Follow-up length ranged from single session interventions with no follow-up [24][25][26][27]29,30,35,36,[42][43][44]46,47 to three 30-minute face-to-face sessions combined with three 10-minute phone sessions over 24 weeks. 38 The mean duration of follow up was 24 weeks.…”

“…35,36 In 18 studies, the control group received no intervention or usual care 23,[26][27][28][29][30][31]34,[37][38][39][40][41][42][43][45][46][47] ; two of these studies 42,43 examined two different brief PA counselling interventions against a usual care group. Four further studies 33,35,36,44 compared a brief PA intervention to a control group who received a minimal intervention. Three studies compared a brief PA counselling intervention to another intervention.…”