Physical activity assessment in practice: a mixed methods study of GPPAQ use in primary care

Abstract

BackgroundInsufficient physical activity (PA) levels which increase the risk of chronic disease are reported by almost two-thirds of the population. More evidence is needed about how PA promotion can be effectively implemented in general practice (GP), particularly in socio-economically disadvantaged communities. One tool recommended for the assessment of PA in GP and supported by NICE (National Institute for Health and Care Excellence) is The General Practice Physical Activity Questionnaire (GPPAQ) but details of how it may be used and of its acceptability to practitioners and patients are limited. This study aims to examine aspects of GPPAQ administration in non-urgent patient contacts using different primary care electronic recording systems and to explore the views of health professionals regarding its use.MethodsFour general practices, selected because of their location within socio-economically disadvantaged areas, were invited to administer GPPAQs to patients, aged 35-75 years, attending non-urgent consultations, over two-week periods. They used different methods of administration and different electronic medical record systems (EMIS, Premiere, Vision). Participants’ (general practitioners (GPs), nurses and receptionists) views regarding GPPAQ use were explored via questionnaires and focus groups.ResultsOf 2,154 eligible consultations, 192 (8.9%) completed GPPAQs; of these 83 (43%) were categorised as inactive. All practices were located within areas ranked as being in the tertile of greatest socio-economic deprivation in Northern Ireland. GPs/nurses in two practices invited completion of the GPPAQ, receptionists did so in two. One practice used an electronic template; three used paper copies of the questionnaires.End-of-study questionnaires, completed by 11 GPs, 3 nurses and 2 receptionists and two focus groups, with GPs (n = 8) and nurses (n = 4) indicated that practitioners considered the GPPAQ easy to use but not in every consultation. Its use extended consultation time, particularly for patients with complex problems who could potentially benefit from PA promotion.ConclusionsGPs and nurses reported that the GPPAQ itself was an easy tool with which to assess PA levels in general practice and feasible to use in a range of electronic record systems but integration within routine practice is constrained by time and complex consultations. Further exploration of ways to facilitate PA promotion into practice is needed.

Feasibility of a physical activity pathway for Irish primary care physiotherapy services

“…The GPPAQ was accepted as a suitable assessment by physiotherapists supporting previous research which found it acceptable for use in general practice, with GPs and practice nurses finding it easy to use and quick to administer [20,21]. Infrequent use of formalised screening tools has previously been described amongst physiotherapists in Ireland [5] and adoption of the GPPAQ as part of the overall PA pathway would offer the opportunity to improve on this.…”

Physical Activity as a Vital Sign: A Systematic Review

“…GPPAQ is supported by the National Institute for Health and Care Excellence (NICE) (22). It includes 7 questions that cover PA involved in work; number of hours participating in various exercises, housework, childcare, gardening, and do-it-yourself activities; and walking pace.…”

“…PAVS was examined in studies of adults included in this review but has been proposed to be appropriate for adolescents (25). GPPAQ is commonly used in the primary care setting in the United Kingdom to assess PA in adults (22). This tool is supported as part of the United Kingdom public health initiative “Let’s Get Moving” campaign and can be self-administered or administered by a health professional (22).…”

Physical Activity Level and Adult Saudi Health Related Quality of Life

“…Physical inactivity in SA is a significant consequence of the socioeconomic development including lifestyle changes and increase in obesity [3]- [5]. General Practice of Physical Activity Questionnaire (GPPAQ) which was developed in 2002 by the London school of hygiene and tropical medicine is a valid and reliable simple tool for ranking subject's physical activity level [6]- [8]. The GPPAQ is composed of 7 self-explanatory questions that can be answered in 30 -60 seconds and are referred to the amount and type of physical activity in the workplace, the number of hours spent on different activities and the usual walking pace [6]- [8] The GPPAQ is suitable for adult from 16 -74 years and its electronic template [9] automatically calculates the subject's data into physical activity index which categorizes the subject's physical activity level (PAL) as active, moderately active, moderately inactive, or inactive [6]- [8].…”