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首页> 外文期刊>BMC Family Practice >Efficacy of GP referral of insufficiently active patients for expert physical activity counseling: protocol for a pragmatic randomized trial (The NewCOACH trial)
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Efficacy of GP referral of insufficiently active patients for expert physical activity counseling: protocol for a pragmatic randomized trial (The NewCOACH trial)

机译：活动不全患者的GP转诊以进行专家体育锻炼咨询的功效：实用的随机试验方案（NewCOACH试验）

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Background Physical inactivity is fourth in the list of risk factors for global mortality. General practitioners are well placed to offer physical activity counseling but insufficient time is a barrier. Although referral to an exercise specialist is an alternative, in Australia, these allied health professionals are only publicly funded to provide face-to-face counseling to patients who have an existing chronic illness. Accordingly, this trial aims to determine the efficacy of GP referral of insufficiently active patients (regardless of their chronic disease status) for physical activity counseling (either face-to-face or predominately via telephone) by exercise specialists, based on patients’ objectively assessed physical activity levels, compared with usual care. If the trial is efficacious, the equivalence and cost-effectiveness of face-to-face counseling versus telephone counseling will be assessed. Methods This three arm pragmatic randomized trial will involve the recruitment of 261 patients from primary care clinics in metropolitan and regional areas of New South Wales, Australia. Insufficiently active (less than 7000 steps/day) consenting adult patients will be randomly assigned to: 1) five face-to-face counseling sessions, 2) one face-to-face counseling session followed by four telephone calls, or 3) a generic mailed physical activity brochure (usual care). The interventions will operationalize social cognitive theory via a behavior change counseling framework. Participants will complete a survey and seven days of pedometry at baseline, and at three and 12?months post-randomization. The primary analyses will be based on intention-to-treat principles and will compare: (i) mean change in average daily step counts between baseline and 12?months for the combined intervention group (Group 1: face-to-face, and Group 2: telephone) and usual care (Group 3); (ii) step counts at 3?months post-randomization. Secondary outcomes include: self-reported physical activity, sedentary behavior, quality of life, and depression. Discussion If referral of primary care patients to exercise specialists increases physical activity, this process offers the prospect of systematically and sustainably reaching a large proportion of insufficiently active adults. If shown to be efficacious this trial provides evidence to expand public funding beyond those with a chronic disease and for delivery via telephone as well as face-to-face consultations. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12611000884909 webcite .
机译：背景缺乏运动是全球死亡率高风险因素中的第四位。全科医生很适合提供体育锻炼咨询，但是时间不足是一个障碍。尽管可以选择聘请运动专家，但在澳大利亚，这些专职医疗保健专业人员仅获得公共资助，可以为患有慢性病的患者提供面对面的咨询。因此，该试验旨在确定运动不足的患者（不论其慢性病状态如何）将GP转诊以进行运动活动咨询（面对面或主要通过电话），由运动专家根据患者的客观评估进行咨询。身体活动水平，与常规护理相比。如果该试验有效，则将评估面对面咨询与电话咨询的等效性和成本效益。方法这项三臂务实的随机试验将招募来自澳大利亚新南威尔士州都会区的261名患者。活动不足（每天少于7000个步骤）的成年患者同意将被随机分配给：1）五个面对面的咨询会议，2）一次面对面的咨询会议，然后是四个电话，或3）a通用邮寄的体育锻炼手册（常规护理）。干预措施将通过行为改变咨询框架来操作社会认知理论。参加者将在基线，随机化后3个月和12个月时完成一项调查和计步法，为期7天。初步分析将基于意向性治疗原则，并将进行比较：（i）联合干预组（第1组：面对面和分组）在基线和12个月之间的平均每日步数变化的平均值2：电话）和日常护理（第3组）; （ii）随机化后3个月的步数。次要结果包括：自我报告的体育活动，久坐的行为，生活质量和抑郁。讨论如果将初级保健患者转介给运动专家可以增加体育锻炼，那么此过程将有可能系统地和可持续地覆盖大量活动不足的成年人。如果证明有效，该试验将提供证据，将公共资金扩大到患有慢性疾病的人群之外，并通过电话以及面对面的咨询来提供。试验注册澳大利亚新西兰临床试验注册中心ACTRN12611000884909网站。

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