The PAC Project: Integrating a Physical Activity Counsellor in the Primary Health Care Team
Condition: Physical Inactivity
Study type: Interventional
Phase: Phase 2

Summary: 
      The Physical Activity Counselling (PAC) randomized controlled trial had as overall goal the
      establishment of a collaborative interdisciplinary primary care team to encourage physical
      activity. The main intervention was to integrate a physical activity counsellor to the
      primary care team so that the most appropriate care was given by the most appropriate
      provider. Much research has shown and many experts agree that patients need significant help
      to make and especially maintain physical activity behavior changes. Maintenance of these
      changes is essential for optimal health benefits. It was predicted that patients receiving
      both brief (2-4 minute) physical activity counselling from their family physician and
      intensive (3 month) physical activity counselling from an integrated physical activity
      counsellor (intensive counselling group) would report greater improvements in task motivation
      and task self-efficacy to engage in physical activity at the end of the intervention than
      those receiving only brief counselling (brief counselling group). The same was expected for
      both self-reported and objective physical activity. This RCT involved testing a theory-based
      counselling intervention, determining why the intervention was effective or ineffective by
      measuring key psychological mediating variables, using an objective measure to track changes
      in physical activity, and assessing physical and metabolic outcomes. This project represents
      an innovative theoretically based multi-level multi-intervention approach to promoting
      physical activity in primary care and is of great public health importance.
    

Detailed description: 
      Family doctors and nurses (health care providers - HCP) recommend that their patients are
      physically active because this is one of the most important things that patients can do to
      benefit their health. The Physical Activity Counselling (PAC) randomized controlled trial
      examined what happens when a physical activity counsellor is added to the family health care
      team. For the project, HCPs did a brief, 2-4 minute counselling session with their patients
      who reported doing less than 150 minutes of physical activity a week. Half (59) of the
      patients in the PAC Project only received this brief counselling from their HCP (brief
      counselling group) while the other half (61) also received six sessions with the physical
      activity counsellor over a three month period (intensive counselling group). The purpose of
      the project was to compare these 2 groups. The HCPs and the PAC used the 7 As shared-care
      model for physical activity counselling in primary care (Fortier et al., 2006). The HCPs and
      the PAC tried to help the patients want to (be motivated to) and to feel able to (be
      confident that they can) increase their level of physical activity. A number of validated
      questionnaires as well as some interviews were used to look at the effects of the counselling
      on motivation, confidence and physical activity. As well patients wore wear a small gadget
      known as an accelerometer to measure their actual physical activity. Quality of life was
      measured in all patients. Some patients (one third) had physical and metabolic testing three
      times during the trial. The cost of adding a PAC to a family health care team was also
      assessed.
    

Intervention name(s): Intensive physical activity counselling by an integrated physical activity counsellor
Intervention type(s): Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Keywords: physical activity counselling; physical activity behavior change intervention; prevention; collaborative health care; physical inactivity; motivation; fitness; randomized controlled trial