PA Moves Trial - PCP Participants

Study Overview
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Brief Summary
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The purpose of this voluntary research study is to determine the impact of an ECHO intervention on the likelihood that rural primary care providers (PCP) will refer their physically inactive patients to be more active.

Detailed Description
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People living in rural areas are diagnosed and die from cancer at higher rates than people living in cities. Physical activity has been shown to decrease the risk and occurrence of a variety of cancers, including bladder, breast, colon, endometrial, gastric, kidney, and prostate cancers. Being inactive can cause over 10% of breast and colon cancer cases. Compared to people living in cities, people living in rural areas tend to be less physically active. They're also more likely to be overweight/obese or have diabetes. Adults who are overweight, obese, or diabetic often have changes in the way their bodies deal with insulin, glucose metabolism, and inflammation. Physical activity is thought to reduce the risk of cancer by improving these issues over time. PCPs and their staff can identify a patient's need for more physical activity, but may not have the time or resources to give advice or assistance. We have set up a telephone-based physical activity coaching program, called the MoveLine, to give inactive patients advice and assistance in becoming more physically active. The purpose of this study is to determine if an ECHO intervention will impact the likelihood that PCPs will refer patients to the MoveLine for physical activity coaching. Approximately 32-48 providers will take part in this research study.

Official Title
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Increasing Physical Activity in Rural Pennsylvanians: PCP Participants

Conditions
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Behavior, Physical Activity

Intervention / Treatment
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* Behavioral: Receive ECHO training
* Behavioral: Offered ECHO training in year 5


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primary care providers or adjunct faculty from Primary Health Network (PHN) and Penn State Health Family and Community Medicine (FCM) rural clinics Must be able to provide and understand informed consent Exclusion Criteria: Primary care providers or adjunct faculty NOT from PHN or FCM rural clinics
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Active Intervention<br>PCP participants in the practice cohort or the intervention group will receive the ECHO46 intervention via real-time, interactive videoconferencing through Zoom sessions held once weekly for 4 weeks (4 sessions total) at regularly scheduled times convenient to providers. Session topics will focus on training PCP participants to assess, advise, and refer patients to be more physically active, as well as provide evidence-based strategies they can use to supplement and sustain their communication efforts. | Behavioral: Receive ECHO training<br>* Active Intervention<br>|
| Active Comparator: Delayed Intervention<br>PCP participants will be offered the intervention in year 5. | Behavioral: Offered ECHO training in year 5<br>* Delayed Intervention<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Likelihood of patient referral | Percentage of participating primary care providers referring their patients to a community-level, telephone-based physical activity counseling service assessed through the EMR of their participating patients | Through study completion, an average of 5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| PAQ-M | The 11-question Morgenstern Physical Activity Questionnaire (PAQ-M) is a self-report of physical activity resulting from recreational activities, exercises, home or work activities, and chores. | Baseline intervention group vs. Baseline delayed intervention group | 
| Estimated average metabolic equivalents expended daily | Daily metabolic equivalents collected using an accelerometer from Actigraph | 1 week at baseline | 
| Estimated metabolic equivalents expended weekly | Weekly metabolic equivalents collected using an accelerometer from Actigraph, expressed in hours/week | 1 week at baseline | 
| Time in Sleep | Weekly time in sleep collected using an accelerometer from Actigraph | 1 week at baseline | 
| Sedentary Time | Weekly sedentary time collected using an accelerometer from Actigraph | 1 week at baseline | 
| Low physical activity | Weekly low physical activity collected using an accelerometer from Actigraph | 1 week at baseline | 
| Moderate physical activity | Weekly moderate physical activity collected using an accelerometer from Actigraph | 1 week at baseline | 
| Vigorous physical activity | Weekly vigorous physical activity collected using an accelerometer from Actigraph | 1 week at baseline |