Mixed Methods Process Evaluation of a National Peer-Led Training Program to Increase Brief Advice on Physical Activity Given By Health Care Professionals.

INTRODUCTION: Health care professionals are well-positioned to encourage physical activity. The Clinical Champions Physical Activity Training Program (CCTP) aimed to increase population-level physical activity across England. This study aimed to (1) evaluate CCTP uptake and utilization; (2) explore CCTP fidelity, barriers, facilitators, and satisfaction; and (3) provide recommendations for program improvement. METHODS: Physical Activity Clinical Champions were recruited and trained to deliver training to other health care professionals about physical activity. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to conduct a process evaluation using data collected from CCTP training sessions delivered (often at hospitals and General Practitioner surgeries) between February and December 2018. RESULTS: About 509 training sessions were delivered, with 89% of sessions delivered by doctor/physician and nurse Clinical Champions; 8917 health care professionals attended a training session. Sessions lasted on average 1 hour 28 minutes and core slide sets were used in 65% of sessions. Barriers related to arranging the sessions and time available to deliver sessions. CONCLUSION: The process evaluation demonstrated a national peer-led training program can reach all geographical regions of England; however, barriers need to be addressed. Recommendations include providing more administrative support to the Clinical Champions, improving communication and advertising to raise awareness of the CCTP, and standardizing training session duration and content.

Impact of a National Peer-Led Training Program to Increase Brief Physical Activity Advice Given to Patients by Health Care Professionals.

BACKGROUND: The benefits of physical activity for preventing and managing long-term health conditions are well established and health care professionals could promote physical activity to patients. The current study aims to evaluate the impact of the Clinical Champions Physical Activity Training Program. METHODS: Health care professionals attend a one-off in-person training session delivered by a trained Clinical Champion. Attendees at the Clinical Champions Physical Activity Training Program were asked to complete a baseline survey prior to the training session and follow-up surveys 4 and 12 weeks posttraining. RESULTS: A total of 5945 training attendees completed the baseline survey. A total of 1859 and 754 participants completed 4- and 12-week follow-up (31.3% and 12.7% response rate, respectively). Significant increases in confidence to deliver brief physical activity advice and knowledge of physical activity guidelines were reported at 12 weeks (P < .001). The perceived frequency of physical activity discussions with patients significantly increased (P < .001). Twelve weeks after training, fewer barriers in promoting physical activity were reported. CONCLUSIONS: The evaluation of the Clinical Champions Physical Activity Training Program demonstrated an increase in knowledge of physical activity guidelines, levels of confidence, and frequency of delivery of brief physical activity advice to patients. Further research is required to determine if this impact translates into changes to patients' physical activity behavior.

Workplace policies and practices promoting physical activity across England: What is commonly used and what works?

PURPOSE: Many adults fail to achieve sufficient moderate-to-vigorous physical activity (MVPA). The purpose of this paper is to understand how workplaces most effectively promote physical activity for the benefit of public health. DESIGN/METHODOLOGY/APPROACH: Data were collected via two online surveys. First, 3,360 adults employed at 308 workplaces across England self-reported their MVPA, activity status at work and frequency of journeys made through active commuting. From this sample, 588 participants reported on the policies and practices used in their workplace to promote physical activity. Factor and cluster analysis identified common practice. Regression models examined the association between the workplace factors and engagement in physical activity behaviours. FINDINGS: Five factors emerged: targeting active travel, availability of information about physical activity outside the workplace, facilities and onsite opportunities, sedentary behaviour, and information about physical activity within the workplace. Further, five clusters were identified to illustrate how the factors are typically being utilised by workplaces across England. Commonly used practices related to promoting active travel, reducing sedentary behaviour and the provision of information but these practices were not associated with meeting MVPA guidelines. The provision of facilities and onsite exercise classes was associated with the most positive physical activity behaviour outcomes; however, these structures were rarely evident in workplaces. ORIGINALITY/VALUE: Previous research has identified a number of efficacious actions for promoting physical activity in the workplace, however, research investigating which of these are likely to be acceptable to worksites is limited. The present study is the first to combine these two important aspects. Five common profiles of promoting physical activity in worksites across England were identified and related to physical activity outcomes. Guidance is given to workplace managers to enable them to maximise the resources they have for the greatest gains in employee health. Where feasible, facilities, and classes should be provided to achieve the most positive outcomes.

Knowledge of physical activity recommendations in adults employed in England: associations with individual and workplace-related predictors.

BACKGROUND: Physical activity guidelines state that adults should engage in at least 150 min of moderate to vigorous physical activity (MVPA) per week to benefit health. A high proportion of adults in England fail to reach this target. Accurate knowledge of MVPA guidelines could influence the amount and quality of MVPA engaged in by adults. This study aimed to determine knowledge of the MVPA guideline within a large sample of working adults in England and identify individual and workplace-related predictors of knowledge. METHODS: 10,992 adults completed an online survey which included questions on demographics, knowledge of the MVPA guideline and workplace predictors for physical activity. Multinomial logistic regression identified predictors of underestimating, overestimating or not knowing the MVPA guideline relative to accurately reporting the guideline for males and females separately. RESULTS: Respondents were 37% male, 95% White, 63% with a degree or higher, and had a mean age of 38.9 ± 11 years. The MVPA guideline was accurately reported by 15% of adults while 13.8% overestimated, 8.9% underestimated and 62.3% failed to provide any estimate of the guideline. Low education predicted underestimation (females: OR = 0.36, 95% CI 0.17, 0.80) and not knowing (males: OR = 0.37, 95% CI 0.14, 0.96; females: OR = 0.36, 95% CI 0.19, 0.69). Ethnicity was a significant predictor for females only (OR 3.55, 95% CI 1.46, 8.63; OR 4.03, 95% CI 1.58, 10.27; OR 3.73, 95% CI 1.67, 8.33). Employer support for physical activity was a significant predictor of accurate knowledge of the MVPA guideline for both males (underestimation: OR = 0.63, 95% CI 0.40, 1.00; 'don't know': OR = 0.71, 95% CI 0.51, 1.00) and females (overestimation: OR = 0.72, 95% CI 0.53, 0.97; underestimation: OR = 0.66, 95% CI 0.47, 0.92; 'don't know': OR = 0.60, 95% CI 0.47, 0.76). CONCLUSIONS: Knowledge of the MVPA guideline within working adults in England is low. Employers should play a role in using targeted strategies to increase knowledge as employer support-related factors may influence knowledge of the MVPA guideline. Employers who assert strategies to promote physical activity and encourage employees who have responsibility for promoting health to educate their colleagues may help improve the MVPA knowledge of their employees.

Does activity-related social support differ by characteristics of the adolescent?

BACKGROUND: Previous research has shown a positive relationship between activity-related social support provided by parents and peers and adolescents' physical activity. However, more information is needed on whether activity-related social support differs by sociodemographic characteristics. The purpose of this study was to investigate differences in activity-related social support in a sample of adolescents, by characteristics such as age, gender, socioeconomic status (SES), ethnicity, and physical activity level and to determine which characteristics are the most important predictors of activity-related social support. METHODS: Information was provided by 578 boys and 588 girls (11-14 years) on demographic factors, physical activity, and activity-related support. ANOVA, correlations, and multiple regression were performed to address the purposes of the study. RESULTS: Boys, White British, younger, more physically active, and high-SES adolescents perceived more support for physical activity. Age predicted all types of support excluding peer support; ethnicity predicted mother logistic support and sibling support; gender predicted peer support, father explicit modeling, and father logistic support; and SES predicted mother and father logistic support. CONCLUSIONS: Families and peers of adolescents who are female, from Black and minority ethnic groups, older, of low-SES, and less active should be targeted for intervention.

Physical activity and body composition outcomes of the GreatFun2Run intervention at 20 month follow-up.

BACKGROUND: Physical inactivity is recognised as a public health concern within children and interventions to increase physical activity are needed. GreatFun2Run was a school-based healthy lifestyles intervention that showed positive changes in physical activity levels and body composition immediately post-intervention. The purpose of this paper was to examine whether these changes in physical activity and body composition were maintained 18-20 months after the intervention ended. METHOD: Participants (n = 589, aged 7-11 yrs) from 4 intervention and 4 control schools took part in the 10-month intervention, of which 421 (71%) were present for follow-up. The intervention comprised a CD-rom learning and teaching resource for teachers; an interactive website for pupils, teachers and parents; two highlight physical activity events (1 mile school runs/walks); a local media campaign; and a summer activity wall planner and record. Randomisation was not possible because of local media content. Outcome measures were objectively measured physical activity (pedometers and accelerometers) and body composition variables (body mass index, waist circumference, estimated percent body fat, and sum of skinfolds). Teacher interviews and participant focus groups were conducted. Multi-level modelling was employed for the data analysis. RESULTS: Both control and intervention participants had increased their physical activity at follow-up but there was no group by time interaction (control: 2726 steps per day increase; intervention 3404 steps per day increase, p > .05). There were significant increases in estimated percent body fat, sum of skinfolds, waist circumference and body mass index (BMI) with increasing age. In the control group, there was evidence for a plateauing in the rate of change in all body composition variables with increasing age, except BMI. In contrast, significant interaction terms suggest that the rate of change in waist circumference, BMI and BMISDS continued to increase with age in the intervention group. Teacher interviews suggested that because of time pressures, competing resources, curriculum demands and staff changes the majority of teachers had not continued to use the resources. CONCLUSIONS: While the intervention initially produced positive changes in physical activity levels and body composition, these changes were not sustained once the intervention ended. Facilitating long-term health behaviour change in children remains a challenge.