Display options
Share it on

J Med Internet Res. 2011 Nov 22;13(4):e99. doi: 10.2196/jmir.1745.

Improvement of Physical Activity by a Kiosk-based Electronic Screening and Brief Intervention in Routine Primary Health Care: Patient-Initiated Versus Staff-Referred.

Journal of medical Internet research

Matti Leijon, Daniel Arvidsson, Per Nilsen, Diana Stark Ekman, Siw Carlfjord, Agneta Andersson, Anne Lie Johansson, Preben Bendtsen

Affiliations

  1. Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden. [email protected].

PMID: 22107702 PMCID: PMC3236669 DOI: 10.2196/jmir.1745

Abstract

BACKGROUND: Interactive behavior change technology (eg, computer programs, Internet websites, and mobile phones) may facilitate the implementation of lifestyle behavior interventions in routine primary health care. Effective, fully automated solutions not involving primary health care staff may offer low-cost support for behavior change.

OBJECTIVES: We explored the effectiveness of an electronic screening and brief intervention (e-SBI) deployed through a stand-alone information kiosk for promoting physical activity among sedentary patients in routine primary health care. We further tested whether its effectiveness differed between patients performing the e-SBI on their own initiative and those referred to it by primary health care staff.

METHODS: The e-SBI screens for the physical activity level, motivation to change, attitudes toward performing the test, and physical characteristics and provides tailored feedback supporting behavior change. A total of 7863 patients performed the e-SBI from 2007 through 2009 in routine primary health care in Östergötland County, Sweden. Of these, 2509 were considered not sufficiently physically active, and 311 of these 2509 patients agreed to participate in an optional 3-month follow-up. These 311 patients were included in the analysis and were further divided into two groups based on whether the e-SBI was performed on the patient´s own initiative (informed by posters in the waiting room) or if the patient was referred to it by staff. A physical activity score representing the number of days being physically active was compared between baseline e-SBI and the 3-month follow-up. Based on physical activity recommendations, a score of 5 was considered the cutoff for being sufficiently physically active.

RESULTS: In all, 137 of 311 patients (44%) were sufficiently physically active at the 3-month follow-up. The proportion becoming sufficiently physically active was 16/55 (29%), 40/101 (40%), and 81/155 (52%) for patients with a physical activity score at baseline of 0, 1 to 2, and 3 to 4, respectively. The patient-initiated group and staff-referred group had similar mean physical activity scores at baseline (2.1, 95% confidence interval [CI] 1.8-2.3, versus 2.3, 95% CI 2.1-2.5) and at follow-up, (4.1, 95% CI 3.4-4.7, vs 4.2, 95% CI 3.7-4.8).

CONCLUSIONS: Among the sedentary patients in primary health care who participated in the follow-up, the e-SBI appeared effective at promoting short-term improvement of physical activity for about half of them. The results were similar when the e-SBI was patient-initiated or staff-referred. The e-SBI may be a low-cost complement to lifestyle behavior interventions in routine primary health care and could work as a stand-alone technique not requiring the involvment of primary health care staff.

References

  1. Int J Telemed Appl. 2011;2011:918763 - PubMed
  2. BMC Fam Pract. 2010 Aug 23;11:60 - PubMed
  3. Prev Med. 2008 Oct;47(4):354-68 - PubMed
  4. Int J Inj Contr Saf Promot. 2009 Sep;16(3):133-41 - PubMed
  5. Health Promot Int. 2012 Jun;27(2):167-76 - PubMed
  6. Am J Prev Med. 2011 Apr;40(4):454-61 - PubMed
  7. J Public Health Med. 2001 Sep;23(3):219-26 - PubMed
  8. J Sci Med Sport. 2004 Apr;7(1 Suppl):67-73 - PubMed
  9. Scand J Med Sci Sports. 2009 Oct;19(5):627-36 - PubMed
  10. Circulation. 2007 Aug 28;116(9):1081-93 - PubMed
  11. Am J Prev Med. 2004 Jun;26(5):426-30 - PubMed
  12. J Stud Alcohol Drugs. 2007 Jul;68(4):529-33 - PubMed
  13. BMC Public Health. 2009 Jul 13;9:229 - PubMed
  14. Int Emerg Nurs. 2009 Apr;17(2):113-21 - PubMed
  15. J Med Internet Res. 2010 Feb 17;12(1):e4 - PubMed
  16. Lakartidningen. 2008 Mar 12-18;105(11):816-21 - PubMed
  17. Addict Behav. 2005 May;30(4):767-76 - PubMed
  18. Am J Prev Med. 2002 May;22(4):267-84 - PubMed
  19. J Fam Pract. 2000 Feb;49(2):158-68 - PubMed
  20. Res Q Exerc Sport. 2000 Jun;71(2 Suppl):S1-14 - PubMed
  21. Patient Educ Couns. 2009 May;75(2):238-43 - PubMed
  22. BMC Public Health. 2006 May 23;6:138 - PubMed
  23. J Eval Clin Pract. 2010 Dec;16(6):1326-32 - PubMed
  24. Accid Emerg Nurs. 2007 Jan;15(1):3-9 - PubMed
  25. Prev Med. 2010 Sep-Oct;51(3-4):214-21 - PubMed
  26. Am J Prev Med. 2010 Aug;39(2):148-56 - PubMed

Publication Types