Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study

详细信息    查看全文

• 作者：David E Goodrich (1) (2)
  Lorraine R Buis (3)
  Adrienne W Janney (1)
  Megan D Ditty (1)
  Christine W Krause (1)
  Kai Zheng (4)
  Ananda Sen (1) (5)
  Victor J Strecher (6) (7)
  Michael L Hess (1)
  John D Piette (2) (8) (9)
  Caroline R Richardson (1) (2)
  
• 关键词：Pedometer ; family medicine ; Internet ; mediated intervention ; physical activity ; walking ; primary care ; patient ; centered medical home
• 刊名：BMC Medical Informatics and Decision Making
• 出版年：2011
• 出版时间：December 2011
• 年：2011
• 卷：11
• 期：1
• 全文大小：322KB
• 参考文献：1. American Diabetes Association: Standards of medical care in diabetes-2010. / Diabetes Care 2010,33(Suppl 1):S11鈥?1. dx.doi.org/10.2337/dc10-S011">CrossRef
  2. De Hert M, Dekker JM, Wood D, Kahl KG, Holt RI, Moller HJ: Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). / European Psychiatry 2009, 24:412鈥?24. dx.doi.org/10.1016/j.eurpsy.2009.01.005">CrossRef
  3. Doyle C, Kushi LH, Byers T, Courneya KS, Demark-Wahnefried W, Grant B, / et al.: Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. / CA Cancer J Clin 2006, 56:323鈥?53. dx.doi.org/10.3322/canjclin.56.6.323">CrossRef
  4. Eyre H, Kahn R, Robertson RM, Clark NG, Doyle C, Hong Y, / et al.: Preventing cancer, cardiovascular disease, and diabetes: a common agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association. / Circulation 2004, 109:3244鈥?255. dx.doi.org/10.1161/01.CIR.0000133321.00456.00">CrossRef
  5. Pi-Sunyer X, Blackburn G, Brancati FL, Bray GA, Bright R, Clark JM, / et al.: Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the Look AHEAD trial. / Diabetes Care 2007, 30:1374鈥?383. dx.doi.org/10.2337/dc07-0048">CrossRef
  6. Slentz CA, Duscha BD, Johnson JL, Ketchum K, Aiken LB, Samsa GP, / et al.: Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE--a randomized controlled study. / Arch Intern Med 2004, 164:31鈥?9. dx.doi.org/10.1001/archinte.164.1.31">CrossRef
  7. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, / et al.: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. / N Engl J Med 2002, 346:393鈥?03. dx.doi.org/10.1056/NEJMoa012512">CrossRef
  8. Franklin BA, Swain DP, Shephard RJ: New insights in the prescription of exercise for coronary patients. / J Cardiovasc Nurs 2003, 18:116鈥?23.
  9. Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, / et al.: Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. / Circulation 2001, 104:1694鈥?740. dx.doi.org/10.1161/hc3901.095960">CrossRef
  10. Murphy MH, Nevill AM, Murtagh EM, Holder RL: The effect of walking on fitness, fatness and resting blood pressure: a meta-analysis of randomised, controlled trials. / Prev Med 2007, 44:377鈥?85. dx.doi.org/10.1016/j.ypmed.2006.12.008">CrossRef
  11. Estabrooks PA, Glasgow RE: Translating effective clinic-based physical activity interventions into practice. / Am J Prev Med 2006,31(Suppl 4):S45鈥?6. dx.doi.org/10.1016/j.amepre.2006.06.019">CrossRef
  12. Eden KB, Orleans CT, Mulrow CD, Pender NJ, Teutsch SM: Does counseling by clinicians improve physical activity? A summary of the evidence for the U.S. Preventive Services Task Force. / Ann Intern Med 2002, 137:208鈥?15.
  13. Jacobson DM, Strohecker L, Compton MT, Katz DL: Physical activity counseling in the adult primary care setting: position statement of the American College of Preventive Medicine. / Am J Prev Med 2005, 29:158鈥?62. dx.doi.org/10.1016/j.amepre.2005.04.009">CrossRef
  14. Cress ME, Buchner DM, Prohaska T, Rimmer J, Brown M, Macera C, / et al.: Best practices for physical activity programs and behavior counseling in older adult populations. / J Aging Phys Act 2005, 13:61鈥?4.
  15. Douglas F, Torrance N, van Teijlingen E, Meloni S, Kerr A: Primary care staff's views and experiences related to routinely advising patients about physical activity. A questionnaire survey. / BMC Public Health 2006, 6:138. dx.doi.org/10.1186/1471-2458-6-138">CrossRef
  16. Castaldo J, Nester J, Wasser T, Masiado T, Rossi M, Young M, / et al.: Physician attitudes regarding cardiovascular risk reduction: the gaps between clinical importance, knowledge, and effectiveness. / Dis Manag 2005, 8:93鈥?05. dx.doi.org/10.1089/dis.2005.8.93">CrossRef
  17. Wee CC, McCarthy EP, Davis RB, Phillips RS: Physician counseling about exercise. / JAMA 1999, 282:1583鈥?588. dx.doi.org/10.1001/jama.282.16.1583">CrossRef
  18. Napolitano MA, Marcus BH: Targeting and tailoring physical activity information using print and information technologies. / Exerc Sport Sci Rev 2002, 30:122鈥?28. dx.doi.org/10.1097/00003677-200207000-00006">CrossRef
  19. Kuhl EA, Sears SF, Conti JB: Internet-based behavioral change and psychosocial care for patients with cardiovascular disease: a review of cardiac disease-specific applications. / Heart Lung 2006, 35:374鈥?82. dx.doi.org/10.1016/j.hrtlng.2006.02.004">CrossRef
  20. Winett RA, Tate DF, Anderson ES, Wojcik JR, Winett SG: Long-term weight gain prevention: a theoretically based Internet approach. / Prev Med 2005, 41:629鈥?41. dx.doi.org/10.1016/j.ypmed.2004.12.005">CrossRef
  21. Richardson CR, Mehari KS, McIntyre LG, Janney AW, Fortlage LA, Sen A, / et al.: A randomized trial comparing structured and lifestyle goals in an internet-mediated walking program for people with type 2 diabetes. / Int J Behav Nutr Phys Act 2007, 4:59. dx.doi.org/10.1186/1479-5868-4-59">CrossRef
  22. Richardson CR, Buis LR, Janney AW, Goodrich DE, Sen A, Hess ML, / et al.: An online community improves adherence in an internet-mediated walking program. Part 1: results of a randomized controlled trial. / J Med Internet Res 2010, 12:e71. dx.doi.org/10.2196/jmir.1338">CrossRef
  23. Richardson CR, Kriska AM, Lantz PM, Hayward RA: Physical activity and mortality across cardiovascular disease risk groups. / Med Sci Sports Exerc 2004, 36:1923鈥?929. dx.doi.org/10.1249/01.MSS.0000145443.02568.7A">CrossRef
  24. Crabtree BF, Nutting PA, Miller WL, Stange KC, Stewart EE, Jaen CR: Summary of the National Demonstration Project and recommendations for the patient-centered medical home. / Ann Fam Med 8(Suppl 1):S80鈥?0.
  25. Jaen CR, Ferrer RL, Miller WL, Palmer RF, Wood R, Davila M, / et al.: Patient outcomes at 26 months in the patient-centered medical home National Demonstration Project. / Ann Fam Med 8(Suppl 1):S57鈥?7.
  26. Griffiths F, Lindenmeyer A, Powell J, Lowe P, Thorogood M: Why are health care interventions delivered over the internet? A systematic review of the published literature. / J Med Internet Res 2006, 8:e10. dx.doi.org/10.2196/jmir.8.2.e10">CrossRef
  27. Bennett GG, Glasgow RE: The delivery of public health interventions via the Internet: actualizing their potential. / Annu Rev Public Health 2009, 30:273鈥?92. dx.doi.org/10.1146/annurev.publhealth.031308.100235">CrossRef
  28. Beyer H, Holtzblatt K: / Contextual Design: Defining Customer-Centered Systems. San Francisco: Morgan Kaufmannn Publishers; 1998.
  29. Dumas JS, Redish JC: / A Practical guide to Usability Testing, Revised Edition. Portland: Intellect Books; 1999.
  30. Schwartz-Shea P: Evaluative criteria and epistemic communities. In / Interpretation and method: empirical research methods and interpretive turn. Edited by: Yanow D, Schwartz-Shea P. Armonk: M.E. Sharpe, Inc; 2006:89鈥?13.
  31. Forman J, Damschroder LJ: Qualitative content analysis. In / Empirical research for bioethics: A primer. Edited by: Jacoby L, Siminoff L. Oxford: Elsevier Publishing; 2008:221.
  32. Buis LR, Janney AW, Hess ML, Culver SA, Richardson CR: Barriers encountered during enrollment in an internet-mediated randomized controlled trial. / Trials 2009, 10:76. dx.doi.org/10.1186/1745-6215-10-76">CrossRef
  33. Cohen DJ, Tallia AF, Crabtree BF, Young DM: Implementing health behavior change in primary care: lessons from prescription for health. / Ann Fam Med 2005,3(Suppl 2):S12鈥?9. dx.doi.org/10.1370/afm.334">CrossRef
  34. Hung DY: Improving the delivery of preventive care services. / Manag Care Interface 2007, 20:38鈥?4.
  35. Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, / et al.: Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association's strategic Impact Goal through 2020 and beyond. / Circulation 2010, 121:586鈥?13. dx.doi.org/10.1161/CIRCULATIONAHA.109.192703">CrossRef
  36. Marcus BH, Ciccolo JT, Sciamanna CN: Using electronic/computer interventions to promote physical activity. / Br J Sports Med 2009, 43:102鈥?05. dx.doi.org/10.1136/bjsm.2008.053744">CrossRef
  37. Sciamanna CN, Novak SP, Marcus BH: Effects of using a computer in a doctor's office on patient attitudes toward using computerized prompts in routine care. / Int J Med Inform 2005, 74:357鈥?65. dx.doi.org/10.1016/j.ijmedinf.2005.03.003">CrossRef
  38. Sinclair J, Lawson B, Burge F: Which patients receive advice on diet and exercise? Do certain characteristics affect whether they receive such advice? / Can Fam Physician 2008, 54:404鈥?12.
  39. Goldstein MG, Pinto BM, Marcus BH, Lynn H, Jette AM, Rakowski W, / et al.: Physician-based physical activity counseling for middle-aged and older adults: a randomized trial. / Ann Behav Med 1999, 21:40鈥?7. dx.doi.org/10.1007/BF02895032">CrossRef
  40. Holtrop JS, Dosh SA, Torres T, Thum YM: The community health educator referral liaison (CHERL): a primary care practice role for promoting healthy behaviors. / Am J Prev Med 2008,35(Suppl 5):S365鈥?72. dx.doi.org/10.1016/j.amepre.2008.08.012">CrossRef
  41. Williams NH, Hendry M, France B, Lewis R, Wilkinson C: Effectiveness of exercise-referral schemes to promote physical activity in adults: systematic review. / Br J Gen Pract 2007, 57:979鈥?86. dx.doi.org/10.3399/096016407782604866">CrossRef
  42. Weidinger KA, Lovegreen SL, Elliott MB, Hagood L, Haire-Joshu D, McGill JB, / et al.: How to make exercise counseling more effective: lessons from rural America. / J Fam Pract 2008, 57:394鈥?02.
  43. Aittasalo M, Miilunpalo S, Stahl T, Kukkonen-Harjula K: From innovation to practice: initiation, implementation and evaluation of a physician-based physical activity promotion programme in Finland. / Health Promot Int 2007, 22:19鈥?7. dx.doi.org/10.1093/heapro/dal040">CrossRef
  44. Jansink R, Braspenning J, van der Weijden T, Elwyn G, Grol R: Primary care nurses struggle with lifestyle counseling in diabetes care: a qualitative analysis. / BMC Fam Pract 11:41.
  45. Aspy CB, Mold JW, Thompson DM, Blondell RD, Landers PS, Reilly KE, / et al.: Integrating screening and interventions for unhealthy behaviors into primary care practices. / Am J Prev Med 2008,35(Suppl 5):S373鈥?80. dx.doi.org/10.1016/j.amepre.2008.08.015">CrossRef
  46. Tulloch H, Fortier M, Hogg W: Physical activity counseling in primary care: Who has and who should be counseling? / Patient Educ Couns 2006, 64:6鈥?0. dx.doi.org/10.1016/j.pec.2005.10.010">CrossRef
  47. Ferrer RL, Mody-Bailey P, Jaen CR, Gott S, Araujo S: A medical assistant-based program to promote healthy behaviors in primary care. / Ann Fam Med 2009, 7:504鈥?12. dx.doi.org/10.1370/afm.1059">CrossRef
  48. Coleman K, Mattke S, Perrault PJ, Wagner EH: Untangling practice redesign from disease management: how do we best care for the chronically ill? / Annu Rev Public Health 2009, 30:385鈥?08. dx.doi.org/10.1146/annurev.publhealth.031308.100249">CrossRef
  49. Puczynski S, Phelps K, Wilke A, Nagel R, Hickey D, Badenhop D, / et al.: Collaborative goal setting to improve lifestyle behaviors: lessons learned from NOPCRN. / Ann Fam Med 2005,3(Suppl 2):S60鈥?2. dx.doi.org/10.1370/afm.364">CrossRef
  50. Glasgow RE, Lichtenstein E, Marcus AC: Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. / Am J Public Health 2003, 93:1261鈥?267. dx.doi.org/10.2105/AJPH.93.8.1261">CrossRef
  51. Goodrich DE, Larkin AR, Lowery JC, Holleman RG, Richardson CR: Adverse events among high-risk participants in a home-based walking study: a descriptive study. / Int J Behav Nutr Phys Act 2007, 4:20. dx.doi.org/10.1186/1479-5868-4-20">CrossRef
  52. Saunders RP, Evans MH, Joshi P: Developing a process-evaluation plan for assessing health promotion program implementation: a how-to guide. / Health Promot Pract 2005, 6:134鈥?47. dx.doi.org/10.1177/1524839904273387">CrossRef
  53. Steckler A, McLeroy KR, Goodman RM, Bird ST, McCormick L: Toward integrating qualitative and quantitative methods: an introduction. / Health Educ Q 1992, 19:1鈥?.
  54. Tufano JT, Ralston JD, Martin DP: Providers' experience with an organizational redesign initiative to promote patient-centered access: a qualitative study. / J Gen Intern Med 2008, 23:1778鈥?783. dx.doi.org/10.1007/s11606-008-0761-3">CrossRef
  55. The pre-publication history for this paper can be accessed here:dcentral.com/1472-6947/11/47/prepub" class="a-plus-plus">http://www.biomedcentral.com/1472-6947/11/47/prepub
  
• 作者单位：David E Goodrich (1) (2)
  Lorraine R Buis (3)
  Adrienne W Janney (1)
  Megan D Ditty (1)
  Christine W Krause (1)
  Kai Zheng (4)
  Ananda Sen (1) (5)
  Victor J Strecher (6) (7)
  Michael L Hess (1)
  John D Piette (2) (8) (9)
  Caroline R Richardson (1) (2)
  
  1. Department of Family Medicine, University of Michigan, 1018 Fuller St, Ann Arbor, 48104, USA
  2. VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Rd, Mailstop 152, Ann Arbor, MI, 48113, USA
  3. College of Nursing - Adult Health, Wayne State University, 5557 Cass Ave Room 368 Cohn Bldg, Detroit, 48202, USA
  4. School of Public Health, Department of Health Management and Policy, University of Michigan, M3531 SPH II, Ann Arbor, 48109, USA
  5. Department of Statistics, University of Michigan, 439 West Hall, 1085, South University Ave, Ann Arbor, 48109, USA
  6. Schools of Medicine and Public Health, University of Michigan, 5D04 300 NIB, Ann Arbor, 48109, USA
  7. HealthMedia, 130 South First St, Ann Arbor, 48104, USA
  8. Department of Internal Medicine, University of Michigan Medical School, 300 N. Ingalls Building, Room 7E10, Ann Arbor, 48109, USA
  9. Michigan Diabetes Research and Training Center, Brehm Tower 6414, 1000 Wall St, Ann Arbor, 48105, USA
  

文摘

Background Regular participation in physical activity can prevent many chronic health conditions. Computerized self-management programs are effective clinical tools to support patient participation in physical activity. This pilot study sought to develop and evaluate an online interface for primary care providers to refer patients to an Internet-mediated walking program called Stepping Up to Health (SUH) and to monitor participant progress in the program. Methods In Phase I of the study, we recruited six pairs of physicians and medical assistants from two family practice clinics to assist with the design of a clinical interface. During Phase II, providers used the developed interface to refer patients to a six-week pilot intervention. Provider perspectives were assessed regarding the feasibility of integrating the program into routine care. Assessment tools included quantitative and qualitative data gathered from semi-structured interviews, surveys, and online usage logs. Results In Phase I, 13 providers used SUH and participated in two interviews. Providers emphasized the need for alerts flagging patients who were not doing well and the ability to review participant progress. Additionally, providers asked for summary views of data across all enrolled clinic patients as well as advertising materials for intervention recruitment. In response to this input, an interface was developed containing three pages: 1) a recruitment page, 2) a summary page, and 3) a detailed patient page. In Phase II, providers used the interface to refer 139 patients to SUH and 37 (27%) enrolled in the intervention. Providers rarely used the interface to monitor enrolled patients. Barriers to regular use of the intervention included lack of integration with the medical record system, competing priorities, patient disinterest, and physician unease with exercise referrals. Intention-to-treat analyses showed that patients increased walking by an average of 1493 steps/day from pre- to post-intervention (t = (36) = 4.13, p < 0.01). Conclusions Providers successfully referred patients using the SUH provider interface, but were less willing to monitor patient compliance in the program. Patients who completed the program significantly increased their step counts. Future research is needed to test the effectiveness of integrating SUH with clinical information systems over a longer evaluation period.