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Nfhk2011 rinne parallel25


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Developing counselling practices in physical activity by tutoring multi-professional teamwork in primary care
UKK Institut, Finland
Marjo Rinne, D.Sc, 1
Erja Toropainen, M.Sc 1
Minna Aittasalo D.Sc 1,
Tommi Vasankari, D.Med.Sci 1,
Katriina Kukkonen-Harjula, D.Med.Sci 1,2

1 The UKK Institute for Health
Promotion Research Tampere
2 University of Eastern Finland, Kuopio

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Nfhk2011 rinne parallel25

  1. 1. Developing counselling practices in physical activity by tutoring multi-professional teamwork in primary careMarjo Rinne, D.Sc, 1Erja Toropainen, M.Sc 1Minna Aittasalo D.Sc 1,Tommi Vasankari, D.Med.Sci 1,Katriina Kukkonen-Harjula, D.Med.Sci 1,21 The UKK Institute for HealthPromotion Research Tampere2 University of Eastern Finland, Introduction Physical Activity Prescription (PAP) has been proven feasible and effective in routine health care practices. (Aittasalo et al. 2006, Aittasalo et al. 2007) However, local efforts are needed to facilitate its adoption in primary health care services. Physical Activity Prescription Program (PAPP) 2001-2004 Marjo Rinne, Turku 24.-26.8.2011 1
  2. 2. 5 A´s FRAMEWORK Assess and Advise -physical activity level -physical abilities -beliefs and knowledge -Health risks, benefits of change Agree and Assist -Collaboratively developed personalized action plan -Identify personal barriers and strategies Arrange - Plan for follow-up Estabrooks et al. 2003 Marjo Rinne, Turku 24.-26.8.2011 Ongoing actions in Finland continuous training integration of PAP to national patient record system updating of PAP material according to recent recommendations producing all material in various electronic formats linking PA and PAP to all relevant clinical guidelines development of dissemination protocol and supportive material forhealth care units Marjo Rinne, Turku 24.-26.8.2011 2
  3. 3. Intervention to improve PA counseling practices,uptake of PAP and collaborationAims are• to increase knowledge about PA, counselling and PAP,• to improve counselling practices and adoption of PAP,• to enhance counselling collaboration among health care and exercise professionals, and• to develop electric documentation of PA counselling in patient records. Marjo Rinne, Turku 24.-26.8.2011ImplementationIn four municipal health centres in Pirkanmaa region, FinlandA multi-professional team selected in each health centre isresponsible for carrying out the 6-month study.Teams select target groups and actions.The professionals in health care have received supportive PAPmaterial (electronic Physical Activity Prescription, User s Guide for PAP, ´ ´ ´ ´Rated Perceived Exertion (RPE) Scale, electronic follow-up description) Marjo Rinne, Turku 24.-26.8.2011 3
  4. 4. Double-sidedUser’sGuide Marjo Rinne, Turku 24.-26.8.2011 Implementation The actions of the responsible teams are tutored for 6 month with 4 goal-oriented meetings. After tutoring process a conclusive meeting will be held. The study will last until February 2012. The preliminary experiences are positive. Marjo Rinne, Turku 24.-26.8.2011 4
  5. 5. Evaluation at baseline and after the intervention:1) Self-administered questionnaire to the professionals:• attitudes, knowledge, current counseling,• use of written PAP,• documentation of PA counseling,• collaboration2) Professionals’ 5-day logbooks after the patient visits:• bringing out the contents of counselling PA,• implementing PA counseling,• use of PAP during patient appointments,• documentation of PA to the patient record system Marjo Rinne, Turku 24.-26.8.2011Evaluation at baseline and after the intervention:3) Self-administered questionnaire to the patients:• discussion about PA,• occurrence of PA counseling,• delivery of PA prescription etc.4) Telephone interview of municipal exercise service providers: to most important collaborators in exercise sector are used to evaluate collaboration with health care. Marjo Rinne, Turku 24.-26.8.2011 5
  6. 6. Evaluation at baseline and after the intervention:5) A sample of patient documentation from the patient record system:• documentation of PA counseling6) Process evaluation is based on• the meeting minutes of the responsible teams and• tutor meetings to explain underlying factors promoting or preventing the process of change.Marjo Rinne, Turku 24.-26.8.2011 Conclusion The intervention produces one approach to improve volume and quality of counselling in primary health care. If the results are positive, they may be applied to other similar kind of processes, e.g. nutrition.Marjo Rinne, Turku 24.-26.8.2011 6
  7. 7. Physicians start to write physical activity prescriptions Unfortunately we do not have these as pills, you have to do these exercises by yourself.Marjo Rinne, Turku 24.-26.8.2011 7