Behaviour change in primary care: very brief interventions for physical activity

Abstract

There is a need for scalable interventions that can reach a large proportion of the adult population and hence improve public health. This presentation will describe a suite of studies included in a research programme about the development and evaluation of very brief interventions (VBIs) to increase physical activity in the context of preventive health checks in primary care. Systematic reviews suggest that physical activity interventions may be integrated into routine care if very brief, and have identified promising approaches (e.g. self-monitoring; action planning) to promoting physical activity that can be delivered face-to-face and in a single session. National Health Service (NHS) Health Checks are a government-sponsored primary care initiative that aims to lower the risk of developing chronic disease by offering free consultations to patients aged between 40 and 74 without current disease or a high risk profile. Coincidentally, health checks offer an ideal opportunity to deliver brief physical activity advice of approximately five minutes to a large proportion of the population. The VBI programme aims to develop and evaluate very brief interventions to increase physical activity that could be delivered by a health care practitioner during a preventive health check. Development work, which included a feasibility study, was carried out which identified three feasible and acceptable VBIs: a Motivational VBI, a Pedometer VBI, and a Combined (Motivational and Pedometer) VBI. The potential efficacy of these three VBIs was evaluated in a pilot trial (n=394), and the Pedometer VBI was found to be the most-promising VBI. The effectiveness of the Pedometer VBI was subsequently evaluated in a large-scale RCT (n=1000). The challenges associated with delivering and evaluating very brief behaviour change interventions in a primary care setting, the implications for clinical practice and policy, and a future research agenda for VBIs will be discussed.