Movement as medicine for CVD prevention: piloting two behaviour change interventions delivered in primary care

Abstract

Objectives: Physical activity (PA) can improve cardiovascular disease (CVD) risk factors, and due to its large reach, primary care may be the ideal setting to reduce CVD risk via PA promotion. This study pilot tested the Movement as Medicine for CVD Prevention Program (MaMCVD), which entails two theory-based behavioural interventions - one for patients and one for healthcare professionals (HCPs) - to promote PA in primary care. Methods: This single-group study tested MaMCVD in 3 primary healthcare practices in Northeast England. Fifteen HCPs completed an online course in PA counselling and motivational interviewing techniques. After the course, HCPs delivered behaviour change consultations to patients with increased CVD risk (n=84). Patients had access to a website containing behaviour change techniques derived from self-determination and self-regulation theories. Outcomes were assessed at baseline and 3 months. Results: Questionnaires and coded audio recordings revealed that HCP’s counselling skills and self-efficacy improved over the course of the trial. Among patients, intention for PA and subjective PA significantly increased from baseline to 3 months. Small changes in objective PA were also observed. 47% of patients made use of the online behaviour change tools. Conclusions: The MaMCVD intervention was acceptable to HCPs and patients, but uptake by patients was low. This study provides initial evidence for the feasibility of combining motivational and volitional interventions to promote PA in primary care settings, and identifies ways to improve MaMCVD before further testing or implementation. These include addressing HCP misconceptions about the patient website, usability issues, and recruitment/retention problems.