Using the RE-AIM framework to evaluate a public health physical activity intervention in primary care

Abstract

Background Physical activity (PA) interventions are routinely used in Public Health, however few have evaluated both individual outcomes and operational processes. To address this gap, the RE-AIM framework (Glasgow et al., 2012) was utilised to evaluate delivery of Let’s Get Moving (LGM), an NHS behaviour change intervention employing Motivational Interviewing (MI) techniques to promoting levels of physical activity. Methods A UK local authority commissioned LGM in two GP surgeries. Patient records were screened to identify adults with a BMI >28 or on a diabetes register. Patients identified as physically inactive (N=248) were subsequently invited to participate in a 12-week, one-to-one MI intervention delivered by a trained practitioner. The primary outcome of interest was physical activity levels assessed by MET (Metabolic Equivalent Task) minutes/week scores, taken at baseline, 12 weeks, 6 and 12 months using the IPAQ questionnaire. Responses across time points were analysed using the Wilcoxon Signed Rank Sum Test. Interviews were conducted with GPs and Practice Managers to explore implementation of the intervention in Primary Care and explored using framework analysis. Findings At 12 weeks, 6 months and 12 months there was a significant increase in total PA, walking and moderate activity, compared to baseline (ps<.001), Interviews highlighted key considerations for integration in to Primary Care- for example, allocating appropriate resources and IT systems able to easily identify the target group. Conclusions Results show a significant increase in physical activity levels suggesting a brief MI intervention, delivered in Primary Care, can impact on short and longer-term changes in behaviour