Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study
<p>Abstract</p> <p>Background</p> <p>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...
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| Format: | Article |
| Language: | English |
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BMC
2011-06-01
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| Series: | BMC Medical Informatics and Decision Making |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1472-6947/11/47 |
| _version_ | 1818229963757715456 |
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| author | Sen Ananda Zheng Kai Krause Christine W Ditty Megan D Janney Adrienne W Buis Lorraine R Goodrich David E Strecher Victor J Hess Michael L Piette John D Richardson Caroline R |
| author_facet | Sen Ananda Zheng Kai Krause Christine W Ditty Megan D Janney Adrienne W Buis Lorraine R Goodrich David E Strecher Victor J Hess Michael L Piette John D Richardson Caroline R |
| author_sort | Sen Ananda |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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 (<it>t </it>= (36) = 4.13, <it>p </it>< 0.01).</p> <p>Conclusions</p> <p>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.</p> |
| first_indexed | 2024-12-12T10:26:57Z |
| format | Article |
| id | doaj.art-8b2682883ea34db39748e1caec84c197 |
| institution | Directory Open Access Journal |
| issn | 1472-6947 |
| language | English |
| last_indexed | 2024-12-12T10:26:57Z |
| publishDate | 2011-06-01 |
| publisher | BMC |
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| series | BMC Medical Informatics and Decision Making |
| spelling | doaj.art-8b2682883ea34db39748e1caec84c1972022-12-22T00:27:26ZengBMCBMC Medical Informatics and Decision Making1472-69472011-06-011114710.1186/1472-6947-11-47Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility studySen AnandaZheng KaiKrause Christine WDitty Megan DJanney Adrienne WBuis Lorraine RGoodrich David EStrecher Victor JHess Michael LPiette John DRichardson Caroline R<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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 (<it>t </it>= (36) = 4.13, <it>p </it>< 0.01).</p> <p>Conclusions</p> <p>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.</p>http://www.biomedcentral.com/1472-6947/11/47Pedometerfamily medicineInternet-mediated interventionphysical activitywalkingprimary carepatient-centered medical home |
| spellingShingle | Sen Ananda Zheng Kai Krause Christine W Ditty Megan D Janney Adrienne W Buis Lorraine R Goodrich David E Strecher Victor J Hess Michael L Piette John D Richardson Caroline R Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study BMC Medical Informatics and Decision Making Pedometer family medicine Internet-mediated intervention physical activity walking primary care patient-centered medical home |
| title | Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study |
| title_full | Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study |
| title_fullStr | Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study |
| title_full_unstemmed | Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study |
| title_short | Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study |
| title_sort | integrating an internet mediated walking program into family medicine clinical practice a pilot feasibility study |
| topic | Pedometer family medicine Internet-mediated intervention physical activity walking primary care patient-centered medical home |
| url | http://www.biomedcentral.com/1472-6947/11/47 |
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