Abstract
BackgroundVery brief interventions (VBIs) for physical activity are promising, but there is uncertainty about their potential effectiveness and cost. We assessed potential efficacy, feasibility, acceptability, and cost of three VBIs in primary care, in order to select the most promising intervention for evaluation in a subsequent large-scale RCT.MethodsThree hundred and ninety four adults aged 40–74 years were randomised to a Motivational (n = 83), Pedometer (n = 74), or Combined (n = 80) intervention, delivered immediately after a preventative health check in primary care, or control (Health Check only; n = 157). Potential efficacy was measured as the probability of a positive difference between an intervention arm and the control arm in mean physical activity, measured by accelerometry at 4 weeks.ResultsFor the primary outcome the estimated effect sizes (95 % CI) relative to the Control arm for the Motivational, Pedometer and Combined arms were respectively: +20.3 (−45.0, +85.7), +23.5 (−51.3, +98.3), and −3.1 (−69.3, +63.1) counts per minute. There was a73% probability of a positive effect on physical activity for each of the Motivational and Pedometer VBIs relative to control, but only 46 % for the Combined VBI. Only the Pedometer VBI was deliverable within 5 min. All VBIs were acceptable and low cost.ConclusionsBased on the four criteria, the Pedometer VBI was selected for evaluation in a large-scale trial.Trial registrationCurrent Controlled Trials ISRCTN02863077. Retrospectively registered 05/10/2012.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3684-7) contains supplementary material, which is available to authorized users.
Highlights
Very brief interventions (VBIs) for physical activity are promising, but there is uncertainty about their potential effectiveness and cost
We developed VBIs to promote physical activity in the context of National Health Service (NHS) Health Checks in England [15], and tested their feasibility prior to the trial reported in this paper [10]
The response rate was lower in the Pedometer VBI arm at 1-month follow-up, we found no evidence of a systematic effect of season, practice, age or gender that could explain the differential response rate
Summary
Very brief interventions (VBIs) for physical activity are promising, but there is uncertainty about their potential effectiveness and cost. Review evidence shows that brief interventions in primary care can increase physical activity in the short term when compared with usual care or more intensive interventions [6, 8]. Descriptions of both brief and very brief advice reported by Campbell et al included such things as: individualized counselling/advice; applying three or more of the 5A’s Behaviour Change Model (ASK, ASSESS, ADVISE, ASSIST, ARRANGE); asking open questions about the benefits of physical activity and barriers to exercise; providing information about the risks of physical inactivity and recommendations for how to increase activity; and providing tailored advice based on stage of motivational readiness to change
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