Background on Provider Education
What are provider education strategies?
- Provider education interventions train qualified health care providers to counsel or provide advice to individuals in order to encourage them to become or remain physically active.
- This type of intervention strategy is geared towards health care providers working in clinical settings including physicians, nurses, dentists, dieticians, etc.
- These interventions can enhance providers’ knowledge and skills related to counseling individuals about behaviors related to physical activity This training offers health care providers access to information and resources about:
- the health benefits of physical activity;
- how to improve culturally competent communication between individuals and health care providers;
- the health risks associated with sedentary behavior; and
- ways to increase individuals’ physical activity behavior by offering support and reducing barriers.
How can provider education impact physical activity related behaviors?
- Health care providers are a primary and respected source of health information. Many individuals and families seek out the advice of health care providers to maintain their health and quality of life on a regular basis. These health care providers are ideally suited to have an ongoing influence on individuals’ decisions to be physically active.
- Previous studies have shown that most individuals will interact with a health care provider at some point during the year so these interventions have the potential to help many people adopt or maintain healthy physical activity behaviors. When present, existing relationships between health care providers and the individuals they counsel can serve to enhance the physical activity advice received because it comes from a trustworthy source.
- Health care providers can increase the likelihood that people will become more active just by writing general information such as "walk for 30 minutes on most days of the week" on a prescription pad. These written prescriptions are more effective than just giving advice to the individuals. Although many health care providers have little time to visit with each individual, most individuals say that if their provider told them to be more physically active, they would listen.
What are provider reminder strategies and how can they be used in physical activity interventions?
- Provider reminder interventions can be developed as part of provider training. Provider reminder interventions give cues or prompts to providers to increase the likelihood that they will discuss physical activity information with individuals. Provider reminder interventions utilize various strategies to prompt providers to discuss physical activity with individuals, including changes to the individual’s file (e.g., stickers, colored folders), changes in the physical environment (e.g., posters in exam rooms), or personal prompts (e.g., laminated pocket-sized information sheets).
What types of settings are appropriate for provider education strategies?
- Provider education interventions are usually offered to health care providers in traditional health care settings, including a provider’s office, hospital, health department, or assisted living facility. However, health care providers without specialized medical training can participate in provider education training for a variety of non-traditional settings, including communities (e.g., mobile clinics), schools (e.g., school nurses), worksites (e.g., health screening), faith-based settings (e.g., health ministry) or homes.
Where are opportunities for interventions in during patient visits?
- As part of their interaction with individuals, health care providers typically provide the following:
- An assessment of an individual’s health, physical activity, and readiness to make behavior changes. This assessment enables the provider to give personally relevant information to the individual about their needs. This information may be intended to increase knowledge or awareness, change attitudes, teach skills, or provide social support.
- An opportunity for the individual to ask questions or clarify what they have been told. This exchange with the provider can help to ensure that the individual understands the information and recommendations that they have been provided.
- Referrals and resources within the community to assist the individual in following recommendations for increasing physical activity. For example, the provider can give the individual a list of recreational facilities or group exercise classes available in the community.
- Subsequent visits with the health care provider, including a reassessment of the individual’s health and activity as well as a discussion of challenges, benefits and advice for maintaining active behaviors over time.
What are the best methods for educating health care providers?
- Provider education training works best if it is hands-on and practical. This may include discussions among health care providers about how to counsel or provide advice to specific individuals (e.g., those with special health care needs, those who show no change over time), how to respond to individual barriers to physical activity (e.g., time, child care), how to reach high risk populations, how to work in different settings, and how to integrate effective practice strategies into different practice styles.
- Previous studies also suggest that it is important to consider longer-term education strategies, tailor provider education about increasing physical activity to specific behaviors, and train providers on community and policy influences on these behaviors in addition to the more traditional focus on individual services. It is also useful to share methods for patient tracking, repeat counseling and referrals as appropriate. Interventions should be accomplishable in a quick and succinct manner.
What are the barriers to implementing provider education interventions?
- It is difficult to understand the effectiveness of these interventions because the interaction between the provider and individual is unique for each individual, short in duration (less than 5 minutes) and can involve recommendations for multiple behaviors at once (e.g., eat healthy, be active, and quit smoking), in addition to a lack of institutional support for sharing this type of information during a visit (e.g., policies, procedures, training or incentives).