Preparation

Design your intervention activities

  • Design your provider education intervention strategies

Think about what you want to prompt people to get from the provider education intervention and how you would like them to respond. For example, you may want the doctors to provide their patients with the tools to increase their physical activity. You may also work with your partners to decide what changes are feasible based upon the amount of political and/or community support and available funding.

These interventions are most effective when characteristics of the patients are taken into consideration (see Assessment and Prioritization).  This may require you to spend time in the population building relationships with people within the community.  People within the population can help you identify the community’s readiness to change as well as specific behaviors and outcomes that your intervention should address. Some provider education interventions have found it helpful to give providers lists of local referrals and resources to provide to their patients who may desire more in-depth counseling on other physical activity-related issues.

There are also several questions that you can consider when planning your provider reminder and education system, including:

  • Will the training take place as part of a larger training program for health care professionals?
  • Will the training be specific to health care organizations in the local area?
  • How many participants will take part in the training?
  • How many trainers or instructors will participate in the training? What will be their roles and responsibilities?
  • Who will coordinate the training? Who else will be needed to assist in the training?
  • How long will the training last? How many sessions will it include?
  • Will you provide continuing medical education credits (CMEs)?

Many different types of provider education interventions have been used by others (go to Tools and Resources for Physical Activity Provider Education to see how these have been used).

  • Create a timeline and assign roles and responsibilities

Work with your partners to decide on the timeline for the intervention as well as who will be responsible for carrying out the intervention activities. Be very specific about roles, tasks and timelines to ensure that the intervention is implemented successfully. Include information about when your intervention will be conducted and how you will recruit practitioners to be part of your intervention.

  • Create your training curriculum

Training for provider education interventions may be conducted in multiple sessions or one. The training techniques have also been varied and may include:

  • face-to-face lecture
  • role play
  • case review
  • distribution of booklets or other materials
  • video observation (e.g., modeling various communication patterns)
  • newsletters
  • pocket cards with information on increasing physical activity
  • ads in medical journals

Provider education interventions may also cover a wide range of information.  It is important to remember that offering a range of learning opportunities, including hands-on, practical experience may be the best way to train health care professionals.  In terms of the curriculum, others have included:

  • Effectiveness of provider advice
  • Consequences of physical inactivity and related behavioral risk factors
  • Prevalence of physical activity in the community
  • Physician role in promoting physical activity
  • Rationale and effectiveness of behavioral changes and self management
  • Availability of materials and services
  • Behavior modification or self-management techniques

The training on interacting with and advising patients or clients may include:

  • Assessing levels of physical activity and related behavioral risk factors by measuring health conditions, behavior patterns and factors affecting a patient’s or client’s lifestyle patterns
  • Advising patients or clients by giving clear, specific, and personalized advice, including information about risks and benefits of various behavior patterns
  • Working with the patient or client to select appropriate goals and methods of increasing physical activity based on their current patterns as well as their interest and willingness to change
  • Helping patients or clients acquire the necessary skills, confidence, or social and environmental supports for increasing physical activity.
  • Arranging ongoing support by scheduling follow-up contacts to provide ongoing assistance and support and to adjust the goals and plans as needed
  • Developing reminder systems that will work for the health care practice

For the assessment of physical activity indicators, it is helpful to ask training participants to consider what information they will collect, how they will collect the information, and how they will use this information to provide specific feedback to individuals. Health care providers may want to encourage patients or clients to participate in physical activity assessments and try new methods of collecting or tracking their behavioral patterns (e.g., pedometers, diary to track physical activity).
The training on advising patients or clients may include:

  • the content of the advice (e.g., blood pressure, cholesterol, nutrition and physical activity recommendations)
  • when and where the advice should be given (e.g., at a doctor’s office, at a local school)
  • who will reinforce the advice given (e.g., a parent, a school nurse).

Training participants should also be encouraged to think about how long the counseling will last as part of the visit (e.g., less than 5 minutes, 10 minutes or 30 minutes) and whether or not they prefer to use a script so that the same advice can be given to all participants.

You may want to have training participants practice or role play giving advice to different types of patients or clients so they get experience tailoring recommendations to individual’s needs and readiness to change. For example, if the patient or client has not yet really considered taking cholesterol medications, it may be helpful to provide information on the health risks of continuing untreated and benefits of taking medications. In order to provide tailored advice to individuals, the health care professionals should be trained on the typical progression of physical activity behavior changes (stages of change) and reminded that most individuals will not change their behaviors the first time they try. Likewise, training participants can receive information on how to take into account the person’s gender, age, health status, and cultural factors. All of these considerations can help the health care provider to make sure that their message fits the particular needs of their patient or client.

Another approach would be to have health care professionals discuss how they can serve as community role models by providing lectures or information sessions reaching multiple community members at the same time. This may be an effective strategy for community outreach and providing credible recommendations for increasing physical activity to high risk communities. Others have also found that it can be useful to have health practitioners tour the population to better understand the community factors influencing physical activity (e.g., where are the fast food restaurants? is there a community park?), and to try certain changes in their own behaviors to increase understanding about the challenges experienced by patients or clients.
 
Finally, health care professionals will need to be trained with respect to follow-up with patients or clients (e.g., subsequent visits, phone calls) and what the follow-up should include (e.g., reassessment of behavior, information about how to overcome barriers). Training can include information on how to track patients and clients for follow-up as well. For example, health care professionals can place color-coded stickers in patients' charts as reminders to follow-up at the next visit or to ask one of their staff to make a follow-up call within two weeks after the patient's visit. Training participants can also be given information to refer patients or clients to other programs, give them information on self-management programs, or refer them to other healthcare team members (e.g., nurse case managers, health educators).

Go to Example Provider Education Interventions or Tools and Resources to see examples of what others have used.

printer-friendly Print this window