Methods of connecting primary care patients with community-based physical activity opportunities:A realist scoping review

Funding: NHS Fife Endowment Fund (Grant Number(s): FIF142).Deemed a global public health problem by the World Health Organization, physical inactivity is estimated to be responsible for one in six deaths in the United Kingdom (UK) and to cost the nation's economy £7.4 billion per year. A response to the problem receiving increasing attention is connecting primary care patients with community-based physical activity opportunities. We aimed to explore what is known about the effectiveness of different methods of connecting primary care patients with community-based physical activity opportunities in the United Kingdom by answering three research questions: 1) What methods of connection from primary care to community-based physical activity opportunities have been evaluated?; 2) What processes of physical activity promotion incorporating such methods of connection are (or are not) effective or acceptable, for whom, to what extent and under what circumstances; 3) How and why are (or are not) those processes effective or acceptable? We conducted a realist scoping review in which we searched Cochrane, Medline, PsycNET, Google Advanced Search, National Health Service (NHS) Evidence and NHS Health Scotland from inception until August 2020. We identified that five methods of connection from primary care to community-based physical activity opportunities had been evaluated. These were embedded in 15 processes of physical activity promotion, involving patient identification and behaviour change strategy delivery, as well as connection. In the contexts in which they were implemented, four of those processes had strong positive findings, three had moderately positive findings and eight had negative findings. The underlying theories of change were highly supported for three processes, supported to an extent for four and refuted for eight processes. Comparisons of the processes and their theories of change revealed several indications helpful for future development of effective processes. Our review also highlighted the limited evidence base in the area and the resulting need for well-designed theory-based evaluations.Publisher PDFPeer reviewe

Step by Step: The Feasibility of a 16-Week Workplace Lunchtime Walking Intervention for Physically Inactive Employees

Background: A 16-week lunchtime walking intervention was designed to increase physical activity in physically inactive University employees. The program was delivered and monitored twice over 7 months to examine feasibility across different seasons. Methods: Seventy-five participants (n = 69 females, n = 6 males; mean age = 47.68) were randomly allocated into a Winter (February start) or Spring group (May start). Participants were asked to complete 3 weekday lunchtime walks and 2 weekend walks. Weeks 1 to 10 were led by walk leaders (group phase) while the participants self-organized their walks during weeks 11 to 16 (independent phase). Yamax pedometers recorded daily step counts and walk group leaders recorded participant attendance in the group phase. Acceptability was assessed via a satisfaction survey and 2 focus groups with participants. Results: A participant pool representative by ethnicity, but not gender was recruited using a range of strategies. The program demonstrated good retention across both groups (73%). The intervention was acceptable to participants. More steps were accumulated in the group-led versus the independent phase. Conclusion: The intervention is feasible in this workplace setting across different seasonal periods. In the future, researchers should examine if the findings can be replicated in a definitive trial and generalize to other workplace settings

A step in the right direction? Change in mental well-being and self-reported work performance among physically inactive university employees during a walking intervention

Objective: To examine well-being and work performance changes accompanying participation in a 16-week uncontrolled feasibility lunchtime walking trial. Method: Participants were 75 (92% female; M age ¼ 47.68) previously physically inactive non-academic employees from a large British university. Multilevel modelling analyses examined well-being and work performance trajectories from baseline to post-intervention, to four months later, controlling for group membership and trait affectivity. Results: Increases in perceptions of health, subjective vitality, and work performance, and decreases in fatigue at work were observed. Changes were sustained four months after the end of the intervention. No changes were identified for enthusiasm, nervousness and relaxation at work. Conclusion: Although this was a relatively small uncontrolled feasibility trial, the results suggest that participation in a walking programme may be associated with sustainable well-being benefits and improvements in perceptions of work performance

Onset and Duration of Intravenous and Intraosseous Rocuronium in Swine

Introduction: The intraosseous (IO) route has become a popular method to gain access to the peripheral circulation in emergency situations. Despite little supporting data, it is generally believed that IO absorption is immediate and equivalent to the intravenous (IV) route. It is important to determine if rocuronium can effectively be administered by the IO route. The aim of the study was to determine and compare the onset and duration of rocuronium when administered via the IO and IV routes in a normovolemic pig model.Methods: We recorded electromyographic (EMG) data following tibial IO and peripheral IV administration of rocuronium (1.2 mg/kg) in 10 swine weighing between 56 and 71 Kg. We transformed data were transformed to percent of baseline, determined onset and recovery characteristics.Results: The onset EMG-time profiles for IO and IV administration were very similar: tibial IO compared to IV administration did not statistically alter the onset of paralysis. The IO group took statistically longer than the IV group to return to 50 (p=0.042), 75 (p=0.034) and 95 (p=0.036) percent of baseline activity.Conclusion: The duration of effect is statistically longer after IO administration but is more of an academic interest than a clinical concern. The results of this study suggest that rocuronium can effectively be administered via the IO route without the need for dose adjustments. [West J Emerg Med. 2014;15(2):241-245.

Onset and Duration of Intravenous and Intraosseous Rocuronium in Swine

Introduction: The intraosseous (IO) route has become a popular method to gain access to the peripheral circulation in emergency situations. Despite little supporting data, it is generally believed that IO absorption is immediate and equivalent to the intravenous (IV) route. It is important to determine if rocuronium can effectively be administered by the IO route. The aim of the study was to determine and compare the onset and duration of rocuronium when administered via the IO and IV routes in a normovolemic pig model.Methods: We recorded electromyographic (EMG) data following tibial IO and peripheral IV administration of rocuronium (1.2 mg/kg) in 10 swine weighing between 56 and 71 Kg. We transformed data were transformed to percent of baseline, determined onset and recovery characteristics.Results: The onset EMG-time profiles for IO and IV administration were very similar: tibial IO compared to IV administration did not statistically alter the onset of paralysis. The IO group took statistically longer than the IV group to return to 50 (p=0.042), 75 (p=0.034) and 95 (p=0.036) percent of baseline activity.Conclusion: The duration of effect is statistically longer after IO administration but is more of an academic interest than a clinical concern. The results of this study suggest that rocuronium can effectively be administered via the IO route without the need for dose adjustments. [West J Emerg Med. 2014;15(2):241-245.

Physical activity interventions in the workplace: implementation, evaluation and challenges

Due to a variety of factors, it is notoriously difficult to implement effective physical activity interventions in the workplace.The aim of the proposed symposium is to highlight relevant issues and challenges associated with implementing rather novel workplace physical activity intervention designed to increase physical activity participation and psychological well-being among sedentary employees.The studies presented will have used a variety of quantitative and qualitative methods to a) highlight issues of implementation and feasibility, b) evaluate the effectiveness of a specific intervention, c) examine potential mechanisms underlying physical activity adoption and adherence and d) discuss pertinent challenges in changing physical activity behaviour in the workplace. The first paper discusses components of, and challenges associated with, the design and implementation of a 16-week lunchtime walking interventions with sedentary employees. The second presentation provides a summary of the evaluation of the above mentioned intervention using quantitative methods.The third presentation uses a qualitative approach to tap into potential mechanisms underpinning physical activity behaviour change in sedentary employees. Using examples from international research, the final presentation considers how aspects of work culture can act as both a promoter and inhibitor of physical activity engagement in the workplace.This series of studies show that the workplace is a viable, but also very challenging, setting for promoting physical activity among a large segment of the adult working population