Determining the Impact of an Educational Intervention on Family Medicine Residents’ Social Cognitions and Behaviour for Discussing Physical Activity

Abstract

Primary care providers are failing to effectively promote physical activity (PA) to their patients. It has been shown that educational approaches promoting the uptake of strategies that are proven to increase patient PA levels are effective for improving primary care providers’ social cognitions and behaviour for discussing PA with patients. However, research on the effectiveness of such strategies among family medicine residents is limited. Utilizing the Theory of Planned Behaviour (TPB), an interactive, educational intervention was developed to increase PA discussion between first year family medicine residents and their patients by focusing on effective PA promotion strategies (e.g., PA counselling). This thesis aimed to determine the impact of the intervention on the social cognitions and behaviour of residents discussing PA with patients. The intervention condition was comprised of 15 2017/2018 residents who received: (1) the full intervention, and (2) completed both the pre- and post- intervention TPB questionnaires assessing changes in PA discussion social cognitions, and (3) had their medical charts reviewed for PA discussion behaviour. Fifteen 2016/2017 residents who were randomly selected to have their medical charts reviewed for PA discussion behaviour comprised the non-intervention condition. A process evaluation confirmed the intervention was successfully delivered. The residents’ social cognitions for discussing PA with patients was not significantly changed by the intervention, however, the residents’ perceptions of feeling adequately trained to discuss PA did increase following the intervention (F(1,14) = 10.839, p = .005). The medical chart review indicated no changes in residents’ behaviour for discussing PA with patients from pre- to post-intervention within both conditions. A significant difference in post-behaviour between conditions was observed (t(28) = 2.778, p = .011), where PA was discussed at more patient visits within the intervention condition. In summary, the intervention did not increase, but did maintain the PA discussion behaviour of residents from pre- to post-intervention. An educational intervention may therefore be sufficient to prevent a decline in residents’ PA discussion behaviour. This research highlights the importance of educating and training residents to use strategies for PA discussion. Future interventions and research should be conducted to further improve these practices.