Table 1.
Summary of intervention components and corresponding conceptual framework
Self-determination theory | 5As | Patient-centered communication (PCC) | |
---|---|---|---|
Design of intervention (key concepts) |
· Promoting autonomy supportive skills for clinicians when counseling patients about physical activity |
· Use of 5As for physical activity counseling |
· Understanding patients’ social context |
· Offering support | |||
· Encouraging patient participation | |||
· Increasing clinician perceived competence to counsel | |||
Intervention training (curriculum components) |
· Interactive discussion on strategies to increase both patient motivation for physical activity and clinician motivation to raise the topic |
· Introduction, repetition, and reinforcement of each of the 5As via didactic presentation, role play, and standardized patient feedback |
· Role play and group discussion to develop and reinforce supportive listening and open-ended questions about physical activity |
· Offering a choice of community resources for referral | |||
· Offering a choice of optional electronic health records tools and eliciting ongoing feedback | |||
· Use of standardized patients to give feedback to clinicians on PCC skills | |||
Assessment/measurement (clinician perspective) |
Clinician surveys and interviews |
Clinician interviews asking about recall of 5As |
Clinician surveys and interviews |
Assessment/measurement (patient perspective) |
Patient ratings of autonomy support of clinicians, perceived competence for physical activity |
Patient report of 5As discussions of physical activity |
Patient ratings of trust and satisfaction with their relationship with their clinician; patient interviews on communication skills of their clinicians |
Assessment/measurement (blinded coder) | Coding of autonomy supportiveness (global rating and for each A) | Coding of content and quality ratings for the 5As | Coding of supportive statements, exploration of patient’s social context related to physical activity, encouraging questions, verifying understanding and agreement |