Resourcing an evolution of roles in general-practice: a study to determine the validity and reliability of tools to assist nurses and patients to assess physical activity
Shona N. Dutton A D , Adrian Bauman B , Sarah M. Dennis C , Nicholas Zwar A and Mark F. Harris AA Centre for Primary Health Care and Equity, University of NSW, Level 3, AGSM Building, UNSW Australia, Sydney, NSW 2052, Australia.
B Sydney Medical School, Edward Ford Building A27, University of Sydney, Sydney, NSW 2006, Australia.
C Faculty of Health Sciences, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia.
D Corresponding author. Email: shona_dutton@hotmail.com
Australian Journal of Primary Health 22(6) 505-509 https://doi.org/10.1071/PY15027
Submitted: 5 March 2015 Accepted: 4 November 2015 Published: 27 April 2016
Abstract
Traditionally, GPs have been responsible for physical activity (PA) assessment within the general practice setting. Multiple questionnaires are available to support uptake of PA assessment but less than 30% of patients are assessed. A range of barriers hamper uptake. Evidence indicates that practice nurses (PNs) and patients are resourceful members of the general practice team but have been underutilised. This study assessed the validity and reliability of two instruments for assessing PA, administered by PNs and patients. The study aimed to identify robust tool(s) to support the evolving role of PNs and patients in prevention and management strategies in general practice. A purposive sample of PNs and patients from general practices in Sydney was invited to participate. The results of the PN- or patient-administered general practice physical activity questionnaire (GPPAQ) and the three-question physical activity questionnaire (3Q) were compared against accelerometer activity. The study examined agreement in classification of PA levels according to Australian PA recommendations. Validity showed low–moderate correlations between accelerometer and GPPAQ (rho = 0.26), 3Q (rho = 0.45). Seven-day test-retest reliability intraclass correlation coefficients (ICCs) were 0.82–0.95 for GGPAQ and 0.94–0.98 for 3Q. Agreement with PA recommendations was moderate for GPPAQ (kappa 0.73, 95% CI, 0.56–0.85) and fair for 3Q (kappa 0.62, 95% CI, 0.47–0.78). Although 3Q demonstrated higher correlation with accelerometry, GPPAQ demonstrated higher agreement with PA guidelines. Given GPPAQ showed reasonable rigour, it may prove useful for PN and patient use.
Additional keywords: general practice, measurement, physical activity, practice nurse, primary health care.
References
Bauman A, Phongsavan P, Schoeppe S, Owen N (2006) Physical activity measurement: A primer for health promotion. Promotion & Education 13, 92–103.| Physical activity measurement: A primer for health promotion.Crossref | GoogleScholarGoogle Scholar |
Blair SN, Paffenbarger RS, Clark DG, Cooper KH, Gibbons LW (1989) Physical fitness and all cause mortality: a prospective study on health men and women. Journal of the American Medical Association 262, 2395–2401.
| Physical fitness and all cause mortality: a prospective study on health men and women.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3c%2Fht1Giug%3D%3D&md5=f86f6a6d4060ba4b8b28f9951d40d7f0CAS | 2795824PubMed |
Britt H, Miller GC, Charles J, Henderson J, Bayram C, Pan Y, Valenti L, Harrison C, O’Halloran J, Fahridin S (2010) General practice activity in Australia 2009–10. Contract no. GEP 27. AIHW, Canberra.
Bull FC, Bauman A (2008) Consistent risk factor monitoring systems underpins good public health practice. Preventive Medicine 47, 154–155.
| Consistent risk factor monitoring systems underpins good public health practice.Crossref | GoogleScholarGoogle Scholar | 18554707PubMed |
Commonwealth Department of Health and Aged Care (1999) National physical activity guidelines for Australians. Department of Health and Aged Care, Canberra.
Dutton S, Dennis S, Harris M, Zwar N, Bauman A, Van Der Ploeg H (2012) Feasibility and acceptability of two instruments for measuring physical activity (PA) in primary care. Journal of Science and Medicine in Sport 15, S295
| Feasibility and acceptability of two instruments for measuring physical activity (PA) in primary care.Crossref | GoogleScholarGoogle Scholar |
Fitzgerald L, Ozemek C, Jarrett H, Kaminski LA (2015) Accelerometer validation of questionnaires used in clinical settings to assess MVPA. Medicine and Science in Sports and Exercise 47, 1538–1542.
| Accelerometer validation of questionnaires used in clinical settings to assess MVPA.Crossref | GoogleScholarGoogle Scholar | 25380474PubMed |
Freedson PBH, Troiano R, Haskell W (2012) Assessment of physical activity using wearable monitors: recommendations for monitor calibration and use in the field. Medicine and Science in Sports and Exercise 44, S1–S4.
| Assessment of physical activity using wearable monitors: recommendations for monitor calibration and use in the field.Crossref | GoogleScholarGoogle Scholar |
Hinrichs T, Moschny A, Klaaßen-Mielke R, Trampisch U, Thiem U, Platen P (2011) General practitioner advice on physical activity: analyses in a cohort of older primary health care patients (getABI). BMC Family Practice 12, 26
| General practitioner advice on physical activity: analyses in a cohort of older primary health care patients (getABI).Crossref | GoogleScholarGoogle Scholar | 21569227PubMed |
Le Grande MR, Elliott PC, Worcester MU, Murphy BM, Goble AJ (2008) An evaluation of self-report physical activity instruments used in studies involving cardiac patients. Journal of Cardiopulmonary Rehabilitation and Prevention 28, 358–369.
| An evaluation of self-report physical activity instruments used in studies involving cardiac patients.Crossref | GoogleScholarGoogle Scholar | 19008689PubMed |
National Health Service (2006) The General Practice Physical Activity Questionnaire (GPPAQ). Department of Health: London.
National Institute for Health and Clinical Excellence (2013) Physical activity: brief advice for adults in primary care. Available at https://www.nice.org.uk/Guidance/PH44 [Verified 26 November 2015]
Orrow G, Kinmonth A-L, Sanderson S, Sutton S (2012) Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials. BMJ (Clinical Research Ed.) 344, e1389
| Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials.Crossref | GoogleScholarGoogle Scholar |
Proudfoot J, Infante F, Holton C, Powell-Davies G, Bubner T, Beilby J, Harris M (2007b) Organisational capacity and chronic disease care – an Australian general practice perspective. Australian Family Physician 36, 286–288.
Smith BJ, Marshall AL, Huang N (2005) Screening for physical activity in family practice: evaluation of two brief assessment tools. American Journal of Preventive Medicine 29, 256–264.
| Screening for physical activity in family practice: evaluation of two brief assessment tools.Crossref | GoogleScholarGoogle Scholar | 16242587PubMed |
Taggart J, Schwartz A, Harris MF, Perkins D, Powell Davies G, Proudfoot J, Fanaian M, Crookes P (2009) Facilitating teamwork in general practice: moving from theory to practice. Australian Journal of Primary Health 15, 24–28.
| Facilitating teamwork in general practice: moving from theory to practice.Crossref | GoogleScholarGoogle Scholar |
Warren JM, Ekelund U, Bessond H, Mezzanif A, Geladasg N, Vanheesh L (2010) Assessment of physical activity – a review of methodologies with reference to epidemiological research: a report of the exercise physiology section of the European Association of Cardiovascular Prevention and Rehabilitation. European Journal of Cardiovascular Prevention and Rehabilitation 17, 127–39.
| Assessment of physical activity – a review of methodologies with reference to epidemiological research: a report of the exercise physiology section of the European Association of Cardiovascular Prevention and Rehabilitation.Crossref | GoogleScholarGoogle Scholar | 20215971PubMed |
Zwar N, Harris M, Griffiths R, Roland M, Dennis S, Powell Davies G, Hasan I. (2006) A systematic review of chronic disease management. UNSW, Sydney.
