Exercise Prescription Project Department of Health.
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Transcript of Exercise Prescription Project Department of Health.
Exercise Prescription Project
Department of Health
Exercise
• reduces mortality and morbidity
• promotes • physical health
• psychological health
• social health
WHO’s recommendations
• at least 30 minutes
• moderate intensity
• on most days of the week
Local situation
• “Population Health Survey” conducted by the Department of Health
–Physical inactivity is common
Primary healthcare to promote physical activities
• A good opportunity–provides services in the community
–gains high level of trust and credibility from the public
• Overseas experiences
Stages of Change Model
• A social psychology model
• Describes motivational readiness of an individual to change behaviour (5 stages)
Pre-contemplation(No intention)
Action(actively engaged)
Maintenance(keep it up)
Contemplation(have intention)
Preparation(preparing)(Prochaska & DiClemente 1984)
Local experience
A study conducted in 2003 by DH• Aim : assess the efficacy of incorporating
exercise prescription and the provision of stage matched health education materials
• Study type : randomized controlled trial• Setting : general practice• Subjects : clients of the participating GPs with
the following inclusion criteria1. 18-64 years old;2. Can read and understand written Chinese; and3. Belong to pre-contemplation, contemplation orpreparation stages in their motivation to do exercise.
Medical assessment
Fill in thequestionnaire for exercise participation
Target populationUnsuitable population
Control group
Randomization
Medically stable
Intervention group
Usual consultation + intervention Usual consultation
Telephone FU interview for Stage of change & exercise participation assessment
Stage of change assessmentInclusion criteria
Excluded cases
Medically unstable
Study Flow
4 weeks later
Pre
Post
Intervention (1)
• Mode;
• Frequency; and
• Duration
Provision of an exercise prescription sheet
Intervention (2)Provision of relevant health education materials
i) Disease specific pamphlets ii) Stage matched booklets
Results
GPs recruited : 17
Patients recruited at pre :636
Patients recruited at FU : 608 (95.6%)
Control group : 304 Intervention group : 332
Outcome measures : patients’
• Stages of changes; and
• Exercise participation levels
Stages of Change• Forward Shift : Stage progression at FU• Backward/No Shift : Stage reversion/no progression at FU
38.547.9
61.5 52.1
010203040506070
Perc
ent
age
Forward shift Backward/No shift
Stage progression in intervention and control groups
Control Intervention
Adjusted OR : 1.51
(95%CI : 1.10 -2.09, p=0.01)
Summary of local experience
• Effect of the exercise prescription project
Increase motivational readiness to exercise
Exercise Prescription Project
Exercise Prescription ProjectAim :• Promote physical activity among the general
public by a multi-sectoral approach and establishing a conducive environment for exercise
Key elements:• Doctors to provide structured and specific health
advice to promote exercise participation (exercise prescription) in a largely healthy population
• Stage matched health education materials• Community participation
Approach
Healthy population various choices of exercise
Supervised exercise
Patients who can do self-exercise
Semi-supervised exercise
Community participation in the EPP
Specialized health professional
Exercise Prescription Project
Collaborators:
Government DepartmentsGovernment Departments
Community participationCommunity participation
Professional bodiesProfessional bodies
Exercise Prescription Project• A Task Force was set up
Task ForceTask ForceExercise Prescription
Development Committee (EPDC)Exercise Prescription
Development Committee (EPDC)
Practitioners Training Committee (PTC)Practitioners Training Committee (PTC)
Community Engagement Committee (CEC)Community Engagement Committee (CEC)
Education and Publicity Committee (EPC)Education and Publicity Committee (EPC)
Exercise Prescription Project
Task ForceTask Force
EPDCEPDC
PTCPTC
CECCEC
EPCEPC
Development of health education resourcesDevelopment of health education resources
Training of Medical and Other PractitionersTraining of Medical and Other Practitioners
Soliciting community resourcesSoliciting community resources
Arranging publicity actionsArranging publicity actions
Doctors
Public
Community
Doctors
Public
Community
Toolkit forExercise Prescription Project
• Introduction to the Exercise Prescription Project
• Guidelines on writing an exercise prescription
• Health education materials for patients
• Exercise prescription pad
Professional Manual -The Exercise Prescription Project
• Overview of the project
• Components of the intervention
Professional Manual – Guidelines on writing an exercise prescription
• Guidance on exercise prescription
Health education materialsfor clients
• Pamphlets for patients with chronic diseases
• Booklets for patients at different stages of change for exercise
Exercise Prescription Sheet
• Specific health advice on exercise
• Work out by the doctor and the patient
• Ownership of one’s own health
Client’s log book
• General information on exercise
• Weekly progress chart
Thematic Websitehttp://exerciserx.cheu.gov.hk
Conclusion
The project will be good for:• Public• Doctors• Community
Let’s build a healthier Hong Kong
Thank you