Physical activity counseling intervention at a federally qualified health center: improves autonomy-supportiveness, but not patients' perceived competence.
OBJECTIVE
To assess the effect of a pilot intervention to promote clinician-patient communication about physical activity on patient ratings of their perceived competence for physical activity and their clinicians' autonomy-supportiveness.


METHODS
Family medicine clinicians (n=13) at two urban community health centers were randomized to early or delayed (8 months later) communication training groups. The goal of the training was to teach the 5As (Ask, Advise, Agree, Assist, Arrange) for physical activity counseling. Outcome measures were changes in patient perceptions of autonomy support (modified Health Care Climate Questionnaire, mHCCQ) and perceived competence (Perceived Competence Scale for physical activity, PCS) completed via surveys at baseline, post-intervention and six-month follow-up.


RESULTS
Patients (n=326) were mostly female (70%) and low income. Using a generalized estimating equations model (GEE) with patients nested within clinician, patient perceived autonomy support increased at post-intervention compared to baseline (mean HCCQ scores 3.68-4.06, p=0.03). There was no significant change in patient perceived competence for physical activity.


CONCLUSIONS
A clinician-directed intervention increased patient perceptions of clinician autonomy support but not patient perceived competence for physical activity.


CONCLUSIONS
Clinicians working with underserved populations can be taught to improve their autonomy supportiveness, according to patient assessments of their clinicians.
University of Rochester Medical Center, Department of Family Medicine, Family Medicine Research Programs, Rochester, NY 14620, USA. Jennifer_carroll@urmc.rochester.edu.
Jennifer K
JK
Carroll
Kevin
K
Fiscella
Ronald M
RM
Epstein
Mechelle R
MR
Sanders
Paul C
PC
Winters
S Anne
SA
Moorhead
Liesbeth
L
van Osch
Geoffrey C
GC
Williams
D000328:Adult; D003142:Communication; D003151:Community Health Centers; D003376:Counseling / Q000379:methods*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D026684:Personal Autonomy; D011368:Professional-Family Relations; D015397:Program Evaluation; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
Autonomy-supportiveness; Counseling intervention; Physical activity