title: Evaluation of a primary care-based programme designed to increase exercise and improve nutrition in patients at risk.
abstract: BACKGROUND
  Evidence is limited regarding the effectiveness of brief interventions delivered through primary care to improve healthy living and increase physical activity. The Healthy As programme delivering brief interventions programmes in primary care to promote physical activity, improved nutrition and weight management was developed, implemented and assessed. This study aimed to identify aspects of the programme that worked well, those that presented problems or barriers, along with suggestions for improvement.
  
  
  METHODS
  Three provider organisations in Auckland were contracted to deliver the Healthy As intervention in primary care settings. Semi-structured interviews were conducted with those delivering the risk assessments and providing the intervention from each provider organisation. A thematic analysis approach based on grounded theory was used to analyse the emerging key themes.
  
  
  RESULTS
  The emerging themes related to the holistic nature of the programme, its structure, resources used with participants, engagement of the providers with the participants, and whether the programme was effective in changing behaviour.
  
  
  CONCLUSIONS
  Initial engagement of participants was found to be particularly important for the success of the Healthy As programme. For a patient-centred approach, good communication between the patient and health provider is required to facilitate shared decision-making and self-management prior to implementation of an intervention. Patients need to indicate whether they want help to make changes. Advice on healthy eating and exercise should not be given in isolation. Patients may also need help with mental health or other lifestyle issues before they can actively engage in exercise or weight reduction programmes.
authors.affiliation: Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, The University of Auckland, PB 92019, Auckland 1146, New Zealand. f.goodyear-smith@auckland.ac.nz.
authors.forename: Felicity
authors.initials: F
authors.lastname: Goodyear-Smith
authors.affiliation: Human Potential Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Julia
authors.initials: J
authors.lastname: McPhee
authors.affiliation: Human Potential Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Scott
authors.initials: S
authors.lastname: Duncan
authors.affiliation: Human Potential Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Grant
authors.initials: G
authors.lastname: Schofield
mesh_terms: D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000458:organization & administration*; D006694:Holistic Health; D006801:Humans; D008297:Male; D062405:Motivational Interviewing / Q000458:organization & administration*; D009520:New Zealand; D011320:Primary Health Care / Q000458:organization & administration*; D015397:Program Evaluation