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A scoping review of tools to guide clinical discussions on physical activity, sedentary behaviour, and/or sleep for health promotion between primary care providers and adults who access care

Submitted by:

Tami Morgan

Email:

t.morgan@queensu.ca

Author(s)

Tamara L. Morgan, Emma Faught, Amanda Ross-White, Michelle S. Fortier, Mary Duggan, Rahul Jain, Kirstin N. Lane, Amanda Lorbergs, Kaleigh Maclaren, Taylor McFadden, & Jennifer R. Tomasone

Institution of primary author:

School of Kinesiology and Health Studies, Queen's University

Background:

The Canadian 24-Hour Movement Guidelines (24HMG) emphasize the 24-hour movement paradigm, explaining how movement behaviours (i.e., physical activity [PA], sedentary behaviour, and sleep) are interrelated and may be optimized each day (CSEP, 2020). However, Canadian adults are engaging in insufficient PA, excess sedentary behaviour, and are experiencing poor sleep (Chastin et al, 2021). One well-positioned population to promote the 24HMG to adults are primary care providers (PCPs) as they are deemed to be reliable sources of health information (Wattanapisit et al., 2018) and are in frequent contact with the majority of the general population (Michas, 2018). Unfortunately, PCPs have reported low knowledge, skill, confidence, and motivation in discussing PA (Hebert et al., 2014; Thornton et al., 2021). To facilitate clinical discussions about movement behaviours between PCPs and adults accessing care, a multiplicity of tools have been developed and used (Golightly et al., 2017; Smith et al., 2017). However, existing tools have overwhelmingly focused on PA, while only a few have focused on sleep and sedentary behaviour. Notably, no tools exist that integrate all movement behaviours, leaving tools limited in their ability to inform discussions on integrating PA, sedentary behaviour, and sleep recommendations. Previous reviews have examined PA discussion tool effectiveness (Golightly et al., 2017; Smith et al. 2017) but have neither captured tools for sedentary behaviour or sleep nor have reviewed perceptions about tools’ utility. Therefore, a scoping review capturing a broader range of features and outcomes for a greater number of discussion tools for PA, sedentary behaviour, and sleep was deemed necessary to fill these gaps and inform future practice.

Purpose:

To report and appraise tools for movement behaviour discussions between PCPs and adults 18+ years accessing care in Canada or analogous countries.

Methods:

An integrated knowledge translation approach (Nguyen et al., 2020) was applied to engage a working group of stakeholders from research question formation to interpretation of findings. Three search strategies (peer-reviewed literature, grey literature, and forward searching) were used to identify studies reporting on perceptions and/or effectiveness outcomes of discussion tools for PA, sedentary behaviour, and/or sleep. The quality of studies evaluating tool effectiveness was appraised using the Mixed Methods Appraisal Tool (Hong et al., 2018).

Results:

In total, 135 studies reporting on 61 tools (51 on PA, one on sleep, and nine combining two movement behaviours) met inclusion criteria. Tools served one or more purpose, including assessment (n=57), counselling (n=50), prescription (n=18), and referral (n=12) related to one or more movement behaviour. The quality of the 116 studies that evaluated tool effectiveness varied.

Conclusions:

Many tools were perceived positively by providers and adults accessing care and were deemed to be effective at enhancing knowledge of, confidence for, ability in, and frequency of movement behaviour discussions. Results of this study have informed a list of seven evidence-based recommendations to guide the development and implementation of future movement behaviour discussion tools, including our development of a 24HMG discussion tool for PCPs.

Tami Morgan poster

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