Date Available

4-26-2023

Year of Publication

2023

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Elizabeth Tovar

Clinical Mentor

Brooke Englert

Committee Member

Dr. Julianne Ewen

Committee Member

Dr. Angela Grubbs

Abstract

Background/Purpose: Physical Activity Guidelines for Americans recommend 150-300 minutes of moderate-intensity physical activity each week for adults; however, half of the adults do not meet this goal, which leads to increased chronic health conditions and poor health outcomes. The physical activity vital sign (PAVS) screening tool is an evidence-based assessment tool associated with increased physical activity counseling, which can lead to increased physical activity and improved patient outcomes.

Objective: The purpose of this study was to examine the impact of PAVS screening on physical activity counseling and referrals in primary care.

Methods: This prospective study took place in a small primary care clinic providing care to women. Physical Activity Vital Sign screening was implemented to examine the effect of PAVS screening on the rate of physical activity counseling and referral to exercise promotion programs. The intervention consisted of provider education and implementation of PAVS screening during annual wellness exams. Six primary care providers working in the clinic were given pre- and post-intervention surveys. Baseline and post intervention data of providers’ physical activity counseling and referrals was obtained via chart review.

Results: The sample consisted of six Caucasian female primary care providers. Five out of six providers chose to participate in the baseline survey and four in the post intervention survey. In the pre survey (N=5) agreed that a visual aid listing current physical activity guidelines would be helpful and they liked the PAVS screening tool. Barriers to physical activity screening and counseling were time to have the conversation (100%) and patients’ disinterest (50%). Prior to the intervention, 49% of patients had documented exercise counseling vs. 64.3% after the intervention (p = 0.15). Similarly, referrals to exercise/weight loss clinic increased from 2% to 7.1% (p = .208). Patients who received exercise counseling had a significantly higher BMI 2 compared to those who did not (M = 32.7, SD = 8.6 vs. M = 28.5, SD = 6.8, p = .003), suggesting high BMI was a trigger for exercise counseling and referral rather than activity levels.

Conclusions: Our findings support established evidence that the PAVS screening is a valuable screening tool and is appropriate for use in a primary care setting. Universal physical activity screening is recommended, and providers should be cautious about relying on BMI as the cue to action for physical activity counseling and referral. The limitations of this study are discussed and suggestions for future research are presented.

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