Promotion of Physical Activity by Health Professionals (PROMOTE-PA): protocol for hybrid type 1 effectiveness-implementation RCT

Background
Promotion of physical activity by health professionals can increase physical activity participation among patients. However, promotion of PA is not part of routine clinical care and systematic implementation within hospital settings is lacking.

Purpose
The Promotion of Physical Activity by Health Professionals (PROMOTE-PA) study is a hybrid type I effectiveness-implementation cluster randomised controlled trial that aims to evaluate the effectiveness of support for physical activity promotion by hospital-based health professionals on physical activity participation of patients.

Methods
Health professionals delivering outpatient healthcare services within five local health districts in Sydney, Australia will be included. The target patient population is children (5-17 years) and adults who are willing to receive additional support to be more physically active. The evidence-based intervention is brief physical activity promotion informed by the ‘5As’ physical activity counselling model and behavioural theory, embedded into routine clinical practice. A multi-faceted strategy to support implementation of physical activity promotion has been developed based on preliminary research and consultation with stakeholders, The tailored implementation strategy includes education, pathways/linkages to community-based PA, access to clinical mentors, and clinical champions. Thirty outpatient clinical teams will be randomised to receive the implementation strategy immediately or after a 3-month delay (waitlist control). Each team will recruit ~ 20 patients (n= approx. 720) to collect self-reported moderate-vigorous physical activity (minutes per week, primary outcome), frequency of balance and strength exercise, mobility, and quality of life at baseline, 3-months, and 6-months post-randomisation. Data on the impact of the implementation strategy will also be collected.

Conclusion
The PROMOTE-PA study aims to address the increasing burden of physical inactivity in a high-risk population using the existing health workforce to deliver physical activity promotion.

Practical Implications
The PROMOTE-PA study will inform future interventions focused on promoting PA in hospital settings.

Funding: NHMRC Partnership Projects APP2011157