From: A 5A's communication intervention to promote physical activity in underserved populations
 | Self-determination theory | 5As | Patient-centered communication (PCC) |
---|---|---|---|
Design of intervention (key concepts) | · Promoting autonomy supportive skills for clinicians when counseling patients about physical activity | · Use of 5As for physical activity counseling | · Understanding patients’ social context |
· Offering support | |||
· Encouraging patient participation | |||
· Increasing clinician perceived competence to counsel | |||
Intervention training (curriculum components) | · Interactive discussion on strategies to increase both patient motivation for physical activity and clinician motivation to raise the topic | · Introduction, repetition, and reinforcement of each of the 5As via didactic presentation, role play, and standardized patient feedback | · Role play and group discussion to develop and reinforce supportive listening and open-ended questions about physical activity |
· Offering a choice of community resources for referral | |||
· Offering a choice of optional electronic health records tools and eliciting ongoing feedback | |||
· Use of standardized patients to give feedback to clinicians on PCC skills | |||
Assessment/measurement (clinician perspective) | Clinician surveys and interviews | Clinician interviews asking about recall of 5As | Clinician surveys and interviews |
Assessment/measurement (patient perspective) | Patient ratings of autonomy support of clinicians, perceived competence for physical activity | Patient report of 5As discussions of physical activity | Patient ratings of trust and satisfaction with their relationship with their clinician; patient interviews on communication skills of their clinicians |
Assessment/measurement (blinded coder) | Coding of autonomy supportiveness (global rating and for each A) | Coding of content and quality ratings for the 5As | Coding of supportive statements, exploration of patient’s social context related to physical activity, encouraging questions, verifying understanding and agreement |