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Table 1 Summary of intervention components and corresponding conceptual framework

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