Health Promotion International Advance Access published online on November 29, 2006
Health Promotion International, doi:10.1093/heapro/dal040
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© The Author (2006). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
research-article |
From innovation to practice: initiation, implementation and evaluation of a physician-based physical activity promotion programme in Finland
1 The UKK Institute for Health Promotion Research, Tampere, Finland 2 Kiipula Rehabilitation Centre, Turenki, Finland 3 Tampere School of Public Health, University of Tampere, Tampere, Finland 4 National Research and Development Centre for Welfare and Health (STAKES), Helsinki, Finland
Address for correspondence: Minna Aittasalo The UKK Institute for Health Promotion Research, PO Box 30 FI-33501 Tampere Finland E-mail: minna.aittasalo{at}uta.fi
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Abstract |
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In 2001, a collaborative Physical Activity Prescription Programme (PAPP) was started in Finland to increase physical activity (PA) counselling among physicians, especially in primary care. This article describes the initiation, implementation and evaluation of PAPP.
Five actions were implemented to reach the programme goal: (i) developing a counselling approach for physicians; (ii) providing easy and open access to counselling material; (iii) facilitating physicians' uptake and adoption of the counselling approach; (iv) disseminating information about the counselling approach to physicians, health and exercise professionals and decision-makers and (v) raising financial resources to cover programme expenses. Evaluation was based on the dimensions of the RE-AIM framework: reach, effectiveness, adoption, implementation and maintenance. Effectiveness and adoption were evaluated with two questions added to the annual survey of the Finnish Medical Association to all practising physicians in the year 2002 (n=16 692) and 2004 (n=17 170).
The 4-year PAPP was successful in reaching health care units (Reach), accomplishing most of the implementation actions (Implementation) and initiating local projects for institutionalizing the prescription-based counselling approach, ‘Prex’ (Maintenance). However, at the national level, the programme was not effective in increasing the frequency of asking about patients' PA habits (Effectiveness) or the frequency of using ‘Prex’ or other written material in PA counselling among physicians (Adoption).
To improve the latter two, the duration of the programme would have had to be extended with more effort at strengthening physicians' confidence in PA counselling and knowledge about its effectiveness. Also, a more systematic approach would have been necessary to facilitate inter-sectoral network for adopting ‘Prex’ as a counselling tool at the local level.
Key words: physical activity; promotion; primary health care; dissemination