Table 1 Details of the PACE-Lift physical activity consultations with the practice nurse
Week | Sessions | Guide to session content | Proposed Behavioural Change Techniques (Michie [[54]])* |
|---|---|---|---|
1 | Session1: First steps (45 minutes) As soon as possible after randomisation | Review health status, current activity, health benefits of physical activity | 1,2, |
Review baseline accelerometer data (step-counts and time spent in at least moderate intensity PA) | 19, | ||
30 mins × 5 days / week message & how to increase PA safely | 4,21 | ||
Teach use of pedometer and calculator to calculate average daily steps | |||
Cost-benefit analysis for increasing physical activity | 2, | ||
Ideas of how, when and where to increase step-counts | 20,38 | ||
Use of rewards for effort and for achieving goals | 12,13 | ||
SMART physical activity goals, weekly walking planner & step-count diary | 7,9,16, | ||
Check confidence levels, ensure goals are realistic | 9, | ||
Summarise & check patient understanding, plan date for wearing accelerometer next and time next meeting | 26, | ||
3 | Session 2: Continuing the changes (30 minutes) Approximately 2 weeks after session 1 | Review step-count and accelerometer data and step-count diary | 10,19, |
Encourage progress in increasing walking and achieving goals | 12,13, | ||
Troubleshoot any problems with equipment or diary | 8, | ||
Barriers and facilitators to increasing physical activity, overcoming barriers | 8 | ||
Review target and set new SMART walking goals using walking planner | 7,9,16 | ||
Check confidence levels, build confidence to make change | 5,18,29,36, | ||
Encourage recording in step-count diary | 16 | ||
Review and set your own goals | 5,8,10, | ||
Summarise & check patient understanding, plan date for wearing accelerometer next and time next meeting | 26, | ||
7 | Session3: Keeping up the changes (30 minutes) Approximately 4 weeks after session 2 | Review step-count and accelerometer data and step-count diary | 10,19, |
Encourage progress in increasing walking and achieving goals | 12,13, | ||
Troubleshoot any problems with equipment or diary | 8, | ||
Preparing for setbacks: discussion of coping strategies, building social support | 29,35, | ||
Introduce pacing; general pacing tips and plans | 9,35 | ||
Building habits – generate ‘if-then’ plans to prevent setbacks or build habits | 7, 23, | ||
Review target and set new SMART walking goals using walking planner | 7,9,16, | ||
Encourage recording in step-count diary | 16, | ||
Summarise & check patient understanding, plan date for wearing accelerometer next & time next meeting | 26, | ||
11 | Session4: Building lasting habits (30 minutes) Approximately 4 weeks after session 3 | Review step-count and accelerometer data and step-count diary | 10,19, |
Review overall progress over the sessions | 11, | ||
Encourage progress in increasing walking and achieving goals | 12,13, | ||
Building habits: discuss methods of maintaining lasting change | 35, | ||
Becoming your own activity coach: review benefits of PA | 1,2, | ||
Set a new overall PA target and step-count goal for next 3 months | 7, | ||
Review stages for making change (SMART goals, set rewards, build confidence to change, review goals, overcome barriers, pacing & dealing with setbacks) | 7,8,9,12,35 |