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Table 1 Findings from Stage 1 systematic reviews, stakeholder consultation [round 1], qualitative research and cost estimation

From: Development and feasibility study of very brief interventions for physical activity in primary care

Systematic reviews Scoping review of promising BCTs* Stakeholder consultation [round 1] (N = 32) Qualitative research Cost estimation
Systematic review of reviews of brief interventions (BIs): [16] BCTs identified as potentially feasible, acceptable and effective: Eleven strategies were identified by at least 5 out of 32 stakeholders: Health check (HC) observations: Self-monitoring interventions:
• Three BI reviews and seven general PA intervention reviews were included. No reviews focusing on VBIs were identified. 1.1 Goal setting (behaviour) 1. Information about behaviour-health link (n = 14); • HC follows a strict template, and lasts approximately 10 minutes. • Estimated cost of pedometer and consumables (e.g. patient information booklet; a PA diary) = £13.30.
• BIs ranged from 1–3 minutes to 30 minutes. Very few were VBIs (<5 minutes). 1.2 Problem Solving 2. Planning (n = 12); • Questions about PA/exercise are minimal and vague, e.g. ‘how much exercise do you do?’ • Estimated cost of nurse time = £8.66 (2010 prices).
• Majority of BIs and VBIs were delivered face to face, but were poorly defined in terms of active ingredients. 1.4 Action Planning 3. Tailoring (n = 11); • Advice on PA not given in the vast majority of HCs observed. • Total estimated cost = £21.96 per patient.
• Evidence favoured the use of supplements (e.g. written materials) to brief advice. 1.5 Review behaviour goals(s) 4. Signposting (n = 10); Patient Interviews (n = 51): Implementation Intentions (action planning) Interventions:
• Uncertainty about the effectiveness, feasibility and acceptability of BIs and VBIs that could be delivered in a routine primary care consultation. 1.6 Discrepancy between current behaviour and goals 5. Time management/ identify opportunities (n = 9); • Patients wanted nurse to ask more detailed questions about their current PA. • Estimated cost of consumables (e.g. printed material for patients; log books) = £2.30.
Meta-analysis of the effects of pedometer use on daily PA [17]: 1.9 Commitment 6. General encouragement (n = 7); • Patients unclear about the definition of ‘exercise’ and ‘PA’. • Estimated cost of nurse time = £8.66 (2010 prices).
• Pedometers are an effective intervention for increasing PA [pedometers increased steps by 2000 [11] to 2419 [10] steps per day. 2.2 Feedback on behaviour 7. Social support (n = 7); • Many patients felt that they had not been given PA advice. • Total estimated cost = £10.96 per patient.
  2.3 Self-monitoring of behaviour 8. Exercise prescription/ referral (n = 6); • Patients wanted tailored PA advice. Conclusion:
  3.1 Social support (unspecified) 9. Goal-setting (n = 6); • Patients felt that PA advice would be best given at a follow-up appointment (after HC results were fed back to them). • The costs of self-monitoring and implementation intention interventions are relatively small, comprising initial consultations, stationery, and follow-up consultations to review patient progress.
  4.1 Instruction on how to perform the behaviour 10. Self-monitoring (n = 5); • Patients felt that PA advice was not necessary if HC results indicated that they were ‘healthy’.  
  5.1 Information about health consequences 11. Provide instruction (n = 5) Implications for a PA VBI:  
  5.3 Information about social and environmental consequences   • There is a need for a VBI focusing on PA in the HC.  
  5.4 Monitoring of emotional consequences   • A 5 minute VBI should fit into a HC.  
  5.6 Information about emotional consequences   • Patients should be asked detailed questions about their current PA.  
  8.7 Graded Tasks   • Patients should be made aware of the definition of PA (e.g. what counts as ‘moderate’ intensity).  
  12.5 Adding objects to the environment   • PA advice should be tailored to the individual (e.g. their current activity, lifestyle, capability etc.)  
  15.4 Self-talk   • PA advice should highlight the benefits of PA with less emphasis on PA as a treatment for a health problem.  
  1. *Numbering refers to BCTTv1