Table 1

Summary of intervention components and corresponding conceptual framework
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

Carroll et al.

Carroll et al. BMC Health Services Research 2012 12:374   doi:10.1186/1472-6963-12-374

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