MiPACT – a technology enabled intervention to increase physical activity in patients at-risk of chronic disease

INTRODUCTION: The NHS Health Check is a national public health initiative that aims to reduce the future burden of chronic disease. Physical activity has the potential to offer a great deal to the success of this initiative if only we can get enough people to change their behaviour. It is becoming clear that there are various dimensions to physical activity that can all improve health. We now have the technology to capture this information and thus provide patients with personalised feedback on all the different ways that they can benefit from physical activity. Funded by the National Prevention Research Initiative (Medical Research Council), our aim is to translate technological innovation and improved understanding of the multidimensional nature of physical activity into a meaningful change in physical activity behaviour in patients at risk of chronic disease.
METHODOLOGY: In this research, we wanted to determine whether technology-enabled multidimensional physical activity graphics and visualisations are comprehensible and usable for patients (Phase 1). We first developed several iterations of graphics for depicting physical activity data. Subsequently, patients (n=29) and healthcare practitioners (n=15) underwent 7 days of activity monitoring followed by individual semi-structured interviews in which they were asked to comment on their own personalised visual feedback. After this development work, in a 12-month randomised controlled trial, we examined whether multidimensional physical activity feedback and self-monitoring increases physical activity and improves health outcomes in at-risk men and women (Phase 2). We recruited 204 patients within primary care aged 40-70 years and at-risk of cardiovascular disease and/or type II diabetes mellitus. Participants were randomised to one of two groups, usual care or the intervention. The control group received usual care from their general practitioner and standardised messages about physical activity. The intervention group received physical activity monitors and access to a web-based platform for a 3-month period to enable self-monitoring and the provision of personalised feedback regarding the multidimensional nature of physical activity. In addition, this feedback was discussed with participants on 5 occasions during trainer-supportive sessions across the 3-month intervention. The primary outcome measure is physical activity and is assessed directly using activity monitors for a 7-day period at baseline, post intervention and at 12 months. Secondary measures include weight loss, fat mass, and markers of metabolic control, motivation and well-being.
RESULTS: Participants demonstrated a clear ability to understand the sophisticated personal information plus an enhanced physical activity knowledge (Phase 1). They also reported that receiving multidimensional feedback was motivating and could be usefully applied to facilitate their efforts in becoming more physically active. Phase 2: Recruitment was completed in May 2015 and follow-up assessment will be complete in June 2016.
CONCLUSION: Multidimensional physical activity feedback can be made understandable, informative and motivational for patients by using appropriate graphics and visualisations. The results of our ongoing trial will provide insight into the effects of this technology-enabled intervention on physical activity and health outcomes in patients at risk of chronic disease. We envisage direct potential application within the NHS Health Check and other public health initiatives.