Exercise-referral scheme to promote physical activity among hypertensive patients: design of a cluster randomized trial in the Primary Health Care Units of Mexico’s Social Security System

BMC Public Health

Felipe Lobelo²  Gabriel Vázquez-Cabrer³  Velia Nelly Salgado-de-Snyder¹  Jorge Salmerón⁶  Carmen García-Peña⁴  Katia Gallegos-Carrillo⁵ 

[1] Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México;Exercise is Medicine Global Research Center, American College of Sports Medicine, Indianapolis, Indiana, USA;Unidad de Rehabilitación Cardíaca, Hospital Ángeles de las Lomas, Huixquilucan, Estado de México, México;Unidad de Investigación Epidemiológica y en Servicios de Salud. Área Envejecimiento, Instituto Mexicano del Seguro Social, México, D.F. México;Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Boulevard Benito Juárez No. 31. Centro. C.P. 62000, Cuernavaca, Morelos, México;Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México

关键词: Mexico;    Hypertension;    Physical activity;    Exercise-referral;   

Others  :  1129029
DOI  :  10.1186/1471-2458-14-706

 received in 2014-05-30, accepted in 2014-06-12,  发布年份 2014

【 摘 要 】

Background

Although the benefits of physical activity (PA) on to prevent and manage non-communicable diseases are well known, strategies to help increase the levels of PA among different populations are limited. Exercise-referral schemes have emerged as one effective approach to promote PA; however, there is uncertainty about the feasibility and effectiveness of these schemes in settings outside high-income countries. This study will examine the effectiveness of a scheme to refer hypertensive patients identified in Primary Health Care facilities (PHCU) of the Mexican social security institution to a group PA program offered in the same institution.

Methods and design

We will describe the methods of a cluster randomized trial study designed to evaluate the effectiveness of an exercise referral scheme to increasing physical activity in hypertensive patients compared to a non-referral scheme. Four PHCU were selected for the study; the PHCU will take part as the unit of randomization and sedentary hypertensive patients as the unit of assessment. 2 PHCU of control group (GC) will provide information to hypertensive patients about physical activity benefits and ways to increase it safely. 2 PHCU of intervention group (IG) will refer patients to sports facilities at the same institution, to follow a group-based PA program developed to increase the PA levels with a designed based on the Transtheoretical Model and Social Cognitive Theory. To evaluate the effects of the intervention as well as short-term maintenance of the intervention’s effects, PA will be assessed at baseline, at 24 and 32 weeks of follow-up.

The main outcome will be the difference before and after intervention in the percentage of participants meeting recommended levels of PA between and within intervention and control groups. PA will be measured through self-report and with objective measure by accelerometer.

Discussion

This study will allow us to evaluate a multidisciplinary effort to link the primary care and community-based areas of the same health care system. Our findings will provide important information about the feasibility and effectiveness of an exercise-referral scheme and will be useful for decision-making about the implementation of strategies for increasing PA among hypertensive and other clinical populations in Mexico and Latin America.

Trial registration

Clinicaltrials.gov Identifier: NCT01910935. Date of registration: 07/05/2013.

【 授权许可】

   
2014 Gallegos-Carrillo et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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