Exercise Prescription Project Department of Health

Exercise reduces mortality and morbidity promotes physical health psychological health social health

WHO’s recommendations at least 30 minutes moderate intensity on most days of the week

Local situation “Population Health Survey” conducted by the Department of Health –Physical inactivity is common

Primary healthcare to promote physical activities A good opportunity –provides services in the community –gains high level of trust and credibility from the public Overseas experiences

Stages of Change Model A social psychology model Describes motivational readiness of an individual to change behaviour (5 stages) Pre- contemplation (No intention) Contemplation (have intention) Preparation (preparing) Action (actively engaged) Maintenance (keep it up) (Prochaska & DiClemente 1984)

Local experience A study conducted in 2003 by DH Aim : assess the efficacy of incorporating exercise prescription and the provision of stage matched health education materials Study type : randomized controlled trial Setting : general practice Subjects : clients of the participating GPs with the following inclusion criteria years old; 2.Can read and understand written Chinese; and 3.Belong to pre-contemplation, contemplation or preparation stages in their motivation to do exercise.

Medical assessment Fill in the questionnaire for exercise participation Target population Unsuitable population Control group Randomization Medically stable Intervention group Usual consultation + intervention Usual consultation Telephone FU interview for Stage of change & exercise participation assessment Stage of change assessment Inclusion criteria Excluded cases Medically unstable Study Flow 4 weeks later Pre Post

Intervention (1) Mode; Frequency; and Duration Provision of an exercise prescription sheet

Intervention (2) Provision of relevant health education materials i) Disease specific pamphlets ii) Stage matched booklets

Results GPs recruited : 17 Patients recruited at pre :636 Patients recruited at FU : 608 (95.6%) Control group : 304 Intervention group : 332 Outcome measures : patients’ Stages of changes; and Exercise participation levels

Stages of Change Forward Shift : Stage progression at FU Backward/No Shift : Stage reversion/no progression at FU Adjusted OR : 1.51 (95%CI : , p=0.01)

Summary of local experience Effect of the exercise prescription project  Increase motivational readiness to exercise

Exercise Prescription Project

Aim : Promote physical activity among the general public by a multi-sectoral approach and establishing a conducive environment for exercise Key elements: Doctors to provide structured and specific health advice to promote exercise participation (exercise prescription) in a largely healthy population Stage matched health education materials Community participation

Approach Healthy population various choices of exercise Supervised exercise Patients who can do self-exercise Semi-supervised exercise Community participation in the EPP Specialized health professional

Exercise Prescription Project Collaborators: Professional bodies Community participation Government Departments

Exercise Prescription Project A Task Force was set up Task Force Exercise Prescription Development Committee (EPDC) Practitioners Training Committee (PTC) Community Engagement Committee (CEC) Education and Publicity Committee (EPC)

Exercise Prescription Project Task Force EPDC Development of health education resources PTC Training of Medical and Other Practitioners CEC Soliciting community resources EPC Arranging publicity actions Doctors Public Community

Toolkit for Exercise Prescription Project Introduction to the Exercise Prescription Project Guidelines on writing an exercise prescription Health education materials for patients Exercise prescription pad

Professional Manual - The Exercise Prescription Project Overview of the project Components of the intervention

Professional Manual – Guidelines on writing an exercise prescription Guidance on exercise prescription

Health education materials for clients Pamphlets for patients with chronic diseases Booklets for patients at different stages of change for exercise

Exercise Prescription Sheet Specific health advice on exercise Work out by the doctor and the patient Ownership of one’s own health

Client’s log book General information on exercise Weekly progress chart

Thematic Website

Conclusion The project will be good for: Public Doctors Community Let’s build a healthier Hong Kong

Thank you