Multidimensional individualised Physical ACTivity (Mi-PACT)--a technology-enabled intervention to promote physical activity in primary care: study protocol for a randomised controlled trial

Abstract

Background: Low physical activity is a major public health problem. New cost-effective approaches that stimulate meaningful long-term changes in physical activity are required, especially within primary care settings. It is becoming clear that there are various dimensions to physical activity with independent health benefits. Advances in technology mean that it is now possible to generate multidimensional physical activity 'profiles' that provide a more complete representation of physical activity and offer a variety of options that can be tailored to the individual. Mi-PACT is a randomised controlled trial designed to examine whether personalised multidimensional physical activity feedback and self-monitoring alongside trainer-supportive sessions increases physical activity and improves health outcomes in at-risk men and women.

Methods/design: We aim to recruit 216 patients from within primary care aged 40 to 70 years and at medium or high risk of cardiovascular disease and/or type II diabetes mellitus. Adopting an unequal allocation ratio (intervention: control) of 2:1, participants will be randomised to one of two groups, usual care or the intervention. The control group will receive usual care from their general practitioner (GP) and standardised messages about physical activity for health. The intervention group will receive 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 technology-enabled feedback will be discussed with participants on 5 occasions during supportive one-to-one coaching sessions across the 3-month intervention. The primary outcome measure is physical activity, which will be directly assessed using activity monitors for a 7-day period at baseline, post intervention and at 12 months. Secondary measures (at these time-points) include weight loss, fat mass, and markers of metabolic control, motivation and well-being.

Discussion: Results from this study will provide insight into the effects of integrated physical activity profiling and self-monitoring combined with in-person support on physical activity and health outcomes in patients at risk of future chronic disease.

Trial registration: ISRCTN18008011 Trial registration date: 31 July 2013.

Fig. 1

Flow of participants through the study. Patients identified as ‘at risk’ and who volunteer will be assessed for eligibility via telephone screen and attendance at a baseline assessment clinic. Eligible people will be randomised to either the control (usual care) or intervention (Mi-PACT) group by concealed minimisation. Follow-up assessments will take place post intervention at 3 and 12 months

Fig. 2

Platform screenshot displaying the integrated physical activity profile across the different physiologically-important dimensions (expressed relative to guidelines)

Fig. 3

Platform screenshot depicting minute-by-minute energy expenditure and both time spent and energy expended in different intensity thresholds (as daily or weekly summaries)

Fig. 4

Platform screenshot displaying personalised minute-by-minute energy expenditure data and accompanying platform features for reviewing behaviour

Fig. 5

Platform screenshot depicting weekly activity patterns expressed relative to an individual’s multidimensional profile and features for exploring the impact of any changes and action plans on their behavioural goal(s)