@文章{信息:doi/10.2196/15424，作者=“Agarwal, Payal和Kithulegoda, Natasha和Bouck, Zachary和Bosiak, Beth和Birnbaum, Ilana和Reddeman, Lindsay和Steiner, Liane和Altman, Liora和Mawson, Robin和Propp, Roni和Thornton, Jane和Ivers, Noah”，标题=“电子健康工具促进初级保健中身体活动的可行性:试点集群随机对照试验”，期刊=“J Med Internet Res”，年=“2020”，月=“Feb”，日=“14”，卷=“22”，号=“2”，页=“e15424”，关键词=“eHealth;初级保健;身体活动;背景:缺乏运动与健康风险增加有关。初级保健提供者(pcp)有能力通过筛查和提供体育活动(PA)处方来支持增加体育活动(PA)水平。然而，PCP对PA的咨询并不常见。目的:本研究旨在评估实施电子健康(eHealth)工具以支持pcp进行PA咨询的可行性，并评估干预对患者PA水平的有效性。方法:采用阶梯楔形聚类随机试验设计进行初步研究。该研究是在一个初级保健诊所进行的，有4个预先存在的PCP团队。 Adult patients who had a periodic health review (PHR) scheduled during the study period were invited to participate. The eHealth tool involved an electronic survey sent to participants before their PHR via an email or a tablet; data were used to automatically produce tailored resources and a PA prescription in the electronic medical record of participants in the intervention arm. Participants assigned to the control arm received usual care from their PCP. Feasibility was assessed by the proportion of completed surveys and patient-reported acceptability and fidelity measures. The primary effectiveness outcome was patient-reported PA at 4 months post-PHR, measured as metabolic equivalent of task (MET) minutes per week. Secondary outcomes assessed determinants of PA, including self-efficacy and intention to change based on the Health Action Process Approach behavior change theory. Results: A total of 1028 patients receiving care from 34 PCPs were invited to participate and 530 (51.55{\%}) consented (intervention [n=296] and control [n=234]). Of the participants who completed a process evaluation, almost half (88/178, 49.4{\%}) stated they received a PA prescription, with only 42 receiving the full intervention including tailored resources from their PCP. A cluster-level linear regression analysis yielded a non--statistically significant positive difference in MET-minutes reported per week at follow-up between intervention and control conditions (mean difference 1027; 95{\%} CI −155 to 2209; P=.09). No statistically significant differences were observed for secondary outcomes. Conclusions: Our results suggest that it is feasible to build an eHealth tool that screens and provides tailored resources for PA in a primary care setting but suboptimal intervention fidelity suggests greater work must be done to address PCP barriers to resource distribution. Participant responses to the primary effectiveness outcome (MET-minutes) were highly variable, reflecting a need for more robust measures of PA in future trials to address limitations in patient-reported data. Trial Registration: ClinicalTrials.gov NCT03181295; https://clinicaltrials.gov/ct2/show/NCT03181295 ", issn="1438-8871", doi="10.2196/15424", url="//www.mybigtv.com/2020/2/e15424", url="https://doi.org/10.2196/15424", url="http://www.ncbi.nlm.nih.gov/pubmed/32130122" }