Doctor Training for Physical Activity Promotion

Not currently recruiting at 1 trial location

Overseen By Kathryn Schmitz, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Pittsburgh

Disqualifiers: Not from PHN or UPMC

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if a special training program, called ECHO, helps rural primary care providers (PCPs) encourage patients to be more active. The focus is on how effectively these doctors can motivate inactive patients to get moving. The trial includes two groups: one receives the training immediately, while the other receives it later. This trial suits PCPs or adjunct faculty working in rural clinics under Primary Health Network or UPMC who are interested in improving patient physical activity levels. As an unphased trial, this study offers patients a unique opportunity to contribute to innovative research that could enhance healthcare delivery in rural areas.

Will I have to stop taking my current medications?

The trial information does not specify whether participants must stop taking their current medications.

What prior data suggests that this ECHO training is safe for primary care providers?

Research has shown that ECHO training, used worldwide, safely and effectively aids healthcare providers. The ECHO model involves mentorship and training through online sessions, such as Zoom, enabling providers to acquire new skills without known health risks.

No reports of negative effects have emerged from participating in ECHO training. It resembles attending an online workshop or class, making it easy for participants to manage, as it does not involve physical treatments or medications. Therefore, those considering joining a trial using ECHO training should have minimal safety concerns. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the ECHO training program because it takes a fresh approach to promoting physical activity by empowering doctors directly. Unlike traditional patient-focused interventions, this program trains primary care providers through interactive Zoom sessions, equipping them with skills to assess and advise patients on becoming more active. This method not only enhances communication between doctors and patients but also integrates evidence-based strategies, making it a sustainable and adaptable solution for encouraging healthier lifestyles. By focusing on doctor training, the program could significantly boost the effectiveness of physical activity promotion in healthcare settings.

What evidence suggests that the ECHO training is effective for promoting physical activity?

Research has shown that encouraging physical activity through primary care can be effective. A review found that when doctors encourage patients to be active, it leads to better fitness results. Another study showed that when doctors regularly discussed exercise, nearly half promoted it, and about a quarter referred patients to exercise programs. This suggests that training doctors to discuss and recommend physical activity can help increase patients' activity levels. In this trial, the ECHO training is being tested to improve these referral and advice practices, making it a promising way to get more people moving. Participants in the active intervention arm will receive the ECHO training, while those in the delayed intervention arm will be offered the training in year 5. ^{3 6 7 8}

Who Is on the Research Team?

Kathryn Schmitz, PhD

Principal Investigator

University of Pittsburgh

Are You a Good Fit for This Trial?

This trial is for rural primary care providers or adjunct faculty from PHN and FCM clinics who can understand and provide informed consent. It's not open to those outside these networks.

Inclusion Criteria

Must be able to provide and understand informed consent

Primary care providers or adjunct faculty from Primary Health Network (PHN) and Penn State Health Family and Community Medicine (FCM) rural clinics

Exclusion Criteria

Primary care providers or adjunct faculty NOT from PHN or FCM rural clinics

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Active Intervention

PCP participants receive the ECHO46 intervention via real-time, interactive videoconferencing through Zoom sessions held once weekly for 4 weeks

4 weeks

4 sessions (virtual)

Delayed Intervention

PCP participants will be offered the intervention in year 5

Year 5

Follow-up

Participants are monitored for the likelihood of patient referral to a community-level, telephone-based physical activity counseling service

5 years

What Are the Treatments Tested in This Trial?

Interventions

• ECHO training

Trial Overview

The study tests whether an ECHO intervention increases the likelihood that rural PCPs will encourage patients to be more physically active. Some participants receive training immediately, while others are offered it in year five.

How Is the Trial Designed?

Group I: Delayed Intervention Active Control 1 Intervention

PCP participants will be offered the intervention in year 5.

Group II: Active Intervention Active Control 1 Intervention

PCP participants in the practice cohort or the intervention group will receive the ECHO46 intervention via real-time, interactive videoconferencing through Zoom sessions held once weekly for 4 weeks (4 sessions total) at regularly scheduled times convenient to providers. Session topics will focus on training PCP participants to assess, advise, and refer patients to be more physically active, as well as provide evidence-based strategies they can use to supplement and sustain their communication efforts.

Who Is Running the Clinical Trial?

University of Pittsburgh

Lead Sponsor

Trials

1,820

Recruited

16,360,000+

Milton S. Hershey Medical Center

Lead Sponsor

Trials

515

Recruited

2,873,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Published Research Related to This Trial

In a review of over 5,500 participants from 11 physical activity interventions, no serious study-related adverse events were reported, indicating a high level of safety in these exercise programs.

While minor musculoskeletal injuries were noted, the studies emphasized a 'start low and go slow' approach, suggesting that moderate-intensity physical activity is safe and effective for sedentary, chronically ill, or older populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Screening, safety, and adverse events in physical activity interventions: collaborative experiences from the behavior change consortium. Ory, M., Resnick, B., Jordan, PJ., et al.[2022]

The EXPERT tool was developed to assist clinicians in prescribing exercise for patients with various cardiovascular diseases and risk factors, providing tailored recommendations based on specific conditions and individual patient factors.

This digital system offers exercise training recommendations and safety advice for 10 cardiovascular diseases and several chronic conditions, potentially improving the implementation of exercise rehabilitation in clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. Concept, definitions and construction methodology. Hansen, D., Dendale, P., Coninx, K., et al.[2018]

An educational intervention consisting of two workshops significantly improved self-efficacy and counseling frequency among 21 internal medicine residents compared to 27 control residents.

Despite the improvement in physicians' confidence and counseling behaviors, there was no significant increase in physical activity levels reported by patients, indicating that further strategies are needed to address barriers to exercise in chronically ill patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changing physician practice of physical activity counseling. Eckstrom, E., Hickam, DH., Lessler, DS., et al.[2023]

In a 1.5-year study involving 274 male veterans with cardiovascular disease risk factors, only one serious adverse event (atrial fibrillation) occurred, indicating that a progressive walking program can be safely recommended for high-risk individuals.

While minor musculoskeletal issues were common, over half of the reported adverse events were unrelated to the exercise program, highlighting the need for strategies to help individuals with chronic illnesses safely resume physical activity after any health setbacks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events among high-risk participants in a home-based walking study: a descriptive study. Goodrich, DE., Larkin, AR., Lowery, JC., et al.[2022]

In a randomized controlled trial involving 209 elderly participants (average age 80), a home-based exercise program was found to be generally safe, with 151 adverse events reported, affecting 47% of participants.

Despite the program's safety, 14% of the adverse events were serious, highlighting that high levels of pre-existing morbidity in this population can pose challenges to maintaining consistent exercise participation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events in mobility-limited and chronically ill elderly adults participating in an exercise intervention study supported by general practitioner practices. Hinrichs, T., Bücker, B., Wilm, S., et al.[2015]

Researchers in resistance training studies often lack clear guidance and motivation for thorough adverse event (AE) reporting, which can lead to inconsistent practices.

There is a need for exercise-specific guidelines for AE reporting, as current standards are perceived as not applicable to exercise trials, highlighting the importance of tailored strategies to improve reporting consistency.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Researchers' perspectives on adverse event reporting in resistance training trials: a qualitative study. El-Kotob, R., Pagcanlungan, JR., Craven, BC., et al.[2022]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC10106078/

Exercise during CHemotherapy for Ovarian cancer (ECHO) trial

Epidemiological evidence supports an association between higher levels of physical activity and improved cancer survival.

2.

sciencedirect.com

sciencedirect.com/science/article/pii/S0531556524003152

An analysis of physical fitness, health and anthropometrics

The 14-week physical exercise intervention resulted in significant improvements in aerobic capacity, muscular strength and agility, indicating a ...

3.

systematicreviewsjournal.biomedcentral.com

systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-023-02245-x

Promoting physical activity to patients: a scoping review of the ...

Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials. BMJ ...

4.

cris.maastrichtuniversity.nl

cris.maastrichtuniversity.nl/files/104930096/Hendriks_2022_Exercise_in_lung_Cancer_the_healthcare.pdf

Results of the EORTC lung cancer Group (LCG) survey

A previous study reported that 46% of oncology care providers regularly promoted physical activity and 23% referred patients to an exercise ...

5.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC6854140/

Impact of Project ECHO Models of Medical Tele-Education

This systematic review examines the effectiveness of ECHO and ECHO-like medical tele-education models of healthcare delivery in terms of improved provider- and ...

6.

projectecho.unm.edu

projectecho.unm.edu/

Project ECHO: Home

The ECHO Model has been used around the world to support mentorship and training in health care, education, climate change and other social determinants of ...

7.

asecho.org

asecho.org/wp-content/uploads/2025/05/Echo-Magazine-April-2023-FNA_v2.pdf

Introducing the Training Guidelines for Interventional Echo

Recommended standards for the performance of transesophageal echocardiographic screening for structural heart intervention: from the Ameri- can ...

8.

journals.sagepub.com

journals.sagepub.com/doi/abs/10.1177/2373379917697066

Supporting Peer Learning Networks for Case-Based ...

Extension for Community Healthcare Outcomes (ECHO) is a model for professional training and support now being used widely in clinical health care.