Professional Referral to Physical Activity, Sport and Exercise in older adults and adults with disability - PROPOSE study

Trial of Physiotherapy Telehealth Physical Activity Advisory Service (TEPP) What procedures 1)Assessment by the TEPP physiotherapist to identify the consumer’s current level of physical activity (PA) , level of impairments/medical issues, personal and social strengths, PA preferences and interests 2) Investigation and identification of suitable PA opportunities in the community and liaison with treating health professional 3) Development of a tailored PA plan developed in collaboration with the consumer to improve their PA and participation in community based structured exercise programs that includes goal setting. 4) Health coaching using motivational interviewing -all participants receive between two and six health coaching sessions over 3 months tailored to consumers’ needs and preferences (maximum sessions every 2 weeks for 20-30 minutes ). What materials -List of suitable PA opportunities- may include face to face and online options and depending on preferences group and individual options -A tailored PA plan Who provided -Initial assessment, investigation of suitable PA options and liaison with treating health professional conducted by a physiotherapist seconded to the study from Sydney Local Health District (SLHD). -Health coaching provided by a physiotherapist seconded to the study from SLHD who has clinical experience working with the study population and has completed training courses in health coaching and motivational interviewing through one of the following Wellness Coaching Australia; Health Change Australia and Medicoach as well as receiving skills training provided by other research physiotherapists in IMH in motivational interviewing. How -The initial physiotherapy assessment with the consumer will be conducted via telehealth (RPA virtual). -Investigation of suitable PA options by the TEPP physiotherapist will utilise internet searching, telephone/email discussions and visits with community- based PA providers -Liaison with treating health professional will be conducted by email or phone by the physiotherapist seconded to the TEPP service -The information about suitable PA options and the physical activity plan will be developed via telehealth appointments and then emailed/ mailed to participants. -The health coaching will be delivered via telehealth (RPA virtual). Where -The intervention will be delivered via telehealth through RPA virtual to consumers from the target groups (people aged 50+ and adults with a physical disability) attending outpatient/community- based services in Sydney LHD. -Participating services will include Physiotherapy Departments, Rheumatology Outpatients, Rehabilitation outpatients, Geriatric/Aged Care outpatients and clients of the Health Promotion Service in Sydney LHD. Health professionals Health professionals working in these participating outpatient services who are treating clients in the target groups will also be invited to participate in the trial. When and how much -The assessment will occur at the beginning of the intervention period and will last for ~ 1 hour delivered by telehealth. -Investigation of suitable PA options and liaison with the treating health professional will occur after the assessment and may take 5- 7 working days. -The development of the individual PA plan will occur via a second telehealth appointment lasting for approximately 30-60 minutes. -The physical activity plan and the PA options will be mailed (or emailed) after the development of the PA plan. -The initial health coaching will occur via telehealth after the development of the PA plan and will last for 20-30 minutes. Subsequent health coaching sessions will be provided at a tailored frequency and duration (maximum sessions provided approximately every 2 weeks for 20-30 min) for a total duration of 3 months. Tailoring The individually-tailored, person-centred approach will work collaboratively with each person to identify their needs, preferences, barriers and strengths impacting on physical activity and will include the development of physical activity recommendations for each individual. The intervention will link participants to existing community programs, with a focus on identifying activities that participants will enjoy and are accessible. Suitable options may include attendance at a group program, such as those indexed on the Active and Healthy website (https://www.activeandhealthy.nsw.gov.au/), and/or participation in sporting opportunities that cater for people with physical disabilities. Both face to face and online programs can be considered depending on preferences and COVID 19 restrictions. The number of health coaching sessions beyond the initial two sessions will be tailored to the needs and preferences of the individual consumer with a maximum of 4 additional sessions of 20-30 minutes every two weeks for 3 months. Strategies to monitor adherence to /fidelity of the intervention will include records of client participation in the essential intervention program components including the assessment session, PA plan development and health coaching sessions. Additional monitoring will include information on number and type of community based PA programs recommended to clients and records of liaison between TEPPS and the treating health professionals as well as community based PA service providers.