Development and evaluation of very brief behaviour change interventions to reduce the risk of chronic disease in primary care

Aims and objectives: The programme aims to develop and evaluate very brief interventions to increase physical activity that could be delivered by a practice nurse in a vascular check or other primary care consultation.Background: The new vascular risk programme offers an ideal opportunity to deliver very brief physical activity interventions to a large proportion of the population aged 40-74. The rationale for very brief interventions is that they can be implemented on large scale so that a small effect could translate into a significant public health benefit. Physical inactivity is associated with a significant burden of chronic disease. The majority of 40-74 year olds do not meet the minimum recommended level of physical activity. Reviews suggest that brief physical activity interventions are promising, but work is needed to develop and test very brief interventions that could be delivered in 5 minutes. There have been few cost-effectiveness analyses of brief interventions.Research plans: Workstream 1 examines the existing evidence on the cost and effectiveness of very brief behaviour change interventions to increase physical activity. Workstream 2 uses qualitative methods to investigate how very brief interventions to increase physical activity can best be integated into routine clinical practice. In workstream 3, protocols, materials and training manuals will be developed and piloted and preliminary tests of efficacy carried out for the most promising brief interventions. In Workstream 4, we will conduct an explanatory trial to evaluate the best-bet intervention. Workstream 5 (economic modelling) underpins the whole programme.Research team: The team has internationally recognised expertise in a range of relevant disciplines: primary care, epidemiology, behavioural science, anthropology, statistics and health economics. Members of the team have collaborated closely for 10 years in the development and evaluation of behavioural interventions.Programme management: SS will direct the programme, assisted by WH. A Research Assistant will be responsible for day-to-day management. All members of the research team will form a Programme Management Group which will oversee the programme. Each workstream will have a designated Lead.Research environment: The General Practice and Primary Care Unit and the MRC Epidemiology Unit have long-established collaborations and are partners in the new UKCRC Centre for Diet and Activity Research which provides a supportive research environment for applied research on physical activity. UEA has internationally recognised strengths in health economics.Anticipated outputs relevant to the NHS: reviews of the effectiveness of brief interventions for physical activity; intervention protocols, materials and training manuals for the selected interventions; precise estimates of the cost and effectiveness of the best-bet brief intervention based on trial evidence; training for practice nurses in intervention delivery and participation in research; an economic model of the cost and effectiveness of very brief interventions to increase physical activity. .Patient and public involvement: The General Practice and Primary Care Research Unit has a strong tradition of PPI which we will bring to the proposed research through our PPI Lead, Sue Boase (named collaborator). Patients and members of the public will be involved throughout the programme, both as consultants and as collaborators.Justification for resources: The main component is staff costs. Significant "PI time" is requested for SS who will direct the programme and for SC who will lead the qualitative component. Smaller contributions requested for ALK, SG, MS and DC. Three co-applicants (WH, AP, EW) will be paid directly from the grant over the 60 month period. They will each be supported by one researcher. Other staff will be employed to work on specific workstreams, with Workstream 4 (the trial) requiring several staff.