Americans In Motion - Healthy Interventions

This research project brought together the American Academy of Family Physicians National Research Network (AAFP NRN) and the AAFP’s public health initiative, Americans In Motion (AIM). This project evaluated a practice improvement program to improve family physicians’ delivery of effective patient-centered behavior change interventions for “fitness” (physical activity, healthy eating and emotional well-being).

The practice improvement program aimed to position fitness in a central role as “the treatment of choice” when dealing with issues of prevention and treatment of chronic conditions. The project sought to shift the paradigm of family physicians’ use of common advice-giving methods to more effective patient-centered lifestyle counseling. The evaluation took place in 24 practices within the AAFP-NRN, Southeast Regional Clinicians' Network (SERCN), and LA Net.

The study consisted of a two-level randomized controlled trial. The first level of randomization was at the practice level, where one group was asked to create a healthy office environment and work on clinician, staff, and patient personal lifestyle changes, while the other was asked only to implement the program with patients. The second level of randomization occurred at the patient level to evaluate the effectiveness of feedback of two novel physiologic measures, Homeostatic Assay – Insulin Resistance (HOMA-IR) and Nuclear Molecular Resonance lipoprotein profiles (NMRLP), on self-reported diet, physical activity and emotional well-being. and on established physiologic measures of behavioral change.

The effectiveness of the intervention on patient-level behavioral change and additional physiologic measures of increased exercise and improved diet are evaluated for all research study patients at baseline, 4 months and 10 months.

Family physicians play a vital role in encouraging patients to lead healthy lives through physical activity, healthy eating, and emotional well-being. The AIM-HI approach focuses on facilitating a conversation between the physician and their patients.

This study was conducted from December 2006 through November 2010.

This project is complete. Please see below for findings and publications from the study.

Principal Investigator for this study is Dr. Wilson D. Pace, MD, Network Director, AAFP NRN.

For additional information on the study, please contact:

Brian K. Manning, MPH
Senior Research Associate
AAFP National Research Network
11400 Tomahawk Creek Parkway
Leawood, KS 66211
913-609-6000 x3179 (AAFP)
913-906-6099 (fax)
bmanning@aafp.org

View a listing of all the paper and poster presentations from the AIM-HI research project.

While many beneficial techniques were employed in the AIM-HI intervention study, preliminary findings indicate that, like the patients they care for, clinicians and staff are resistant to health behavior change. The effect of the AIM-HI intervention on patient care is still unknown, analysis is ongoing.

Access the complete manuscripts:

Use of the Americans in Motion-Healthy Interventions (AIM-HI) Intervention to Create a Culture of Fitness in the Family Practice. Erskine J, Lanigan AM, Emsermann CB, Manning BK, Staton EW, Pace WD.J AM Board Fam Med. 2012; 25(5): 694-700.
(7-page PDF file; About PDFs)

Encouraging Patients to Change Unhealthy Behaviors With Motivational Interviewing. Stewart EE, Fox C. Family Practice Management. 2011 May-June;18(3):21-25.
(5-page PDF file; About PDFs)

4 Strategies for Promoting Healthy Lifestyles in Your Practice. McAndrews JA, McMullen S, Wilson SL. Fam Pract Manag. 2011. Mar-Apr; 18(2) 16-20.
(5-page PDF file; About PDFs)

This project was funded by a grant from the Pepsico Foundation.