Physical activity and health – the role of the physician
New
scientific research published in the Lancet has shown that
the adverse health impact of physical inactivity at the population
level is comparable to the one of smoking and obesity.
Non-communicable diseases such as cardiovascular disease, cancer
and diabetes represent a growing burden for primary care. Regular
physical activity is one of the cornerstones in the fight against
non-communicable diseases. A number of successful approaches to
physical activity promotion have been identified. The specific
role and potential of the physician in this context emerges
clearly both from international studies and from experiences in
Switzerland.
A whole range of approaches to physical activity promotion in
primary care has already been developed in Switzerland, with
documentation of effectiveness for several of them. However, none
of these approaches has been widely adopted by the medical
community. Therefore PAPRICA (Physical Activity Promotion in
Primary Care) has been developed in a multi-year and multi-partner
process including the Swiss College for Primary Care Medicine, the
Policlinique Médicale Universitaire in Lausanne, the Ligue
Vaudoise contre les Maladies Cardiovasculaires and the Institute
of Social and Preventive Medicine of the University of Zurich.
PAPRICA is based on international evidence as well as on
established approaches and tools, but it is streamlined to the
specific demands of primary care practices and has been
successfully tested in both the French speaking and the German
speaking part of Switzerland.
The PAPRICA approach
Inhabitants of Switzerland value their family physicians greatly
and appreciate it if they address their patients’ physical
activity behaviour. PAPRICA offers targeted continuing education
programmes for physicians, using the established Thursday
afternoon format. These training sessions provide background
knowledge, hands-on experience and counselling skills based on the
motivational interviewing technique which has been successfully
introduced also for other aspects of prevention and health
promotion in primary care. PAPRICA provides a manual for
physicians, a brochure for patients and additional counselling
support.
Physical Activity Promotion in Primary Care is most successful
when general counselling and strategies for behavioural change can
make a link to specific opportunities and offers for physical
activity. Through the unique access of physicians to individuals
of all backgrounds and interests, this integration also enables
local physical activity and sports promotion institutions to
extend their reach.
National implementation in Switzerland since October 2012
Since 2009 PAPRICA is implemented in the French speaking canton of
Vaud. In collaboration with the move>med Swiss Olympic Medical
Center at the Balgrist University Hospital in Zurich, the training
module has been adapted for the German speaking part of
Switzerland. Continuing education in PAPRICA is offered to
physicians in a growing number of cantons. The Swiss Society for
Sports Medicine had "Physical activity promotion in health care
settings" as the main topic of its annual congress in Interlaken
on 18 and 19 October 2012. Not only PAPRICA, but also experiences
from other European countries as well as the “Exercise is
Medicine” initiative of the American College of Sports Medicine
ACSM were presented, and the possibilities for collaboration and
exchange between medical societies and across national borders
were explored.
24.06.13
