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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 8: Physical Activity

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Strategy. Individual Counseling by Health Professionals

Approach. Promote physical activity counseling during well-child visits.

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Overview. Patient-centered, individual face-to-face counseling seems to be effective in positively influencing physical activity levels.1,2

Evidence. Moderate Evidence. Individual counseling by health professionals, including the use of physical activity prescriptions have shown to be effective. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. Access additional peer-reviewed evidence through the Cochrane Library. (Read more about understanding evidence ratings).

Target Audience. Children and adolescents.

Outcome. Increased level of physical activity. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. There are currently 1 ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Promote physical activity counseling during well-child visits,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

  • Number of children receiving physical activity counseling during well-child visits.

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

  • Percent of children receiving physical activity counseling during well-child visits.

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

  • Number of children receiving physical activity counseling during well-child visits who report increased physical activity during subsequent visit.

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

  • Percent of children receiving physical activity counseling during well-child visits who report increased physical activity during subsequent visit.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

Reference:

1 Videira-Silva, A., & Fonseca, H. (2017). The effect of a physical activity consultation on body mass index z-score of overweight adolescents: results from a pediatric outpatient obesity clinic. European journal of pediatrics, 176(5), 655-660

2 Proper, K. I., Hildebrandt, V. H., Van der Beek, A. J., Twisk, J. W., & Van Mechelen, W. (2003). Effect of individual counseling on physical activity fitness and health: a randomized controlled trial in a workplace setting. American Journal of Preventive Medicine, 24(3), 218-226.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.