Physical Activity Counselling Toolkit
The toolkit includes handouts for practitioners to use when counselling clients on starting and maintaining a physically active lifestyle. The 10 handouts focus on different physical activity topics. They are translated into five languages, and a set was tailored for Northern populations and French Northern populations in partnership with the Government of the Northwest Territories.
Using the Resources for Counselling
Practitioners: here are a few tips to keep in mind when using the toolkit:
- Each resource in the toolkit has been designed to help facilitate the physical activity counselling process.
- Practitioners should use these resources in conjunction with other approaches and techniques used for physical activity counselling.
- These resources are not designed for clients to use on their own. Rather, a practitioner should meet with a client to review and discuss the content of each resource being used.
- The resources are also available in French, Punjabi, Spanish, Chinese, and Korean for those clients who may have limited knowledge of English. In addition, a set is tailored for Northern populations and French Northern populations, in partnership with the Government of the Northwest Territories.
About the Project
The resources that have been developed for the Physical Activity Counselling Toolkit are written in plain language and are intended to widen the choice of resources available to practitioners. We hope that practitioners will find some or all of the resources to be of practical, day-to-day assistance when working with clients.
Identifying the Need
Before this project began, the Centre had been approached by and spoke with a wide range of practitioners (e.g., exercise physiologists and others) over a significant period of time. Collectively, the practitioners clearly identified am increasing need for appropriate resources or tools that would help them with physical activity counselling, especially in health care settings.
Some examples of the key problems that practitioners encountered include:
- many available resources are not evidence- or behavior-based;
- many available resources are not suitable for different audiences (e.g., for people with chronic conditions) or do not have appropriate content or messaging;
- many (or most) resources are not written in plain language (for easier readability by the public, and by people with low literacy or whose first language is not English); and
- most resources are not written in other languages.
The lack of appropriate (or quality) resources is a problem shared by many practitioners who play a direct role in promoting physical activity. Although practitioners do have access to quality resources such as the Canadian Physical Activity Guidelines, such resources may not be the most appropriate tool for different clients.
Developing the Resources
Each resource in the toolkit:
- reflects the current literature and research;
- has a focus towards behaviour change (not just an educational focus);
- is written in plain language;
- is formatted to ensure high standards of readability are met; and
- meets the needs of practitioners working with clients who have a chronic condition(s) or are at risk of developing a chronic condition(s).
During the development process, each resource was evaluated to improve the readability and suitability for the general public. In addition, the resources were field-tested and evaluated by practitioners and their clients, throughout the province.
Each resource has been reviewed and endorsed by the Alberta Provincial Fitness Unit.
The Alberta Centre for Active Living led the development of resources included in the toolkit. An advisory committee of Alberta-based practitioners provided guidance, helpful inputs and expertise.
- Angela Torry, Project Coordinator and Content Developer
- Don Buchanan, Editor
- Betty Lee, Graphic Design
Advisory Committee members
- Marni Armstrong - Exercise Physiologist, PhD candidate, University of Calgary
- Nancy Becker Hallford - Health Literacy Consultant, Chronic Disease Management, Alberta Health Services
- Taniya Birbeck - Exercise Specialist, Chronic Disease Management, Alberta Health Services
- Steven Cheetham - Exercise Specialist, Edmonton North Primary Care Network
- Judith Down - Director, Alberta Centre for Active Living
- Katherine MacKeigan - Director, Provincial Fitness Unit of Alberta
- Janice Patterson - Active Living Specialist, Health Promotion, Disease & Injury Prevention, Population & Public Health, Alberta Health Services
- Dr. Ron Sigal – Associate Professor, Departments of Medicine, Cardiac Sciences and Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary
- Dr. Lorian Taylor - Dietitian, PhD (health literacy expert)
- Lisa Workman - Kinesiologist/Exercise Specialist, Edmonton Oliver Primary Care Network
The Alberta Centre for Active Living thanks the advisory committee members for their hard work, dedication and involvement in this project. As well, thanks to the practitioners and their clients who participated in evaluating the resources. Thanks also to the Alberta Sport, Recreation, Parks & Wildlife Foundation and the Government of Alberta for funding of this project.
References and Useful Links
For each Toolkit resource, we have provided references and useful links.
Behaviour Change resources:
1. Taking the first step: deciding to be physically active
This resource is partly based on the following helpful reference:
- Miller, W.R. & Rollnick, S. (2002). Motivational Interviewing: Preparing People for Change, 2nd edition. New York, NY: Guilford Press
Other references and useful links:
- Motivational Interviewing
- Rollnick, S., Butler, C.C., Kinnersley, P., Gregory, J. & Mash, B. (2010). Motivational Interviewing. Behavioral Medicine Journal, 340, c1900. doi: 10.1136/bmj.c1900
2. Making a physical activity plan
This resource may work well with Setting goals for physical activity.
Other references and useful links:
3. Setting goals for physical activity
This resource uses the popular and commonly-used “SMART” goal setting principles. This resource may work well with Making a physical activity plan.
4. What stops you from being physically active?
Chronic Conditions resources:
1. Benefits of physical activity
Please note: This resource was written for those who are at risk or currently have a chronic disease.
2. Physical activity and your blood pressure; High blood pressure: how to stay active when active
References and useful links:
- Pescatello, L.S., Franklin, B. A., Fagard, R.M.D., Farquhar, W.B., Kelley, G.A., & Ray, C. A. (2004). American College of Sports Medicine Position Stand: Exercise and hypertension. Medicine and Science in Sport and Exercise, 36, 533-553. Retrieved from http://journals.lww.com/acsm-msse/Fulltext/2004/03000/Exercise_and_Hypertension.25.aspx
- Warburton, D.E.R., Katzmarzyk, P.T., Rhodes, R.E., & Shephard, R.J. (2007). Evidence-informed physical activity guidelines for Canadian adults. Applied Physiology, Nutrition and Metabolism, 32 (suppl.2E), S16-S68. doi:10.1139/H07-123
- Leon, A.S., Franklin, B.A., Costa, F., Balady, G.J., Berra, K.A., … Lauer, M.S. (2005). Cardiac Rehabilitation and Secondary Prevention of Coronary Heart Disease: An American Heart Association Scientific Statement From the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in Collaboration with the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation, 111, 369-376. doi: 10.1161/01.CIR.0000151788.08740.5C
- Kokkinos, P.F., Gianneloi, A., Manolis, A., & Pittaras, A. (2009). Physical Activity in the Prevention and Management of High Blood Pressure. Hellenic Journal of Cardiology, 50, 52-59. Retrieved from http://www.hellenicjcardiol.com/archive/full_text/2009/1/2009_1_52.pdf.
- Heart and Stroke Foundation of Canada: My Blood Pressure Action Plan; Get Your Blood Pressure Under Control; Public Recommendations: Hypertension.
3. Physical activity and type 2 diabetes; Diabetes: how to stay safe when active
References and useful links:
- Hayes, C. & Krisk, A. (2008). Role of Physical Activity in Diabetes Management and Prevention. Journal of American Dietetic Association, 108, S19-S23. doi:10.1016/j.jada.2008.01.016
- Sigal, R.J., Wasserman, D.H., Kenny, G.P., & Castaneda-Sceppa, C. (2004). Physical Activity/Exercise and Type 2 diabetes. Diabetes Care, 27, 2518-2539. doi:10.2337/dc06-9910
- American College of Sports Medicine and the American Diabetes Association. (2010). Exercise and Type 2 Diabetes: Joint Position Statement. Medicine & Science in Sports & Exercise, 42, 2282-2303. doi:10.1249/MSS.0b013e3181eeb61c
- Canadian Diabetes Association: Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada (2008).
- Canadian Diabetes Association, general information to share with clients: Diabetes and You
- American Diabetes Association: Fitness resources.
4. Healthy weight and physical activity
References and useful links:
- Donnelly, J.E., Blair, S.N., Jakicic, J.M., Manore, M.M., Rankin, J.W., & Smith B.K. (2009). Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults (Special Communications, Position Stand). Medicine & Science in Sports & Exercise, 41, 459-471. doi: 10.1249/MSS.0b013e3181949333
- Jakicic, J.M. (2009). The Effect of Physical Activity on Body Weight. Obesity, 17, S34–S38. doi:10.1038/oby.2009.386
- Freedhoff, Y., Sharma, A.M. (2010). Best weight: A practical guide to office-based obesity management. Retrieved from http://www.obesitynetwork.ca/best-weight
- Lau, D.C.W. (2007). Synopsis of the 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children. Canadian Medical Association Journal, 176. doi:10.1503/cmaj.070306
- Canadian Obesity Network: A selection of helpful resources.
The following references were helpful in the development of all the Toolkit resources.
Physical Activity Counselling
- Peterson, J.A. (2007). Get moving! Physical activity counseling in primary care Journal of the American Academy of Nurse Practitioners, 19, 349–357. doi: 10.1111/j.1745-7599.2007.00239.x
- Rejeski, W. J., Brawley, L.R., Ambrosius, W.T., Brubaker, P. H., Focht, B.C., Foy, C.G., & Fox, D. (2003). Older adults with chronic disease: Benefits of group-mediated counseling in the promotion of physically active lifestyles. Health Psychology, 22, 414-423. doi: 10.1037/0278-6184.108.40.2064
- Rollnick, S., Butler, C.C., McCambridge, J., Kinnersley, P., Elwyn, G., & Resnicow, K. (2005) Consultations about changing behavior. Behavioral Medicine Journal, 331, 961. doi: 10.1136/bmj.331.7522.961
Patient Education and Health Literacy
- Vallence, J.K., Taylor, L.M., & Lavallee, C. (2008). Suitability and readability assessment of educational print resources related to physical activity: Implications and recommendations for practice. Patient Education and Counseling, 72, 342–349. doi: 10.1016/j.pec.2008.03.010
- Doak, C.C., Doak, L.G., & Root, J.H. (1996) Teaching Patients with Low Literacy Skills, 2nd edition. Philadelphia: J.B. Lippincott Company.
- Rudd, R.E., Kaphingst, K., Colton, T., Gregoire, J., & Hyde, J. (2004). Rewriting Public Health Information in Plain Language. Journal of Health Communication, 9, 195-206. doi: 10.1080/10810730490447039
- Centers for Disease Control and Prevention. (2011). Simply Put: A guide for creating easy to understand materials. Retrieved from http://www.cdc.gov/healthliteracy/pdf/Simply_Put.pdf.
- Alberta Centre for Active Living. (2007). Literacy and Health: Implications for Active Living, WellSpring, 18.
- U.S. Department of Health and Human Services. (2011). Plain Language: A Promising Strategy for Clearly Communicating Health Information and Improving Health Literacy Retrieved from