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Targeting physical activity promotion in general practice: characteristics of inactive patients and willingness to change.

ABSTRACT: BACKGROUND: Counselling in routine general practice to promote physical activity (PA) is advocated, but inadequate evidence is available to support this intervention, and its sustainable implementation over time is difficult. OBJECTIVES: To describe the characteristics of physically inactive adults visiting GPs and the factors associated with their willingness to change PA. METHODS: A cross-sectional analysis of 4317 Spanish people aged 20-80 years, selected by systematic sampling among those attending 56 public primary health care practices identified as inactive by their GPs in 2003. PA (7-day PAR), PA stage of change, health-related quality of life (SF-36), cardiovascular risk factors, and social and demographic characteristics were measured. Multivariate mixed effects ordinal logistic models were adjusted to identify factors associated with motivational readiness to change. RESULTS: At least 70% (95% CI: 67.6% to 72.8%) of patients assessed by GPs did not achieve minimal PA recommendations. In addition, 85% (95% CI: 83% to 86.3%) had at least an additional cardiovascular risk factor. Only 30% (95% CI: 25.8% to 33.5%) were prepared for or attempting a change. A younger age; retirement or work at home; higher education and social class levels; obesity; and hypertension were associated with a higher motivational readiness to change (p < 0.05). CONCLUSION: The overburden that would result from counselling such a high proportion of inactive primary care patients justifies a targeted strategy for PA promotion in family practice. Selection of a target population based on readiness to change, the combination of risk factors and socio-demographic characteristics of patients is suggested in order to prioritise promotion efforts.

SUBMITTER: Grandes G

PROVIDER: S-EPMC2412873 | biostudies-literature | 2008

REPOSITORIES: biostudies-literature

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Targeting physical activity promotion in general practice: characteristics of inactive patients and willingness to change.

Grandes Gonzalo G Sánchez Alvaro A Sánchez Alvaro A Torcal Jesús J Sánchez-Pinilla Ricardo Ortega RO Lizarraga Kepa K Serra Javier J

BMC public health 20080522

<h4>Background</h4>Counselling in routine general practice to promote physical activity (PA) is advocated, but inadequate evidence is available to support this intervention, and its sustainable implementation over time is difficult.<h4>Objectives</h4>To describe the characteristics of physically inactive adults visiting GPs and the factors associated with their willingness to change PA.<h4>Methods</h4>A cross-sectional analysis of 4317 Spanish people aged 20-80 years, selected by systematic samp ...[more]

PMID: 18498623

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Project description:BackgroundLow levels of physical activity are associated with numerous adverse health outcomes, yet sedentary lifestyles are common among both children and adults. Physical activity levels tend to decline steeply among children aged between 8 and 12 years, even though children's behavioral patterns are largely governed by familial structures. Similarly, parents' activity levels have been generally reported as lower than those of nonparents of comparable age. For this reason, family-based physical activity promotion interventions are a potentially valuable and relatively underresearched method for mitigating physical activity declines as children develop into adolescents and for increasing physical activity in parents.ObjectiveThis study aims to assess the efficacy, feasibility, and acceptability of a novel theory-based web-based physical activity promotion intervention among parent-child dyads in Finland who do not meet physical activity recommendations at baseline.MethodsParticipants (target N=254) will be recruited from the general population using a panel company and advertisements on social media and randomly assigned to either an immediate intervention group or a waitlist control group. The intervention consists of 4 web-based group workshops over the course of 10 weeks, web-based tasks and resources, and a social support chat group. Data on physical activity behavior and constructs from the integrated behavior change model will be collected through self-report surveys assessing physical activity, autonomy support, autonomous motivation, attitude, subjective norm, perceived behavioral control, intention, self-monitoring, habit, and accelerometer measurements at baseline, post intervention, and 3 months post intervention. Exit interviews with participants will assess the feasibility and acceptability of the intervention procedures.ResultsThis study will reveal whether the intervention changes leisure-time physical activity among intervention participants relative to the control group and will examine the intervention's effects on important theoretical predictors of physical activity. It will also yield data that can be used to refine intervention materials and inform further implementation. Trial recruitment commenced in September 2023, and data collection should be completed by December 2024.ConclusionsThe planned intervention has potential implications for both theory and practice. Practically, the use of an entirely web-based intervention may have scalable future uses for improving physical activity in 2 key populations, while also potentially informing on the value of dyadic, family-based strategies for encouraging an active lifestyle as an alternative to strategies that target either parents or children independently. Further, by assessing change in psychological constructs alongside potential change in behavior, the intervention also allows for important tests of theory regarding which constructs are most linked to favorable behavior change outcomes.Trial registrationClinicalTrials.gov NCT06070038; https://clinicaltrials.gov/study/NCT06070038.International registered report identifier (irrid)DERR1-10.2196/55960.

Project description:Further research is needed to improve the evidence regarding determinants of physical activity (PA) as a crucial step to plan higher effective intervention strategies. The goal of the present study is to identify socio-demographic and clinical characteristics of primary care (PHC) insufficiently active patients that are associated with longitudinal changes in the level of physical activity.Longitudinal analysis of baseline socio-demographic and clinical predictors of physical activity change in insufficiently active PHC patients who participated in a PA-promoting multi-centre randomized clinical trial conducted from October 2003 through March 2006. The primary outcome measure was the self-reported physical activity assessed with the 7-day Physical Activity Recall (PAR), at baseline, 6, 12 and 24 months. Baseline covariates included sex, age, social class, anthropometric measures and other cardiovascular risk factors or associated diseases (Diabetes, HTA, tobacco use, etc.), and stage of readiness to change PA. Generalized linear mixed models were used to estimate longitudinal association of studied variables on PA change over the three follow-up measurements.A total of 3691 patients (85% of the 4317 recruited in the trial) with at least one follow-up measurement were included in the longitudinal analysis. At baseline, analysed patients (mean age: 50.6 years; 64.6% women) devoted 34.7 minutes and 2.36 metabolic equivalent hours per week (MET.h/week) to moderate and vigorous physical activity. Older age, male gender, higher social class, lower BMI, diagnosis of diabetes or hypertension, and measurement season were significant predictors of PA longitudinal change. The effect of baseline readiness to change on PA dose was modified by time, showing a positive gradient in favour of those with more readiness to change that increases significantly at 12 and 24 months (p-value interaction < .0001).Identified baseline characteristics such as readiness to change and risk factors can guide physicians to prioritize time and intervention efforts for maximizing their impact on insufficiently active PHC patients.

Project description:IntroductionCoronavirus disease (COVID-19) pandemic and the nationwide lockdown has increased sedentary time and physical inactivity. Physiotherapists are one of the essential health professionals who are actively involved in promoting physical activities. The study objectives included assessing knowledge of physical activity guidelines, physiotherapist attitude towards involvement in physical activities and practice of routine physical activity assessment, and its promotion among physiotherapists in India during COVID-19.MethodIn this cross-sectional survey study, the study tool was prepared using Google Forms. It consisted of sixteen questions on knowledge, attitude, and practice of physical activities among physiotherapists. Study participants were physiotherapists with a minimum of a bachelor's degree qualification and practicing in India.ResultsOne hundred and eighty responses were received from sixteen states of India. The average age of respondents was 28 years, and the average work experience of five years. This study found that only 19% of physiotherapists could give the correct answer in all three domains of WHO PA guidelines. 70% of physiotherapists found with an appropriate attitude as they met the 150 min of moderate PA per week. 68% reported that they promote physical activities in routine practice.ConclusionThis study suggested the majority of physiotherapists perform physical activity assessment and promotion in routine practice in India. Most of them have an appropriate attitude towards physical activity, but very few physiotherapists have adequate knowledge of WHO physical activity guidelines. Physiotherapists should actively promote physical activities in routine practice to reduce the impairment due to physical inactivity especially during the Corona virus disease pandemic in India. Efforts should be made to increase the physical activity awareness in terms of knowledge of WHO physical activity guidelines, different assessment, and promotion strategies.

Project description:BackgroundWe evaluate the effectiveness of a physical activity promotion programme carried out by general practitioners with inactive patients in routine care.Methods and findingsPragmatic, cluster randomised clinical trial conducted in eleven public primary care centres in Spain. Fifty-six general practitioners (GPs) were randomly assigned to intervention (29) or standard care (27) groups. They assessed the physical activity level of a systematic sample of patients in routine practice and recruited 4317 individuals (2248 intervention and 2069 control) who did not meet minimum physical activity recommendations. Intervention GPs provided advice to all patients and a physical activity prescription to the subgroup attending an additional appointment (30%). A third of these prescriptions were opportunistically repeated. Control GPs provided standard care. Primary outcome measure was the change in self-reported physical activity from baseline to six, 12 and 24 months. Secondary outcomes included cardiorespiratory fitness and health-related quality of life. A total of 3691 patients (85%) were included in the longitudinal analysis and overall trends over the whole 24 month follow-up were significantly better in the intervention group (p<0.01). The greatest differences with the control group were observed at six months (adjusted difference 1.7 MET*hr/wk [95% CI, 0.8 to 2.6], 25 min/wk [95% CI, 11.3 to 38.4], and a 5.3% higher percentage of patients meeting minimum recommendations [95% CI: 2.1% to 8.8%] NNT = 19). These differences were not statistically significant at 12 and 24 months. No differences were found in secondary outcomes. A significant difference was maintained until 24 months in the proportion of patients achieving minimum recommendation in the subgroup that received a repeat prescription (adjusted difference 10.2%, 95% CI 1.5% to 19.4%).ConclusionsGeneral practitioners are effective at increasing the level of physical activity among their inactive patients during the initial six-months of an intervention but this effect wears off at 12 and 24 months. Only in the subgroup of patients receiving repeat prescriptions of physical activity is the effect maintained in long-term.Trial registrationclinicaltrials.gov NCT00131079.

Project description:BackgroundGeneral practice is well situated to promote physical activity (PA), but with PA levels declining after 45 years of age, often those who are most likely to benefit from interventions tend to be the least likely recruited to participate in research.Aims and rationaleThe aim of this study was to investigate recruitment and reporting of participant demographics in PA trials for adults aged 45 years and above. Specific objectives were: (i) to examine the reporting of demographics of participants; (ii) to investigate the strategies used to recruit these participants; and, (iii) to examine the efficiency of recruitment strategies.MethodsSeven databases were searched, including: PubMed, CINAHL, the Cochrane Library Register of Controlled Trials, Embase, Scopus, PsycINFO, and Web of Science. Only randomized control trials involving adults 45 years old or older recruited through primary care were included. The PRISMA framework for systematic review was followed, which involved 2 researchers independently conducting title, abstract, and full article screening. Tools for data extraction and synthesis were adapted from previous work on inclusivity in recruitment.ResultsThe searches retrieved 3,491 studies of which 12 were included for review. Sample size of the studies ranged from 31 to 1,366, with a total of 6,042 participants of which 57% were female. Of 101 participating practices, 1 was reported as rural. Reporting of recruitment lacked detail-only 6 studies outlined how practices were recruited. 11/12 studies involved a database or chart review to identify participants that met the inclusion criteria, followed by a letter of invitation sent to those people. The studies with higher recruitment efficiency ratios each employed more than 1 recruitment strategy, e.g. opportunistic invitations and telephone calls.ConclusionThis systematic review has presented deficits in the reporting of both demographics and recruitment. Future research should aim for a standardized approach to reporting.

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Targeting physical activity promotion in general practice: characteristics of inactive patients and willingness to change.

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Targeting physical activity promotion in general practice: characteristics of inactive patients and willingness to change.

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