Physical activity referral (PAR) schemes or concepts occur in varying forms. Because few physical activity intervention studies have been carried out in routine health care settings, it is difficult to translate research findings into daily practice. The aim of this study was to analyze the effectiveness of a PAR scheme implemented in routine primary health care. The study did not include a control group and was based on the ordinary staff's work efforts and follow-up measures. During a 2-year period, 6300 PARs were issued. Effectiveness was measured by an increase in self-reported physical activity. Half of the patients reached reported increased physical activity both at 3 months (49%) and at 12 months (52%). The proportion of inactive patients decreased from 33% at baseline to 17% at 3 months and 20% at 12 months. The proportion of patients who were physically active on a regular basis increased from 22% at baseline to 33% at 3 months and 32% at 12 months. Neither the patient's age nor the profession of the prescriber was associated with differences in effectiveness. The patient's activity level at baseline, the type of physical activity as well as the reason for the prescription were associated with increased physical activity.A physically active life promotes both physical and mental health and increases quality of life, well-being, and functional independence (U.S. Department of Health and Human Services, 1996; Department of Health and Ageing, 1999; The Swedish National Institute of Public Health & Yrkesföreningar för fysisk aktivitet, 2003; Department of Health, 2004;Pedersen & Saltin, 2006). Today's guidelines for physical activity state that adults should accumulate at least 30 min of moderate-intensity physical activity on at least 5 days a week (The Swedish National Institute of Public Health & Yrkesföreningar för fysisk aktivitet, 2003;Haskell et al., 2007). However, approximately 60% of the adult populations in the world today do not reach this recommended level (World Health Organisation, 2002). The health care system, particularly primary health care (PHC), is in a strategic position for promoting population health (The National Public Health Committe, 2000;Whitlock et al., 2002), as approximately 70% of the Swedish population consults PHC each year (The National Board of Health and Welfare, 2004). By broadening its base to encompass behavioral risk factors and behaviors, including physical inactivity, PHC could potentially prevent a considerable amount of mortality, morbidity, and disability before serious health problems develop (Babor et al., 2004).PHC-based interventions aimed at increased physical activity of individuals, groups, and populations have gained interest during the last decade (Elley et al., 2003;Harrison et al., 2005a;Morgan, 2005;Sorensen et al., 2006). However, the literature shows mixed results on the effectiveness of different types of health care-based interventions to increase patients' levels of physical activity (Hillsdon et al., 2005;Morgan, 2005; National Inst...

SEPI appears to be a stable instrument with an overall acceptable validity and reliability, applicable for use in populations exposed to different UVR environments, in order to evaluate individual sun exposure and protection.

BackgroundWritten prescriptions of physical activity have increased in popularity. Such schemes have mostly been evaluated in terms of efficacy in clinical trials. This study reports on a physical activity prescription referral scheme implemented in routine primary health care (PHC) in Sweden. The aim of this study was to evaluate patients' self-reported adherence to physical activity prescriptions at 3 and 12 months and to analyse different characteristics associated with adherence to these prescriptions.MethodsProspective prescription data were obtained for the general population in 37 of 42 PHC centres in Östergötland County, during 2004. The study population consisted of 3300.ResultsThe average adherence rate to the prescribed activity was 56% at 3 months and 50% at 12 months. In the multiple logistic regression models, higher adherence was associated with higher activity level at baseline and with prescriptions including home-based activities.ConclusionsPrescription from ordinary PHC staff yielded adherence in half of the patients in this PAR scheme follow-up.

The majority of the respondents on long-term sickness absence have had positive interactions with healthcare and social insurance. More research is required to determine the impact that such experiences might have on return to work, and how such interactions might be promoted.

Objective . To analyse patients ' self-reported reasons for not adhering to physical activity referrals (PARs). Design and setting . Data on 1358 patients who did not adhere to PARs were collected at 38 primary health care (PHC) centres in Sweden. Intervention . PHC providers issued formal physical activity prescriptions for home-based activities or referrals for facilitybased activities. Subjects . Ordinary PHC patients whom regular staff believed would benefi t from increased physical activity. Main outcome measure: Reasons for non-adherence to PARs: " sickness " , " pain " , " low motivation " , " no time " , " economic factors " , and " other " . Results . Sickness and pain were the most common motives for non-adherence among older patients. The youngest patients blamed economic factors and lack of time more frequently than those in the oldest age group. Economic factors was a more common reason for non-adherence among those referred for facility-based activities compared with those prescribed home-based activities. Low motivation was a more frequent cause of non-adherence among those prescribed home-based activities compared with those referred for facility-based activities. Furthermore, lack of time was a more common reason for non-adherence among patients issued with PARs due to high blood pressure than other patients, while low motivation was a more common reason among patients issued with PARs because of a BMI of Ͼ 25. Conclusion . The reasons for non-adherence differ between patients prescribed home-based activities and referred for facility-based activities, as well as between patients with different specifi c characteristics. The information obtained may be valuable not only for the professionals working in PHC, but also for those who work to develop PARs for use in different contexts.