A systematic review of physical activity promotion in primary care office settings.

Abstract

Objective-To assess the eYcacy of physical activity promotion in primary care oYce settings. Design-Systematic review of clinical trials in which the eYcacy of physical activity promotion was investigated in a primary care oYce setting with at least one month of follow up. Subjects-A total of 13 981 adults, aged 17-85+, were included from 203 practices in eight trials assessing physical activity promotion in primary care oYce settings. Main outcome measures-Odds ratios and 95% confidence intervals were calculated comparing the number of participants who increased their physical activity or were active at follow up in the intervention group with a control group for each study. Results-Five of eight trials where positive with statistically significant results (range 0.91-6.56), but significant biases or limited clinical relevance of the outcomes were found in all trials. Short term trials of less than one year (four of four were positive), single-risk-factor trials (three of three were positive), randomised clinical trials (two of three were positive), and those assessing moderate levels of physical activity (three of four were positive) were most likely to find benefit. Only one of four trials lasting longer than a year were positive. Conclusion-There is limited evidence from well designed trials that oYce based physical activity promotion in primary care settings is eYcacious in promoting changes in physical activity that could conceivably have lasting clinical benefits. (Br J Sports Med 1998;32:11-16)

Are health care professionals advising adults with arthritis to become more physically active?

“…These results are similar to those obtained by others (13)(14)(15)(16)(17)(18). For example, using data from the 2000 National Health Interview Survey, Honda reported that being middle-aged, having a college degree or higher, and being obese were associated with a higher likelihood of receiving physician advice to exercise (13).…”

Clinical Counseling for Physical Activity: Translation of a Systematic Review Into Care Recommendations

“…Three systematic reviews on the efficacy of physician counseling, however, have called such suggestions into question. [30][31][32] The general consensus of these articles indicated that physician counseling outcomes tend to be modest and short-lived at best. Methodological shortcomings limited the validity of most trials, 32 but even large, wellconducted investigations have yielded mixed results.…”

“…37,38 Addressing the gamut of such factors for each patient during a brief office visit is likely impossible. 39 Consequently, as some researchers have suggested, 31,40 a multidisciplinary approach may be best, wherein providers raise the issue of physical activity in their sedentary patients and refer patients to a support system of allied health professionals that can provide ongoing counseling and follow-up as part of their diabetes education efforts.…”

Physical Activity as Primary Prevention to Address Cancer Disparities

“…Some found overall statistically significant (though modest) results, especially in the short term. 59,60 However, results from other reviews 61,62 were mixed and inconclusive when comparing interventions to usual-care controls. Qualities of successful interventions included multiple contacts with the health care team, behavioral approaches, supervised PA, equipment provision, and frequent patient follow-up.…”