Physical Activity Promotion Through Primary Care

Estabrooks, Paul A.; Glasgow, Russell E.; Dzewaltowski, David A.

doi:10.1001/jama.289.22.2913

Cited by 143 publications

(126 citation statements)

References 43 publications

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“…12,20,21 Further research is necessary to evaluate the success of using written health materials in conjunction with brief provider interventions to assist patients in making sustained behavior change. …”

Section: Discussionmentioning

confidence: 99%

Facilitating Behavior Change With Low-literacy Patient Education Materials

Seligman¹,

Wallace²,

DeWalt³

et al. 2007

am j health behav

103

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Objective-To describe a process for developing low-literacy health education materials that increase knowledge and activate patients toward healthier behaviors.Methods-We developed a theoretically informed process for developing educational materials. This process included convening a multidisciplinary creative team, soliciting stakeholder input, identifying key concepts to be communicated, mapping concepts to a behavioral theory, creating a supporting behavioral intervention, designing and refining materials, and assessing efficacy.Results-We describe the use of this process to develop a diabetes self-management guide.

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Section: Discussionmentioning

confidence: 99%

Facilitating Behavior Change With Low-literacy Patient Education Materials

Seligman¹,

Wallace²,

DeWalt³

et al. 2007

am j health behav

103

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“…Most health professionals understand the value of exercise (8). However, counseling older adults about how to increase physical activity is challenging in general (9), and becomes particularly complex when arthritis pain becomes a barrier to vigorous exercise.…”

Section: Introductionmentioning

confidence: 99%

Effect of physical activity on functional status among older middle‐age adults with arthritis

Feinglass¹,

Thompson²,

He³

et al. 2005

Arthritis & Rheumatism

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Objective. To determine the effect of leisure time and work-related physical activity on changes in physical functioning among 3,554 nationally representative survey respondents, ages 53-63 years in 1994, with arthritis and joint symptoms, interviewed in the Health and Retirement Study (HRS). Methods. In 1992-1994, light and vigorous exercise items were empirically categorized into recommended, insufficient, and inactive leisure time physical activity levels using data from the HRS. Leisure and work-related physical activity levels in 1994 were used to predict 1996 functional decline or improvement, controlling for baseline functional difficulties, health status, sociodemographic characteristics, and behavioral risk factors. Results. Whereas 29.7% of respondents reported functional declines in 1996, 38.6% of those with baseline difficulties in 1994 reported improvement. Compared with inactive respondents, recommended and insufficient leisure time physical activity were equally protective against functional decline (odds ratio [OR] 0.59 and 0.62, respectively; P < 0.0001). Higher levels of physical activity were also modestly associated with functional improvement among respondents with baseline functional difficulties (OR 1.47, P ‫؍‬ 0.05 and OR 1.45, P ‫؍‬ 0.01, respectively). Work-related physical activity was not a significant predictor of decline or improvement. Conclusion. Given the high prevalence of arthritis, even modest increases in rates of lifestyle physical activity among older adults could make a substantial contribution to disability-free life expectancy.

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“…Conversely, physical inactivity is one of the primary behavioral causes of death in the USA [2] and contributes to the 483.8 billion dollars spent each year for the management and treatment of cardiovascular diseases and diabetes [3]. Unfortunately, less than half of the adult population is active at a recommended level [4] of moderate intensity for at least 30 min/day, 5 days or more per week [5]. While interventions (programs, policy, and practice) exist that aim to increase physical activity, there is a lack of translation of effective evidence-based programs into practice [6].…”

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confidence: 99%

“…In practice, activities are often driven by contextual factors related to organizational mission, resource availability, and the needs of the community or patient population targeted for health improvement [13]. Hence, researchers develop programs with the intent that evidence-based practice will eventually occur while the practitioners often perceive a lack of fit between the evidence-based programs and their organizational structure, values, and culture [4].…”

mentioning

confidence: 99%

“…The integration of research and community health professionals has the ability to address and overcome each of these obstacles and is proposed to speed the translation of evidence-based principles within typical practice. The benefit of an integrated approach to program development is that evidence from both research and practice environments are considered to determine effectiveness for behavior change (i.e., research evidence) and the fit of programs within the delivery system (i.e., evidence from within the system regarding mission, values, and resources) [4]. Thus, programs developed using integrated processes are thought to be more likely to be adopted in practice settings [16].…”

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confidence: 99%

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Improving physical activity program adoption using integrated research-practice partnerships: an effectiveness-implementation trial

Harden

Johnson

Almeida

et al. 2016

Behav. Med. Pract. Policy Res.

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Integrated research-practice partnerships (IRPPs) may improve adoption of evidence-based programs. The aim of this study is to compare adoption of an IRPP-developed physical activity (PA) program (Fit Extension, FitEx) to a typical efficacy-effectiveness-dissemination pipeline model program (Active Living Every Day, ALED). Guided by the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework, a randomized controlled trial assigned health educators (HEs) to FitEx (n = 18) or ALED (n = 18). Fourteen HEs adopted FitEx, while two HEs adopted ALED (χ 2 = 21.8; p < 0.05). FitEx HEs took less time to deliver (p < 0.05), stated greater intentions for continued program delivery (p < 0.05), and reached more participants (n = 1097 total; 83 % female; 70 % Caucasian; M age = 44 ± 11.8) per HE than ALED (n = 27 total; 60 % female; 50 % Caucasian; M age = 41 ± 11.3). No significant difference existed in FitEx or ALED participants' increased PA (M increase = 9.12 ±29.09 min/ day; p > 0.05). IRPP-developed programs may improve PA program adoption, implementation, and maintenance and may also result in programs that have higher reach-without reducing effectiveness. KeywordsTranslation, Physical activity, RE-AIM, Researchpractice Regular physical activity plays an important role in the prevention, onset, and management of many adverse chronic health conditions [1]. Conversely, physical inactivity is one of the primary behavioral causes of death in the USA [2] and contributes to the 483.8 billion dollars spent each year for the management and treatment of cardiovascular diseases and diabetes [3]. Unfortunately, less than half of the adult population is active at a recommended level [4] of moderate intensity for at least 30 min/day, 5 days or more per week [5]. While interventions (programs, policy, and practice) exist that aim to increase physical activity, there is a lack of translation of effective evidence-based programs into practice [6].Reasons for this lack of translation are related to both research and practice. First, using research reporting guidelines that are predominantly focused on internal validity (e.g., CONSORT Statement [7]) results in a body of literature that values the strong internal validity but attributes only a passing focus on issues of external validity [8]. In fact, a series of reviews of intervention studies published in leading journals that targeted physical activity (as well as nutrition and smoking) bears this out, showing that external validity (e.g., participant's representativeness, organizational adoption, and program sustainability) was rarely reported [9][10][11]. Second, a linear (or top down) model of dissemination, which highlights the researcher as the expert and developer of products, and the delivery system as a simple receptor of evidence-based programs are a common depiction of translation of research to practice [12]. A linear model has a number of drawbacks for translation of research to practice: (1) it fails to address the organizational and community ca...

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Physical Activity Promotion Through Primary Care

Cited by 143 publications

References 43 publications

Facilitating Behavior Change With Low-literacy Patient Education Materials

Facilitating Behavior Change With Low-literacy Patient Education Materials

Effect of physical activity on functional status among older middle‐age adults with arthritis

Improving physical activity program adoption using integrated research-practice partnerships: an effectiveness-implementation trial

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