What is the effect of a brief intervention to promote physical activity when delivered in a health care setting? A systematic review

Abstract

Issue AddressedWhat are the effects of a brief intervention to promote physical activity (PA) delivered in a health care setting other than primary care?MethodsMEDLINE, EMBASE, CINAHL and PsycINFO were used to identify randomised controlled trials which evaluated the effect of brief interventions to increase PA, delivered in a health care setting. Review outcomes included subjectively or objectively measured PA, adherence to prescribed interventions, adverse events, health‐related quality of life, self‐efficacy and stage of change in relation to PA. Where possible, clinically homogenous studies were combined in a meta‐analysis.ResultsTwenty‐five eligible papers were included. Brief counselling interventions were associated with increased PA compared to control, for both self‐reported PA (mean difference 34 minutes/week, 95% confidence intervals [95% CI] 9‐60 minutes), and pedometer (MD 1541 steps/day, 95% CI 433‐2649) at medium term follow up.ConclusionOur findings suggest that some brief interventions to increase PA, delivered in the health care setting, are effective at increasing PA in the medium term. There is limited evidence for the long‐term efficacy of such interventions. The wide variation in types of interventions makes it difficult to determine which intervention features optimize outcomes.So What?Brief counselling interventions delivered in a health care setting may support improved PA. Clinicians working in health care settings should consider the implementation of brief interventions to increase PA in vulnerable patient groups, including older adults and those with chronic illness.

Supporting home‐based meal preparation improves lunchtime habits and self‐assessed work performance of interns at a tertiary hospital

“…6 Furthermore, a recent review of published trials on the efficacy of a brief intervention promoting physical activity demonstrated sustained change at 12 months in three studies in the cardiac healthcare setting. 16 Limitations of our study include the small sample size of junior doctors, all of whom were undertaking internships at a single hospital. Interns were working in various departments, with those on busier terms likely less able to take meal breaks and having less time at home to prepare food.…”

“…A health promotion strategy at Liverpool Hospital, which included provision of a water bottle and cookbook, resulted in significant improvements in employees' fruit, vegetable and water consumption at 12 weeks 6 . Furthermore, a recent review of published trials on the efficacy of a brief intervention promoting physical activity demonstrated sustained change at 12 months in three studies in the cardiac healthcare setting 16 …”

Experiences, perceptions and attitudes on providing advice on physical activity to patients with chronic ischemic heart disease – A qualitative study in general practitioners in Germany

“…[11] More recent studies, focussing on brief interventions, show that brief advice on PA delivered by GPs can also enhance self-reported and measured PA levels of patients at least in the medium-term (up to six months). [12,13] Brief advice in these studies is characterised as de ned by the National Institute for Health and Care Excellence (NICE): It is offered opportunistically, includes the assessment of the PA level, brief advice on PA with negotiation or encouragement, with or without written support or follow-up. [5] A systematic review, focussing on studies with different approaches of PA advice (e.g., motivational interviewing), shows that there is no clear effect of PA advice on sedentary behaviour.…”

Optimising the treatment of chronic ischemic heart disease by training general practitioners to deliver very brief advice on physical activity (OptiCor): protocol of the systematic development and evaluation of a complex intervention

“…Studies that systematically focus on brief advice approaches as de ned by the National Institute for Health and Care Excellence (NICE (19), de nition see below), show that providing brief advice on PA can effectively enhance patients' PA level in the medium term (up to six months) (20,21). However, taken together, the evidence so far does not allow clear conclusions about the long-term effects of brief advice (13).…”