Advertisement

Advice on exercise from a family physician can help sedentary patients to become active

  • Fiona C Bull
    Correspondence
    Address correspondence to: Dr. Fiona Bull, Department of Public Health and Human Movement, The University of Western Australia, Nedlands Western Australia 6907
    Affiliations
    Department of Public Health and Human Movement, The University of Western Australia, Nedlands, Perth, Western Australia, 6907
    Search for articles by this author
  • Konrad Jamrozik
    Affiliations
    Department of Public Health and Human Movement, The University of Western Australia, Nedlands, Perth, Western Australia, 6907
    Search for articles by this author

      Abstract

      Objectives: To test the effectiveness, in the setting of primary health care, of verbal advice on exercise from a family physician (FP) combined with supporting written information.
      Design: A controlled trial with subjects allocated to a control group or one of two intervention groups using a balanced design based on day of the week.
      Setting: Ten general practices in Perth, Western Australia.
      Subjects: All sedentary patients consulting an FP.
      Intervention: Verbal advice on exercise from the FP and a pamphlet on exercise mailed to the patient’s home address within 2 days of his/her visit to the doctor.
      Main outcome measure: Level of physical activity at follow-up.
      Results: 6,351 adult patients attending an FP practice completed a screening questionnaire, and 763 sedentary adults were recruited to the project. The response to follow-up, via a postal survey at 1, 6, and 12 months after the index consultation was 70%, 60%, and 57%, respectively. At 1 month a subsample of the control and intervention subjects were contacted for a telephone interview to verify self-reported levels of activity (n = 136). Treating all nonresponders as sedentary, at 1 month significantly more subjects in the combined intervention groups reported doing some physical activity (40%) compared with the control group (31%). Similarly, at 6 months, 30% of the control group and 38% of the combined intervention groups were “now active.” There was very little change at follow-up at 12 months (31% control and 36% intervention groups, respectively).
      Conclusion: A simple intervention aimed at the promotion of physical activity to sedentary patients in general practice can help reduce inactivity.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Pate R.R
        • Pratt M
        • Blair S.N
        • et al.
        Physical activity and public health.
        JAMA. 1995; 273: 402-407
        • Blair S.N
        • Kohl H.W
        • Gordon N.F
        • Paffenbarger Jr, R.S
        How much physical activity is good for health?.
        Annu Rev Pub Health. 1992; 13: 99-126
        • Blair S.N
        • Connelly J.C
        How much physical activity should we do?.
        Res Q Exerc Sport. 1996; 67: 193-205
        • Powell K.E
        • Blair S.N
        The public health burdens of sedentary living habits.
        Med Sci Sports Exerc. 1994; 26: 851-856
      1. U.S. Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Atlanta, Georgia: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, The Presidents’ Council on Physical Fitness and Sports; 1996.

        • American College of Sports Medicine
        Position statement on the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults.
        Med Sci Sports Exerc. 1990; 22: 265-274
      2. Australian Sports Commission. Active Australia. Canberra, Australia: Australian Sports Commission; 1997.

      3. Cavill N. Promoting physical activity in England: a national campaign. National Physical Activity, Sport and Health Conference. Melbourne, Australia; March 1997.

      4. Risk Factor Prevalence Study Management Committee. Risk factor prevalence study: Survey no. 3, 1989. Canberra: National Heart Foundation of Australia and Australian Institute of Health; 1991.

      5. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey. Atlanta, Georgia: Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion; 1994.

      6. Activity and Health Research. Allied Dunbar national fitness survey. London: The Sports Council and the Health Education Authority; 1992.

        • Harris S.S
        • Caspersen C.J
        • DeFriese G.H
        • Estes E.H
        Physical activity for healthy adults.
        in: Golblum R.B Lawrence R.S Preventing disease beyond the rhetoric. Springer-Verlag, New York1990: 50-70
        • Biddle S.J
        • Fox K.R
        • Edmunds L
        Physical activity, promotion in primary health care in England. Health Education Authority, London1994
        • Hillsdon M
        • Thorogood M
        • Antiss T
        • Morris J
        Randomised controlled trials of physical activity promotion in free living populations.
        J Epidemiol Commun Health. 1995; 49: 448-453
        • Hillsdon M
        • Thorogood M
        A systematic review of physical activity promotion strategies.
        Br J Sports Med. 1996; 30: 84-89
        • Cupples M.E
        • McKnight A
        Randomised controlled trial of health promotion in general practice for patients at high cardiovascular risk [see comments].
        BMJ. 1994; 309: 993-996
        • Family Heart Study Group
        Randomised controlled trial evaluating cardiovascular screening and intervention in general practice.
        BMJ. 1994; 308: 313-320
        • Imperial Cancer Research Fund OXCHECK Study Group
        Effectiveness of health checks conducted by nurses in primary care.
        BMJ. 1994; 308: 308-312
        • Oldenburg B
        • Gomel M
        • Graham-Clarke P
        Cardiovascular risk reduction through lifestyle change in clinical settings.
        Ann Acad Med, Singapore. 1992; 21: 114-120
        • Logsdon D.N
        • Lazaro C.M
        • Meier R.V
        The feasibility of behavioral risk reduction in primary medical care.
        Am J Prev Med. 1989; 5: 249-256
        • Lewis B.S
        • Lynch W.D
        The effect of physician advice on exercise behavior.
        Prev Med. 1993; 22: 110-121
        • Calfas K.J
        • Long B.J
        • Sallis J.F
        • Wooten W.J
        • Pratt M
        • Patrick K
        A controlled trial of physician counseling to promote the adoption of physical activity.
        Prev Med. 1996; 25: 225-233
        • Calfas K.J
        • Sallis J.F
        • Oldenburg B
        • Ffrench M
        Mediators of change in physical activity following an intervention in primary care.
        Prev Med. 1997; 26: 297-304
        • Long B
        • Calfas K.J
        • Patrick K
        • et al.
        A multi-site field test of the acceptability of physical activity counseling in primary health care.
        Am J Prev Med. 1996; 12: 73-81
        • Swinburn B.A
        • Walter L.G
        • Arroll B
        • Tilyard M.W
        • Russell D.G
        The Green Prescription study.
        Am J Pub Health. 1998; 88: 288-291
        • Ashenden R
        • Silagy C
        • Weller D
        A systematic review of the effectiveness of promoting lifestyle change in general practice.
        Fam Pract. 1997; 14: 160-176
        • Booth M.L
        • Owen N
        • Bauman A.E
        • Gore C.J
        Retest reliability of recall measures of leisure-time physical activity in Australian adults.
        Int J Epidemiol. 1996; 25: 153-159
        • Marcus B.H
        • Simkin L.R
        The transtheoretical model.
        Med Sci Sports Exerc. 1994; 26: 1400-1404
        • Department of the Arts Sport the Environment and Territories
        Pilot survey of the fitness of Australians. Australian Government Publishing Service, Canberra1992
        • Lakka T.A
        • Kauhanen J
        • Salonen J.T
        Conditioning leisure time physical activity and cardiorespiratory fitness in sociodemographic groups of middle-ages men in eastern Finland.
        Int J Epidemiol. 1996; 25: 86-93
        • Lee I.M
        • Hsieh C.C
        • Paffenbarger Jr, R.S
        Exercise intensity and longevity in men.
        JAMA. 1995; 273: 1179-1184
        • Graham-Clarke P
        • Oldenburg B
        The effectiveness of a general-practice-based physical activity intervention on patients’ physical activity status.
        Behav Change. 1994; 11: 132-144
        • Dishman R.K
        Exercise adherence. Human Kinetics, Champaign, IL1988
        • Shephard R
        Motivation.
        Physician Sports Med. 1985; 13: 88-100
        • Snyder E
        • Speitzer E
        Patterns of adherence to a physical conditioning program.
        Social Sport J. 1984; 1: 103-116
        • Wankel L.M
        • Yardley J.K
        • Graham J
        The effects of motivational interventions upon the exercise adherence of high and low self-motivated adults.
        Can J Appl Sport Sci. 1985; 10: 147-156
        • Oldridge N
        • Streiner D
        The health belief model.
        Med Sci Sports Exerc. 1990; 22: 679-683
        • Wallace P.G
        • Brennan P.J
        • Haines A.P
        Are general practitioners doing enough to promote healthy lifestyle?.
        Br Med J Clin Res Ed. 1987; 294: 940-942
      7. King A, Sallis JF, Dunn AL, et al. Promoting physical activity in primary health care settings: rationale and methods of the Activity Counseling Trial (ACT). Med Sci Sports Exerc (in press).

      8. U.S. Public Health Service. Healthy people 2000: National health promotion and disease prevention objectives. Washington, DC; 1991.

        • Bull F.C
        • Schipper E.C
        • Jamrozik K
        • Blanksby B.A
        Beliefs and behaviour of general practitioners regarding promotion of physical activity.
        Aust J Pub Health. 1995; 19: 300-304
        • Bull F.C
        • Schipper E.C
        • Jamrozik K
        • Blanksby B.A
        How can and do general practitioners promote physical activity.
        Prev Med. 1997; 26: 866-873
        • Bauman A
        • Mant A
        • Middleton L
        • Mackertich M
        • Jane E
        Do general practitioners promote health?.
        Med J Aust. 1989; 151: 262-269
        • Orleans C.T
        • George L.K
        • Houpt J.L
        • Brodie K
        • H
        Health promotion in primary care.
        Prev Med. 1985; 14: 636-647