Evaluation of a physical activity promotion program in primary care.

BACKGROUND: Physical inactivity increases the risk of many chronic disorders. It is not clear which strategies are the most appropriate to enable people to adopt a more active lifestyle. Randomized controlled trials have found that brief advice from GPs supported by written material had a significant positive effect on patient's physical activity. The pilot project 'Move for Health and the Environment' translated this evidence into a program suitable for the real-life situation of busy practices. The aim of this study was to evaluate the change in physical activity level of the participating patients 1 year after the intervention. METHODS: Patients aged 16-65 years completed a screening questionnaire before consultation with their physician. Insufficiently active patients were offered an information leaflet and a voucher for a physical activity counselling session. One year later, all inactive patients and a random selection of the active were re-contacted and invited to answer identical questions. RESULTS: A total of 1239 (73.9%) returned the follow-up questionnaire. In all, 37.3% of the formerly inactive patients met the threshold of sufficient activity at follow-up, whereas 20.3% of the previously active no longer did. Formerly inactive patients reported an increase of 58.8 minutes/week of moderate and 34.6 minutes/week of vigorous activity and spending more time walking and cycling. Formerly active patients reported less time spent in moderate activities. CONCLUSIONS: Systematic counselling in primary care encouraged insufficiently active patients to adopt a more active lifestyle. Yet it became evident that active patients also need counselling to maintain their activity levels.

Patient and physician acceptance of a campaign approach to promoting physical activity: the "Move for Health" project.

QUESTIONS UNDER STUDY: Physical inactivity increases the risk of many chronic disorders. There is clear evidence that primary care-based interventions to promote physical activity may be effective under controlled research conditions. Yet little is known how this evidence translates into routine primary care practice. The pilot project "Move for Health" tested recruitment of family physicians for a primary prevention project and evaluated the feasibility of systematic assessment and discussion of patients' physical activity taking daily practice routine into account. METHOD: Patients aged 16-65 years completed a screening questionnaire during 8 two-week campaigns in 2004-5. Physicians evaluated and discussed questionnaire responses and offered a physical activity information leaflet and/or a voucher for a special physical activity counselling session to all inactive patients. Participating practices were interviewed to assess their experience of the project. RESULTS: 40 primary care physicians were motivated to participate. Recruitment was most effective through personal contacts of the project team's colleagues. 67% of the patients completed the screening questionnaire and 92% of these questionnaires were discussed during consultation. 83% of patients accepted the leaflet or the voucher, but only a minority of patients attended the special counselling session. With increasing age and readiness for behavioural change patients were more likely to attend the counselling session. CONCLUSIONS: A campaign approach consisting of systematic screening and brief counselling of insufficiently active patients in general practice is feasible. Participating practices considered the amount of work associated with the project to be manageable and 1-3 counselling campaigns per year to be feasible if the project runs for several years.