Systematic Review and Meta-Analysis of Primary Care-Based Physical Activity Interventions Among Older Adults.

The purpose of this research is to identify the effectiveness of primary care-based interventions designed to increase older adults' physical activity (PA). Primary care was defined as a patient's main source of health care. Standardized mean difference effect size (ES) was calculated related to changes in PA levels in adults' ≥65. Moderator analysis was performed to explore the relationship between participant characteristics, interventions, interventionists, and ES. Overall mean ES 0.27 (95% confidence interval [0.15, 0.39], p < .01) was calculated for 25 two-group comparisons involving 4,685 total participants with a mean age of 75.08. There was little evidence to support counseling over exercise referrals. The use of theory or a pedometer did not modify the ES. PA interventions delivered in primary care are effective and can be delivered by other health-care providers working with the primary provider. Many different behavior change strategies may be used to promote PA.

Practical implications for providing physical activity counseling for the older adult: An integrative review.

BACKGROUND: Physical inactivity in the older adult is associated with functional decline, increased fall risk, and threatens the ability of the older adult to live independently. Nurse practitioners, with their expertise in health promotion and chronic disease management, are well positioned to provide physical activity (PA) counseling. However, there is a gap in the literature describing a practical formula for providing PA counseling and PA prescriptions for clinical practice. OBJECTIVE: The objective of this integrative review was to synthesize the literature related to counseling interventions designed to increase PA among older adults and provide practical recommendations for incorporating recommendations into practice. DATA SOURCES: Five different databases were searched along with ancestry searching of relevant articles. Eligible studies tested methods of recommending PA for adults age ≥65 years, including in-person counseling, phone calls, written information, and exercise prescriptions. CONCLUSIONS: Health care providers are able to motivate older adults to increase PA in the short term. Diverse health care disciplines are efficacious at motivating older adults to increase PA. Various counseling interventions can be used with varying amounts of time investment. IMPLICATIONS FOR PRACTICE: Physical activity counseling is an underused but effective intervention for increasing PA in older adults. Older adults respond well to advice to increase their PA especially with the addition of a written exercise prescription. Basing PA counseling interventions on a theoretical construct such as social cognitive theory or transtheoretical stages of change theory improves the efficacy of the interventions.