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BMC Public Health
Published in: BMC Public Health 1/2008

Open Access 01-12-2008 | Research article

Targeting physical activity promotion in general practice: Characteristics of inactive patients and willingness to change

Authors: Gonzalo Grandes, Alvaro Sánchez, Jesús Torcal, Ricardo Ortega Sánchez-Pinilla, Kepa Lizarraga, Javier Serra, The PEPAF Group

Published in: BMC Public Health | Issue 1/2008

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Abstract

Background

Counselling in routine general practice to promote physical activity (PA) is advocated, but inadequate evidence is available to support this intervention, and its sustainable implementation over time is difficult.

Objectives

To describe the characteristics of physically inactive adults visiting GPs and the factors associated with their willingness to change PA.

Methods

A cross-sectional analysis of 4317 Spanish people aged 20–80 years, selected by systematic sampling among those attending 56 public primary health care practices identified as inactive by their GPs in 2003. PA (7-day PAR), PA stage of change, health-related quality of life (SF-36), cardiovascular risk factors, and social and demographic characteristics were measured. Multivariate mixed effects ordinal logistic models were adjusted to identify factors associated with motivational readiness to change.

Results

At least 70% (95% CI: 67.6% to 72.8%) of patients assessed by GPs did not achieve minimal PA recommendations. In addition, 85% (95% CI: 83% to 86.3%) had at least an additional cardiovascular risk factor. Only 30% (95% CI: 25.8% to 33.5%) were prepared for or attempting a change. A younger age; retirement or work at home; higher education and social class levels; obesity; and hypertension were associated with a higher motivational readiness to change (p < 0.05).

Conclusion

The overburden that would result from counselling such a high proportion of inactive primary care patients justifies a targeted strategy for PA promotion in family practice. Selection of a target population based on readiness to change, the combination of risk factors and socio-demographic characteristics of patients is suggested in order to prioritise promotion efforts.
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Literature
1.
U. S. Department of Health and Human Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion: Physical Activity and Health: a report of the Surgeon General. Atlanta, GA. 1996
2.
Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007, 39: 1423-1434. 10.1249/mss.0b013e3180616b27.CrossRefPubMed
3.
Martínez-González MA, Varo JJ, Santos JL, De Irala J, Gibney M, Kearney J, Martínez JA: Prevalence of physical activity during leisure time in the European Union. Med Sci Sports Exerc. 2001, 33 (7): 1142-1146.CrossRefPubMed
4.
Centers for Disease Control and Prevention (CDC): Surveillance of certain health behaviors among states and selected local areas-United States, 2005. MMWR Surveill Summ. 2007, 56 (4): 1-160.
5.
van Sluijs EM, van Poppel MN, Stalman WA, van Mechelen W: Feasibility and acceptability of a physical activity promotion programme in general practice. Fam Pract. 2004, 21: 429-436. 10.1093/fampra/cmh414.CrossRefPubMed
6.
National Institute for Health and Clinical Excellence: Four commonly used methods to increase physical activity: brief interventions in primary care, exercise referral schemes, pedometers and community-based exercise programmes for walking and cycling. 2006, London: National Institute for Health and Clinical Excelence, (Accessed 25 Sep 2006)., [http://​www.​nice.​org.​uk/​PHI002]
7.
Tulloch H, Fortier M, Hogg W: Physical activity counseling in primary care: Who has and who should be counseling?. Patient Educ Couns. 2006, 64: 6-20. 10.1016/j.pec.2005.10.010.CrossRefPubMed
8.
Eden KB, Orleans CT, Mulrow CD, Pender NJ, Teutsch SM: Does counseling by clinicians improve physical activity? A summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002, 137: 208-215.CrossRefPubMed
9.
Smith BJ: Promotion of physical activity in primary health care: update of the evidence on interventions. J Sci Med Sport. 2004, 7 (1 Suppl): 67-73. 10.1016/S1440-2440(04)80280-9.CrossRefPubMed
10.
Foster C, Hillsdon M, Thorogood M: Interventions for promoting physical activity. Cochrane Database of Systematic Reviews. 2008, 1:
11.
King AC, Stokols D, Talen E, Brassington GS, Killingsworth R: Theoretical approaches to the promotion of physical activity: forging a transdisciplinary paradigm. Am J Prev Med. 2002, 23 (suppl): 15-25. 10.1016/S0749-3797(02)00470-1.CrossRefPubMed
12.
Prochaska JO, Velicer WF, Rossi JS, Goldstein MG, Marcus BH, Rakowski W, Fiore C, Harlow LL, Redding CA, Rosenbloom D, Rossi SR: Stages of change and decisional balance for 12 problem behaviors. Health Psychol. 1994, 13: 39-46. 10.1037/0278-6133.13.1.39.CrossRefPubMed
13.
Pinto BM, Lynn H, Marcus BH, DePue J, Goldstein MG: Physician-based activity counseling: intervention effects on mediators of motivational readiness for physical activity. Ann Behav Med. 2001, 23: 2-10. 10.1207/S15324796ABM2301_2.CrossRefPubMed
14.
Steptoe A, Rink E, Kerry S: Psychosocial predictors of changes in physical activity in overweight sedentary adults following counseling in primary care. Prev Med. 2000, 31: 183-194. 10.1006/pmed.2000.0688.CrossRefPubMed
15.
Elley CR, Kerse NM, Arroll B: Why target sedentary adults in primary health care? Baseline results from the Waikato Heart, Health, and Activity Study. Prev Med. 2003, 37: 342-348. 10.1016/S0091-7435(03)00142-7.CrossRefPubMed
16.
Simons-Morton DG, Hogan P, Dunn AL, Pruitt L, King AC, Levine BD, Miller ST: Characteristics of inactive primary care patients: baseline data from the activity counseling trial. For the Activity Counseling Trial Research Group. Prev Med. 2000, 31: 513-521. 10.1006/pmed.2000.0733.CrossRefPubMed
17.
Grandes G, Sanchez A, Torcal J, Ortega Sanchez-Pinilla R, Lizarraga K, Serra J, Grupo PEPAF: Protocol for the multi-centre evaluation of the Experimental Programme Promotion of Physical Activity (PEPAF) [Article in Spanish]. Aten Primaria. 2003, 32: 475-480. 10.1157/13054004.CrossRefPubMed
18.
Sallis JF, Haskell WL, Wood PD: Physical activity assessment methodology in the Five-City Project. Am J Epidemiol. 1985, 121: 91-106.PubMed
19.
Reed GR, Velicer WF, Prochaska JO, Rossi JS, Marcus BH: What makes a good staging algorithm: examples for regular exercise. Am J Health Promot. 1997, 12: 57-66.CrossRefPubMed
20.
Ware JE, Snow KK, Kosinski M: SF-36 health survey: manual and interpretation guide. 1993, Lincoln, RI: QualityMetric Incorporated
21.
Alonso J, Regidor E, Barrio G, Prieto L, Rodríguez C, de la Fuente L: Population reference values of the Spanish version of the Health Questionnaire SF-36 [Article in Spanish]. Med Clin. 1998, 111: 410-416.
22.
Gómez Arnáiz A, Conde Martela A, Aguiar Bautista JA, Santana Montesdeoca JM, Jorrín Moreno A, Betancor León P: Diagnostic usefulness of Alcohol Use Disorders Identification Test (AUDIT) for detecting hazardous alcohol consumption in primary care settings [Article in Spanish]. Med Clin. 2001, 116: 121-124.CrossRef
23.
Alvarez Dardet C, Alonso J, Domingo A, Regidor E: La medición de la clase social en ciencias de la salud. 1995, Barcelona: SG Editores
24.
Estabrooks PA, Glasgow RE: Translating effective clinic-based physical activity interventions into practice. Am J Prev Med. 2006, 31 (4 Suppl): S45-56. 10.1016/j.amepre.2006.06.019.CrossRefPubMed
25.
O'Connor PJ, Rush WA, Prochaska JO, Pronk NP, Boyle RG: Professional advice and readiness to change behavioral risk factors among members of a managed care organization. Am J Manag Care. 2001, 7: 125-130.PubMed
26.
Boudreaux ED, Francis JL, Carmack Taylor CL, Scarinci IC, Brantley PJ: Changing multiple health behaviors: smoking and exercise. Prev Med. 2003, 36: 471-478. 10.1016/S0091-7435(02)00048-8.CrossRefPubMed
27.
Mein GK, Shipley MJ, Hillsdon M, Ellison GT, Marmot MG: Work, retirement and physical activity: cross-sectional analyses from the Whitehall II study. Eur J Public Health. 2005, 15: 317-322. 10.1093/eurpub/cki087.CrossRefPubMed
28.
Ministerio de Sanidad y Consumo: Encuesta Nacional de Salud de España. 2003, Madrid: Ministerio de Sanidad y Consumo, [Accessed February 14, 2008]
29.
Galan I, Rodriguez-Artalejo F, Diez-Ganan L, Tobias A, Zorrilla B, Gandarillas A: Clustering of behavioural risk factors and compliance with clinical preventive recommendations in Spain. Prev Med. 2006, 42: 343-347. 10.1016/j.ypmed.2006.01.018.CrossRefPubMed
30.
Wendel-Vos GC, Schuit AJ, Tijhuis MAR, Kromhout D: Leisure time physical activity and health-related quality of life: Cross-sectional and longitudinal associations. Qual Life Res. 2004, 13: 667-677. 10.1023/B:QURE.0000021313.51397.33.CrossRefPubMed
31.
Elley CR, Kerse N, Arroll B, Robinson E: Effectiveness of counselling patients on physical activity in general practice: cluster randomised controllerd trial. BMJ. 2003, 326: 793-796. 10.1136/bmj.326.7393.793.CrossRefPubMedPubMedCentral
32.
Calfas KJ, Long BJ, Sallis JF, Wooten WJ, Pratt M, Patrick K: A controlled trial of physician counseling to promote the adoption of physical activity. Prev Med. 1996, 25: 225-233. 10.1006/pmed.1996.0050.CrossRefPubMed
33.
Duncan GE, Sydeman SJ, Perri MG, Limacher MC, Martin AD: Can sedentary adults accurately recall the intensity of their physical activity?. Prev Med. 2001, 33 (1): 18-26. 10.1006/pmed.2001.0847.CrossRefPubMed
34.
Washburn RA, Jacobsen DJ, Sonko BJ, Hill JO, Donnelly JE: The validity of the Stanford Seven-Day Physical Activity Recall in young adults. Med Sci Sports Exerc. 2003, 35 (8): 1374-1380. 10.1249/01.MSS.0000079081.08476.EA.CrossRefPubMed
35.
Verheijden MW, Bakx JC, Delemarre IC, Wanders AJ, van Woudenbergh NM, Bottema BJ, van Weel C, van Staveren WA: GPs' assessment of patients' readiness to change diet, activity and smoking. Br J Gen Pract. 2005, 55 (515): 452-457.PubMedPubMedCentral
36.
WHO, Global Strategy on Diet, Physical Activity and Health. 2004, Geneva: WHO
37.
Yancey AK, Fielding JE, Flores GR, Sallis JF, McCarthy WJ, Breslow L: Creating a robust public health infrastructure for physical activity promotion. Am J Prev Med. 2007, 32: 68-78. 10.1016/j.amepre.2006.08.029.CrossRefPubMed
Metadata
Title
Targeting physical activity promotion in general practice: Characteristics of inactive patients and willingness to change
Authors
Gonzalo Grandes
Alvaro Sánchez
Jesús Torcal
Ricardo Ortega Sánchez-Pinilla
Kepa Lizarraga
Javier Serra
The PEPAF Group
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2008
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-8-172

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