Physician-based physical activity counseling for middle-aged and older adults: A randomized trial

Sedentary behavior among older adults increases risk for chronic diseases. Physicians in a primary care setting can play an important role in promotin g physical activity adoption among their older patients. The Physically Act ive for Life (PAL) project was a randomized, controlled trial comparing the efficacy of brief physician-delivered physical activity counseling to usua l care on self-reported physical activity levels. The physical activity cou nseling was based on the Transtheoretical Model of Change and social learni ng theory. Twenty-four community-bused primary care medical practices were recruited into the study; 12 were randomized to the intervention condition and 12 to the Control condition. Physicians in the Intervention practices r eceived training in the delivery of brief physical activity counseling. Sub jects in the intervention practices (n = 181) received brief activity couns eling matched to their stage of motivational readiness for physical activit y a patient manual, a follow-lip appointment with their physician to discus s activity counseling, and newsletter mailings. Subjects in the Control pra ctices (n = 174) received standard care. Measures of motivational readiness for physical activity and the Physical Activity Scale for the Elderly (PAS E) were administered to subjects in both conditions at baseline, 6 weeks fo llowing their initial appointment, and at 8 months. Results showed that at the 6-week follow-up, subjects in the intervention condition were more like ly to be in more advanced stages of motivational readiness for physical act ivity than subjects in the Control condition. This effect was not maintaine d at the 8 month follow-up and the intervention did not produce significant changes in PASE scores. Results suggest that more intensive, sustained int erventions may be necessary to promote the adoption of physical activity am ong sedentary, middle-aged, and older adults in primary care medical practi ces.