The physical activity counselling (PAC) randomized controlled trial: rationale, methods, and interventions. The impact of self-reported arthritis and diabetes on response to a home-based physical activity counselling intervention Evaluating the Effectiveness of a Physical Activity Referral Scheme Among Women A systematic review of school-based interventions targeting physical activity and sedentary behaviour among older adolescents The diabetes network internet-based physical activity intervention: a randomized pilot study. Relationship between regular walking, physical activity, and health-related quality of life. Cluster randomized controlled trial of a multilevel physical activity intervention for older adults Measuring pain as the 5th vital sign does not improve quality of pain management The Veterans Learning to Improve Fitness and Function in Elders Study: a randomized trial of primary care-based physical activity counseling for older men. Physical activity and psychosocial benefits among breast cancer patients. Randomized controlled trial of a primary care and home-based intervention for physical activity and nutrition behaviors: PACE+ for adolescents. Is intensive counseling in maternity care feasible and effective in promoting physical activity among women at risk for gestational diabetes? Secondary analysis of a cluster randomized NELLI study in Finland A randomized trial to promote physical activity among breast cancer patients. Testing the Efficacy of OurSpace, a Brief, Group Dynamics-Based Physical Activity Intervention: A Randomized Controlled Trial Impact of an educational intervention on internal medicine residents' physical activity counselling: the Pressure System Model. Physical activity counseling in maternity and child health care – a controlled trial Self-Efficacy Intervention Effect on Physical Activity in Older Adults Effects of a standard provision versus an autonomy supportive exercise referral programme on physical activity, quality of life and well-being indicators: a cluster randomised controlled trial A self-regulation-based intervention to increase physical activity in cancer patients A new model of exercise referral scheme in primary care: is the effect on adherence to physical activity sustainable in the long term? A 15-month randomised controlled trial Sustaining self-regulatory efficacy and psychological outcome expectations for postnatal exercise: effects of a group-mediated cognitive behavioural intervention. Affective responses in mountain hiking—A randomized crossover trial focusing on differences between indoor and outdoor activity Effect of physical activity guidelines on physical function in older adults.
Primary care is a promising venue to build patient motivation and confidence to increase physical activity ( PA ) . Physician PA counselling has demonstrated some success ; however , maintenance of behaviour change appears to require more intensive interventions . In reality , most physicians do not have the necessary training nor the time for this type of counselling . The purpose of this paper is to outline the rationale , methods , and interventions for the ongoing physical activity counselling ( PAC ) r and omized controlled trial ( RCT ) , which aims to assess the impact of integrating a PA counsellor into a primary care practice . This RCT has 2 arms : ( i ) brief PA counselling ( 2 - 4 min ) from a health care provider and ( ii ) brief PA counselling+intensive PA counselling from a PA counsellor ( 3 months ) . The impact of this intervention is being evaluated using the comprehensive RE- AIM framework . One hundred twenty insufficiently active adult patients , aged 18 to 69 y and recruited during regular primary care visits have been r and omized . Dependent measures include psychological mediators , PA participation , quality of life , and physical and metabolic outcomes . The PAC project represents an innovative , theoretically-based approach to promoting PA in primary care , focusing on psychological mediators of change . We anticipate that key lessons from this study will be useful for shaping future public health interventions , theories , and research Objectives : Physical activity ( PA ) has the potential to improve outcomes in both arthritis and diabetes , but these conditions are rarely examined together . Our objective was to explore whether persons with arthritis alone or those with both arthritis and diabetes could improve amounts of PA  with a home-based counselling intervention . Methods : As part of the Veterans LIFE ( Learning to Improve Fitness and Function in Elders ) Study , veterans aged 70–92 were r and omized to usual care or a 12-month PA counselling programme .  Arthritis and diabetes were assessed by self-report . Mixed models were used to compare trajectories for minutes of endurance and strength training PA for persons with no arthritis ( n = 85 ) , arthritis ( n = 178 ) , and arthritis plus diabetes ( n = 84 ) . Results : Recipients of PA counselling increased minutes of PA per week independent of disease status ( treatment arm by time interaction p < 0.05 for both ; endurance training time p = 0.0006 and strength training time p < 0.0001 ) . Although PA was lower at each wave among persons with arthritis , and even more so among persons with arthritis plus diabetes , the presence of these conditions did not significantly influence response to the intervention ( arthritis/diabetes group × time interactions p > 0.05 for both outcomes ) as each group experienced a nearly twofold or greater increase in PA  . Conclusions : A home-based PA intervention was effective in increasing minutes of weekly moderate intensity endurance and strength training PA in older veterans , even among those with arthritis or arthritis plus diabetes . This programme may serve as a useful model to improve outcomes in older persons with these pervasive diseases Evidence supports the effectiveness of interventions delivered in primary care to promote physical activity ( PA ) . Specifically , approaches where physician counseling is coupled with other strategies ( eg , referrals to community re sources ) have been recognized as the most promising . The purpose of this study was to compare the effectiveness of a PA prescription plus referral intervention versus a prescription only intervention delivered in primary care . Ten family physicians and their female patients ( N = 35 , mean age = 36 years ) were r and omly assigned to 1 of 3 conditions : prescription plus  ( n = 12 ) ,  prescription only ( n = 12 ) , and  usual care ( n = 11 ) . The prescription plus group received a PA prescription plus a referral to a community program , the prescription only group received only the PA prescription , and the usual care group received usual health care .  The Godin Leisure-Time Exercise Question naire was used to measure PA . A significant increase on the PA score ( P < .05 , partial η2 = .178 ) and on total weekly PA minutes ( P < .05 , partial η2 = .179 ) was observed in both prescription groups after the intervention . There were no significant group differences ( P > .05 ) . No PA changes were observed in the usual care group . Findings from this pilot study suggest that brief PA counseling and a prescription delivered in primary care can be effective for promoting PA among women . Referring patients did not seem to enhance the effect on PA ABSTRACT Lack of  physical activity  (  PA  ) and high levels of sedentary behaviour ( SB ) have been associated with health problems . This systematic review evaluates the effectiveness of school-based interventions to increase PA  and decrease SB  among 15–19-year-old adolescents , and examines whether intervention characteristics ( intervention length , delivery mode and intervention provider ) and intervention content ( i.e. behaviour change techniques , BCTs ) are related to intervention effectiveness . A systematic search of r and omised or cluster r and omised controlled trials with outcome measures of PA and /or SB rendered 10 results . Risk of bias was assessed using the Cochrane risk of bias tool . Intervention content was coded using Behaviour Change Technique Taxonomy v1 . Seven out of 10 studies reported significant increases in PA . Effects were generally small and short-term ( Cohen 's d ranged from 0.132 to 0.659 ) . Two out of four studies that measured SB reported significant reductions in SB . Interventions that increased PA  included a higher number of BCTs , specific BCTs ( e.g. , goal setting , action planning and self-monitoring ) , and were delivered by research staff . Intervention length and mode of delivery were unrelated to effectiveness . More studies are needed that evaluate long-term intervention effectiveness and target SBs among older adolescents OBJECTIVE Because of other competing priorities ,  physical activity ( PA ) is seldom addressed in a consistent way in either primary care or diabetes education . This 8-week pilot study evaluated the short-term benefits of an Internet-based supplement to usual care that focused on providing support for sedentary patients with type 2 diabetes to increase their PA levels . RESEARCH DESIGN AND METHODS A total of 78 type 2 diabetic patients ( 53 % female , average age 52.3 years ) were r and omized to the Diabetes Network ( D-Net ) Active Lives PA Intervention or an Internet information-only condition .  The intervention condition received goal - setting and personalized feedback , identified and developed strategies to overcome barriers , received and could post messages to an on-line " personal coach , " and were invited to participate in peer group support areas . Key outcomes included minutes of PA per week and depressive symptomatology . RESULTS There was an overall moderate improvement in PA levels within both intervention and control conditions , but there was no significant improvement in regard to condition effects . There was substantial variability in both site use and outcomes within the intervention and control conditions . Internal analyses revealed that among intervention participants , those who used the site more regularly derived significantly greater benefits , whereas those in the control condition derived no similar benefits with increased program use . CONCLUSIONS Internet-based self-management interventions for  PA and other regimen areas have great potential to enhance the care of diabetes and other chronic conditions . We conclude that greater attention should be focused on methods to sustain involvement with Internet-based intervention health promotion programs over time BACKGROUND The current physical activity ( PA ) and  health-related quality of life ( HRQoL ) literature warrants further investigation with general population sample s. The exploratory-focused purpose of this study was to compare total PA-HRQoL and walking-HRQoL relations , include a measure of general happiness , and to evaluate potential activity-HRQoL demographic moderators . METHODS A r and om sample of 351 adults completed an adapted Godin Leisure Time Question naire , the SF-36 , and the Satisfaction with Life Scale .  RESULTS Partial correlations revealed small-to-moderate associations between walking/total PA and general health , vitality , and social functioning after controlling for key demographics ( P < 0.05 ) . A dependent t-test determined  walking and PA  as equally related to vitality and social functioning . Multiple regression revealed annual income as a moderator of the total PA/walking-social functioning relationship [ F(3,315 ) = 9.71 and F(3,316 ) = 12.03 , P < 0.01 , respectively ] . CONCLUSIONS HRQoL may be considered with walking interventions and annual income . The contribution of PA to overall happiness appears to be minor Background Older adults are the least active population group . Interventions in residential setting s may support a multi-level approach to behavior change . Methods In a cluster r and omized control trial , 11 San Diego retirement communities were assigned to a physical activity ( PA ) intervention or a healthy aging attention control condition .  Participants were 307 adults over 65 years old . The multilevel PA intervention was delivered with the assistance of peer leaders , who were trained older adult from the retirement communities . Intervention components included individual counseling & self-monitoring with pedometers , group education sessions , group walks , community advocacy and pedestrian community change projects . Intervention condition by time interactions were tested using generalized mixed effects regressions . The primary outcomes was accelerometer measured physical activity . Secondary outcomes were blood pressure and objective ly measured physical functioning . Results Over 70 % of the sample were 80 years or older .  PA  significantly increased in the intervention condition ( 56 min of moderate-vigorous PA per week ; 119 min of light PA ) compared with the control condition and remained significantly higher across the 12 month study . Men and participants under 84 years old benefited most from the intervention . There was a significant decrease in systolic ( p < .007 ) and diastolic ( p < .02 ) blood pressure at 6 months . Physical functioning improved but the changes were not statistically significant . Conclusions Intervention fidelity was high demonstrating feasibility . Changes in PA and blood pressure achieved were comparable to other studies with much younger participants . Men , in particular , avoided a year-long decline in PA.Trial registration clincialtrials.gov Identifier : NCT01155011 Abstract BACKGROUND : To improve pain management , the Veterans Health Administration launched the “ Pain as the 5th Vital Sign ” initiative in 1999 , requiring a pain intensity rating ( 0 to 10 ) at all clinical encounters . OBJECTIVE : To measure the initiative ’s impact on the quality of pain management . DESIGN : We retrospectively review ed medical records at a single medical center to compare providers ’ pain management before and after implementing the initiative and performed a subgroup analysis of patients reporting substantial pain ( ≥4 ) during a postimplementation visit . PARTICIPANTS : Unique patient visits selected from all 15 primary care providers of a general medicine outpatient clinic . MEASUREMENTS : We used 7 process indicators of quality pain management  , based on appropriately evaluating and treating pain , to assess 300 r and omly selected visits before and 300 visits after implementing the pain initiative . RESULTS : The quality of pain care was unchanged between visits before and after the pain initiative ( P>.05 for all comparisons ) : subjective provider assessment ( 49.3 % before , 48.7 % after ) , pain exam ( 26.3 % , 26.0 % ) , orders to assess pain ( 11.7 % , 8.3 % ) , new analgesic ( 8.7 % , 11.0 % ) , change in existing analgesics ( 6.7 % , 4.3 % ) , other pain treatment ( 11.7 % , 13.7 % ) , or follow-up plans ( 10.0 % , 8.7 % ) . Patients ( n=79 ) who reported substantial pain often did not receive recommended care : 22 % had no attention to pain documented in the medical record , 27 % had no further assessment documented , and 52 % received no new therapy for pain at that visit . CONCLUSIONS : Routinely measuring pain by the 5th vital sign did not increase the quality of pain management . Patients with substantial pain documented by the 5th vital sign often had inadequate pain management OBJECTIVES To determine the effects of primary care-based , multicomponent physical activity counseling ( PAC ) promoting physical activity ( PA ) guidelines on gait speed and related measures of PA and function in older veterans . DESIGN R and omized controlled trial . SETTING Veterans Affairs Medical Center of Durham , North Carolina . PARTICIPANTS Three hundred ninety-eight male veterans aged 70 and older . INTERVENTION Twelve months of usual care ( UC ) or multicomponent PAC consisting of baseline in-person and every other week and then monthly telephone counseling by a lifestyle counselor , one-time clinical endorsement of PA , monthly automated telephone messaging from the primary care provider , and quarterly tailored mailings of progress in PA . MEASUREMENTS Gait speed ( usual and rapid ) , self-reported PA , function , and disability at baseline and 3 , 6 , and 12 months . RESULTS Although no between-group differences were noted for usual gait speed , rapid gait speed improved significantly more for the PAC group ( 1.56 + /- 0.41 m/s to 1.68 + /- 0.44 m/s ) than with UC ( 1.57 + /- 0.40 m/sec to 1.59 + /- 0.42 m/sec , P=.04 ) . Minutes of moderate/vigorous PA increased significantly in the PAC group ( from 57.1 + /- 99.3 to 126.6 + /- 142.9 min/wk ) but not in the UC group ( from 60.2 + /- 116.1 to 69.6 + /- 116.1 min/wk , P<.001 ) . Changes in other functional/disability outcomes were small . CONCLUSION In this group of older male veterans , multicomponent PA significantly improved rapid gait and PA . Translation from increased PA to overall functioning was not observed . Integration with primary care was successful OBJECTIVE Physical activity ( PA ) has been shown to provide health benefits for breast cancer patients . The effects of augmenting oncology healthcare provider ( HCP ) advice for PA with 3 months of telephone counseling versus contact control were evaluated in a r and omized trial . Our goal in this secondary analysis was to examine the amount of PA ( min/week ) needed for psychosocial benefits among both groups . METHODS After receiving brief HCP advice to become physically active , 192 women ( age in years : mean = 60.0 , SD = 9.9 ) who had completed treatment for Stage 0-IV breast cancer were r and omized to  telephone counseling to support PA ( n = 106 ) or contact control ( n = 86 ) . Their PA , fatigue , physical functioning , and quality of life were assessed at baseline ( before receiving HCP advice ) , 3 , 6 , and 12 months . A non-r and omized design was used to examine the dose-response relationship between PA and psychosocial outcomes . RESULTS Exercising for at least 150 min/week at moderate intensity was associated with improved physical functioning ( b = 5.9 , SE = 2.9 , p = 0.04 ) and quality of life ( b = 3.6 , SE = 1.9 , p = 0.05 ) at 3 months . These relationships were not found at 6 and 12 months ( p 's > 0.05 ) . However , women who reported at least 150 min/week of PA at both 3 and 6 months had significantly reduced fatigue ( b = 1.3 , SE = 0.7 , p = 0.05 ) and improved physical functioning ( b = 3.1 , SE = 1.3 , p = 0.02 ) and quality of life ( b = 2.0 , SE = 0.9 , p = 0.02 ) compared with women who did not meet this criterion . CONCLUSION Women who exercised at recommended levels ( at least 150 min/week ) and sustained this level of activity for at least 6 months accrued psychosocial benefits OBJECTIVE Many adolescents do not meet national guidelines for participation in regular moderate or vigorous physical activity ( PA ) ; limitations on sedentary behaviors ; or dietary intake of fruits and vegetables , fiber , or total dietary fat . This study evaluated a health care-based intervention to improve these behaviors . DESIGN R and omized controlled trial . SETTING Primary care with follow-up at home . PARTICIPANTS Eight hundred seventy-eight adolescent girls and boys aged 11 to 15 years . INTERVENTIONS Two experimental conditions : ( 1 ) Primary care , office-based , computer-assisted diet and PA assessment and stage-based goal setting followed by brief health care provider counseling and 12 months of monthly mail and telephone counseling and ( 2 ) a comparison condition addressing sun exposure protection . MAIN OUTCOME MEASURES Minutes per week of moderate plus vigorous PA measured by self-report and accelerometer ; self-report of days per week of PA and sedentary behaviors ; and percentage of energy from fat and servings per day of fruits and vegetables measured by three 24-hour diet recalls . Body mass index ( calculated as weight in kilograms divided by the square of height in meters ) was a secondary outcome . RESULTS Compared with adolescents in the sun protection condition , girls and boys in the diet and PA intervention significantly reduced sedentary behaviors ( intervention vs control change , 4.3 to 3.4 h/d vs 4.2 to 4.4 h/d for girls , respectively [ P = .001 ] ; 4.2 to 3.2 h/d vs 4.2 to 4.3 h/d for boys , respectively [ P = .001 ] ) . Boys reported more active days per week ( intervention vs control change : 4.1 to 4.4 d/wk vs 3.8 to 3.8 d/w , respectively [ P = .01 ] ) , and the number of servings of fruits and vegetables for girls approached significance ( intervention vs control change , 3.5 to 4.2 servings/d vs 3.5 to 3.9 servings/d , respectively [ P = .07 ] ) . No intervention effects were seen with percentage of calories from fat or minutes of PA per week . Percentage of adolescents meeting recommended health guidelines was significantly improved for girls for consumption of saturated fat ( intervention vs control change , 23.4 % to 41.0 % vs 18.5 % to 31 % , respectively [ relative risk , 1.33 ; 95 % confidence interval , 1.01 - 1.68 ] ) and for boys ' participation in d/wk of PA ( intervention vs control change , 45.3 % to 55.4 % vs 41.9 % to 38.0 % , respectively [ relative risk , 1.47 ; 95 % confidence interval , 1.19 - 1.75 ] ) . No between-group differences were seen in body mass index . CONCLUSIONS Improvements in some diet , PA , and sedentary behaviors in adolescents can be enabled through the use of a 1-year , integrated intervention using the computer , health provider counseling , mail , and telephone . The amount of intervention received may contribute to its efficacy Abstract Background Women who are physically active during early pregnancy have notably lower odds of developing gestational diabetes than do inactive women . The purpose of the intervention was to examine whether intensified physical activity ( PA ) counseling in Finnish maternity care is feasible and effective in promoting leisure-time PA ( LTPA ) among pregnant women at risk of gestational diabetes . Methods Fourteen municipalities were r and omized to intervention ( INT ) and usual care group ( UC ) . Nurses in INT integrated five PA counseling sessions into routine maternity visits and offered monthly group meetings on PA instructed by physiotherapists . In UC conventional practice s were continued . Feasibility evaluation included safety ( incidence of PA-related adverse events ; question naire ) , realization ( timing and duration of sessions , number of sessions missed , attendance at group meetings ; systematic record-keeping of the nurses and physiotherapists ) and applicability ( nurses ’ views ; telephone interview ) . Effectiveness outcomes were weekly frequency and duration of total and intensity-specific LTPA and meeting PA recommendation for health self-reported at 8 - 12 ( baseline ) , 26 - 28 and 36 - 37 weeks ’ gestation . Multilevel analysis with adjustments was used in testing for between-group differences in PA changes . Results The decrease in the weekly days of total and moderate-to-vigorous-intensity LTPA was smaller in INT ( N = 219 ) than in UC ( N = 180 ) from baseline to the first follow-up ( 0.1 vs. -1.2 , p = 0.040 and −0.2 vs. -1.3 , p = 0.016 ) . A similar trend was seen in meeting the PA recommendation ( −11%-points vs. -28%-points , p = 0.06 ) . INT did not experience more adverse events classified as warning signs to terminate exercise than UC , counseling was implemented as planned and viewed positively by the nurses . Conclusions Intensified counseling had no effects on the duration of total or intensity-specific weekly LTPA . However , it was able to reduce the decrease in the weekly frequency of total and moderate-to-vigorous-intensity LTPA from baseline to the end of second trimester and was feasibly embedded into routine practice s . Trial registration IS RCT N 33885819 ( http://www.is rct n.org OBJECTIVE  Physical activity ( PA ) has been shown to provide health benefits for breast cancer patients . The effects of augmenting oncology health care provider ( HCP ) advice for PA with 3 months of telephone counseling versus contact control were evaluated in a r and omized trial . METHODS After receiving brief HCP advice to become physically active , 192 women ( age in years : M = 60.0 , SD = 9.9 ) who had completed treatment for Stage 0-IV breast cancer were r and omized to telephone counseling to support PA ( n = 106 ) or contact control ( n = 86 ) . Their PA , motivational readiness , fatigue , and physical functioning were assessed at baseline ( before receiving HCP advice ) , 3 , 6 , and 12 months . RESULTS Telephone counseling produced significant effects on the primary outcome of moderate-intensity PA of about 30 min/week at both 3 months ( 95 % CI = 0.44 , 57.32 ) and 6 months ( 95 % CI = 3.06 , 61.26 ) . Intervention participants were also more than twice as likely as control participants to report improvements in achieving PA guidelines of at least 150 min/week at 3 ( OR = 2.43 , 95 % CI = 1.18 , 4.98 ) and 6 months ( OR = 2.11 , 95 % CI = 1.00 - 4.48 ) . Telephone counseling was significantly more effective than contact control in increasing motivational readiness for PA at all follow-ups ( ORs = 3.93 - 6.28 , all ps < .003 ) . No between-groups differences were found for fatigue , while differential improvements in physical functioning did not remain significant past 3 months ( p = .01 ) . CONCLUSION HCP advice plus telephone counseling improved PA among breast cancer patients at 3 and 6 months and also differentially improved patients ' motivational readiness at all follow-ups , suggesting the potential for exercise promotion in cancer follow-up care Background Emerging technologies ( ie , mobile phones , Internet ) may be effective tools for promoting  physical activity ( PA ) . However , few interventions have provided effective means to enhance social support through these platforms . Face-to-face programs that use group dynamics-based principles of behavior change have been shown to be highly effective in enhancing social support through promoting group cohesion and PA , but to date , no studies have examined their effects in Web-based programs . Objective The aim was to explore proof of concept and test the efficacy of a brief , online group dynamics-based intervention on PA  in a controlled experiment . We expected that the impact of the intervention on PA would be moderated by perceptions of cohesion and the partner ’s degree of presence in the online media . Methods Participants ( n=135 ) were r and omized into same-sex dyads and r and omly assigned to one of four experimental conditions : st and ard social support ( st and ard ) , group dynamics-based – high presence , group dynamics-based – low presence , or individual control . Participants performed two sets of planking exercises ( pre-post ) . Between sets , participants in partnered conditions interacted with a virtual partner using either a st and ard social support app or a group dynamics-based app ( group dynamics-based – low presence and group dynamics-based – high presence ) , the latter of which they participated in a series of online team-building exercises . Individual participants were given an equivalent rest period between sets . To increase presence during the second set , participants in the group dynamics-based – high presence group saw a live video stream of their partner exercising . Perceptions of cohesion were measured using a modified PA Group Environment Question naire . Physical activity was calculated as the time persisted during set 2 after controlling for persistence in set 1 . Results Perceptions of cohesion were higher in the group dynamics-based – low presence ( overall mean 5.81 , SD 1.04 ) condition compared to the st and ard ( overall mean 5.04 , SD 0.81 ) conditions ( P=.006 ) , but did not differ between group dynamics-based – low presence and group dynamics-based – high presence ( overall mean 5.42 , SD 1.07 ) conditions ( P=.25 ) . Physical activity was higher in the high presence condition ( mean 64.48 , SD 20.19 , P=.01 ) than all other conditions ( mean 53.3 , SD 17.35 ) . Conclusions A brief , online group dynamics-based intervention may be an effective method of improving group cohesion in virtual PA groups . However , it may be insufficient on its own to improve PA RATIONALE , AIMS AND OBJECTIVES Systematic review s point to inconclusive evidence that counselling patients in a primary care setting is effective in increasing  adults ' physical activity ( PA ) levels .  This study evaluates the impact of an innovative physician counselling programme on physicians ' PA counselling behaviour and their patients ' PA levels . METHODS A controlled educational study conducted at six Yale School of Medicine hospitals . Sixty-five internal medicine residents and 316 primary care patients were r and omized to intervention or control groups . Intervention physicians participated in five interactive sessions outlining details of the Pressure System Model , while control physicians received usual residency training . Intervention and control patients '  PA levels and residents counselling behaviour  were assessed using a vali date d question naire and compared pre- and post intervention . Data analysis was performed using paired t-tests and repeated measures anova . RESULTS At 6-month follow-up intervention , patients ' PA levels increased significantly from baseline ( 1.77 + /- 0.84 ; P = 0.0376 ) . A similar pattern was observed after 12 months ( 1.94 + /- 0.98 ; P = 0.0486 ) . Control patients ' PA did not change significantly from baseline at 6 or 12 months ( 0.35 + /- 1.00 ; P = 0.7224 and 0.99 + /- 1.52 ; P = 0.5160 , respectively ) . At 12 months , intervention residents provided PA counselling 1.5 times more than they did at baseline ( P < 0.05 ) compared with no significant changes in the control group . CONCLUSIONS The present study has shown that providing residents with a practical tool , enabling them to deal with patients ' barriers and previous failure in behavioural change , is efficacious in increasing PA levels of adult patients Background The purpose of the study is to examine the effects and feasibility of individual physical activity ( PA ) counseling in maternity and child health clinics in Finl and . Methods Three clinics including both maternity and child health care signed up for the experimental ( EXP ) and three for the control group ( CON ) . The participants were 132 pregnant and 92 postpartum primiparas . The nurses in EXP integrated a primary and four booster PA counseling sessions into routine visits . An option for supervised group exercise was offered . In CON former practice s , usually including brief PA advice , were continued .  Leisure-time PA ( LTPA ) prior to pregnancy was elicited by question naire and followed 16–18 and 36–37 weeks ' gestation in maternity clinics and 5 and 10 months postpartum in child health clinics . Feasibility included safety , participant responsiveness , realization of counseling and applicability . Results According to analysis of covariance adjusted for baseline LTPA and possible confounders , no relative between-group differences in LTPA were found at the first follow-up in either maternity or child health clinics . At the last follow-up in maternity clinics the weekly number of at least moderate-intensity LTPA days was 43 % ( 95 % CI : 9 , 87 ) higher and the weekly duration of at least moderate-intensity LTPA 154 % ( 95 % CI : 16 , 455 ) higher in EXP compared with CON . Counseling proved feasible in both maternity and child health clinics . Conclusion Counseling  encouraged pregnant women to sustain their moderate-intensity LTPA and was feasible in routine practice s. No effects were observed if counseling was initiated postpartum . Trial registration Current Controlled Trials IS RCT This study determined the effectiveness of a self-efficacy intervention design ed to improve selfefficacy and physical activity in older adults postcardiac event . An experimental three-group design tested the intervention , with treatment groups receiving 1 of 2 supportive telephone protocol s ( theory-based self-efficacy coaching or attention control ) . Outcome variables included selfefficacy expectations for physical activity ( PA ) , self-reported PA , and PA performance ( distance walked in 6 minutes ) . The self-efficacy intervention was effective in demonstrating greater PA performance when compared to the attention control intervention , and PA self-efficacy was significantly correlated with both measures of PA . There were significant main effects of time for PA self-efficacy and distance walked , and a significant interaction effect on the distance walked because of time and treatment condition . Although the self-efficacy intervention did not show a direct effect on level of PA self-efficacy as hypothesized , there was an indirect interaction effect on distance walked and physical activity confidence Background The National Institute for Health and Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials . Recent empirical evidence in health care and physical activity promotion context s provides a foundation for testing the feasibility and impact of a Self Determination Theory-based ( SDT ) exercise referral consultation . Methods An exploratory cluster r and omised controlled trial comparing st and ard provision exercise referral with an exercise referral intervention grounded in Self Determination Theory . Individuals ( N = 347 ) referred to an exercise referral scheme were recruited into the trial from 13 centres . Outcomes and processes of change measured at baseline , 3 and 6-months : Minutes of self-reported moderate or vigorous physical activity ( PA ) per week ( primary outcome ) , health status , positive and negative indicators of emotional well-being , anxiety , depression , quality of life ( QOL ) , vitality , and perceptions of autonomy support from the advisor , need satisfaction ( 3 and 6 months only ) , intentions to be active , and motivational regulations for exercise . Blood pressure and weight were assessed at baseline and 6 months . Results Perceptions of the autonomy support provided by the health and fitness advisor ( HFA ) did not differ by arm . Between group changes over the 6-months revealed significant differences for reported anxiety only . Within arm contrasts revealed significant improvements in anxiety and most of the Dartmouth CO-OP domains in the SDT arm at 6 months , which were not seen in the st and ard exercise referral group . A process model depicting hypothesized relationships between advisor autonomy support , need satisfaction and more autonomous motivation , enhanced well being and PA engagement at follow up was supported . Conclusions Significant gains in physical activity and improvements in quality of life and well-being outcomes emerged in both the st and ard provision exercise referral and the SDT-based intervention at programme end . At 6-months , observed between arm and within intervention arm differences for indicators of emotional health , and the results of the process model , were in line with SDT . The challenges in optimising recruitment and implementation of SDT-based training in the context of health and leisure services are discussed . Trial registration The trial is registered as Current Controlled trials IS RCT N07682833 The study examined whether a behavior-change intervention focusing on self-regulatory strategies and emphasizing role model support increases physical activity ( PA ) among insufficiently active ( not meeting PA guidelines of 150 min/week ) cancer patients . Ambulatory cancer patients [ N = 72 ; 54 % female ; M = 56 years , SD = 12.34 ; most with breast or colon cancer ( 34 , 15 % ) ] were enrolled in the MOTIVACTION- study , a 4-week intervention ( 1-hr counseling , followed by weekly phone calls ) , with pretest ( T1 ) , posttest ( T2 ) and a 10-week follow-up ( T3 ) . Participants were r and omized to either an exercise or to a stress management intervention ( active control ) . The exercise intervention emphasized self-regulatory strategies ( e.g. action- and coping planning and self-monitoring ) ; patients were also encouraged to contact a physically active same-sex role model as a potential exercise partner . The active control condition consisted of coping and relaxation techniques .  Sixty-seven patients remained in the study and completed the SQUASH assessment of PA and a measure of perceived stress . PA was vali date d by Actigraph accelerometry . At T2 , 46 % of the patients in the exercise group and 19 % of stress management patients increased their activity levels to meet PA guidelines ( > 150 min/week ; χ2(1 ) = 5.51 , p = .019 ) . At T3 , participants in the exercise intervention maintained their exercise level ( 46 % ) , but also 31 % of the stress management patients met the guidelines . All patients reported reductions in perceived stress . Additional analyses comparing patients in the exercise group by role model contact ( 63 % realized contact ) revealed that those who had contact with their role model were significantly more likely to adhere to the recommended guidelines ( T2:50 % ; T3:64 % ) compared to those who did not have contact with a role model ( T2:39 % ; T3:15 % ) , suggesting the potential of mobilizing role model support to facilitate PA . In sum , cancer patients may not only benefit from an exercise intervention emphasizing self-regulation , but also from stress management , regarding both reducing stress and increasing PA Introduction Studies had not yet overcome the most relevant barriers to physical activity ( PA ) adherence . An exercise referral scheme ( ERS ) with mechanisms to promote social support might enhance adherence to PA in the long term . Setting A r and omised controlled trial in 10 primary care centres in Spain . Objective To assess the effectiveness of a primary care-based ERS linked to municipal re sources and enhancing social support and social participation in establishing adherence to PA among adults over a 15-month period . Participants 422 insufficiently active participants suffering from at least one chronic condition were included . 220 patients ( 69.5 ( 8.4 ) years ; 136 women ) were r and omly allocated to the  intervention group ( IG ) and 202 ( 68.2 ( 8.9 ) years ; 121 women ) to the control group  ( CG ) . Interventions The IG went through a 12-week st and ardised ERS linked to community re sources and with inclusion of mechanisms to enhance social support . The CG received usual care from their primary care practice . Outcomes The main outcome measure was self-report PA with the International Physical Activity Question naire and secondary outcomes included stages of change and social support to PA practice . Data collection Participant-level data were collected via question naires at baseline , and at months 3 , 9 and 15 . Blinding The study statistician and research assessors were blinded to group allocation . Results Compared with usual care , follow-up data at month 15 for the ERS group showed a significant increase of self-reported PA ( IG : 1373±1845 metabolic equivalents ( MET ) min/week , n=195 ; CG : 919±1454 MET min/week , n=144 ; P=0.009 ) . Higher adherence ( in terms of a more active stage of change ) was associated with higher PA level at baseline and with social support . Conclusions Prescription from ordinary primary care centres staff yielded adherence to PA practice in the long term . An innovative ERS linked to community re sources and enhancing social support had shown to be sustainable in the long term . Trial registration number NCT00714831 ; Results OBJECTIVE The objective of the current investigation was to examine if the effects of a group-mediated cognitive behavioural counselling plus exercise intervention were superior to the effects of a st and ard exercise care condition on postnatal mothers ' self-regulatory efficacy ( SRE ) , outcome expectations ( OEs ) and self-directed physical activity ( PA ) . DESIGN The design of the study consisted of two intervention conditions ; group-mediated cognitive behavioural counselling plus exercise ( GMCB ) and st and ard exercise ( SE ) . Each condition consisted of two phases ; a 4-week supervised , centre-based intensive exercise training phase followed by a 4-week home-based phase . METHODS Participants were 57 postnatal women r and omly assigned to conditions ( SE : N=31 ; GMCB : N=26 ) .  Measures of SRE and OEs were assessed prior to and following the centre-based aspect of the intervention . Physical activity was measured following the intensive exercise training phase as well as the home-based phase . RESULTS GMCB participants ' SRE and OEs were sustained during the intervention whereas those of SE participants declined . GMCB participants also reported significantly greater time spent engaging in self-directed PA at the conclusion of the intensive and home-based phases . Mediation analysis revealed that SRE partially mediated the relationship between intervention condition and post home-based PA as confirmed by a significant sobel test . CONCLUSIONS These findings suggest that a theory-based GMCB counselling plus exercise intervention is superior to the SE condition in sustaining SRE and OEs , and in promoting greater self-directed PA . SRE partially mediated the relationship between intervention condition and post home-based PA supporting the targeting of that variable for change as part of the intervention Introduction Affective responses during physical activity ( PA ) are important for engagement in PA programs and for adherence to a physically active lifestyle . Little is known about the affective responses to PA bouts lasting longer than 45 minutes . Therefore , the aims of the present study were to analyse acute effects on affective responses of a three-hour outdoor PA intervention ( mountain hiking ) compared to a sedentary control situation and to an indoor treadmill condition . Methods Using a r and omized crossover design , 42 healthy participants were r and omly exposed to three different conditions : outdoor mountain hiking , indoor treadmill walking , and sedentary control situation ( approximately three hours each ) . Measures included the Feeling Scale , Felt Arousal Scale and a Mood Survey Scale . Repeated measures ANOVAs were used to analyse differences between the conditions . Results Compared to the control situation , the participants showed a significant increase in affective valence ( d = 1.21 , p < .001 ) , activation ( d = 0.81 , p = .004 ) , elation ( d = 1.07 , p < .001 ) , and calmness ( d = 0.84 , p = .004 ) , and a significant decrease in fatigue ( d = -1.19 , p < .001 ) and anxiety ( d = -.79 , p < .001 ) after mountain hiking . Outdoor mountain hiking showed significantly greater positive effects on affective valence , activation , and fatigue compared to indoor treadmill walking . Discussion The results indicate that a three-hour PA intervention ( mountain hiking ) elicits higher positive and lower negative affective responses compared to a sedentary control situation and to an indoor PA condition . Outdoor mountain hiking can be recommended by health professionals as a form of PA with the potential to positively influence affective responses . Trial registration Clinical Trials.gov NCT02853760 . https:// clinical trials.gov/. Date of registration : 08/02/2016 ( retrospectively registered ) . Date of enrolment of the first participant to the trial : 05/01/2014 OBJECTIVES To determine whether elderly people who meet national guidelines have higher physical function ( PF ) scores than those who do not and the effect on functional trajectory when physical activity ( PA ) levels change from above to below this threshold , or vice versa . DESIGN Pooled data . SETTING Two 6-month r and omized controlled trials aim ed at increasing PA in adults . PARTICIPANTS Adults aged 65 to 94 ( N=357 ) . INTERVENTION PA counseling over the telephone and through mailed material s. MEASUREMENTS  Self-reported PA  dichotomized at 150 minutes/week and PF using the Medical Outcomes Study 36-item Short Form Question naire PF subscale . RESULTS At baseline , individuals reporting 150 minutes or more of moderate PA/week had mean PF scores that were 20.3 points higher than those who did not ( P<.001 ) . Change in PA minutes from above threshold to below threshold or from below threshold to above threshold from baseline to 6 months result ed in an average change in PF of -11.18 ( P<.001 ) and + 5.10 ( P=.05 ) , respectively . CONCLUSION These findings suggest that PA is an important predictor of functional status . Older sedentary adults can improve PF by meeting recommended PA levels . Conversely , dropping below recommended PA levels has a deleterious effect on PF . Given the importance of PF in maintenance of independence and quality of life in older adults , adherence to recommended PA guidelines should be endorsed
Over 1.5 years of using EVS in a large hospital system , improvements occurred in relative weight loss among overweight patients and reduction in glycosylated hemoglobin among diabetic patients .
Few studies have examined a brief physical activity tool as a vital sign measure .
Initial investigations suggest the promise of these simple and quick assessment tools , and research is needed to test the effects of their use on chronic disease outcomes
INTRODUCTION Physical activity ( PA ) is strongly endorsed for managing chronic conditions , and a vital sign tool ( indicator of general physical condition ) could alert providers of inadequate PA to prompt counseling or referral .
This systematic review examined the use , definitions , psychometric properties , and outcomes of brief PA instruments as vital sign measures , with attention primarily to studies focused on arthritis .