Nurse Physical Activity Counseling in Primary Care
Condition: Frail Elderly; Aged; Physical Fitness
Study type: Interventional

Summary: 
      Aging veterans with functional impairments followed in primary care clinics were randomized
      to counseling for a walking plus strength exercise home-based exercise program or to health
      education by a nurse. Exercise participants attended 3 intervention sessions totaling about
      100 minutes of contact with the nurse and a physical therapy assistant over 10 months. They
      were also asked to record walking and strength exercise on monthly calendars and received
      motivational automated phone messages. Education control patients discussed health topics of
      their choice with the nurse. Materials were based on National Institute of Aging materials
      currently available on the internet. After 10 months, the exercise participants reported more
      time spent in walking and strength exercise and accelerometer data indicated a greater
      increase in time spent in moderate or higher intensity activity per day. Participants who
      engaged in strength exercises improved more on functional fitness tests and quality of life
      after 10 months. Analyses from the cognitive sub-study remain incomplete.
    

Detailed description: 
      Description Background: Many older individuals are at high risk for health complications and
      functional impairment due to low levels of physical activity. Walking is an acceptable and
      safe activity associated with many health benefits. Strength and flexibility exercises are
      also important components of the exercise prescription for optimal health and function in the
      elderly. Developing interventions to promote healthy physical activity is a current public
      health priority, and counseling by providers in health care settings is a promising approach.
      Objectives: The primary objective was to evaluate the effects of nurse counseling on total
      weekly minutes and frequency of home-based walking and strength/flexibility exercises.
      Secondary objectives included evaluating physical function and accelerometer physical
      activity. A sub-study initiated in April 2004 examined the association between exercise and
      cognitive functioning. Methods: The design is a randomized clinical trial. Outcomes were
      assessed at 5 months (end of initiation phase) and 10 months (maintenance). Clinic-based
      exercise counseling was delivered by a nurse and physical therapy assistant at baseline and a
      1-month follow-up. Interventions were based on exercise for people over 50 information
      available on the National Institute on Aging internet website. VA primary care patients aged
      60 to 85 referred by their primary care provider were assigned to one of 2 conditions: a)
      exercise counseling or b) health education contact control. All participants received
      preventive health counseling emphasizing safety and falls prevention. The exercise counseling
      group also received follow-up phone contacts, including automated motivational messages, from
      the nurse. All participants had continuing contact with research staff but were exposed to
      different specific intervention components. . Status: Data collection complete; additional
      analyses in progress.
    

Intervention name(s): Exercise counseling
Intervention type(s): Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Nurses; Telephone; Counseling; Exercise