Predictors of Increased Physical Activity in Patients Receiving Physical Activity on Prescription
Condition: Health Behavior; Physical Activity; Metabolic Syndrome X; Primary Health Care
MeSH terms: Metabolic Syndrome
Study type: Observational [Patient Registry]

Summary: 
      The aim of this study is to explore possible predicting factors associated with physical
      activity (PA) level change in a 6-month period of physical activity on prescription (PAP)
      treatment. This is done in order to highlight potential predictors important for increased
      PA-level and to identify which primary care patients who may benefit from the
      PAP-intervention.

      Four hundred forty four patients are included in the study, 27-85 years, physically inactive,
      having at least one component of the metabolic syndrome (MetS) present and receiving
      PAP-treatment. Possible predicting factors of PA change at baseline and PA-level at 6-month
      follow-up are analyzed.
    

Detailed description: 
      Aim:

      To explore possible predicting factors associated with PA-level change in a 6-month period of
      PAP-treatment. This is done in order to highlight potential predictors important for
      increased PA-level and to identify which primary care patients who may benefit from the
      PAP-intervention.

      Methods:

      Study design:

      This is a longitudinal prospective observational cohort study with a 6-month follow-up of
      PAP-treatment. The treatment is carried out as part of a daily clinical primary care
      practice.

      Study population:

      The 444 patients included in the study, are selected from 15 primary health care centres in
      Gothenburg, Sweden, and are 27-85 years, physically inactive, having at least one component
      of the MetS present and receiving PAP-treatment. The patients have to understand the Swedish
      language to fill in the questionnaires.

      Intervention:

      The PAP-treatment is offered by authorized personnel, educated in PA-effects and
      PAP-intervention and consists of an individual-based dialogue with the patient, an
      individually tailored recommendation of PA including a written prescription, and customized,
      structured support during 6 months. The patients health status, previous respectively current
      PA level, preferences for different physical activities, motivation, self-efficacy and
      readiness to change PA behavior are evaluated. An agreed individually dosed PA is written
      down and the support during the 6-month intervention is individually structured either by
      revisits or by telephone contacts.

      Measurements:

      The following measurements are conducted at baseline and the 6-month follow-up: PA-level,
      self-efficacy expectations, outcome expectations, enjoyment, social support, readiness to
      change PA, body mass index (BMI), and health related quality of life. Age, sex, social
      situation, economy, education, and smoking is also measured.

      Statistical analysis:

      A per-protocol analysis is used. In the predictor analysis, Spearman rank correlation and a
      univariate regression analysis is used, respectively, to examine the association between
      possible predicting factors at baseline and PA level at 6-month follow-up. Significant
      predictors from the regression analysis are dichotomized into positive and negative values,
      respectively, and a Chi-square test for independence is used in analysing the predictors at
      baseline to increased PA level at 6-month follow-up. Statistical significance is set at p
      ≤0.05.

      Hypothesis:

      It is possible finding predicting factors among the patient´s answers according to
      self-reported questionnaires for the purpose of identifying responders/non-responders to
      increased physical activity level at 6 month follow-up of PAP-treatment.

      Clinical implication:

      Highlighting possible predicting factors to increased PA in an early stage of
      PAP-intervention, offers the opportunity to support the patient in the behavioural change
      process and to individualize the PAP-treatment, with the aim to increase physical activity
      level.
    

Intervention name(s): Predicting factors for increased physical activity
Intervention type(s): Behavioral
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The 444 patients included in the study, are selected from 15 primary health care centres in
        Gothenburg, Sweden and are 27-85 years, physically inactive, having at least one component
        of the MetS present and receiving PAP-treatment. The patients have to understand the
        Swedish language to fill in the questionnaires.
      
Keywords: Physical activity on prescription; Correlate of physical activity; Predicting factor