Evaluating the effectiveness of an intervention promoting walking and lifestyle physical activity in a primary care practice.

摘要

Sedentary behavior is a risk factor for many chronic diseases and conditions including cardiovascular disease, hypertension, diabetes, obesity, osteoporosis, colon cancer and depression. Nevertheless, only 25% of US adults achieve recommended levels of physical activity and 29% report no regular leisure activities.; This study used a sequential explanatory design to evaluate the effectiveness of a 13-week intervention to increase lifestyle physical activity among primary care patients. The primary quantitative outcome was change in average daily step count over time. Interviews were conducted after the intervention and 6 months later to explore participant's experiences with the intervention.; Of 83 enrollees, 33 completed the intervention; 26 dropped out after submitting at least one week of data; and 24 never submitted data. Between group comparisons were significant for age F(2, 76) = 4.07, p = .021, BMI F(2, 78) = 3.49, p = .035, race x 2 (1, N =83) = 10.13, p .001, and baseline step count t(56.9) = 2.026, p .047 (two-tailed). Eight-eight percent (n = 59) of participants were in the lowest categories of activity (59% sedentary, 29% low activity) at baseline. Self-reported activity level was poorly correlated with baseline activity rs (n = 59) = .256, p = .0502. Comparison of baseline steps with daily steps averaged over the last 4 weeks of the intervention showed study completers increased their average daily steps by 1,850.3 (95% CI = 1,024.2, 2,676.4, p .001).; Wearing step counters increased activity awareness and motivated behavior change. Positive health benefits, including weight loss, improvements in chronic disease markers and subjective experiences of feeling better were associated with attitudinal changes that reinforced behavior change. Although step counters motivated physical activity behavior change during the intervention, different patterns of use were observed in the maintenance phase. During the intervention, participants developed strategies to deal with stable physical activity barriers, however the maintenance phase was often characterized by emergent situations that interrupted regular patterns of physical activity.; The clinical implications of this study are that personalized information coupled with educational messages encouraging self-monitoring and realistic goal setting can motivate physical activity behavior change for sedentary individuals.