Is brief advice in primary care a cost-effective way to promote physical activity?

Along with proper diet and avoidance of tobacco use, physical activity is extremely important to maintain and improve overall health of the individual and population. Despite evidence for the cost-effectiveness of physical activity counseling in primary care, only one-third of patients report that they received physical activity counseling by their primary care physician (PCP). Both PCPs and patients face numerous barriers to addressing insufficient physical activity. To assist patients in overcoming their barriers to regular physical activity, the PCP should assess and address the patient’s specific barriers to physical activity and counsel patients about the most common general barriers, such as lack of time, knowledge, and motivation. Numerous benefits and barriers are present, and the PCP should understand them and use the information to better counsel patients regarding the benefit of and need for regular physical activity. Brief counseling is an efficient, effective, and cost-effective means to increase physical activity and to bring considerable clinical benefits to various patient populations.

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Physical activity promotion in primary care: a Utopian quest?

Health Promotion International ◽

10.1093/heapro/day038 ◽

2018 ◽

Vol 34 (4) ◽

pp. 877-886 ◽

Cited By ~ 13

Author(s):

Alexis Lion ◽

Anne Vuillemin ◽

Jane S Thornton ◽

Daniel Theisen ◽

Saverio Stranges ◽

...

Keyword(s):

Physical Activity ◽

Primary Care ◽

Physical Inactivity ◽

Physical Activity Promotion ◽

Cost Effective ◽

Effective Interventions ◽

Activity Promotion ◽

Increased Risk ◽

Primary Care Professionals ◽

Exercise Referral

Abstract The health benefits of physical activity (PA) are acknowledged and promoted by the scientific community, especially within primary care. However, there is little evidence that such promotion is provided in any consistent or comprehensive format. Brief interventions (i.e. discussion, negotiation or encouragement) and exercise referral schemes (i.e. patients being formally referred to a PA professional) are the two dominant approaches within primary care. These cost-effective interventions can generate positive changes in health outcomes and PA levels in inactive patients who are at increased risk for non-communicable diseases. Their success relies on the acceptability and efficiency of primary care professionals to deliver PA counselling. To this end, appropriate training and financial support are crucial. Similarly, human resourcing and synergy between the different stakeholders must be addressed. To obtain maximum adherence, specific populations should be targeted and interventions adapted to their needs. Key enablers include motivational interviewing, social support and multi-disciplinary approaches. Leadership and lines of accountability must be clearly delineated to ensure the success of the initiatives promoting PA in primary care. The synergic and multisectoral action of several stakeholders, especially healthcare professionals, will help overcome physical inactivity in a sustainable way.

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Are physical activity interventions in primary care and the community cost-effective? A systematic review of the evidence

British Journal of General Practice ◽

10.3399/bjgp11x561249 ◽

2011 ◽

Vol 61 (584) ◽

pp. e125-e133 ◽

Cited By ~ 100

Author(s):

Sue Garrett ◽

C Raina Elley ◽

Sally B Rose ◽

Des O'Dea ◽

Beverley A Lawton ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Primary Care ◽

Cost Effective ◽

Physical Activity Interventions

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Symposium 17: Physical activity interventions using the transtheoretical model: A Transtheoretical Model-based Physical Activity Intervention Targeting Overweight/Obese Primary Care Patients: PACE Results from Italy

PsycEXTRA Dataset ◽

10.1037/e547922012-265 ◽

2003 ◽

Author(s):

Claudio R. Nigg ◽

Massimo Bolognesi ◽

Massimo Massarini

Keyword(s):

Physical Activity ◽

Primary Care ◽

Transtheoretical Model ◽

Physical Activity Intervention ◽

Model Based ◽

Physical Activity Interventions ◽

Primary Care Patients

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The impact of participant pathways on the effectiveness of a community-based physical activity intervention grounded in motivational interviewing

10.31219/osf.io/2sxc3 ◽

2020 ◽

Author(s):

Matthew Wade ◽

Nicola Brown ◽

James Steele ◽

Steven Mann ◽

Bernadette Dancy ◽

...

Keyword(s):

Physical Activity ◽

Primary Care ◽

Motivational Interviewing ◽

Social Action ◽

Multilevel Models ◽

Physical Activity Intervention ◽

Mental Wellbeing ◽

Community Based ◽

The Impact ◽

Time Point

Background: Brief advice is recommended to increase physical activity (PA) within primary care. This study assessed change in PA levels and mental wellbeing after a motivational interviewing (MI) community-based PA intervention and the impact of signposting [SP] and Social Action [SA] (i.e. weekly group support) pathways. Methods: Participants (n=2084) took part in a community-based, primary care PA programme using MI techniques. Self-reported PA and mental wellbeing data were collected at baseline (following an initial 30-minute MI appointment), 12-weeks, six-months, and 12-months. Participants were assigned based upon the surgery they attended to the SP or SA pathway. Multilevel models were used to derive point estimates and 95%CIs for outcomes at each time point and change scores. Results: Participants increased PA and mental wellbeing at each follow-up time point through both participant pathways and with little difference between pathways. Retention was similar between pathways at 12-weeks, but the SP pathway retained more participants at six-months and 12-months. Conclusions: Both pathways produced similar improvements in PA and mental wellbeing, suggesting the effectiveness of MI based PA interventions. However, due to lower resources required yet similar effects, SP pathways are recommended over SA to support PA in primary care settings.

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Experiences in physical activity promotion in health care settings for primary prevention in the UK

Swiss Sports & Exercise Medicine ◽

10.34045/ssem/2014/11 ◽

2014 ◽

Vol 62 (2) ◽

Keyword(s):

Physical Activity ◽

Primary Care ◽

Health Professionals ◽

Controlled Trial ◽

Full Range ◽

Tertiary Care ◽

Physical Activity Promotion ◽

Community Based ◽

Activity Promotion ◽

Randomised Controlled

In addition to the delivery of primary care services, recent changes to the NHS in the United Kingdom have placed increasing responsibility on GPs for the commissioning of the full range of health services from prevention through to clinical interventions and rehabilitation. Whilst historically there has always been an expectation that primary care professionals were ideally placed to provide support for prevention as well as treatment, their active engagement in the promotion of physical activity has remained largely superficial. With notable exceptions where individuals have a personal interest or commitment, the majority of health professionals tend to limit themselves to peremptory non-specific advice at best, or frequently don’t broach the subject at all. There are a number of reasons for this including increasing time pressures, a general lack of knowledge, limited evidence and concerns about litigation in the event of an adverse exercise induced event. However in the 1990s there was a surge of interest in the emerging “Exercise on Prescription” model where patients could be referred to community based exercise instructors for a structured “prescription” of exercise in community leisure centres. Despite the continuing popularity of the model there remain problems particularly in getting the active support of health professionals who generally cite the same barriers as previously identified. In an attempt to overcome some of these problems Wales established a national exercise referral scheme with an associated randomised controlled trial. The scheme evaluated well and had subsequently evolved with new developments including integration with secondary and tertiary care pathways, accredited training for exercise instructors and exit routes into alternative community based exercise opportunities.

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The Evolution of Physical Activity on Prescription (FaR) in Sweden

Swiss Sports & Exercise Medicine ◽

10.34045/ssem/2014/10 ◽

2014 ◽

Vol 62 (2) ◽

Keyword(s):

Physical Activity ◽

Primary Care ◽

Healthcare Professionals ◽

Systems Approach ◽

Ecological Model ◽

Controlled Trial ◽

Professional Associations ◽

Successful Implementation ◽

Surgeon General ◽

Positive Effects

In 1996, the first Report of the US Surgeon General on Physical Activity and Health provided an extensive knowledge overview about the positive effects of physical activity (PA) on several health outcomes and PA recommendations. This contributed to an enhanced interest for PA in Sweden. The Swedish Professional Associations for Physical Activity (YFA) were appointed to form a Scientific Expert Group in the project “Sweden on the Move” and YFA created the idea of Physical Activity on Prescription (FaR) and the production of a handbook (FYSS) for healthcare professionals. In Swedish primary care, licensed healthcare professionals, i.e. physicians, physiotherapists and nurses, can prescribe PA if they have sufficient knowledge about the patient’s current state of health, how PA can be used for promotion, prevention and treatment and are trained in patient-centred counselling and the FaR method. The prescription is followed individually or by visiting local FaR providers. These include sport associations, patient organisations, municipal facilities, commercial providers such as gyms, sports clubs and walking clubs or other organisations with FaR educated staff such as health promoters or personal trainers. In clinical practice, the FaR method increases the level of PA in primary care patients, at 6 and at 12 months. Self-reported adherence to the prescription was 65% at 6 months, similar to the known compliance for medications. In a randomised controlled trial, FaR significantly improved body composition and reduced metabolic risk factors. It is suggested that a successful implementation of PA in healthcare depends on a combination of a systems approach (socio-ecological model) and the strengthening of individual motivation and capability. General support from policymakers, healthcare leadership and professional associations is important. To lower barriers, tools for implementation and structures for delivery must be readily available. Examples include handbooks such as FYSS, the FaR system and the use of pedometers.

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Yoga in the management of Diabetes Mellitus

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i2.7716 ◽

2017 ◽

Vol 2 (2) ◽

Author(s):

Sreeharsha N. ◽

Bargale Sushant Sukumar ◽

Divyasree C. H.

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Eating Habits ◽

Cost Effective ◽

The Body ◽

Positive Thinking ◽

The World ◽

Diabetic Population ◽

Major Factors ◽

Excess Glucose

Diabetes mellitus is a chronic metabolic disorder in which the body is unable to make proper utilisation of glucose, resulting in the condition of hyperglycaemia. Excess glucose in the blood ultimately results in high levels of glucose being present in the urine (glycosuria). This increase the urine output, which leads to dehydration and increase thirst. India has the largest diabetic population in the world. Changes in eating habits, increasing weight and decreased physical activity are major factors leading to increased incidence of Diabetes. Lifestyle plays an important role in the development of Diabetes. Yoga offers natural and effective remedies without toxic side-effects, and with benefits that extend far beyond the physical. This system of Yoga is a simple, natural programme involving five main principles: proper exercise, proper breathing, proper relaxation, proper diet and positive thinking and meditation. It is a cost effective lifestyle intervention technique.

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