Prompting Primary Providers to Increase Community Exercise Referrals for Older Adults: A Randomized Trial

Abstract

Objectives: To determine whether a clinic‐based physical activity promotion intervention can lead to more community‐based exercise referrals by providers and higher exercise motivation in patients. Design: Cluster randomized, controlled trial. Setting: Seattle Veterans Affairs General Internal Medicine Clinic. Participants: Thirty‐one physicians and nurse practitioners were randomized to a physical activity counseling intervention or control condition (counseling about tobacco cessation). Three hundred thirty‐six patients aged 50 and older and visiting a study provider were enrolled. Intervention: Intervention providers were trained to offer referrals to community exercise programs for patients who reported before their clinic visit that they were “contemplative” about regular exercise. Measurements: Process measures of health behavior assessment and provider advice, exercise stage‐of‐change, proportion of participants reporting regular physical activity. Results: At baseline, 172 intervention patients and 164 controls were similar with respect to sex, age, comorbidity score, and exercise motivation level. Forty‐five percent of all intervention patients and 35% of controls reported receiving exercise advice ( P =.07). Intervention patients who were contemplative about exercise were even more likely to receive exercise advice than contemplative controls (59% vs 38%; P =.02). After 4 months, 35% of all intervention patients reported regular exercise, compared with 28% of controls ( P =.06). Conclusion: Primary providers are more likely to offer exercise advice when informed whether patients are contemplative about exercise. Patients may be more likely to start regular exercise as a result of this advice.

Keywords

Affiliated Institutions

• Indiana University Bloomington US

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