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A randomised controlled trial of three pragmatic approaches to initiate increased physical activity in sedentary patients with risk factors for cardiovascular disease

A randomised controlled trial of three pragmatic approaches to initiate increased physical activity in sedentary patients with risk factors for cardiovascular disease
A randomised controlled trial of three pragmatic approaches to initiate increased physical activity in sedentary patients with risk factors for cardiovascular disease
Background: physical activity is a major modifiable risk factor for cardiovascular disease, but it is unclear what combination of feasible approaches, using existing resources in primary care, work best to initiate increased physical activity.

Aim: to assess three approaches to initiate increased physical activity.

Design of study: randomised controlled (2 X 2 X 2) factorial trial.

Setting: four general practices.

Method: one hundred and fifty-one sedentary patients with computer documented risk factors for cardiovascular disease were randomised to eight groups defined by three factors: prescription by general practitioners (GPs) for brisk exercise not requiring a leisure facility (for example, walking) 30 minutes per day, 5 days per week; counselling by practice nurses, based on psychological theory to modify intentions and perceived control of behaviour, and using behavioural implementation techniques (for example, contracting, 'rehearsal'); use of the Health Education Authority booklet 'Getting active, feeling fit'.

Results: single interventions had modest effects. There was a trend from the least intensive interventions (control +/- booklet) to the more intensive interventions (prescription and counselling combined +/- booklet) for both increased physical activity and fitness (test for trend, P = 0.02 and P = 0.05, respectively). Only with the most intense intervention (prescription and counselling combined) were there significant increases in both physical activity and fitness from baseline (Godin score = 14.4, 95% confidence interval [CI] = 7.8 to 21, which was equivalent to three 15-minute sessions of brisk exercise and a 6-minute walking distance = 28.5 m, respectively, 95% CI = 11.1 to 45.8). Counselling only made a difference among those individuals with lower intention at baseline.

Conclusion: feasible interventions using available staff, which combine exercise prescription and counselling explicitly based on psychological theory, can probably initiate important increases in physical activity.
cardiovascular disease, counselling, exercise prescription, physical activity, psychological theory
0960-1643
189-195
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Dorward, M.
ede98eab-1027-4a21-a38c-3bccb7c71e06
Gralton, S.
a6c925a0-2093-404d-be9a-a06201250b3b
Hammerton, L.
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Pillinger, J.
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White, P.
7af189b9-069f-440f-bbef-78c56ae40bb6
Moore, M.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
McKenna, J.
323b1b43-84c3-46f3-8354-ea137722841b
Payne, S.
72967c33-d094-4fbe-9ac5-1d60087fb0e7
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Dorward, M.
ede98eab-1027-4a21-a38c-3bccb7c71e06
Gralton, S.
a6c925a0-2093-404d-be9a-a06201250b3b
Hammerton, L.
0dc7cdc6-4925-4f7e-928b-564d734a9e7c
Pillinger, J.
80dbe4c3-ccca-412d-b447-7c4897b053d8
White, P.
7af189b9-069f-440f-bbef-78c56ae40bb6
Moore, M.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
McKenna, J.
323b1b43-84c3-46f3-8354-ea137722841b
Payne, S.
72967c33-d094-4fbe-9ac5-1d60087fb0e7

Little, P., Dorward, M., Gralton, S., Hammerton, L., Pillinger, J., White, P., Moore, M., McKenna, J. and Payne, S. (2004) A randomised controlled trial of three pragmatic approaches to initiate increased physical activity in sedentary patients with risk factors for cardiovascular disease. British Journal of General Practice, 54 (500), 189-195. (PMID:15006124)

Record type: Article

Abstract

Background: physical activity is a major modifiable risk factor for cardiovascular disease, but it is unclear what combination of feasible approaches, using existing resources in primary care, work best to initiate increased physical activity.

Aim: to assess three approaches to initiate increased physical activity.

Design of study: randomised controlled (2 X 2 X 2) factorial trial.

Setting: four general practices.

Method: one hundred and fifty-one sedentary patients with computer documented risk factors for cardiovascular disease were randomised to eight groups defined by three factors: prescription by general practitioners (GPs) for brisk exercise not requiring a leisure facility (for example, walking) 30 minutes per day, 5 days per week; counselling by practice nurses, based on psychological theory to modify intentions and perceived control of behaviour, and using behavioural implementation techniques (for example, contracting, 'rehearsal'); use of the Health Education Authority booklet 'Getting active, feeling fit'.

Results: single interventions had modest effects. There was a trend from the least intensive interventions (control +/- booklet) to the more intensive interventions (prescription and counselling combined +/- booklet) for both increased physical activity and fitness (test for trend, P = 0.02 and P = 0.05, respectively). Only with the most intense intervention (prescription and counselling combined) were there significant increases in both physical activity and fitness from baseline (Godin score = 14.4, 95% confidence interval [CI] = 7.8 to 21, which was equivalent to three 15-minute sessions of brisk exercise and a 6-minute walking distance = 28.5 m, respectively, 95% CI = 11.1 to 45.8). Counselling only made a difference among those individuals with lower intention at baseline.

Conclusion: feasible interventions using available staff, which combine exercise prescription and counselling explicitly based on psychological theory, can probably initiate important increases in physical activity.

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More information

Published date: March 2004
Keywords: cardiovascular disease, counselling, exercise prescription, physical activity, psychological theory

Identifiers

Local EPrints ID: 24410
URI: http://eprints.soton.ac.uk/id/eprint/24410
ISSN: 0960-1643
PURE UUID: a6b739ed-13c3-49e7-959b-63a3fe919283
ORCID for M. Moore: ORCID iD orcid.org/0000-0002-5127-4509

Catalogue record

Date deposited: 30 Mar 2006
Last modified: 08 Jan 2022 03:01

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Contributors

Author: P. Little
Author: M. Dorward
Author: S. Gralton
Author: L. Hammerton
Author: J. Pillinger
Author: P. White
Author: M. Moore ORCID iD
Author: J. McKenna
Author: S. Payne

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