Physical activity counseling in primary care and patient well-being: Do patients benefit?
BACKGROUND
Promoting physical activity is an important public health strategy for long-term reductions in incidence or severity of clinical disease. Benefits to health-related quality of life (HRQL) and subjective well-being may be as important and take less time to accrue.


OBJECTIVE
We examined the HRQL benefits of a social-cognitive-theory-based intervention of the Activity Counseling Trial (ACT), both directly in terms of changes in physical fitness and indirectly from increased self-efficacy associated with the intervention.


METHODS
In ACT, 395 female and 479 male inactive patients ages 35 to 75 years were randomized to one of: physician advice, advice plus behavioral counseling during primary care visits, or advice plus behavioral counseling that also included telephone contact and behavioral classes. Participants were assessed at baseline, 6 months, and 24 months. HRQL was assessed as perceived quality of life, perceived stress, depression, and general health. Satisfaction with function and appearance, self-efficacy, and social support were also assessed.


RESULTS
At 24 months women who received counseling or assistance had significant reductions in daily stress and improvements in satisfaction with body function compared to those receiving advice only. Men had reductions in daily stress across all treatment arms. These results mirrored VO2max changes observed per group. Change in barriers self-efficacy was significantly associated with reductions in daily stress at 24 months.


CONCLUSIONS
Patient benefit from ACT intervention was mediated by enhanced cardiorespiratory fitness and by barriers self-efficacy.
Anderson
Roger T
RT
Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27104, USA. rtanders@wfubmc.edu
King
Abby
A
Stewart
Anita L
AL
Camacho
Fabian
F
Rejeski
W Jack
WJ
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001521:Behavior Therapy / Q000379:methods; D003376:Counseling; D015444:Exercise / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010809:Physical Fitness / Q000523:psychology*; D011320:Primary Health Care; D011788:Quality of Life / Q000523:psychology*; D012016:Reference Values; D020377:Self Efficacy; D016896:Treatment Outcome