title: Is physical activity counseling effective for older people? A cluster randomized, controlled trial in primary care.
abstract: OBJECTIVE
  To establish the effectiveness of the Green Prescription physical activity counseling program in increasing activity and quality of life in older community-dwelling people.
  
  
  METHODS
  Post hoc subgroup analysis of a large cluster randomized, controlled trial.
  
  
  METHODS
  One hundred seventeen doctors in 42 primary care practices (74% participation rate) in the Waikato region of New Zealand.
  
  
  METHODS
  Two hundred seventy sedentary primary healthcare patients aged 65 and older (67% participation rate).
  
  
  METHODS
  Patients in intervention practices prompted their primary care doctors or practice nurse to deliver brief activity counseling. A "Green Prescription" was written involving the negotiation of activity goals. Trained exercise specialists from a regional sports foundation gave follow-up telephone support over 3 months.
  
  
  METHODS
  Leisure moderate and vigorous physical activity, total energy expenditure, systolic and diastolic blood pressure, health-related quality of life, musculoskeletal injuries, falls, and hospitalizations.
  
  
  RESULTS
  After 12 months of follow-up, leisure time moderate activity increased by 0.67 h/wk more in the intervention group than the control group (95% confidence interval (CI)=0.17-1.17) and energy expenditure increased by 2.67 kcal/kg per week (95% CI=0.87-4.47) more. For intervention group participants, vitality and general health scales of the 36-item Short Form showed statistically and clinically relevant improvements, and there was a decrease in hospitalizations (P<.03). There were no observable changes in blood pressure, injuries, or falls as a result of the Green Prescription program.
  
  
  CONCLUSIONS
  This physical activity intervention improved activity, energy expenditure, health-related quality of life, and hospitalizations for older primary care patients. Systematic inclusion of the Green Prescription in routine primary health care will probably lead to health gain for older people.
authors.affiliation: Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. n.kerse@auckland.ac.nz
authors.forename: Ngaire
authors.initials: N
authors.lastname: Kerse
authors.forename: C Raina
authors.initials: CR
authors.lastname: Elley
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Robinson
authors.forename: Bruce
authors.initials: B
authors.lastname: Arroll
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology / Q000534:rehabilitation*; D016000:Cluster Analysis; D004734:Energy Metabolism; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006305:Health Status Indicators; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010353:Patient Education as Topic; D011320:Primary Health Care; D011788:Quality of Life; D016896:Treatment Outcome