Physical activity counseling in primary care: who has and who should be counseling?
OBJECTIVE
To examine the physical activity (PA) counseling literature in primary care in order to identify which intervention provider has been used to date and their relative effectiveness for increasing PA.


METHODS
MEDLINE and PsycINFO databases were searched for PA intervention studies in primary care settings.


RESULTS
Of the 19 studies, 37% were conducted solely by physicians, 37% by allied health professionals, while 26% were combined-provider interventions. There was a decline in the number of physician-only interventions and a shift towards interventions offered by allied health professionals as adjuncts or alone. Interventions across all provider categories generated some improvements in physical activity behavior, however, it appears that allied health professionals as adjuncts or alone produced the best results in the long-term (>6 months). There was substantial variation in the location and counseling approach employed by allied health professionals.


CONCLUSIONS
We argue for an interdisciplinary model in which physicians recommend PA and provide referrals to allied health professionals such as physical activity counselors.


CONCLUSIONS
With physical activity counselors' specialized training and greater time available to the patient, they may provide more intensive and effective counseling required for behavior change and maintenance.
Tulloch
Heather
H
School of Psychology, University of Ottawa, P.O. Box 450, Stn. A, Ottawa, Ont., Canada K1N 6N5. heathertulloch@hotmail.com
Fortier
Michelle
M
Hogg
William
W
D000488:Allied Health Personnel / Q000458:organization & administration; D002983:Clinical Competence; D003376:Counseling / Q000458:organization & administration*; D015444:Exercise; D005544:Forecasting; D015438:Health Behavior; D006301:Health Services Needs and Demand; D006801:Humans; D017146:Models, Organizational; D010348:Patient Care Team / Q000458:organization & administration; D010353:Patient Education as Topic / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D024382:Professional Role; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D016896:Treatment Outcome