title: Meta-analysis of patient education interventions to increase physical activity among chronically ill adults.
abstract: OBJECTIVE
  This meta-analysis integrates primary research testing the effect of patient education to increase physical activity (PA) on behavior outcomes among adults with diverse chronic illnesses.
  
  
  METHODS
  Extensive literature searching strategies located published and unpublished intervention studies that measured PA behavior outcomes. Primary study results were coded. Fixed- and random-effects meta-analytic procedures included moderator analyses.
  
  
  RESULTS
  Data were synthesized across 22,527 subjects from 213 samples in 163 reports. The overall mean weighted effect size for two-group comparisons was 0.45 (higher mean for treatment than control). This effect size is consistent with a difference of 48 min of PA per week or 945 steps per day. Preliminary moderator analyses suggest interventions were most effective when they targeted only PA behavior, used behavioral strategies (versus cognitive strategies), and encouraged PA self-monitoring. Differences among chronic illnesses were documented. Individual strategies unrelated to PA outcomes included supervised exercise sessions, exercise prescription, fitness testing, goal setting, contracting, problem solving, barriers management, and stimulus/cues. PA outcomes were unrelated to gender, age, ethnicity, or socioeconomic distribution among samples.
  
  
  CONCLUSIONS
  These findings suggest that some patient education interventions to increase PA are effective, despite considerable heterogeneity in the magnitude of intervention effect.
  
  
  CONCLUSIONS
  Moderator analyses are preliminary and provide suggestive evidence for further testing of interventions to inform practice.
authors.affiliation: S317 School of Nursing, University of Missouri, Columbia, MO 65211, USA. conn@missouri.edu
authors.forename: Vicki S
authors.initials: VS
authors.lastname: Conn
authors.forename: Adam R
authors.initials: AR
authors.lastname: Hafdahl
authors.forename: Sharon A
authors.initials: SA
authors.lastname: Brown
authors.forename: Lori M
authors.initials: LM
authors.lastname: Brown
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002908:Chronic Disease / Q000523:psychology / Q000534:rehabilitation*; D003627:Data Interpretation, Statistical; D015987:Effect Modifier, Epidemiologic; D005081:Exercise Therapy / Q000193:education / Q000458:organization & administration; D030141:Feedback, Psychological; D006040:Goals; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration*; D055656:Prescriptions; D011340:Problem Solving; D015397:Program Evaluation; D012107:Research Design; D012648:Self Care / Q000379:methods / Q000523:psychology; D012944:Social Support; D012959:Socioeconomic Factors