Health promotion in primary care: evaluation of a systematic procedure and stage specific information for physical activity counseling.
BACKGROUND
Given the demographic development, healthy aging becomes more and more relevant. However, physical activity as an important health resource lacks dissemination in persons of older age in Switzerland. Thus, the present study aimed to develop and evaluate a feasible approach for physical activity promotion in the promising primary care setting.


METHODS
An expert panel developed two procedures for physical activity counselling in the primary care setting. The first complete procedure consisted of a written assessment and personal counselling by physicians. It was evaluated by focus groups with primary care physicians. The second modified procedure consisted of mailings to inactive patients selected by physicians. It was evaluated by a written questionnaire sent to participants.


RESULTS
The study demonstrated that physical activity promotion through primary care has a high potential. However, core issues such as dealing with time pressure on physicians, applying screening instruments on a broad basis beyond high risk patients, expanding physicians' roles towards primary prevention as well as providing intervention materials actually comprehensible to patients need to be well considered.


CONCLUSIONS
To facilitate large scale implementation of physical activity promotion, a range of flexible procedures should be provided so the physician can select and adapt them to his needs and desired role in health promotion. Further, physical activity promotion should be integrated into multidimensional health promotion to meet the diverse health needs of patients. The presented multi-stakeholder approach is generally recommended for future development of health promotion interventions.
Schmid
M
M
Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland. schmid@access.uzh.ch
Egli
K
K
Martin
B W
BW
Bauer
G
G
D000368:Aged; D001291:Attitude of Health Personnel; D015444:Exercise; D005194:Family Practice; D005240:Feasibility Studies; D017144:Focus Groups; D015577:Geriatric Assessment; D006293:Health Promotion / Q000379:methods* / Q000592:standards; D006801:Humans; D010174:Pamphlets; D011320:Primary Health Care; D016730:Program Development; D012015:Reference Standards; D011795:Surveys and Questionnaires; D013557:Switzerland