title: Integrating Physical Activity in Primary Care Practice.
abstract: Based on a collaborative symposium in 2014 hosted by the Society of Behavioral Medicine (SBM) and the American College of Sports Medicine (ACSM), this paper presents a model for physical activity counseling for primary care physicians (PCPs). Most US adults do not meet national recommendations for physical activity levels. Socioecological factors drive differences in physical activity levels by geography, sex, age, and racial/ethnic group. The recent Patient Protection and Affordable Care Act incentivizes PCPs to offer patients physical activity counseling. However, PCPs have reported socioecological barriers to physical activity counseling and also patient barriers to physical activity, spanning from the individual to the environmental (eg, lack of safe spaces for physical activity), policy (eg, reimbursement policies), and organizational (eg, electronic medical record protocols, worksite norms/policies) levels. The aims of this paper are to: 1) discuss barriers to PCP counseling for physical activity; 2) provide evidence-based strategies and techniques to help PCPs address these counseling barriers; and 3) suggest practical steps for PCPs to counsel patients on physical activity using strategies and supports from policy, the primary care team, and other support networks.
authors.affiliation: Ann Arbor VA Center for Clinical Management Research, Mich.
authors.forename: Mona
authors.initials: M
authors.lastname: AuYoung
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego (UC San Diego).
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Linke
authors.affiliation: Department of Medicine, University of Massachusetts Medical School, Worcester.
authors.forename: Sherry
authors.initials: S
authors.lastname: Pagoto
authors.affiliation: School of Nutrition and Health Promotion, Arizona State University, Phoenix.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Buman
authors.affiliation: Northwestern University, Feinberg School of Medicine, Chicago, Ill.
authors.forename: Lynette L
authors.initials: LL
authors.lastname: Craft
authors.affiliation: Department of Family Medicine, University of Michigan, Ann Arbor.
authors.forename: Caroline R
authors.initials: CR
authors.lastname: Richardson
authors.affiliation: American College of Sports Medicine (ACSM), Indianapolis, Ind.
authors.forename: Adrian
authors.initials: A
authors.lastname: Hutber
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego (UC San Diego).
authors.forename: Bess H
authors.initials: BH
authors.lastname: Marcus
authors.affiliation: Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha.
authors.forename: Paul
authors.initials: P
authors.lastname: Estabrooks
authors.affiliation: New York Physicians against Cancer (NYPAC), New York, NY; National Institutes of Health, Leidos Biomedical Research (SAIC), Frederick, Md. Electronic address: sherri.gorin@gmail.com.
authors.forename: Sherri
authors.initials: S
authors.lastname: Sheinfeld Gorin
mesh_terms: D002983:Clinical Competence; D003376:Counseling / Q000379:methods*; D015444:Exercise; D006801:Humans; D008403:Mass Screening; D058991:Patient Protection and Affordable Care Act; D058007:Physicians, Primary Care; D011320:Primary Health Care / Q000379:methods*; D012051:Reimbursement Mechanisms; D040242:Risk Reduction Behavior; D013997:Time Factors
keywords: Physical activity; Primary care; Socioecologic model