title: The effects of health counseling and exercise training on self-rated health and well-being in middle-aged men: a randomized trial.
abstract: BACKGROUND
  Few community-based lifestyle interventions have examined subjective well-being. We examined the effects of health counseling and exercise training on self-rated health (SRH), self-rated well-being (SRW) and depressive symptoms in middle-aged men at increased risk for cardiovascular disease (CVD) in a randomized controlled trial.
  
  
  METHODS
  Men (N.=168) with at least two CVD risk factors engaging in leisure-time physical activity less than three times/week were randomized into: A) a group receiving single-session health counseling; B) a group receiving single-session health counseling and three months of weekly structured group exercise training; or C) a control group. We assessed SRH and SRW using visual analogue scales and depressive symptoms using a brief depression screener (the Patient Health Questionnaire-2, PHQ-2).
  
  
  RESULTS
  Generalized estimating equation (GEE) models showed that, after 3 and 12 months, SRH (P=0.024) and SRW (P=0.014) improved across all groups. We found no differences between the groups (group by time effect, P=0.44 and P=0.80). The proportion of men with PHQ-2 scores ≥3 (positive depression screen) decreased in groups A (from 27% to 13%) and B (from 34% to 18%), but increased among controls (from 26% to 31%) (group by time effect, P=0.078).
  
  
  CONCLUSIONS
  We found improvements in SRH and SRW, with a diminishing proportion of men screening positive for depression one year after a single health counseling session and a three-month exercise-training program. We detected, however, no statistically significant differences when comparing men who received health counseling or health counseling combined with exercise training to controls.
authors.affiliation: Department of Sports and Exercise Medicine, Clinicum, University of Helsinki, Helsinki, Finland - elina.engberg@helsinki.fi.|Foundation for Sports and Exercise Medicine, Clinic for Sports and Exercise Medicine, Helsinki, Finland - elina.engberg@helsinki.fi.
authors.forename: Elina
authors.initials: E
authors.lastname: Engberg
authors.affiliation: Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.|School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Crawley, Australia.
authors.forename: Helena
authors.initials: H
authors.lastname: Liira
authors.affiliation: UKK Institute for Health Promotion Research, Tampere, Finland.
authors.forename: Katriina
authors.initials: K
authors.lastname: Kukkonen-Harjula
authors.affiliation: Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Svetlana
authors.initials: S
authors.lastname: From
authors.affiliation: Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.|Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.affiliation: Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Kaisu
authors.initials: K
authors.lastname: Pitkälä
authors.affiliation: Department of Sports and Exercise Medicine, Clinicum, University of Helsinki, Helsinki, Finland.|Foundation for Sports and Exercise Medicine, Clinic for Sports and Exercise Medicine, Helsinki, Finland.|Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Heikki O
authors.initials: HO
authors.lastname: Tikkanen
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases; D003376:Counseling; D003863:Depression / Q000523:psychology*; D059026:Diagnostic Self Evaluation; D015444:Exercise; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors