The purpose of this study was to investigate the importance of enjoyment of exercise in a health care-based intervention aimed at promoting physical exercise in primary health care patients. In a controlled study design, the intervention group was offered a wide range of group exercises over 3 months, followed by support in designing their own exercise program. The control group received usual care. Enjoyment of exercise and exercise level were measured. Associations between enjoyment and exercise level were analyzed using Spearman's rank correlation coefficients. Changes in enjoyment between and within study groups were analyzed by the independent and paired t-test. Associations were found between enjoyment and exercise level (r=0.36, P<0.01), as well as between changes in enjoyment and changes in exercise level (r=0.34, P<0.01). At the 12-month follow-up, enjoyment of exercise was 25% higher in the intervention group than in the control group (P<0.01). In this group of primary health care patients, enjoyment of exercise was associated with exercise level. Enjoyment of exercise seems to be a mediator of exercise level. Furthermore, health care-based interventions seem to be able to affect enjoyment of exercise. Enjoyment of exercise may be important for the long-term effectiveness, of health care-based interventions.
An 8-month dance intervention can improve self-rated health for adolescent girls with internalizing problems. The improvement remained a year after the intervention.
There is strong evidence that inadequate physical activity (PA) leads to an increased risk of lifestyle-related diseases and premature mortality. Physical activity on prescription (PAP) is a method to increase the level of PA of patients in primary care, but needs further evaluation. The aim of this observational study was to explore the association between PAP-treatment and the PA level of patients with metabolic risk factors and the relationship between changes in the PA level and health outcomes at the 6 month follow-up. This study included 444 patients in primary care, aged 27–85 years (56% females), who were physically inactive with at least one component of metabolic syndrome. The PAP-treatment model included: individualized dialogue concerning PA, prescribed PA, and a structured follow-up. A total of 368 patients (83%) completed the 6 months of follow-up. Of these patients, 73% increased their PA level and 42% moved from an inadequate PA level to sufficient, according to public health recommendations. There were significant improvements (p≤ 0.05) in the following metabolic risk factors: body mass index, waist circumference, systolic blood pressure, fasting plasma glucose, cholesterol, and low density lipoprotein. There were also significant improvements regarding health-related quality of life, assessed by the Short Form 36, in: general health, vitality, social function, mental health, role limitation-physical/emotional, mental component summary, and physical component summary. Regression analysis showed a significant association between changes in the PA level and health outcomes. During the first 6-month period, the caregiver provided PAP support 1–2 times. This study indicates that an individual-based model of PAP-treatment has the potential to change people’s PA behavior with improved metabolic risk factors and self-reported quality of life at the 6 month follow-up. Thus, PAP seems to be feasible in a clinical primary care practice, with minimum effort from healthcare professionals.
Lifestyle intervention in primary care improves QOL and is highly cost-effective in relation to standard care. Trial Registration clinicaltrials.gov Identifier: NCT00486941.
BackgroundThe increasing prevalence of psychological health problems among adolescent girls is alarming. Knowledge of beneficial effects of physical activity on psychological health is widespread. Dance is a popular form of exercise that could be a protective factor in preventing and treating symptoms of depression. The aim of this study was to assess the cost-effectiveness of a dance intervention in addition to usual school health services for adolescent girls with internalizing problems, compared with usual school health services alone.MethodsA cost-utility analysis from a societal perspective based on a randomized controlled intervention trial was performed. The setting was a city in central Sweden with a population of 130 000. A total of 112 adolescent girls, 13–18 years old, with internalizing problems participated in the study. They were randomly assigned to intervention (n = 59) or control (n = 53) group. The intervention comprised dance twice weekly during eight months in addition to usual school health services. Costs for the stakeholder of the intervention, treatment effect and healthcare costs were considered. Gained quality-adjusted life-years (QALYs) were used to measure the effects. Quality of life was measured with the Health Utility Index Mark 3. Cost-effectiveness ratios were based on the changes in QALYs and net costs for the intervention group compared with the control group. Likelihood of cost-effectiveness was calculated.ResultsAt 20 months, quality of life had increased by 0.08 units more in the intervention group than in the control group (P = .04), translating to 0.10 gained QALYs. The incremental cost-effectiveness ratio was USD $3,830 per QALY and the likelihood of cost-effectiveness was 95%.ConclusionsIntervention with dance twice weekly in addition to usual school health services may be considered cost-effective compared with usual school health services alone, for adolescent girls with internalizing problems.Trial registrationName of the trial registry: “Influencing Adolescent Girls’ With Creative Dance Twice Weekly”Trial registration number: NCT01523561
A PS has significant effects on the areas of activity, participation and QoL in elderly people. These findings have implications for prescriptions of a PS to this population. Implications for Rehabilitation Powered scooter interventions increased the performance of activities and increased participation in elderly people with mobility limitations. Actions from several parts of the community are required to prevent from mishaps from using powered scooters. The Individually Prioritized Problem Assessment is an adequate method to measure goal attainment in elderly users of powered scooters.
This review found many examples of cost-effective interventions. There is a lack of evidence for the cost-effectiveness of interventions aimed at those whose only risk factor for illness is a sedentary lifestyle. There is more evidence, although it is limited, for the cost-effectiveness of interventions aimed at high-risk groups or those who manifest poor health related to physical inactivity. Most of the evidence for cost-effectiveness is for older people and those with heart failure. Promotion of physical activity can be cost-effective with different methods and in different settings, but there remains a lack of evidence for specific methods in specific populations.
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