A Multisite Field Test of the Acceptability of Physical Activity Counseling in Primary Care: Project PACE

Long, Barbara; Calfas, Karen J.; Wooten, Wilma; Sallis, James F.; Patrick, Kevin; Goldstein, Michael G.; Marcus, Bess H.; Schwenk, Thomas L.; Chenoweth, James A.; Carter, Richard; Torres, Trissa; Palinkas, Lawrence A.; Heath, Gregory W.

doi:10.1016/s0749-3797(18)30348-9

Cited by 172 publications

(120 citation statements)

References 26 publications

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“…First, because DPP participants underwent a rigorous screening process before inclusion and needed to be willing to accept random assignment to lifestyle intervention, they are different than a general population of patients with IGT. This is apparent by the fact that none of our participants indicated being in the precontemplation stage of change for physical activity and only 28% were in the contemplation stage of change, whereas in other populations, the majority of patients report being in the precontemplation or contemplation stage of change (21,29). Anxiety and depression tend to be less common in clinical trial participants, and levels were quite low in this sample and in the entire DPP cohort (30), which may diminish the likelihood of finding significant associations with leisure physical activity.…”

Section: Discussionmentioning

confidence: 69%

Psychological Predictors of Physical Activity in the Diabetes Prevention Program

Delahanty

Conroy²,

Nathan³

2006

Journal of the American Dietetic Association

133

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Objective-To identify the baseline psychological variables before receiving a Diabetes Prevention Program (DPP) lifestyle intervention that predict physical activity levels (PALs) at baseline, 1 year, and end of study (2 to 3 years after randomization).Design and subjects-Of the final 293 DPP lifestyle participants randomized, 274 (94%) completed validated questionnaires at baseline assessing stage of change for PAL, exercise selfefficacy, perceived stress, depression, and anxiety. Statistical analyses performed-Correlations and stepwise multiple regression analyses.Results-At baseline, this subset was similar to the entire DPP lifestyle cohort: mean age was 52.5 years, 65% were women, and mean PAL was 15.7 metabolic equivalent hours per week. Higher levels of baseline leisure PAL correlated with greater readiness to change PAL (r=0.44, P<0.0001), higher exercise self-efficacy (r=0.18, P=0.002), and lower levels of perceived stress (r=−0.16, P=0.009), depression (r=−0.18, P=0.003), and anxiety (r=−0.14, P=0.03), with similar correlations at 1 year and end of study. In multivariate models, being a man, lower levels of depression, and lower body mass index were independent correlates of higher baseline leisure PAL; being a man, greater baseline exercise self-efficacy, and activity level were independent correlates of greater leisure PAL levels at 1 year and end of study. Greater readiness to change PAL at baseline was also an independent correlate of greater PAL at end of study.Conclusions-In this representative sample of DPP lifestyle participants, being a man, lower body mass index, greater readiness for change in PAL, higher exercise self-efficacy, and lower perceived stress, depression, and anxiety scores correlated with higher levels of baseline PAL with similar patterns at 1 year and end of study. These findings may help determine which patients are most likely to increase PAL in lifestyle intervention programs.Lack of physical activity is a major risk factor for premature morbidity and mortality and contributes to the death of 200,000 Americans every year (1). Despite strong evidence for the benefits of regular physical activity (2,3), 24% of US adults engage in no recreational physical activity at all, and only 25% meet recommended physical activity levels (PALs) (4).One of the many major health benefits of regular physical activity is the prevention of type 2 diabetes (5-7), mediated by weight control and other mechanisms (6,8,9). Given that both inactivity and obesity seem to be strongly and independently associated with diabetes and diabetes-related cardiovascular comorbidities (10), it is particularly crucial to understand how to promote physical activity in persons at high risk for diabetes.Physical activity is a complex behavior that has been correlated with numerous demographic and psychological variables (11-13). However, much of the current literature focuses on the general population rather than on people at high risk for diabetes, like those with impaired glucose tolerance (IGT).The Diab...

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Section: Discussionmentioning

confidence: 69%

Psychological Predictors of Physical Activity in the Diabetes Prevention Program

Delahanty

Conroy²,

Nathan³

2006

Journal of the American Dietetic Association

133

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“…However, 87% of the GPs who wrote EoP prescriptions in the month before completing the survey had written less than 10. One study reported that only 35% of GPs expected to be able to implement the EoP scheme without the support of the research staff [28]. In a recent population-based analysis of 6610 exercise referrals it was reported that only an estimated 4% of the 'at risk' population was referred to an EoP scheme [36].…”

Section: Feasibility For General Practicementioning

confidence: 99%

Exercise on prescription in general practice: A systematic review

Sørensen

Skovgaard

Puggaard

2006

Scandinavian Journal of Primary Health Care

142

113

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“…Stages of change for physical activity were assessed using the 11-item Physicianbased Assessment and Counselling for Physical Activity (PACE; Long et al, 1996) measure. Respondents classified themselves by selecting one of 11 staging statements (0 ¼ I do not exercise or walk regularly now, and I do not intend to start in the near future [ precontemplation], 11 ¼ I do vigorous exercise six or more times per week for over six months [maintenance]).…”

Section: Tailoringmentioning

confidence: 99%

Effects of a tailored lifestyle self‐management intervention in patients with Type 2 diabetes

Clark

Hampson

Avery

et al. 2004

British J Health Psychol

140

146

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Objectives. The aim of the present study was to develop, implement and evaluate a brief intervention to improve adherence to the recommended lifestyle changes for patients with Type 2 diabetes, in particular to help patients to reduce the total amount of fat consumed and to increase lifestyle physical activity levels.Design and method. A brief, tailored lifestyle self-management intervention for patients with Type 2 diabetes was evaluated in a randomized controlled trial. One hundred participants (aged 40 -70 yrs) completed assessments at three time pointsbaseline, three months and one year. Participants were allocated to either an intervention group who received the brief tailored intervention including follow-up telephone calls, or a usual care control group.Results. Results indicate that the intervention was successful in helping patients to reduce fat intake and, to a lesser extent, increase lifestyle physical activity levels. These self-reported changes in behaviour were reflected in the objective data with weight maintenance in the intervention group compared to the control group, together with a significant reduction (2 cm) in waist circumference.Conclusions. These results provide further evidence of the effectiveness of tailored interventions for lifestyle change.

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A Multisite Field Test of the Acceptability of Physical Activity Counseling in Primary Care: Project PACE

Cited by 172 publications

References 26 publications

Psychological Predictors of Physical Activity in the Diabetes Prevention Program

Psychological Predictors of Physical Activity in the Diabetes Prevention Program

Exercise on prescription in general practice: A systematic review

Effects of a tailored lifestyle self‐management intervention in patients with Type 2 diabetes

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