A New Tool for Encouraging Activity

Abstract

In brief Promoting physical activity among patients is an essential role for physicians. Project PACE (Physician-based Assessment and Counseling for Exercise) is a practical system of matching physician counseling with patient readiness for physical activity. The PACE counseling approach will help physicians attain national goals for health promotion for the year 2000.

The green prescription study: a randomized controlled trial of written exercise advice provided by general practitioners.

“…The 35 participants lost to followup (21 in the green prescription group, 14 in the verbal advice group) had a mean age and gender proportion similar to that of the full group. Of those lost to follow-up, 15 had missing or incorrect phone numbers and 20 were not reached after five attempts.…”

The role of physician counseling in improving adherence to physical activity among the general population

“…61,62 The program guidelines suggest three to fi ve minutes of counseling per medical visit, during which topics of relevance to the patient are discussed and physical activity goals are established. The program consists of three stages: "getting out of the chair" (pre-contemplation), "planning the fi rst steps" (contemplation) and "keeping the PACE" (active).…”

“…When the plan of action and these goals have been identifi ed, the physician and the patient sign the protocol that will be tested for two weeks. 61,62 For individuals in the third stage (active), the physician praises the patient for adhering to the program, reviews goals and aids the patient to avoid possible relapses. In addition, the physician assesses the sources of social support, identifi es possible barriers to physical activity and helps the patient fi nd ways to overcome these barriers, thereby demonstrating confi dence that the patient will maintain adherence to the physical activity program.…”

“…77 There is no single well-defi ned protocol for evaluating and counseling physical activity. [61][62][63][64][65][66] Tables 4 and 5 show a list of strategies suggested that could be used during the fi rst and subsequent medical appointments. There are several strategies for enhancing adherence to physical activity plans.…”

“…In addition, the physician assesses the sources of social support, identifi es possible barriers to physical activity and helps the patient fi nd ways to overcome these barriers, thereby demonstrating confi dence that the patient will maintain adherence to the physical activity program. 61,62 The Physically Active for Life (PAL) project was developed in order to reduce sedentary behavior among elderly adults. 63 Like the Physician-Based Assessment and Counseling for Exercise project, the PAL model was developed in primary-care clinics and uses the transtheoretical model for behavioral change and health education, with the aim of overcoming barriers to physical activity.…”