Nurse Counseling for Physical Activity in Primary Care Patients

Overview

Many elderly primary care patients are at high risk for health complications and functional impairment due to low levels of physical activity. Previous trials of counseling of elderly patients in primary care clinics have not demonstrated lasting physical activity change and have not evaluated fitness changes associated with any increased activity.

Background: Many elderly primary care patients are at high risk for health complications and functional impairment due to low levels of physical activity. Previous trials of counseling of elderly patients in primary care clinics have not demonstrated lasting physical activity change and have not evaluated fitness changes associated with any increased activity. Objectives: The primary objective was to determine if nurse telephone counseling could assist 60 to 80 year old VA primary care patients to establish and maintain a regular walking program. Methods: In this randomized clinical trial, 60-80 year old patients were referred to a walking program by primary care providers. All participants received individualized counseling by the nurse and, over the next year, one of three follow-up interventions: 1) 20 calls initiated by the nurse; 2) ten calls initiated by the nurse and ten initiated by an automated telephone message delivery system; or 3) no follow-up calls. All kept walking diaries and mailed these in to a data collector blinded to intervention group. Follow-up research visits were scheduled at six and 12 months. Self-reported walking, the primary outcome measure, was assessed from the walking diaries and validated by reports of significant others and accelerometer data. Improvement in fitness was assessed at 12 months with a standardized six minute walking test. Tinetti mobility scores, body mass index, and body girths were also assessed. Several quality of life measures were also administered. Status: Complete.

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Eligibility

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