Targeting physical activity promotion in general practice: characteristics of inactive patients and willingness to change

Grandes, Gonzalo; Sánchez, Alvaro; Torcal, Jesús; Sánchez-Pinilla, Ricardo Ortega; Lizarraga, Kepa; Serra, Javier
January 2008
BMC Public Health;2008, Vol. 8 Issue 1, p172
Academic Journal
Background: Counselling in routine general practice to promote physical activity (PA) is advocated, but inadequate evidence is available to support this intervention, and its sustainable implementation over time is difficult. Objectives: To describe the characteristics of physically inactive adults visiting GPs and the factors associated with their willingness to change PA. Methods: A cross-sectional analysis of 4317 Spanish people aged 20-80 years, selected by systematic sampling among those attending 56 public primary health care practices identified as inactive by their GPs in 2003. PA (7-day PAR), PA stage of change, health-related quality of life (SF-36), cardiovascular risk factors, and social and demographic characteristics were measured. Multivariate mixed effects ordinal logistic models were adjusted to identify factors associated with motivational readiness to change. Results: At least 70% (95% CI: 67.6% to 72.8%) of patients assessed by GPs did not achieve minimal PA recommendations. In addition, 85% (95% CI: 83% to 86.3%) had at least an additional cardiovascular risk factor. Only 30% (95% CI: 25.8% to 33.5%) were prepared for or attempting a change. A younger age; retirement or work at home; higher education and social class levels; obesity; and hypertension were associated with a higher motivational readiness to change (p < 0.05). Conclusion: The overburden that would result from counselling such a high proportion of inactive primary care patients justifies a targeted strategy for PA promotion in family practice. Selection of a target population based on readiness to change, the combination of risk factors and sociodemographic characteristics of patients is suggested in order to prioritise promotion efforts.


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