Computerized Physical Activity Promotion in Primary Care

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DESCRIPTION (provided by applicant): Encouraging the incorporation of effective physical activity promotion interventions into routine care is a national health priority to decrease the morbidity and mortality from cardiovascular disease. Physicians note several barriers to counseling patients to be physically active, including a lack of time, expertise, and organizational support. Using computers for collecting data to assist in counseling patients and to provide patient-specific materials to promote physical activity is a way of improving the utilization of current computer technologies and behavioral models. The specific aim of this study is to determine the efficacy of a computer program that creates 1) patient-specific physical activity self-help reports for individuals and 2) patient-specific reports to prompt and guide physician advice. The major objective of the proposed study is to determine via a randomized controlled trial design, the effects of the patient and physician physical activity computer reports on physical activity after a 6-month intervention and subsequent 6 months of follow-up. Physician practices will be the unit of randomization. Intervention condition (IC) physicians will receive training on physical activity counseling once and patient-specific computer-generated counseling prompts at all scheduled, non-acute visits of IC subjects. Enhanced Usual Care (EUC) condition physicians will receive training on general prevention guidelines but no tailored counseling prompts at patient visits. IC subjects will receive tailored print messages at baseline, 1, 3, and 6 months, in addition to a set of manuals targeted to their readiness to become physically active and standard prevention-oriented health education materials. EUC condition subjects will receive usual care physical activity advice and standard prevention-oriented health education materials. We hypothesize that at the end of 12 months, IC subjects will have a significantly greater increase in minutes of physical activity of at least moderate intensity (namely a 90 minute increase at 6 months and a 60 minute increase at 12 months) compared to EUC subjects.