Promoting physical activity in general practice: a controlled trial of written advice and information materials

Ben J Smith¹, Adrian E Bauman², Fiona C Bull³, Michael L Booth⁴, Mark F Harris²

¹ Epidemiology Unit, South Western Sydney Area Health Service, Sydney, Australia
² School of Community Medicine, University of New South Wales, Sydney, Australia
³ Department of Public Health, University of Western Australia, Perth, Australia
⁴ Department of Public Health and Community Medicine, University of Sydney

Correspondence to:
Correspondence to: A Bauman, Epidemiology Unit, Liverpool Hospital, Locked Mail Bag 17, Liverpool, NSW, Australia 2170 email: a.bauman{at}unsw.edu.au

Objective—To investigate the impact of a simple written prescription for physical activity given by a general practitioner and the effect of supplementing this with mailed information materials about physical activity.

Methods—A controlled trial was conducted in 27 general practices in New South Wales, Australia. Subjects were sequential routine care patients between 25 and 65 years old. Controls (n = 386) were recruited first, and intervention subjects two weeks later. Intervention subjects were randomised to receive a prescription only (n = 380) or a prescription plus a mailed booklet (n = 376). Self reported physical activity levels were measured by interview at baseline, 6–10 weeks, and seven to eight months.

Results—By intention to treat, the average changes in minutes of total physical activity did not differ significantly between the groups. Inactive people in the prescription plus supplementary booklet group were significantly more likely than controls to report an increase in their physical activity by at least 60 min/week after 6–10 weeks (odds ratio 1.58, 95% confidence interval 1.06 to 2.35). No significant short term improvements in self reported activity were shown in the prescription only group. In the supplemented group, the proportion reporting an increase in physical activity to 3344 kJ/week at 6–10 weeks was not significant, and neither intervention group showed significant increases in any of the outcome measures at seven to eight months by intention to treat. Treatment received analysis showed greater improvements in intervention groups, especially the prescription plus booklet group, in which the odds of inactive people in this group reporting increased activity became significant at seven to eight months.

Conclusions—A prescription for physical activity from a general practitioner, supplemented by additional written materials, can lead to modest short term improvements in self reported physical activity levels among inactive patients. A prescription alone was found not to be effective.

Key Words: physical activity; family doctors; health education; patient education; intervention studies

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