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‘Sedentary behaviour counselling’: the next step in lifestyle counselling in primary care; pilot findings from the Rapid Assessment Disuse Index (RADI) study
  1. Kerem Shuval1,2,
  2. Loretta DiPietro3,
  3. Celette Sugg Skinner2,4,
  4. Carolyn E Barlow1,5,
  5. Jay Morrow6,
  6. Robert Goldsteen7,
  7. Harold W Kohl III1,8
  1. 1Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas, School of Public Health, Dallas and Austin, Texas, USA
  2. 2Harold C Simmons Cancer Center, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
  3. 3Department of Exercise Science, The George Washington University, School of Public Health and Health Services, Washington, DC, USA
  4. 4Division of Behavioral and Communication Sciences, Department of Clinical Sciences, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
  5. 5Cooper Institute, Dallas, Texas, USA
  6. 6Department of Family Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
  7. 7Division of General Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
  8. 8Department of Kinesiology and Health Education, University of Texas at Austin, Austin, Texas, USA
  1. Correspondence to Dr Kerem Shuval, Division of Epidemiology, Human Genetics and Environmental Sciences, UT School of Public Health, 6011 Harry Hines Blvd., Dallas, TX 75390, USA; kerem.shuval{at}


Background Accumulating evidence emphasises a relationship between prolonged sitting and increased risk for cardiometabolic disorders and premature death irrespective of the protective effects of physical activity. Primary care physicians have the potential to play a key role in modifying patients’ sedentary behaviour alongside physical activity.

Methods A pilot study examining sedentary behaviour and physical activity counselling in a primary care clinic. A total of 157 patients completed a detailed survey related to lifestyle counselling received from their primary care physician. We analysed these responses to describe counselling practices within the 5A framework, and to examine correlates (ie, patients’ demographics, sedentary behaviour and physical activity and clinical variables) related to receiving counselling.

Results A total of 10% received general advice to decrease sitting time, in comparison with 53% receiving general physical activity counselling. None, however, received a written plan pertaining to sedentary behaviour whereas 14% received a written physical activity prescription. Only 2% were provided with specific strategies for sedentary behaviour change in comparison with 10% for physical activity change. Multivariable analysis revealed that patients who were obese were more likely to receive counselling to decrease sitting (OR=7.0; 95% CI 1.4 to 35.2). In comparison, higher odds for receiving physical activity counselling were associated with being younger, aged 40–59 years (OR=2.4; 95% CI 1.1 to 5.4); and being a non-smoker (OR=6.1; 95% CI 1.3 to 28.4).

Conclusions This study is the first to assess sedentary behaviour counselling practices in primary care and such practices appear to be infrequent. Future research should attempt to establish a ‘knowledge base’ to inform development of sedentary behaviour interventions, which should be followed by testing feasibility, efficacy, and subsequent effectiveness of these programmes in a clinical setting.

  • Physical activity promotion in primary care

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