A stage matched physical activity intervention in military primary care

Abstract

Helping individuals increase their physical activity in a population where 85% of US adults essentially are sedentary (US Department of Health and Human Services, 1996) can contribute significantly to achieving the Healthy People 2010 goals (Healthy People 2010, 2000). The purpose of this study was to test a physical activity intervention that would positively impact behavioral mediators, levels of physical activity participation, and cardiovascular indicators in a sample of healthy, military affiliated, primary care patients. There were 96 participants 18-44 years old in this study. Most were enlisted military (56%), Caucasian (54%), females (60%), who had some college education. Measures of motivation, self-efficacy, decisional balance, and stage of physical activity change comprised the behavioral measures, while estimated peak VO 2 and blood pressure were the physiologic measures. Data were collected pre- and post-intervention and again four months after the intervention was completed. Participants were randomized to either the experimental intervention, the Physical Activity Modification Program (PAMP), or to the exercise prescription control group. The PAMP was based upon constructs from the Transtheoretical Model of behavior change. PAMP participants made no significant improvements in motivation, physical activity self-efficacy and the benefits associated with physical activity from pre- to posttest, although there were positive trends noted. There was no significant decrease in the number of barriers associated with physical activity pre- to posttest, in either group. The groups did not differ significantly in forward movement from stage of change to the next but there was positive movement in both groups combined. Although not significant, the PAMP group tended to engage in more daily physical activity. The PAMP did not affect cardiovascular health indicators. Interpretation of data from this study was inconclusive because post hoc power analysis was low. Further investigation is recommended. With Americans averaging 2.7 office visits per person per year to health care providers, and with 60% of these visits occurring in primary care (Patrick et al., 1994), there may be a formidable opportunity to influence the cardiovascular health of many patients before they develop cardiovascular disease.