Karen B. Eden, PhD; C. Tracy Orleans, PhD; Cynthia D. Mulrow, MD, MSc; Nola J. Pender, PhD, RN; Steven M. Teutsch, MD, MPH
Note: This manuscript is based on a longer systematic evidence review that was reviewed by outside experts and representatives of professional societies. A complete list of peer reviewers is available on line at www.ahrq.gov/clinic/uspstfix.htm.
Disclaimer: The authors of this article are responsible for its contents, including any clinical or treatment recommendations. No statement of this article should be construed as an official position of the U.S. Agency for Healthcare Research and Quality, the U.S. Department of Health and Human Services, or Merck & Co., Inc.
Acknowledgments: The authors thank Mark Helfand, MD, MS, and Gary Miranda, MA, from the Oregon Health & Science University Evidence-based Practice Center for helpful comments on earlier versions of this review; Evelyn Whitlock, MD, MPH, for help with independent abstraction of several of the trials; Kathryn Pyle Krages, AMLS, MA, and Susan Wingenfeld for administrative and clerical assistance; and Patty Davies, MS, for designing the literature search strategy.
Grant Support: By the U.S. Agency for Healthcare Research and Quality (contract no. 290-97-0018, task order no. 2), Rockville, Maryland.
Requests for Single Reprints: Reprints are available from the USPSTF Web site (www.preventiveservices.ahrq.gov) and in print through the Agency for Healthcare Research and Quality Publications Clearinghouse (telephone, 800-358-9295; e-mail, firstname.lastname@example.org).
Current Author Addresses: Dr. Eden: Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code BICC, Portland, OR 97201.
Dr. Orleans: Robert Wood Johnson Foundation, College Road East, Princeton, NJ 08543.
Dr. Mulrow: University of Texas Health Science Center, San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229.
Dr. Pender: 22838 Harbor Lane, Plainfield, IL 60544-7777.
Dr. Teutsch: Merck and Co., Inc., PO Box 4, WP39-168, West Point, PA 19486-0004.
To determine whether counseling adults in primary care settings improves and maintains physical activity levels.
The Cochrane Database of Systematic Reviews and Registry of Controlled Trials and the MEDLINE, HealthStar, and Best Evidence databases were searched for papers published from 1994 to March 2002.
Controlled trials, case–control studies, and observational studies that examined counseling interventions aimed at increasing physical activity in general primary care populations were reviewed. The researchers included trials in which 1) a patient's primary care clinician performed some of the counseling intervention; 2) behavioral outcomes [physical activity] were reported; and 3) the study was of “good” or “fair” quality, according to criteria developed by the U.S. Preventive Services Task Force.
Data were abstracted on design and execution, quality, providers, patients, setting, counseling intervention, and self-reported physical activity at follow-up.
Eight trials involving 9054 adults met the inclusion criteria. Among six controlled trials with a usual care control group, the effects of counseling on physical activity were mixed. Because most studies had at least one methodologic limitation, it was difficult to rigorously assess the efficacy of the interventions. More research is needed to clarify the effect, benefits, and potential harms of counseling patients in primary care settings to increase physical activity.
Evidence is inconclusive that counseling adults in the primary care setting to increase physical activity is effective.
Table. Summary of Controlled Trials of Counseling for Physical Activity
Appendix Table. Studies Rated as Poor Quality
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Eden KB, Orleans CT, Mulrow CD, Pender NJ, Teutsch SM. Does Counseling by Clinicians Improve Physical Activity? A Summary of the Evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002;137:208-215. doi: 10.7326/0003-4819-137-3-200208060-00015
Download citation file:
Published: Ann Intern Med. 2002;137(3):208-215.
Cardiology, Coronary Risk Factors, Guidelines, Hypertension, Nephrology.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only