Objective: To summarize the literature on primary care-based interventions for increasing physical activity and make recommendations for future research and for integrating successful strategies into practice.
Search strategies: We searched MEDLINE (1980 to 1998), psychological abstracts, ERIC and HealthStar databases, the WeB site for The Journal of Family Practice, bibliographies of selected studies, and previous reviews for relevant articles. The search was limited to the English language. Three experts in the field of physical activity were contacted for leads on unpublished trials.
Selection criteria: Inclusion criteria were: randomized controlled trial or quasiexperimental study using a comparison group, intervention delivered or initiated in a primary care setting, and reported results on at least 1 measure of physical activity. Studies that focused solely on patients with cardiovascular disease were excluded.
Main results: Primary care-based physical activity counseling is moderately effective in the short term, although there is considerable variability across studies. Studies in which the interventions were tailored to participant characteristics and which offered written materials to patients produced stronger results. Unlike many types of health promotion, the reach of primary care-based physical activity interventions is high. Questions remain about the consistency of implementation and long-term maintenance of outcomes.
Conclusions: Despite the need for further research, enough is known to recommend integration of key strategies of physical activity counseling into routine practice. We recommend incorporating these strategies into primary care and prioritizing them for further research.