Report Urges Primary Care Physicians to Encourage Physical Activity

In a new report, researchers present a model for physical activity counseling for primary care physicians and urge primary care practitioners to play a key role in helping patients become more physically active.

The paper, authored by a team including researchers from the University of Massachusetts Medical School and the University of California San Diego, is based on a collaborative symposium hosted in 2014 by the Society of Behavioral Medicine and the American College of Sports Medicine, and notes that “most US adults do not meet national recommendations for physical activity levels.” The paper also points out some of the socioecological factors that drive differences in physical activity levels by geography, sex, age, and racial and ethnic groups.
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While acknowledging that the Patient Protection and Affordable Care Act incentivizes primary care physicians to offer patients physical activity counseling, the paper also notes that primary care practitioners have reported encountering socioecological barriers to providing physical activity counseling, as well as patient barriers to becoming more physically active, such as lack of safe spaces for physical activity, reimbursement policies, and workplace norms and policies, for instance. The authors discuss potential interventions to guide patients toward a more physically active lifestyle, including physical activity screenings, offering “prescriptions” for physical activity in the form of advance about positive lifestyle modifications, and encouraging patients to adopt wearable technology such as fitness trackers, for example.

While many physicians “do not have enough time with a patient to be solely responsible for helping the patient exercise,” primary care practitioners “can be both catalyst and connector,” said Sherry Pagoto, PhD, associate professor of medicine at the University of Massachusetts Medical School, and a coauthor of the study.

“[Being a catalyst] means impressing upon the patient how essential physical activity is to both physical and mental health,” Dr Pagoto said. “The connector role means connecting the patient to resources that will assist them in developing a physically active lifestyle.

“Some upfront effort to develop a list of local resources could be invaluable,” she continued. “This will lead patients to local recreation centers, parks, events, gyms, personal trainers, exercise physiologists, and physical therapists (in cases where pain or orthopedic issues are impeding physical activity).”

Physicians “should feel empowered to promote physical activity among their patients without feeling like they need to carry all the burden related to uptake and maintenance,” said study coauthor Sarah E. Linke, PhD, MPH, an assistant clinical professor at the University of California San Diego.

Primary care providers “can make a difference by recommending physical activity to their patients, even writing a prescription to exercise, and then directing them to resources within the community, and, ideally, within their clinics via supporting healthcare providers and built-in infrastructure supporting these efforts,” Dr Linke said.

Physician follow-up is “essential for accountability,” added Pagoto. “When physician and patient collaborate on a plan, follow-up strengthens the commitment on behalf of both parties.”

—Mark McGraw

Reference

AuYoung M, Linke SE, Pagoto S, et al. Integrating physical activity in primary care practice [published online March 6, 2016]. Am J Med. doi:10.1016/j.amjmed.2016.02.008.