Predictors of long-term change of a physical activity promotion programme in primary care

Alvaro Sanchez, Gonzalo Grandes, Ricardo Ortega Sánchez-Pinilla, Jesus Torcal, Imanol Montoya, PEPAF Group, Gonzalo Grandes, Jesus Torcal, Ricardo Ortega Sanchez-Pinilla, Alvaro Sanchez, Kepa Lizarraga, Javier Serra, Imanol Montoya, Angel Fernandez, Victor Manuel Lopez, Lourdes Marijuan, Begoña Etxeguren, Victor Landa, Jesus Martınez, Ma Mercedes Dıez, Juan Ramon Lejarza, Judith Gonzalez, Vidal Salcedo, Idoia Ibañez, Agurtzane Ortego, Pedro Iraguen, Pilar Echevarria, Virginia Villaverde, Amaia Ecenarro, Ma Teresa Uribe, Carmen Moral, Eguskiñe Iturregui, Ana Belen Fernandez, Jose Marıa Paez, M Angeles Tarilonte, Concepcion Molina, Vicente Rodrıguez, Isabel Villafuente, Mercedes Alvarez, Andreu Estela, Jose Marıa Coll, Angels Llach, Josep Ma Masuet, Ana Moll, Monica Pons, Bonaventura Bolibar, Agusti Guiu, Amadeu Dıaz, Xavier Martınez, Ma Dolores Hernandez, Jose Ignacio Olivares, Francisco Hernansanz, Rita Ayala, Ana Cascos, Vicente Martınez, Ma del Carmen Garcıa, M Angeles Gabriel, M Luscinda Velazquez, Natividad Ortega, M Jesus Segura, Rodrigo Cerrillo, Patricia Lopez, Carmen Fernandez, Amparo Gomez, Miguel Angel Dıez, Ruperto Sanz, Luis Miguel Quintero, Jose Ignacio Recio, Luis Garcıa, Jose Antonio Iglesias, Manuel Gomez, Emilio Ramos, Pilar Moreno, Yolanda Castaño, Nadia Carrillo, Pilar Ganoso, Luciano Casariego, Manuel Domınguez, Jose Ramon Moliner, Fernando Lago, M Concepcion Cruces, Marisa Enrıquez, Tomas Gomez Gascon, Javier Martınez, Jose Antonio Granados, M Angeles Ferna'ndez, M Isabel Gutierrez, Carlos San Andres, Concepcion Vargas-Machuca, Cristina Dıaz, Alvaro Sanchez, Gonzalo Grandes, Ricardo Ortega Sánchez-Pinilla, Jesus Torcal, Imanol Montoya, PEPAF Group, Gonzalo Grandes, Jesus Torcal, Ricardo Ortega Sanchez-Pinilla, Alvaro Sanchez, Kepa Lizarraga, Javier Serra, Imanol Montoya, Angel Fernandez, Victor Manuel Lopez, Lourdes Marijuan, Begoña Etxeguren, Victor Landa, Jesus Martınez, Ma Mercedes Dıez, Juan Ramon Lejarza, Judith Gonzalez, Vidal Salcedo, Idoia Ibañez, Agurtzane Ortego, Pedro Iraguen, Pilar Echevarria, Virginia Villaverde, Amaia Ecenarro, Ma Teresa Uribe, Carmen Moral, Eguskiñe Iturregui, Ana Belen Fernandez, Jose Marıa Paez, M Angeles Tarilonte, Concepcion Molina, Vicente Rodrıguez, Isabel Villafuente, Mercedes Alvarez, Andreu Estela, Jose Marıa Coll, Angels Llach, Josep Ma Masuet, Ana Moll, Monica Pons, Bonaventura Bolibar, Agusti Guiu, Amadeu Dıaz, Xavier Martınez, Ma Dolores Hernandez, Jose Ignacio Olivares, Francisco Hernansanz, Rita Ayala, Ana Cascos, Vicente Martınez, Ma del Carmen Garcıa, M Angeles Gabriel, M Luscinda Velazquez, Natividad Ortega, M Jesus Segura, Rodrigo Cerrillo, Patricia Lopez, Carmen Fernandez, Amparo Gomez, Miguel Angel Dıez, Ruperto Sanz, Luis Miguel Quintero, Jose Ignacio Recio, Luis Garcıa, Jose Antonio Iglesias, Manuel Gomez, Emilio Ramos, Pilar Moreno, Yolanda Castaño, Nadia Carrillo, Pilar Ganoso, Luciano Casariego, Manuel Domınguez, Jose Ramon Moliner, Fernando Lago, M Concepcion Cruces, Marisa Enrıquez, Tomas Gomez Gascon, Javier Martınez, Jose Antonio Granados, M Angeles Ferna'ndez, M Isabel Gutierrez, Carlos San Andres, Concepcion Vargas-Machuca, Cristina Dıaz

Abstract

Background: Further research is needed to improve the evidence regarding determinants of physical activity (PA) as a crucial step to plan higher effective intervention strategies. The goal of the present study is to identify socio-demographic and clinical characteristics of primary care (PHC) insufficiently active patients that are associated with longitudinal changes in the level of physical activity.

Methods: Longitudinal analysis of baseline socio-demographic and clinical predictors of physical activity change in insufficiently active PHC patients who participated in a PA-promoting multi-centre randomized clinical trial conducted from October 2003 through March 2006. The primary outcome measure was the self-reported physical activity assessed with the 7-day Physical Activity Recall (PAR), at baseline, 6, 12 and 24 months. Baseline covariates included sex, age, social class, anthropometric measures and other cardiovascular risk factors or associated diseases (Diabetes, HTA, tobacco use, etc.), and stage of readiness to change PA. Generalized linear mixed models were used to estimate longitudinal association of studied variables on PA change over the three follow-up measurements.

Results: A total of 3691 patients (85% of the 4317 recruited in the trial) with at least one follow-up measurement were included in the longitudinal analysis. At baseline, analysed patients (mean age: 50.6 years; 64.6% women) devoted 34.7 minutes and 2.36 metabolic equivalent hours per week (MET.h/week) to moderate and vigorous physical activity. Older age, male gender, higher social class, lower BMI, diagnosis of diabetes or hypertension, and measurement season were significant predictors of PA longitudinal change. The effect of baseline readiness to change on PA dose was modified by time, showing a positive gradient in favour of those with more readiness to change that increases significantly at 12 and 24 months (p-value interaction < .0001).

Conclusions: Identified baseline characteristics such as readiness to change and risk factors can guide physicians to prioritize time and intervention efforts for maximizing their impact on insufficiently active PHC patients.

Figures

Figure 1
Figure 1
Flow diagram of study participants.
Figure 2
Figure 2
Longitudinal change in activity dose (MET*h/week) by baseline stage of change. Figure legend: Adjusted for group by time interaction, reported elsewhere [23].

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