Telephone Counseling for Physical Activity and Diet in Primary Care Patients
published online 08 December 2008.
Background
The delivery of effective interventions to assist patients to improve their physical activity and dietary behaviors is a challenge in the busy primary care setting.
Design
Cluster RCT with practices randomized to telephone counseling intervention or usual care. Data collection took place from February 2005 to November 2007, with analysis from December 2007 to April 2008.
Setting/participants
Four-hundred thirty-four adult patients with type 2 diabetes or hypertension (mean age=58.2 [SD=11.8]; 61% female; mean BMI=31.1 [SD=6.8]) from a disadvantaged community were recruited from ten primary care practices.
Intervention
Twelve-month telephone counseling intervention.
Main outcome measures
Physical activity and dietary intake were assessed by self-report at baseline, 4, and 12 months.
Results
At 12 months, patients in both groups increased moderate-to-vigorous physical activity by a mean of 78 minutes per week (SE=10). Significant intervention effects (telephone counseling minus usual care) were observed for: calories from total fat (decrease of 1.17%; p<0.007), energy from saturated fat (decrease of 0.97%; p<0.007), vegetable intake (increase of 0.71 servings; p<0.039), fruit intake (increase of 0.30 servings; p<0.001), and grams of fiber (increase of 2.23 g; p<0.001).
Conclusions
The study targeted a challenging primary care patient sample and, using a telephone-delivered intervention, demonstrated modest improvements in diet and in physical activity. Results suggest that telephone counseling is a feasible means of delivering lifestyle intervention to primary care patients with chronic conditions—patients whose need for ongoing support for lifestyle change is often beyond the capacity of primary healthcare practitioners.
Trial registration
Australian Clinical Trials Registry, Australian New Zealand Clinical Trials Registry, www.anzctr.org.au/default.aspx, ACTRN012607000195459.
aCancer Prevention Research Centre, School of Population Health, The University of Queensland, Brisbane, Queensland, Australia
bInstitute of Health and Biomedical Innovation, School of Public Health, Queensland University of Technology, Brisbane, Queensland, Australia
cDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
dFaculty of Health Science and Medicine, Bond University, Gold Coast, Queensland, Australia
eLogan Area Division of General Practice, Logan, Queensland, Australia
Address corresponding and reprint requests to: Elizabeth Eakin, PhD, Deputy Director, Cancer Prevention Research Centre, School of Population Health, Level 3, Public Health Building, The University of Queensland, Herston Road, Herston QLD 4006 Australia
ABSTRACT