Evidence-based ways to help patients increase physical activity

A great deal of patient education content is now focusing on the treatment of obesity. Nutrition has been in the forefront for years, with good fats and bad fats, good carbs and bad carbs, antioxidants and anti-inflammatories. But weight loss depends on burning more calories than you consume, so the educational push is evolving towards exercise.

Ruppar and Conn (2010) just published a meta-analysis of interventions used to promote physical activity in adults with various chronic illnesses. Their findings: Interventions are most effective in promoting physical activity among chronically ill adults when they
• targeted physical activity exclusively

• used behavioral (as opposed to cognitive) strategies

• encouraged self-monitoring.

Here are some ways to apply this evidence to practice:
• Have that conversation. Don’t just say, “improve diet and exercise.” Have the patient identify what might work for him or her. Discuss the patient’s physical activity plan in detail. What, when, how long, how often.
• Help the patient identify strategies for success. Outcomes will be better if behavior changes are targeted sequentially. It’s hard to start if the plan is overwhelming.
• Individualize the self-monitoring method to the patient’s lifestyle. Pedometers are popular. Activity records can be kept in a range of ways: on a calendar, a notebook, a log, on paper or electronically. Many computer and smart phone programs, as well as monitors, are available for keeping track of daily activity.
• Follow up over time. How is the patient doing? What adjustments need to be made to optimize success?

So health coaching can work to help chronically-ill patients increase physical activity. The article concluded that further evaluation is needed to determine the effectiveness of other physical activity interventions and how to best implement effective interventions in the clinical practice setting. Now that you have a place to start in your practice, why don’t you add your findings to the professional literature? What works for you?

Source: Ruppar, T. M., & Conn, V. S. (2010). Interventions to promote physical activity in chronically ill adults. Am J Nurs, 110(7), 30-37; quiz 38-39.