Health-related quality of life and intensity-specific physical activity in high-risk adults attending a behavior change service within primary care.

Ellen Eimhjellen Blom,Line Merethe Oldervoll,Guri Kaurstad Skrove,Ane Kristiansen Solbraa,Eivind Aadland

doi:10.1371/journal.pone.0226613

Abstract

ObjectivesHealth-related quality of life (HRQoL) is an important outcome for health interventions, such as physical activity (PA) promotion among high-risk populations. The aim of this study was to investigate levels of PA and HRQoL, and associations between PA and HRQoL, in participants attending a behavior change service within primary care in Norway.MethodsAdult participants (≥ 18 years) from 32 Healthy Life Centers (HLCs) in four regions of Norway, who provided valid data on HRQoL (SF-36) and PA (ActiGraph accelerometer) were included (N = 835). HRQoL scores were compared to normative data by independent sample t-tests. Associations between eight dimensions of HRQoL and time spent sedentary (SED), in light PA (LPA) or in moderate to vigorous PA (MVPA) were determined using general linear models adjusted for relevant confounders.ResultsNineteen percent of the participants (mean age 50; body mass index 32) met PA recommendations of > 150 min MVPA per week. SF-36 scores were 10 to 28 points lower than the norm (all p < 0.001). Positive associations were found between MVPA and the SF-36 dimensions physical functioning, role physical, general health and vitality, (all p < 0.045). LPA was positively associated with physical functioning, role physical, general health, vitality and role emotional (all p < 0.046). Time spent SED was negatively associated with physical functioning, general health, vitality, social functioning and mental health (all p < 0.030).ConclusionsIndividuals attending a Norwegian behavior change service within primary care had low PA level and low HRQoL compared to the general population. Our study suggest there is a positive dose-response relationship between PA and HRQoL, and a negative relationship between SED and HRQoL. Furthermore, that specific PA intensities and SED are related to different dimensions of HRQoL.

Highlights

Life expectancy has increased substantially worldwide over the last decades [1], resulting in an increased prevalence of people living with chronic diseases and disabilities [2]
Positive associations were found between moderate to vigorous PA (MVPA) and the SF-36 dimensions physical functioning, role physical, general health and vitality
light PA (LPA) was positively associated with physical functioning, role physical, general health, vitality and role emotional

Summary

Introduction

Life expectancy has increased substantially worldwide over the last decades [1], resulting in an increased prevalence of people living with chronic diseases and disabilities [2]. As populations’ age and chronic conditions increase, there is a need to promote behaviors that might prevent disability and hospitalization. Physical activity (PA) has well-documented beneficial effects on prevention and treatment of non-communicable diseases (NCDs) and other chronic conditions [4,5,6] as well as on promotion of HRQoL [7,8,9]. The existing knowledge about the relationship between PA and HRQoL is primarily based on self-reported measurements of PA [7, 9], which are known to have low correlation to direct measurements of PA, and to be influenced by several biases, such as recall and social desirability biases [10]. Duration and intensity of PA, in particular, are difficult to recall precisely [10,11,12], which in turn, hampers the possibility of drawing conclusions about the dose-response relationship between PA and HRQoL

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