Abstract
BackgroundPhysical inactivity is a major public health problem. The It’s LiFe! monitoring and feedback tool embedded in the Self-Management Support Program (SSP) is an attempt to stimulate physical activity in people with chronic obstructive pulmonary disease or type 2 diabetes treated in primary care.ObjectiveOur aim was to evaluate whether the SSP combined with the use of the monitoring and feedback tool leads to more physical activity compared to usual care and to evaluate the additional effect of using this tool on top of the SSP.MethodsThis was a three-armed cluster randomised controlled trial. Twenty four family practices were randomly assigned to one of three groups in which participants received the tool + SSP (group 1), the SSP (group 2), or care as usual (group 3). The primary outcome measure was minutes of physical activity per day. The secondary outcomes were general and exercise self-efficacy and quality of life. Outcomes were measured at baseline after the intervention (4-6 months), and 3 months thereafter.ResultsThe group that received the entire intervention (tool + SSP) showed more physical activity directly after the intervention than Group 3 (mean difference 11.73, 95% CI 6.21-17.25; P<.001), and Group 2 (mean difference 7.86, 95% CI 2.18-13.54; P=.003). Three months after the intervention, this effect was still present and significant (compared to Group 3: mean difference 10.59, 95% CI 4.94-16.25; P<.001; compared to Group 2: mean difference 9.41, 95% CI 3.70-15.11; P<.001). There was no significant difference in effect between Groups 2 and 3 on both time points. There was no interaction effect for disease type.ConclusionsThe combination of counseling with the tool proved an effective way to stimulate physical activity. Counseling without the tool was not effective. Future research about the cost-effectiveness and application under more tailored conditions and in other target groups is recommended.Trial RegistrationClinicalTrials.gov: NCT01867970, https://clinicaltrials.gov/ct2/show/NCT01867970 (archived by WebCite at http://www.webcitation.org/6a2qR5BSr).
Highlights
Physical inactivity is a major public health problem [1,2] because it increases the risk of several diseases, such as coronary heart disease, type 2 diabetes, and several types of cancer
In Group 1, one participant did not start with the intervention because in his opinion, the intervention was not tailored to his age group, and 12 participants did not receive the minimal intervention as intended
Significant group differences, which were included as confounders in further analyses, were found for body mass index (BMI), computer use, minutes of physical activity (PA) (≥3 METS), and quality of life
Summary
Physical inactivity is a major public health problem [1,2] because it increases the risk of several diseases, such as coronary heart disease, type 2 diabetes, and several types of cancer. It shortens life expectancy [1]. Monitoring and feedback tool embedded in the Self-Management Support Program (SSP) is an attempt to stimulate physical activity in people with chronic obstructive pulmonary disease or type 2 diabetes treated in primary care The It’s LiFe! monitoring and feedback tool embedded in the Self-Management Support Program (SSP) is an attempt to stimulate physical activity in people with chronic obstructive pulmonary disease or type 2 diabetes treated in primary care
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